PENGARUH PERBAIKAN MUTU TERHADAP PENURUNAN LAMA RAWAT INAP (LENGTH OF STAY) : LITERATURE REVIEW
DOI:
https://doi.org/10.31004/jkt.v5i4.37747Keywords:
lama tinggal, pelayanan kesehatan, peningkatan kualitasAbstract
Masa tinggal di rumah sakit (Length of Stay/LOS) adalah indikator kualitas yang digunakan oleh sistem kesehatan sebagai representasi dari manajemen rumah sakit yang efisien. Lama masa tinggal yang terlalu lama dapat dikaitkan dengan pengalaman negatif bagi pasien dan staf, serta peningkatan komplikasi selama rawat inap (seperti infeksi yang didapat di rumah sakit dan resiko jatuh), banyak di antaranya dapat dicegah. Quality Improvement berperan penting dalam memperbaiki efisiensi pelayanan. Tinjauan literatur ini bertujuan untuk mengevaluasi efek dari perbaikan kualitas terhadap pengurangan Length of Stay di rumah sakit. Penelitian ini menggunakan metode tinjauan literatur untuk mengevaluasi efektivitas inisiatif perbaikan kualitas dalam mengurangi masa tinggal di rumah sakit (Length of Stay). Artikel akhir yang akan ditelaah untuk menganalisis pengaruh peningkatan kualitas terhadap penurunan lama tinggal pasien sejumlah enam artikel. Hasil Intervensi peningkatan kualitas (Quality Improvement) secara konsisten menunjukkan efektivitasnya dalam mengurangi lama masa tinggal (Length of Stay) di berbagai setting pelayanan kesehatan terutama di rumah sakit. Intervensi Peningkatan kualitas yang diterapkan pada bahan-bahan telaah tidak memiliki batasan kualitas yang ditingkatkan. Tinjauan literatur menunjukkan serangkaian intervensi Quality Improvement (perbaikan mutu) dapat digunakan untuk mengatasi masalah yang mengakibatkan terjadinya lama masa tinggal (Length of Stay). Kesimpulan yang dapat diambil dari literature review menunjukan Implementasi Quality Improvement yang berkelanjutan sangat penting untuk memastikan bahwa perbaikan yang telah dicapai dapat ditingkatkan dan dipertahankan dari waktu ke waktu.References
Alemu, G. H., Negari, K. G., Rodamo, K. M., & Hirigo, A. T. (2019). Factors associated with the length of stay in emergency departments in Southern-Ethiopia. BMC Research Notes, 12(1), 1–5.
Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice. BMJ (Clinical Research Ed.), 368. https://doi.org/10.1136/BMJ.M865
Caldwell, J. A., Caldwell, J. L., Thompson, L. A., & Lieberman, H. R. (2019). Fatigue and its management in the workplace. Neuroscience and Biobehavioral Reviews, 96, 272–289. https://doi.org/10.1016/J.NEUBIOREV.2018.10.024
Chaou, C. H., Chen, H. H., Chang, S. H., Tang, P., Pan, S. L., Yen, A. M. F., & Chiu, T. F. (2017). Predicting length of stay among patients discharged from the emergency department-using an accelerated failure time model. PLoS One, 12(1), e0165756. https://doi.org/10.1371/journal.pone.0165756
Flæten ØØ, Stafseth SK, Vinje H, Johansen E, Sunde K, Wøien H, Beeckman D, Petosic A. Incidence, characteristics, and associated factors of pressure injuries acquired in intensive care units over a 12-month period: A secondary analysis of a quality improvement project. Intensive Crit Care Nurs. 2024 Apr;81:103587. doi: 10.1016/j.iccn.2023.103587. Epub 2023 Nov 28. PMID: 38029679.
Han, T. S., Murray, P., Robin, J., Wilkinson, P., Fluck, D., & Fry, C. H. (2021). Evaluation of the association of length of stay in hospital and outcomes. International Journal for Quality in Health Care, 2022(2), 1–9. https://doi.org/10.1093/intqhc/mzab160
Jones, B., Vaux, E., & Olsson-Brown, A. (2019). How to get started in quality improvement. BMJ (Online), 364. https://doi.org/10.1136/bmj.k5437
Kefyalew M, Gidey U, Azazh A, Kaki M, Mesfin N. Reducing the length of stay of cardiac patients in the Adult Emergency department by using a Quality improvement framework. Int Emerg Nurs. 2023 Nov;71:101368. doi: 10.1016/j.ienj.2023.101368. Epub 2023 Oct 19. PMID: 37864950.
Kiran, T., Rozmovits, L., & O’Brien, P. (2023). Factors influencing family physician engagement in practice-based quality improvement. Canadian Family Physician, 69, E113–E119. https://doi.org/10.46747/cfp.6905e113Knudsen, S. V., Laursen, H. V. B., Johnsen, S. P., Bartels, P. D., Ehlers, L. H., & Mainz, J. (2019). Can quality improvement improve the quality of care? A systematic review of reported effects and methodological rigor in plan-do-study-act projects. BMC Health Services Research, 19(1), 1–10. https://doi.org/10.1186/s12913-019-4482-6
Lee SR, Shin SD, Ro YS, Lee H, Yoon JY. Multimodal Quality Improvement Intervention With Dedicated Patient Flow Manager to Reduce Emergency Department Length of Stay and Occupancy: Interrupted Time Series Analysis. J Emerg Nurs. 2022 Mar;48(2):211-223.e3. doi: 10.1016/j.jen.2021.12.001. Epub 2022 Feb 10. PMID: 35151500.
Mahbooba, Z., Chera, B., & Evarts, L. (2021). Engaging Physicians in Quality Improvement in a Hospital Setting: A Scoping Review. American Journal of Medical Quality?: The Official Journal of the American College of Medical Quality, 36(5), 328–336. https://doi.org/10.1097/01.JMQ.0000735456.03039.2E
Mizuno, S. (2020). Management for quality improvement: The seven new QC tools. In Management for Quality Improvement: The Seven New QC Tools. Taylor and Francis. https://doi.org/10.4324/9781003070450
Purwaningsih, P., Nasronudin, N., Damayanti, N. A., Mahmudah, M., Andarini, S., Qomarudin, B., Chalidyanto, D., Yuwono, S. R., Septanto, A. N., & Zulkarnain, H. (2023). Development of a Hospital-Stakeholder Collaboration Tool Using Mixed Methods to Assess Stakeholder Perspectives for Hospital Service Improvement. Ethiopian Journal of Health Sciences, 33(6), 1075–1086. https://doi.org/10.4314/ejhs.v33i6.18
Ratner, S., & Pignone, M. (2019). Quality Improvement Principles and Practice. Primary Care - Clinics in Office Practice, 46(4), 505–514. https://doi.org/10.1016/j.pop.2019.07.008
Seilhamer C, Miller K, Holstine J. Reducing Postoperative Length of Stay for Idiopathic Scoliosis Patients using Quality Improvement Methodology. Pediatr Qual Saf. 2023 Aug 7;8(4):e672. doi: 10.1097/pq9.0000000000000672. PMID: 37551258; PMCID: PMC10403041.
Shamsuddin Alaraki, M. (2018). Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals. Quality Management in Health Care, 27(1), 8–16. https://doi.org/10.1097/QMH.0000000000000152
Spencer, S., Stephens, K., Swanson-Biearman, B., & Whiteman, K. (2019). Health Care Provider in Triage to Improve Outcomes. Journal of Emergency Nursing, 45(5), 561–566. https://doi.org/10.1016/J.JEN.2019.01.008
Taglione, M. S., & Brown, J. B. (2023). Primary care engagement in health system change: a scoping review of common barriers and effective strategies. BMC Primary Care, 24(1). https://doi.org/10.1186/s12875-023-02117-2
Walker, M., Gay, L., Raynaldo, G., Von Marensdorff, H., Bates, J. T., Friedland, J. A., Park, J. H., Kehl, E., Sowers, B., Bhavani, S., Lan, C., Bozkurt, B., Stewart, D. E., & Horstman, M. J. (2019). Impact of a Resident-Centered Interprofessional Quality Improvement Intervention on Acute Care Length of Stay. Journal for Healthcare Quality?: Official Publication of the National Association for Healthcare Quality, 41(4), 212–219. https://doi.org/10.1097/JHQ.0000000000000156
Williams D, Fredendall LD, Hair G, Kilton J, Mueller C, Gray JD, Graver C, Kim J. Quality Improvement: Implementing Nurse Standard Work in Emergency Department Fast-Track Area to Reduce Patient Length of Stay. J Emerg Nurs. 2022 Nov;48(6):666-677. doi: 10.1016/j.jen.2022.07.009. Epub 2022 Sep 6. PMID: 36075769; PMCID: PMC9444840.
Zach M. Feldman, Srihari K. Lella, Sujin Lee, Tiffany Bellomo, Jennifer Bocklett, Anahita Dua, Glenn M. LaMuraglia, Sunita D. Srivastava, Matthew J. Eagleton, Nikolaos Zacharias,. 2023. Implementation of a Consensus-Driven Quality Improvement Protocol to Decrease Length of Stay after Elective Carotid Endarterectomy, Annals of Vascular Surgery, Volume 97, Pages 97-105, ISSN 0890-5096, https://doi.org/10.1016/j.avsg.2023.06.007
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