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CHANGE TOWARDS A BETTER TOMORROW, HOW YOU WILL MANAGE? AHADITOMO Asosiasi Farmasis Asia Pasifik, Vice President 2009 Seminar Farmasi Klinik di RS Saiful Anwar, Malang Topik bahasan : •Kajian tentang perpektif berubah ( Change) •Farmasi Klinik •Perpektif manajemen bekerja The Global Standard of Pharmacy Services The Next Syaiful Anwar The Current Pharmacy Settings and Practices The Next Syaiful Anwar Pharmacy Service The Change THE CHANGE THE PLAN HOW TO ORGANIZE HOW TO IMPLEMENT HOW YOU WILL CONTROL THE PROCESS HOW YOU MEASURE THE RESULT HOW YOU IMPROVE THE ORIGINAL PLAN HOW TO SUSTAIN YOUR CHANGE PROCESS TOWARDS THE CHANGE IN PHARMACEUTICAL SERVICE IN YOUR INSTITUTION DID YOU RECORD THE DATA DID YOU “RESEARCH” THE DATA DID YOU SUMMARIZE THE DATA AND DID YOU REPORT AND DISCUSS YOUR ANALYSIS The Change Initiative Who will Lead ?

3/24/2009 Seminar Farmasi Klinik CHANGE TOWARDS di · PDF filetermasuk farmakologi Klinik, Uji Klinik • Membaiknya keadaan patofisiologik dari organ sesuai penegakan diagnosa •

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Page 1: 3/24/2009 Seminar Farmasi Klinik CHANGE TOWARDS di · PDF filetermasuk farmakologi Klinik, Uji Klinik • Membaiknya keadaan patofisiologik dari organ sesuai penegakan diagnosa •

3/24/2009

1

CHANGE TOWARDS A BETTER TOMORROW,

HOW YOU WILL MANAGE?

AHADITOMO

Asosiasi Farmasis Asia Pasifik,

Vice President

2009

Seminar Farmasi Klinikdi RS Saiful Anwar, Malang

Topik bahasan :

•Kajian tentang perpektif berubah ( Change)•Farmasi Klinik•Perpektif manajemen bekerja

The Global Standard of Pharmacy Services

The Next Syaiful Anwar

The Current Pharmacy Settings and Practices

The Next Syaiful Anwar Pharmacy ServiceThe Change

THE CHANGE

• THE PLAN

• HOW TO ORGANIZE

• HOW TO IMPLEMENT

• HOW YOU WILL CONTROL THE PROCESS

• HOW YOU MEASURE THE RESULT

• HOW YOU IMPROVE THE ORIGINAL PLAN

• HOW TO SUSTAIN YOUR CHANGE PROCESS

TOWARDS THE CHANGE IN PHARMACEUTICAL SERVICE IN YOUR INSTITUTION

• DID YOU RECORD THE DATA• DID YOU “RESEARCH” THE DATA•DID YOU SUMMARIZE THE DATA AND •DID YOU REPORT AND DISCUSS YOUR ANALYSIS

The Change Initiative

Who will Lead ?

Page 2: 3/24/2009 Seminar Farmasi Klinik CHANGE TOWARDS di · PDF filetermasuk farmakologi Klinik, Uji Klinik • Membaiknya keadaan patofisiologik dari organ sesuai penegakan diagnosa •

3/24/2009

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Change 1 stKurt Lewin

• Unfreezing• It involved overcoming inertia

d di tli th i tiand dismantling the existing "mindset".

• Defense mechanisms have to be bypassed

Change 2 nd

• a period of confusion and transition

• the old ways are being challenged but we do not havechallenged but we do not have a clear picture to replace them with yet.

Change 3rd

• "freezing" (or "refreezing”)• The new mindset is

crystallizing and one's comfort level is returning to previous levels.

Farmakoterapi dalam Pelayanan Rumah Sakit

Kaitannya dengan peningkatan Pelayanan KefarmasianDalam kerangka MeningkatkanDalam kerangka Meningkatkan Pelayanan Klinik oleh Apoteker

Ahaditomo

Disampaikan di RS Syaiful Anwar

22 Maret 2009

RUMAH SAKITAdalah Organisasi Usaha Jasa

Pelayanan Kesehatan

• Ada Produk Jasa yang di Usahakan• Mempunyai dimensi produk, mutu, macam , j l h d h d kjumlah dan harga produk

• Fasilitas Produksi• Alat Produksi• Pelaku Produksi dengan Kompetensi• Proses dan Prosedur Produksi• Biaya Produksi ( biaya pokok) dan Harga Jual• Ada Margin Keuntungan Usaha

FARMASI DI RS

SEBAGAI BAGIAN DARI SISTEM JASA PELAYANAN RS ?

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3/24/2009

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FARMASI RUMAH SAKIT

MANAJEMEN FRS

MANAJEMEN “BARANG OBAT”

MANAJAMEN PRODUK JASA KEPROFESIAN

P A S I E N

STANDARD DAN PROSEDUR PROFESI

Specific Objectives Pharmacy Service

• To provide maximum safety to the patient through direct pharmacist supervision of control in distribution and use of all drugs on a patient unit, up to the point of administration of the dose.p p

• To provide an immediate and accessible source of drug information to members of the medical staff, nursing staff, and others involved in patient care on the nursing unit.

• To reduce the cost of medications to patients.

• The Annals of Pharmacotherapy: Vol. 40, No. 1, pp. 119-122. DOI 10.1345/aph.140004© 2006 Harvey Whitney Books Company

Responsibility of Pharmacist• To Control of all drug supplies on the patient-care

unit.• Receive, evaluate, and interpret physicians' orders

for drugs.• Maintain a record of drug usage for each patient.• Prepare all drugs and dosage forms forPrepare all drugs and dosage forms for

administration by the nurse.• Regulate and standardize dosage administration

schedules.• Initiate and develop a drug information service to

members of the health-care team according to professional needs.

• Work cooperatively with members of the nursing service and medical staff in developing programs related to patient care.

APOTEKER DIMANA ?

PASIEN RAWAT INAP

PASIEN RAWAT JALAN

Farmakoterapi• Bagi Dokter ?• Senyawa Aktif Farmasi (SAF) sebagai bagian

dari Intervensi medis

• Pilihan berdasarkan Ilmu farmakologi termasuk farmakologi Klinik, Uji Klinik

• Membaiknya keadaan patofisiologik dari organ sesuai penegakan diagnosa

• Kesembuhan dari sakit‐penyakit

Farmakoterapi

• Bagi Apoteker • Pilihan SAF dalam Dosage Form yang sesuai

• Dosis setiap kali pemberian

• Regimentasi Dosis sesuai Status Tubuh Pasien

• Jadwal dan Cara pemberian yang optimal untuk menghasilkan efek farmakokinetik yang sesuai

• Perhitungan efek farmakodinamik dari SAF

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TENAGA KESEHATAN / NON KESEHATAN LAINNYA

Hubungan antar Tenaga Kesehatan di RS FORMAT

KOMUNIKASI ?

PASIEN RAWAT INAP DAN

RAWAT JALAN

FARMASI ?

D O K T E RP E R A W A T

TENAGA KESEHATAN / NON KESEHATAN LAINNYA

MASYARAKAT

MANAJEMENSHARE

Positioning RS didalam Sistem

PASIEN

FARMASI ?

MANAJEMENSHARE HOLDERS

MUTU PELAYANAN

D O K T E RP E R A W A T

PELAYANAN FARMASI RUMAH SAKIT ADALAH PELAYANAN PROFESI

ADANYA

SISTEM PELAYANAN FARMASI

ADANYA STANDARD PELAYANAN

YANG MENJAMIN SISTEM PELAYANAN

BERLANGSUNG

STANDARD PELAYANAN FARMASI (ASHP)

1.LEADERSHIP AND PRACTICE MANAGEMENT2.DRUG INFORMATION AND EDUCATIONUG O O UC O3.OPTIMIZING MEDICATION THERAPY4.MEDICATION DISTRIBUTION AND CONTROL5.FACILITIES, EQUIPMENT AND INFORMATION

RESOURCES6.RESEARCH

Standard I: Leadership and Practice Management

Effective leadership and practice management skills are necessary for the delivery of pharmaceutical services in a manner consistent with the hospital’s and patients’ needs as well as continuous improvement in patient care outcomes.

Pharmaceutical service management must focus on the pharmacist’s responsibility to provide pharmaceutical care and to develop an organizational structure to support that mission.

The director of the pharmacy shall be responsible for

(1) Setting the short and long term goals of the pharmacy based on the needs of the patients served, the specific needs of the hospital (and any health system of which the hospital may be a component), and developments and trends in health care and hospital pharmacy practice, p p y p ,(2) Developing plans and schedules for achieving these goals, (3) Directing the implementation of the plans and the day‐to‐day activities associated with them,(4) Determining whether the goals and schedule are being met, and(5) Instituting corrective actions where necessary. pharmacy, the hospital, and their respective positions.

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FARMASI

MANAJEMEN FARMAKOTERAPI YANG DISELENGGARAKAN OLEH APOTEKER

BERBASIS ASUHAN KEFARMASIAN

FARMASI

PENGADAAN BARANG OBAT DAN MEDICAL DEVICES

PELAYANAN PROFESI KE PASIEN,• TINDAKAN APOTEKER• SOP

DOKUMENTASI DAN INFORMASI

KEFARMASIAN,TER • SAINS• ETIK

MASUK CATATAN KEFARMASIAN

PELAYANAN ANTAR TENAGA KESEHATAN

MANAJEMEN

PELAYANAN MEDIK OLEH DOKTER

PELAYANAN

PELAYANAN KEPERAWATAN OLEH

PERAWAT

PELAYANAN KEFARMASIAN OLEH

APOTEKERAPOTEKER

DATA

KEFARMASIAN

SETTING RUANGAN PELAYANAN “KLINIK”

KEPUTUSAN DIAGNOSA DAN PILIHAN TINDAKAN MEDIK, TERMASUK FARMAKOTERAPI OLEH DOKTER

KEPUTUSAN FARMAKOTERAPI DAN DAN PILIHAN TINDAKAN KEFARMASIAN BERBASIS ASUHAN KEFARMASIAN OLEH APOTEKER

SKEMA FARMAKOTERAPI IMPLEMENTASINYA

UNTUK PASIEN, DENGAN DIMENSI

•HIPOTESIS KEBERHASILAN TERAPI

KASUS PASIEN

OLEH APOTEKER

KEPUTUSAN TINDAKAN KEPERAWATAN BERBASIS ASUHAN KEPERAWATAN

HARMONISASI KEPUTUSAN TEAM KESEHATAN TENTANG

FARMAKOTERAPI

•ANALISIS FARMAKOEKONOMI

•RASIONAL DX‐TX

DOSAGE FORM FARMAKOTERAPI SIAP

DIBERIKAN KEPADA PASIEN MANAJEMEN OLEH APOTEKER

OUT COME FARMAKOTERAPI

• PENEGAKAN DIAGNOSA DOKTER

• PILIHAN FARMAKOTERAPI

APOTEKERPATIENTS

CARE UNIT

OUT COME OF PHARMACO-

THERAPY

DOCTORSTX/DX DX/TX

•Receive•Evaluate•Interpret

Record

PrepareRegulate and Stndaradize

Drugs Information

PX

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DOSAGE FORM FARMAKOTERAPI SIAP

DIBERIKAN KEPADA PASIEN MANAJEMEN OLEH APOTEKER

OUT COME FARMAKOTERAPI

• PENEGAKAN DIAGNOSA DOKTER

• PILIHAN FARMAKOTERAPI

TEAM KESEHATAN PEDIATRI

MODEL INTEGRASI PELAYANAN

PRODUK TINDAKAN PROFESI APOTEKER

SETTING RUANGAN “PEDIATRI”

N‐PASIEN DENGAN SPESIFIKASI STATUS DX

DAN PLIHAN SAF TX

APOTEKER

• PELAYANAN MEDIK

• SOP• PELAYANAN

KEPERAWATAN

PERAWAT• PELAYANAN

KEFARMASIAN• SOP

TEAM KESEHATAN RUMAH SAKIT

SOP

DOKTER

KEPERAWATAN• SOP

SOP

APOTEKER

OUT COME PELAYANAN MELALUI ASUHAN

STANDARD PELAYANAN FARMASI RS

LEADERSHIPDAN MANAJEMEN DAN KOMPETENSI PROFESI DALAM PELAYANAN

KEFARMASIAN

Perspektif Pekerjaan

• Jenis Pekerjaan, diakui oleh pasar• Definisi Pekerjaan, jelas dan diakui• Segmentasi Pekerjaan• Cara melakukan Pekerjaan• Cara melakukan Pekerjaan• Beban Pekerjaan Setiap Saat• Organisasi Pekerjaan•Kompetensi, jenjang dan tanggung jawab•Siapa melakukan apa

Format Pekerjaan

• Hasil Pekerjaan Yang Terukur

• Uraian Pekerjaan

PROSES MELAKUKAN PEKERJAAN SESUAI

•STANDARD PEKER-• Data hasil

Pekerjaan• Angka Pencapaian

terhadap Target

yang tertulis• Target Pe-

kerjaan ditetapkan

JAAN•SOP MELAKSANAKAN PEKERJAAN •PELATIHAN MELAK-SANAKAN PEKER-JAAN

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3/24/2009

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KASUS MANAJEMEN

PERSPEKTIF POACHUBUNGAN DIANTARA PELAKSANA

STANDARD PEMAHAMAN DARI PELAKU ORGANISASI

TRANSPARANSI

KASUS PELAYANAN

HARMONISASI PELAYANAN PROFESI

KESENJANGAN KOMPETENSIKESENJANGAN KOMPETENSI PROFESI

PERSPEKTIF ASUHAN PELAYANAN

KASUS IN‐KOMPETEN

PELAKSANAAN STANDARD PELAYANANKETIADAAN UKURAN KUANTITATIFKETIADAAN UKURAN KUANTITATIF ATAS KEMAMPUAN / KOMPETENSIKEGAGALAN OUT COME FARMAKOTERAPI

TIDAK ADA PELATIHAN YANG REGULER

TERIMA KASIH