KOMPENDIUM GREEN HOSPITAL bagian 1

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KOMPENDIUM
LINGKUNGAN DAN
PEMBANGUNAN
GREEN HOSPITAL
A Green Hospital is defined according to Physicians for Social
Responsibility as a hospital that has taken the initiative to do the
one or more of the following:
1. Choose an environmentally friendly site,
2. Utilizes sustainable and efficient designs,
3. Uses green building materials and products,
4. Thinks green during construction and keeps the greening
process going.
A Green Hospital is constructed around a hospital that recycles,
reuses materials, reduces waste, and produces cleaner air.
Koleksi: Soemarno
PM-PSLP PPSUB Maret 2012
RUMAH SAKIT
A hospital is a health care institution providing patient treatment by
specialized staff and equipment. Hospitals often, but not always,
provide for inpatient care or longer-term patient stays.
Hospitals are usually funded by the public sector, by health
organizations (for profit or nonprofit), health insurance companies, or
charities, including direct charitable donations.
General Hospital
The best-known type of hospital is the general hospital, which is set up
to deal with many kinds of disease and injury, and normally has an
emergency department to deal with immediate and urgent threats to
health. Larger cities may have several hospitals of varying sizes and
facilities. Some hospitals, especially in the United States, have their
own ambulance service.
SPECIALIZED HOSPITALS
Types of specialized hospitals include trauma centers, rehabilitation
hospitals, children's hospitals, seniors' (geriatric) hospitals, and
hospitals for dealing with specific medical needs such as psychiatric
problems (see psychiatric hospital), certain disease categories such as
cardiac, oncology, or orthopedic problems, and so forth.
A hospital may be a single building or a number of buildings on a
campus. Many hospitals with pre-twentieth-century origins began as
one building and evolved into campuses. Some hospitals are affiliated
with universities for medical research and the training of medical
personnel such as physicians and nurses, often called teaching
hospitals. Worldwide, most hospitals are run on a nonprofit basis by
governments or charities. There are however a few exceptions, e.g.
China, where government funding only constitutes 10% of income of
hospitals.
Sumber: http://en.wikipedia.org/wiki/Hospital ….. Diunduh 6/4/2012
RUMAH SAKIT HUJAU
“SUATU PENDEKATAN GLOBAL"
According to Physicians for Social Responsibility, The green hospital movement
began a few years ago following the U.S. Green Building Council (USGBC)’s
release of their Leadership in Energy and Environmental Design (LEED) standards
for building construction. Although initial construction costs are higher, green
hospitals have been shown to reduce long-term energy costs. In addition, there is a
growing consensus among the health care profession that pollutants generated by
medical facilities must be reduced. Moreover, green hospital design has been
linked to better patient outcomes and staff retention. In the past few years, a
number of newly constructed and renovated hospital buildings have strived for and
received LEED certification.
A Green Hospital is defined according to Physicians for Social Responsibility as a
hospital that has taken the initiative to do the one or more of the following: choose
an environmentally friendly site, utilizes sustainable and efficient designs, uses
green building materials and products, thinks green during construction and keeps
the greening process going. A Green Hospital is constructed around a hospital that
recycles, reuses materials, reduces waste, and produces cleaner air.
Green Hospital Intitive is ready to launch A Green Hospital “A global
Approach” Conference through Hospital 2020 Partnership that will be held in
January 2011 as part of an integrated campaign to promote the best practices in the
future hospital .
TUJUAN KONFERENSI:
To accelerate the development, use, and diffusion of environmentally preferable
products and practices, and the construction of green buildings in future hospital
projects around the world by disseminating examples of best practices and
convening health care professionals, university researchers, designers of
professional buildings, and vendors of cleaner and safer products and services.
To provide examples of best practices in environmentally preferable purchasing
from the U.S., Canada, and Europe.
To address environmentally sustainable design practices and construction materials
in healthcare.
To discuss and evaluate initiatives to incorporate environmentally preferable
purchasing in health care and group purchasing organizations.
To showcase environmentally preferable and occupationally safer products and
practices.
To evaluate alternatives to medical waste incineration.
Sumber:
….. Diunduh 6/4/2012
RUMAH SAKIT HUJAU
“SUATU PENDEKATAN GLOBAL"
Issues of concern and focus:
1. Mercury
2. Lead
3. PVC & DEHP (Polyvinyl Chloride)
4. Medical Waste
5. Green hospital building
6. Food
7. BFRs (Brominated Flame Retardants)
8. E-waste ( Electronic Waste)
9. VOCs ( Volatile Organic Compounds)
10.EPP (Environmentally Preferable Purchasing)
11.Chemical policy
Interested parties or companies in the Conference:
1.
2.
3.
4.
Sustainable building materials
Products free of mercury, latex, PVC, and DEHP
Energy and water conservation
Tools and resources for environmentally preferable
purchasing
5. Greener cleaners
6. Integrated pest management
7. Waste Reduction and Recycling
8. Green Electronics
9. Managing pharmaceuticals
10. Environmentally Preferable Medical Waste Treatment and
Disposal
11. Safer alternatives to PBDEs: products in health care
settings
12. Nutritious, Sustainable Foods and Food Systems .
.
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
Memilih Lokasi yang ramah lingkungan bagi RSH
1.
2.
3.
4.
5.
6.
Avoid farmland, wetlands, flood plains, environmentally sensitive
lands, and hazardous substance sites.
Rehabilitate vacant areas as necessary.
Share existing parking/transportation infrastructure.
Minimize heat island (thermal gradient differences between
developed and undeveloped areas).
Take advantage of existing transit, water, and energy
infrastructure in the community.
Preserve local habitat, green fields, and natural resources..
RSU PINDAD BANDUNG
Lokasi berada di tempat yang cukup strategis dan mudah
dijangkau dari segala arah, Rumah sakit yang nyaman,
dengan lingkungan yang asri, kawasan sekitar yang sejuk,
bebas dari gangguan bising kendaraan, bebas polusi serta
kenyamanan untuk beristirahat bagi setiap penderita yang
dirawat.
Sumber:
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh 6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
DISAIN BANGUNAN YANG EFISIEN DAN RAMAH LINGKUNGAN
1.
Prioritize parks, greenways, and bikeways throughout the new
hospital area. Plan sufficient shade.
2. Investigate incentives available from the U.S. Department of
Energy.
3. Consider (re)use of existing buildings, including structure, shell,
etc.
4. Identify opportunities to incorporate recycled materials into the
building, such as beams and posts, flooring, paneling, bricks,
doors, frames, cabinetry, furniture, trim, etc.
5. Provide suitable means of securing bicycles with convenient
change/shower facilities for those who cycle to work.
6. Design for durability-life cycle costing/value engineering strategy
for finishes and systems to reduce waste.
7. Maximize day lighting and view opportunities (building orientation,
exterior/interior shading devices, high-performance glazing, photointegrated light sensors, shallow floor plates, increased building
perimeter, etc.).
8. Designate an area for recyclable collection and storage that is
appropriate and convenient with consideration given to using
cardboard balers, aluminum can crushers, recycling chutes, and
other waste management technologies to enhance recycling
program.
9. Consider the installation of an on-site compost vessel.
10. Design for adaptability of building design as user needs change.
11. Establish a project goal for locally sourced materials and identify
materials and material suppliers that can help achieve this goal;
this reduces environmental impact due to transportation and
supports the local economy.
12. Provide capacity for indoor air quality monitoring to sustain longterm occupant health and comfort (carbon dioxide sensors
integrated into building automation system).
Sumber:
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh
6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
ENERGI
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Sumber:
Orient building to take advantage of solar energy for heating and
daylighting, and to encourage natural ventilation and passive
cooling.
Consider heat recovery systems where appropriate.
Use computer-simulation model to assist in maximizing energy
performance.
Install mechanical ventilation equipment.
Install high-efficiency heating and cooling equipment.
Install a lighting control system.
Install high-efficiency lights, appliances, and fixtures with
motion/occupancy sensors where appropriate.
Consider heating/cooling and energy from renewable sources (e.g.,
solar, wind, biomass, geothermal, bio-gas, etc.).
Minimize light pollution by proper and judicious illumination.
Design the building with equipment to measure water and energy
performance.
Consider task lighting "opening window" technology, and underfloor
HVAC systems with individual diffusers.
Exceed minimum insulation requirements for walls, ceilings, etc.,
as prescribed by the U.S. Department of Energy.
Install and maintain a temperature/humidity monitoring system to
automatically adjust to building conditions and link system to
building automation system.
Consider the use of Energy Star and Environmental Choice
products wherever possible.
Deploy a monitoring and tracking system for all energy inputs with
scheduled reviews to ensure efficiencies are being met..
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh 6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
AIR
1.
2.
3.
4.
5.
6.
Evaluate safe strategies to recycle wastewater/gray water for other purposes on
the site.
Limit disruption of storm water flows by minimizing runoff, increase on-site
infiltration, and reduce containments through constructed wetlands, bioswales, etc.
Consider collecting storm water runoff for other purposes (irrigation) on the site.
Consider use of reverse osmosis feed water to feed steam boilers in power plant
to reduce chemicals required, produce cleaner steam, increase cycles, and reduce
boiler blowdown to the environment.
Landscape with drought-resistant native plants and perennial ground covers.
Situate building to take advantage of existing vegetation.
Use low-flow taps, nozzles, and toilets.
STUDI ANALISIS SISTEM PENYEDIAAN AIR BERSIH DAN KUALITAS BAKTERIOLOGIS
AIR BERSIH DI RSUD BLAMBANGAN BANYUWANGI TAHUN 2011
MEIHANA NURUL H. 2011. Skripsi, FKM UNAIR
Sistem penyediaan air bersih di rumah sakit merupakan bagian dari sanitasi. Sehingga, air
bersih mempunyai peranan penting dalam upaya pencegahan penyakit atau kejadian infeksi di
rumah sakit.
Hasil penelitian menunjukkan adanya peningkatan yang cukup bagus sistem penyediaan air
bersih dan kualitas bakteriologis air bersih di RSUD Banyuwangi pada tahun 2011.
Berdasarkan penilaian observasi di RSUD Blambangan Banyuwangi terhadap sistem
penyediaan air bersih didapatkan total skor 605 dari 800 (75,625%) memenuhi syarat
Kepmenkes 1204 Tahun 2004 dan kualitas bakteriologis air bersih di RSUD Blambangan
Banyuwangi dari hasil pemeriksaan laboratorium terhadap 11 titik sampel air memenuhi syarat
ditinjau dari Permenkes RI No. 416/Menkes/Per/IX/1990.
Saran bagi RSUD Blambangan Banyuwangi perlu memperbaiki sistem penyediaan air bersih
meliputi pengurasan reservoir, kegiatan desinfeksi serta pemeriksaan kualitas air seharusnya
dilakukan secara secara rutin dan konsisten, selain itu perlu dilakukan analisis pencatatan
hasil laboratorium kualitas bakteriolgis air bersih secara berkesinambungan untuk perbaikan
ke depan.
(sumber: http://adln.fkm.unair.ac.id/gdl.php?mod=browse&op=read&id=adlnfkm-adlnmeihananur-2063)
Sumber:
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh
6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
EVALUASI
1.
2.
Ensure that building elements are installed and calibrated properly to
meet the project's environmental health goals in addition to mechanical,
electrical, and plumbing system requirements.
Perform a two-week building flushout or test contaminant levels in
building before occupancy.
Sumber:
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh
6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
BAHAN KIMIA / KUALITAS UDARA INDOOR
1.
Avoid ozone-depleting chemicals in mechanical equipment and insulation
(zero tolerance for CFC-based refrigerant).
Avoid materials that will offgass pollutants, such as solvent-based finishes
and adhesives, carpeting, and particleboards that release formaldehyde.
Audit existing building systems using refrigerant and fire suppression
chemicals and remove HCFCs and halons.
Specify refrigeration/fire-suppression systems that use no HCFCs or halons.
Specify materials free from toxic chemicals and that do not release toxic
byproducts throughout their life cycle, and avoid those toxins that are
carcinogenic, persistent, or bio-accumulative. Key materials to avoid include
mercury (switching equipment), arsenic (pressure-treated wood), urea
formaldehyde (engineered wood), PVC (floors, wall coverings, furniture, roof
membranes, plumbing pipe, electrical wire), and asbestos.
Place air intakes away from vehicles and other such sources of pollution to
prevent indoor air contamination.
Adopt an indoor air quality management plan to protect the HVAC system
during construction, control pollutant sources, and interrupt pathways for
contamination.
2.
3.
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7.
Pelayanan rumah sakit untuk pasien sangat diprioritaskan.
Peralatan canggih dalam dunia medika sangat diperlukan untuk melancarkan proses
penyembuhan pasien. Tingkat kenyamanan pasien mencerminkan kuwalitas rumah
sakit yang profesional. Kondisi tersebut memicu rumah sakit untuk mendapatkan
kepercayaan dari pasien yang mengharapkan sembuh dari penyakit yang diderita.
Salah satu kenyamanan yang diberikan rumah sakit adalah tempat tidur transport
pasien.
Pada saat ini rumah sakit diseluruh wilayah Indonesia umumnya memperhatikan
standart kenyamanan pasien khususnya saat berada di tempat tidur. Saat pasien
dipindahkan ketempat pemeriksaan lain dimana bidang yang akan dilalui tidak selalu
datar. Untuk itu dibutuhkan tempat tidur transport pasien yang mampu
mengkondisikan tempat tidur tersebut agar tetap datar secara otomatis.
Sumber:
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh
6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
LIMBAH
1.
2.
3.
Encourage environmentally responsible forest management by using
woodbased materials certified in accordance with the Forest
Stewardship Council Principles and Criteria.
Incorporate materials that are designed for disassembly and
recycle/reuse at the end of functional life.
Ensure adequate space for storage of hazardous waste (e.g.,
biomedical, chemical, radioactive, etc.)..
Ir. Nusa Idaman Said, M.Eng
Kelompok Pengkajian Teknologi Pengelolaan Air Bersih dan Limbah Cair,
Direktorat Teknologi Lingkungan, Kedeputian Bidang Informatika, Energi dan Material.
Badan Pengkajian dan Penerapan Teknologi
Air limbah rumah sakit merupakan salah satu sumber pencemaran lingkungan yang
sangat potensial. Oleh karena itu air limbah tersebut perlu diolah terlebih dahulu
sebelum dibuang ke saluran umum. Masalah yang sering muncul dalam hal
pengelolaan limbah rumah sakit adalah terbatasnya dana yang ada untuk membangun
fasilitas pengolahan limbah serta operasinya, khususnya untuk rumah sakit tipe kecil
dan menengah. Untuk mengatasi hal tersebut maka perlu dikembangkan teknologi
pengolahan air limbah rumah sakit yang murah, mudah operasinya serta harganya
terjangkau, khususnya untuk rumah sakit dengan kapasitas kecil sampai sedang.
Selain itu perlu menyebar-luaskan informasi teknologi khususnya untuk pengolahan air
limbah rumah sakit, sehingga dalam memilih teknologi pihak pengelola rumah sakit
mendapatkan hasil yang optimal.
Salah satu cara pengolahan air limbah rumah sakit yang murah, sederhana dan hemat
energi adalah proses pengolahan dengan sistem biofilter anaerob-aerob. Dengan
sistem kombinasi biofilter "Anaerob-Aerob" diperoleh hasil air olahan yang cukup baik,
serta proses pengolahannya sangat stabil walaupun konsentrasi maupun debit air
limbah berfluktuasi
Sumber: http://www.enviro.bppt.go.id/~Kel-1/)
Sumber:
http://hospital2020.org/documents/GreenHospitalChecklist.pdf….. Diunduh
6/4/2012
BUILDING A GREEN HOSPITAL CHECKLIST
Use Green Building Materials and Products
1.
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3.
4.
5.
Minimize the use of carpets and other such materials that have the
potential to absorb and release indoor pollutants.
Use high-reflectant roofing.
Use high-performance windows (double-glazed, argon, etc.).
Use rapidly renewable building materials, such as bamboo flooring,
wool carpet, strawboard, linoleum, poplar OSB, sunflower seed
board, wheatgrass cabinetry, hemp fabrics, etc.
Use durable products and materials that require low maintenance.
Think Green During Construction
1.
2.
3.
4.
5.
Establish landfill diversion plan (or site and building elements (land
clearing debris, cardboard, metals, brick, concrete, plastic, clean
wood, glass gypsum wallboard, carpet insulation) and track efforts
to comply with recycling/diversion plan.
Protect trees and topsoil during site work.
Centralize cutting operations to reduce job site waste and simplify
sorting.
Minimize construction packaging material or return such waste to
suppliers for reuse/recycling.
Educate and seek feedback from crews, including subcontractors,
about the environmental vision and the importance of green design
and construction practices..
Sumber:
….. Diunduh 6/4/2012
MEMBANGUN RUMAH SAKIT HIJAU: CHECKLIST
Keep Greening
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Establish a waste separation and recycling program, and educate
staff as to the benefits.
Educate and engage staff in all departments in current
environmental initiatives and about opportunities to get involved.
Establish a "Green Team" of staff from all departments to monitor
progress toward environmental goals.
Draft a measurements and verification plan to compare predicted
savings (water, electricity) with those actually achieved once built.
Create a staff environmental coordinator position.
Phase out the use of chemical pesticides on greenspace in favor
of organic horticultural approaches.
Adopt green procurement protocols to screen all products for
environmental benefits and alternatives.
Develop an environmental management system.
Engage in a "green power" contract with a local utility.
Identify local recyclers/buyers of glass, plastic, organic waste,
office paper, cardboard, etc.
Identify and support waste haulers/recyclers who share a green
philosophy.
Initiate a policy of purchasing only fairly traded coffee and
chocolate products in cafeterias/vending machines.
Develop a wellness initiative to improve the quality of the
employee's work life..
Sumber:
….. Diunduh 6/4/2012
Green+ Hospitals
Sustainable Healthcare Infrastructure.
More than just Green.
Hospitals need to cope with various challenges in order to be
sustainably profitable and thus fulfill economic as well as ecological
requirements. To address these challenges, being a green hospital
is not enough. Therefore a program called Green+ Hospitals was set
up by Siemens.
It encompasses the following critical success factors for sustainable
healthcare infrastructure:
1. Green
2. Efficiency
3. Quality
+
A Green Hospital designed by Siemens addresses these three
success factors comprising products and solutions from different
application areas: energy generation and distribution, building
automation, IT and communications infrastructure, green IT, and
medical technology.
Green: The green effects include:
reduction of energy consumption;
sustainable and careful use of resourceS
pollution reduction.
Quality. The quality effects include:
patient identification and safety;
convenient and healthy procedures;
health supporting environmental conditions.
Efficiency . The efficiency effects include:
optimized clinical, non-clinical, and support workflows;
efficient assignment of time;
efficient assignment of costs.
Sumber:
http://www.medical.siemens.com/webapp/wcs/stores/servlet/CategoryDisplay~q_catalogId~e_11~a_categoryId~e_1029615~a_catTree~e_1021331,1029615~a_langId~e_-
Green
Ecological Aspects for Sustainable Healthcare Infrastructure
One success factor of Green+ Hospitals deals with ecological aspects, which can be
summarized under green technologies concerning environmental care. Besides the
reduction of energy consumption, we turn our attention to sustainable and careful
use of resources and pollution reduction. This leads to better environmental care,
lower costs, and increased quality.
A broad portfolio in the areas Infrastructure, IT and Medical Technology supports
you in reaching green goals. Please follow the links to find more detailed information
and significant examples.
Infrastructure:
1. Cost savings up to 40%* thanks to optimized and modernized heating,
ventilation and cooling
2. Optimized illumination control systems for more comfort and energy savings
3. Enhanced customized solutions, services, products, and technologies optimize
the life-cycle performance for hospitals to achieve maximum energy savings,
performance and sustainability without compromising comfort and life safety
4. Reduced travel efforts through optimized communications systems, e.g. video
conferencing
5. Green patient multimedia infotainment
6. Desktop phones with reduced energy consumption
IT:
1. Transformational data center (consolidation and virtualization technologies)
2. Data center energy efficiency (file server storage reduction, and usage of ground
water for air cooling in DC)
3. Green IC architectures = desktop and server virtualization (including hosted
architectures)
Medical Technology:
1. Energy efficient medical technologies
2. Environmentally friendly operation of medical technologies
3. Careful use of resources in production and recycling of medical technologies
Sumber:
….. Diunduh 6/4/2012
Quality:
ASPEK MUTU INFRASTRUKTUR LAYANAN KESEHATAN YANG
BERKELANJUTAN
Ecological and economical efforts are important for a hospital. But as essential as
they are, the most important aspect for a sustainable hospital is the quality of
patient care. Therefore, we pay special attention to patient identification and
safety, reliable and secure storage, access to data, convenient and healthy
procedures, enhanced quality of diagnosis and treatment, and also to healthsupporting environmental conditions.
A broad portfolio in the areas Infrastructure, IT and Medical Technology supports
you in reaching quality goals. Please follow the links to find more detailed
information and significant examples.
Infrastructure:
1.
2.
3.
4.
5.
6.
People and asset tracing – maximum safety and comfort for patients and
elderly people, protection of babies
Compact monitoring technology (clean rooms) – to protect patients reliably
and fulfill regulatory requirements
Efficient e-health infrastructure
Intrusion detection, video surveillance, access control – for more security
and enhanced comfort for staff, patients and visitors
Patient terminal – for the highest possible independence of patients and
more comfort for staff
Tailored fire-safety solutions to protect patients, staff, visitors, and assets
reliably
IT:
1. Enhanced quality of diagnosis and treatment, e.g. e-prescription, emedication, and e-health record
2. Reliable storage and access to health data
3. Optimized diagnostic time and less waiting time thanks to state-of-the-art IT
4. Ubiquitous access to patient data
Medical Technology:
1. Optimized diagnostic time and less waiting time thanks to state-of-the-art
imaging systems
2. Dose reduction, low-dose imaging
3. Implementation of clinical processes aligned with Standard-of-Care
classification.
EFFICIENCY:
ASPEK EFISIENSI INFRASTRUKTUR LAYANAN KESEHATAN YANG
BERKELANJUTAN
Green+ Hospitals are more than just ecologically efficient buildings. A holistic view on
efficiency as well as processes is essential, including planning, equipment, system
integration, IT, and operation. Optimized workflows and medical and support
processes are required to leverage the full potential of efficiency. Besides the
optimization of clinical, non-clinical, and support workflows, we care about the
efficient assignment of time and costs.
A broad portfolio in the areas Infrastructure, IT and Medical Technology supports
you in reaching efficiency goals. Please follow the links to find more detailed
information and significant examples.
Infrastructure:
1. Demand-based heating, ventilation and cooling systems ensure optimal room
conditions and avoid unnecessary energy costs
2. Energy Performance Contracting guarantees costs savings up to 40% to finance
other measures, e.g. building modernization work
3. Life safety and security systems ensure business continuity, and efficient
resource allocations and reduce losses
4. Integrated power distribution for optimal patient care
5. Unified communications and seamless media integration
6. Mobile voice and data communications
7. Reduced reaction time to patients’ needs
IT:
1. Enhanced data quality through archive and document solutions (enterprise
content management for hospitals)
2. System integration for hospital information systems
3. Workflow optimization by workflow-oriented medical IT
4. Efficient care processes through unified IT and communication processes
5. Fixed-mobile convergence with integrated networks and user interfaces
Medical Technology:
Time saving state-of-the-art imaging systems
Consulting for efficient clinical paths, efficient planning of room concepts, and
efficient radiology concepts
.
GREEN+ HOSPITALS REFERENCES
Infrastruktur Layanan Kesehatan yang Berkelanjutan
Sustainable healthcare infrastructure means the big challenge to unify
ecological and economical demands in healthcare.
Siemens supports you in meeting these challenging demands and prepares you
for the future — with Green+ Hospitals. With a variety of levers that lead to
sustainable healthcare infrastructure.
First “Green+ Hospital” in Germany
Open since mid-2010, the Ethianum in Heidelberg, Germany is a clinic specializing
in plastic surgery, aesthetic surgery and preventive medicine. It is one of the first
hospitals in Germany to rigorously focus on sustainability criteria. Based on an
innovative solution concept from Siemens, the Ethianum combines the latest
diagnostic procedures and treatments with the use of natural resources – for
example, in the area of power supply.
Significant characteristics
Intelligent building management system using geothermal energy as a source of
energy-efficient heating, ventilation and air-conditioning
Resource-saving, patient-friendly medical systems and lighting technology to
make examinations as pleasant and efficient as possible
Energy-saving, multifunctional communications network that gives physicians
reliable access to treatment data from patient rooms, provides patients with
multimedia and telephone access, and allows them to control the heating and
cooling in their room
Consistent use of communications technology to support more efficient workflows
Environmental value
Intelligent planning ensures a high recycling quota – during construction,
operation, and in the event the building is ever taken down*
No carbon emissions from heating, air-conditioning or water heating thanks to
geothermal energy*
Sustainable energy savings of up to 50 percent through the use of efficient
medical technology*
Customer and patient value
Reduced energy and operating costs thanks to consistent energy management*
Excellent patient care with the aid of the latest medical technology
Friendly, healing atmosphere and hotel-like comfort, for example
through innovative lighting concepts and use of daylight
Enhanced image thanks to focus on sustainability and environmental protection
MENUJU RUMAH SAKIT HIJAU: DARI GRAY HOSPITAL
St. Joseph Hospital in Berlin-Tempelhof, Germany is an advanced care hospital with
475 beds and around 1,100 staff. It has entrusted Gegenbauer Health Care Services
(GHC) with operating its building technology facilities. In 2007, when GHC determined
the hospital needed renovations totaling approximately €3 million, it started looking
around for an innovative financing concept. To take the pressure off the budget, the
hospital’s supporting organization Katholische Wohltätigkeitsanstalt zur heiligen
Elisabeth (St. Elizabeth Catholic charitable foundation) chose Siemens’ energy
management performance contracting as its modernization and financing strategy.
Using this approach, the hospital’s facilities will be modernized within the framework
of a 15-year contract.
Significant characteristics
Modernize the drinking water heating system and the heat networks; install highly
efficient circulating pumps and mini combi-valves with pressure differential regulation
Set up a decentralized electric steam system
Upgrade the existing heat recovery system and optimize the ventilation systems by
installing a high-efficiency heat recovery register
Optimize and make flexible the refrigeration supply, chilled water distribution net, and
recooling system by adapting temperatures and flow rates as needed
Set up the new DESIGO building automation system with around 2,500 data points;
nearly all cables, sensors, and actuators of the old system will be reused
Retrofit or replace the conventional ballasts and T8 bulbs with highly efficient T5
technology from Osram
Environmental value
Active climate protection by reducing CO2 emissions by approx. 1,300 tons per year*
Ongoing process optimization through joint continuous consumption monitoring by
Siemens and GHC
Customer and patient value
Contractually fixed energy-saving goal: €325,000 or 23.8 percent below the 2007
energy consumption level*
Guaranteed energy savings over €4.8 million within contract period related to energy
pricing 2008 (heating oil) and 2009 (electricity)*
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AN IMPRESSIVE EXAMPLE FOR ENERGY EFFICIENCY IN
HOSPITALS
When the Bremerhaven/Reinkenheide Clinical Center with more than 700 beds opened
its doors in 1976, it was the most modern hospital of its kind in the state of Bremen. It
has continued to extend its leading position as a therapy and diagnostic center right up
to the present day. By contrast, the productivity and efficiency of its building services
installations have declined over the years, especially with regard to energy consumption.
Primary energy costs amounted to some two million euros in 2004. There was an urgent
need for extensive refurbishment and upgrading. Thanks to an Energy Management
Performance Contract with Siemens, the Clinical Center is now achieving enormous
savings.
Significant characteristics
A total of 120 separate measures taken which affect the building infrastructure (such as
heating and cooling equipment, medical compressed-air supply, main low-voltage supply,
steam sterilizers and the entire building automation facilities including the management
system).
Annual cost savings for energy: 520,000 €*
For instance, the power required to generate steam for air conditioning, cooking and
sterilization has been reduced by 6,200 MWh* or 72%*. The air conditioning systems
outside of the operating or intensive care areas now only start heating when outdoor
temperatures drop to 2°C.
Load-demand heat supply to the building represents an additional major source of
potential savings. The use of highly efficient circulating pumps enables some 50 MWh* of
electricity to be saved annually.
Upgrading the heating circuit control system enables room temperatures in certain parts
of the building to be reduced during the night, i.e. outside their hours of use. The energy
savings on room heating amounts to 5,000 MWh* or 50%*.
The Bremerhaven/Reinkenheide Clinical Center has achieved a milestone in terms of
installation quality, sustained cost economies and energy optimization.
Environmental value
Reduced energy consumption by more than 25%*.
Reduced CO2 emissions by 4,100 tons* annually.
Customer value
The Clinical Center is saving 520,000 €* in energy costs annually.
Siemens Energy Savings Performance Contracting guarantees annual energy savings of
25%*.
Increases building value and patient comfort
Klinikum Bremerhaven Reinkenheide
The extensive modernization activities lead to more comfort for patients and staff,
reduced the energy costs, and lead to tremendous cost reductions.
LABORATORIUM HIJAU
The Laboratório Dr. Joaquim Chaves in Miraflores near Lisbon, Portugal is a main
pillar of the Joaquim Chaves Group – which also includes Imaging and Oncology
Centers – and one of the leading private laboratories operating in Portugal. Due to its
size, high levels of specialization, and superior-quality work, the facility is also
considered a reference laboratory for the region. In view of increasing cost pressures
triggered by market consolidation, the economic crisis, and increasing wastewater
and solid-waste disposal costs, in December 2007 the Laboratório invested in a
Siemens laboratory automation solution. This investment boosted the company’s
competitiveness and environmental friendliness.
Significant characteristics
Implementation of customized Siemens Automation Solutions including
clinical chemistry, immunoassay, and haematology complemented with
haemostasis, urinalysis and blood gas instruments
Installation of kPCR technology for molecular testing
Consolidation of departments in one core lab with 40 percent reduction in
space required*
Relocation of 10 percent of lab personnel to manual testing sections in
the laboratory*
Environmental value
30 tons less material waste annually – thanks to eliminating the use of
nearly a million sample tubes each year*
74 percent reduction of liquid waste*
40 percent savings in water consumption*
Customer and patient value
Higher profitability and increased competitiveness, thanks to 30 percent
lower lab costs*
Acceleration of analysis periods by 59 percent without affecting quality*
Reduction of 50 percent in volume of blood samples*
Sumber:
http://www.medical.siemens.com/webapp/wcs/stores/servlet/CategoryDisplay~q_catalogId~e_11~a_categoryId~e_1041070~a_catTree~e_1021331,1029615,1031068,1041070~a_langId~e_11~a_storeId~e_10001.htm….. Diunduh 6/4/2012
Why are hospitals associated with the colour green?
By Thomas Söderqvist On 15 Jul 2009 · 7 Comments · In displays/exhibits, history of
medicine, visual studies
Ever wondered why hospitals are associated with the colour green?
Green surgery scrubs, green operating theatres, green-painted
instruments, and so on and so forth.
A temporary exhibition called ‘Artifact Spotlight: The Colour of
Medicine’ at the Canada Science and Technology Museum in
Ottawa shows how the colour green conquered the hospital
world during the 20th century:
Green was a popular choice. Surgeons first added “spinach-leaf
green” to their clothing in 1914 to reduce glare from traditional
hospital whites. In the 1930s, hospital decorators used green to
influence patient moods. It carried associations with nature, growth
and recovery. Tiled surgical suites, patient rooms, clothing and
instruments all went green in the post World War Two era.
The exhibition curator, David Pantalony, is currently exploring the
history of the colour green in medical instruments in the period 1950
to 1975 and in medicine in general. Look out for his forthcoming
article in the Canadian Medical Association Journal this summer.
Green is a color of peace.Hospitals must maintain a peaceful
environment.Patients in hospitals must be peaceful so that they will
recover faster.
Sumber:
http://www.museion.ku.dk/2009/07/why-are-hospitals-associated-with-thecolour-green/….. Diunduh 6/4/2012
GERAKAN RUMAH SAKIT HIJAU
Sometimes called the "healthy hospital movement," this is a worldwide
effort of over 440 organizations in over 55 nations to "green" health care
facilities and to ensure that medical care does not further contribute to
diseases caused by environmental contaminants.
Typical projects include stopping the manufacture and use of mercurybased thermometers (U.S.), eliminating hospital incinerators that emitted
toxic dioxin, improving hospital food quality, green purchasing of
materials, green building to save energy and water and eliminate volatile
pollutants, and elimination of PVC in hospital equipment.
The movement has been spearheaded by nurses, doctors, and
concerned NGOs.
Keywords
Sustainable health care systems, green health care, PVC, waste
incineration, medical waste disposal, dioxin, environmental health,
ecologically sustainable health care, sustainable health care, sustainable
medicine, disease prevention, raising awareness, health literacy, health
promotion, health care, medical facilities, clinics, emergency care, public
health, green building, green purchasing, food ingredients, food safety,
hazardous substances, persistent organic pollutants, volatile organic
pollutants, body burden, biomonitoring, ecotoxicology, nutrition, mercury
pollution, public health, epidemiology, workplace safety, food safety,
product safety, toxicology, food web, dose, exposure, risk management,
risk assessment, toxic pollution, pollution source, bioaccumulation,
biomagnification, pesticides, fungicides, plasticizers, solvents,
polychlorinated biphenyls, halogenated aryl hydrocarbons (HAH),
endocrine disruptors, environmental estrogens, polynuclear aromatic
hydrocarbons (PAH), petroleum hydrocarbons, precautionary principle,
environmental pharmaceuticals .
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A GREEN HOSPITAL IS A COMFORTABLE HOSPITAL
By: Jonathan Hiskes
Published: Jun 29 2011 - 10:34am
RSH = RUMAH SAKIT YANG NYAMAN
Hospitals use more energy per square foot than any other type of commercial
building, so they’re a prime target for greener design. But nobody cares about
energy efficiency when they’re rushing to the hospital, right?
The builders of the new Swedish Issaquah hospital and medical center, opening
next month 18 miles east of Seattle, hope to convince patients and visitors that
greener design doesn’t just save money and carbon emissions – it also makes for
a more comfortable treatment environment.
I toured the 550,000-square-foot facility this week and found a host of smart design
features to back up that claim. The building is oriented around a large courtyard
garden, reducing lighting loads and providing natural light and views of greenery to
all inpatient rooms. Heating comes from a network of steam pipes, forgoing energyintensive electric baseboards and recapturing excess heat that otherwise would be
vented out. The steam-based heating system also keeps surfaces warmer, making
for more comfortable rooms. And a high-efficiency ventilation system will provide
fresher, higher-quality air than conventional setups.
The goal is to use less than 150 kBTU (British thermal units) per square foot per
year, which would make Swedish Issaquah the most energy efficient hospital in
Washington and well below the national average of 246 kBTU, according to Kevin
Brown, chief strategic office at Swedish. If it can get usage below 100 kBTU, it’ll be
the most efficient hospital in the nation, he said.
Building a new hospital isn’t cheap – the latest reported cost for the project is $365
million (which includes the 18-acre land purchase). The nonprofit Swedish network
has help from Puget Sound Energy, which is offering between $2 million and $4
million in grants and rebates for hitting efficiency targets. The utility also gave input
on the design, suggesting, for example, larger ducts that would require less energy
for ventilation.
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A GREEN HOSPITAL IS A COMFORTABLE HOSPITAL
By: Jonathan Hiskes
Published: Jun 29 2011 - 10:34am
RSH = RUMAH SAKIT YANG NYAMAN
The hospital uses Energy Star lighting fixtures and appliances, though it’s still
limited by the offerings of medical equipment makers, according to Chuck
Salmon, Swedish’s executive director for Issaquah operations and
development. “Energy efficient equipment has not really caught on in the
medical equipment industry,” he said. “They just want to make sure things
work.”
But what about the number one factor in green building – location? The site
near Interstate 90 gets a paltry Walk Score of 28 out of 100, compared to 78 for
downtown Issaquah, a Seattle exurb tucked into the Cascade foothills. There
weren’t any 18-acre sites available in the town center, Brown said. And because
the hospital will serve a large area, from Lake Washington to the west to Cle
Elum, over the mountain pass to the east, quick access from the highway was
more important than a walkable location, he said. Fair enough.
When I toured the facility, I was struck that hospital executives talk about time
efficiency in much the same way that environmental wonks talk about energy
efficiency. In the emergency room, there is no waiting area or triage area.
Instead, patients will be brought directly to one of 28 treatment rooms where
they can receive diagnoses and treatment in one location.
“Any time in which a patient is not getting value-added treatment is wasted
time,” said ER physician John Milne.
One more thing: Hospital chef Eric Eisenberg hopes nearby residents will stop
by the hospital even when they don’t have medical issues to address – for the
food. Seriously. It may sound like a bad joke, but the facility includes a stylish
Café 1910 that offers local organic fare like Alki Bakery bread. He knows that
convincing people to stop by a hospital café, even one with a separate outside
entrance, is a tall order. The location will help, positioned between the highway
and a profusion of new housing subdivisions without many businesses to serve
them.
Whether or not outsiders stop by for the food, I’m sure patients, their families,
and hospital staff will appreciate the non-cafeteria-style offerings. Chef
Eisenberg said the approach fits the effort to see diet and medicine as part of a
broader understanding of community wellness. The same holds true for energy
– these things can’t be separated.
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DEFINISI RUMAH SAKIT
Let us examine a few definitions of the term ‘hospital’.
The word ‘hospital’ is derived from the Latin word hospitalis which
comes from hospes, meaning a host. The English word ‘hospital’
comes from the French word hospitale, as do the words ‘hostel’ and
‘hotel’, all originally derived from Latin. The three words, hospital,
hostel and hotel, although derived from the same source, are used
with different meanings. The term ‘hospital’ means an establishment
for temporary occupation by the sick and the injured.
Today hospital means an institution in which sick or injured
persons are treated..
Dorland’s Illustrated Medical Dictionary defines a
hospital as:
An institution suitably located, constructed, organized, staffed to
supply scientifically, economically, efficiently and unhindered, all
or any recognized part of the complex requirements for the
prevention, diagnosis and treatment of physical, mental and the
medical aspects of social ills; with functioning facilities for training
new workers in many special professional, technical and
economical fields, essential to the discharge of its proper functions
and with adequate contacts with physicians, other hospitals,
medical schools and all accredited health agencies engaged in the
better-health programme.
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DEFINISI RUMAH SAKIT
A hospital in Steadman’s Medical Dictionary is defined as an
institution for the care, cure and treatment of the sick and
wounded, for the study of diseases and for the training of
doctors and nurses.
Blackiston’s New Gould Medical Dictionary (McGraw-Hill, New
York, 1959, p. 560) describes a hospital as
an institution for medical treatment facility primarily intended,
appropriately staffed and equipped to provide diagnostic and
therapeutic services in general medicine and surgery or in some
circumscribed field or fields of restorative medical care, together
with bed care, nursing care and dietetic service to patients requiring
such care and treatment.
According to the Directory of Hospitals in India, 1988,
a hospital is an institution which is operated for the medical,
surgical and/or obstetrical care of in-patients and which is treated
as a hospital by the Central/state/government/local body/private
and licensed by the appropriate authority.
.
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KONSEP RUMAH SAKIT
A modern hospital is an institution which possesses adequate
accommodation and well-qualified and experienced personnel to
provide services of curative, restorative and preventive character of
the highest quality possible to all people regardless of race, colour,
creed or economic status; which conducts educational and training
programmes for the personnel particularly required for efficacious
medical care and hospital service; which conducts research
assisting the advancement of medical service and hospital services
and which conducts programmes in health education.
Modern hospitals are open 24 hours a day. Their personnel render
services for the cure and comfort of patients. In the operation theatre,
skilled surgeons perform life-saving surgery. In the nursery, new-borns
receive the tender care of trained nurses. In the laboratory, expert
technicians conduct urine, stool and blood tests, vital to the battle
against disease. In the kitchen, cooks and dieticians prepare balanced
meals that contribute to the patient’s speedy recovery.
A hospital aims at the speedy recovery of patients. That is why its rooms
are equipped with air-conditioners, call-bells and other devices.
Several hospitals have libraries which provide books for the patients.
The telephone keeps the sick in touch with their friends and relatives. In
most of the hospitals today, patients have newspaper and barber
services in their rooms. Many hospitals, keeping in view the recreation
needs of their patients, have provided televisions and radio sets in their
rooms/wards.
To save the precious time of the medical staff, secondary duties, like
explaining the diagnosis and line of treatment to the patients and their
attendants, are entrusted to another section of the staff called ‘medical
social workers’. In hospitals, therefore, the endeavour is to provide the
best possible facilities to the patients within the hospital’s resources.
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TIPE MANAJEMEN RUMAH-SAKIT
Types of hospital management
1.
2.
3.
4.
5.
6.
Federal Government of Nigeria: All hospitals administered by the
Government of India, viz. hospitals run by the railways,
military/defence, mining, or public sector undertakings of the Federal
Government such as teaching/specialist hospital.
State government: All hospitals administered by the state
government authorities and public sector undertakings operated by
state such as state university teaching hospitals, specialist hospitals,
general hospitals, comprehensive health centres.
Local bodies: All hospitals administered by local governments, viz.
the rural and basic health centres (Primary Health Care Centres),
dispensaries.
Private: All private hospitals owned by an individual or by a private
organization.
Voluntary organization: All hospitals operated by a voluntary body/a
trust/charitable society registered or recognized by the appropriate
authority under federal/state government laws. This includes
hospitals run by missionary bodies and co-operatives.
Corporate body: A hospital ran by a public limited company. Its
shares can be purchased by the public and dividend distributed
among its shareholders..
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APA ITU MANAJEMEN RUMAH SAKIT?
Hospital Management provides a direct link between healthcare
facilities and those supplying the services they need. This
procurement and reference resource provides a one-stop-shop for
professionals and decision makers within the hospital management,
healthcare and patient care industries.
Hospital Management is a new theory in management faculty. Earlier
a senior doctor used to perform the role of a hospital manager.
However, nowadays everything demands a specialist. Almost all the
things related to hospital have changed. Many categories concerning
medical sciences and hospital have altered totally. There are various
types of hospitals today, including ordinary hospitals, specialty
hospitals and super specialty hospitals. The categories are regarding
to the types of facilities they offer to the people. Eligible professionals
are needed for the smooth operating of a hospital. Various courses
and training programs have been developed to find out eligible
hospital managers.
Such professionals are well trained to solve the rising challenges and
specific necessities of modern day hospitals. The Hospital
Management courses are open to non-medical background
graduates also.
A hospital manager is in a way responsible for administrative
dealings of the hospital. He accepts the charge of various aspects of
hospital management and health administration reverencing to the
patients and healthcare..
Sumber: http://in.answers.yahoo.com/question/index?qid=20081201060335AAjCpI0 …..
Diunduh 6/4/2012
Hospital Management Information System (HMIS)
(An electronic Management)
An electronic management in a Hospital or a Nursing Home would require to
very precise and must result into cost cutting and efficient management. We
have developed this revolutionary product” Electra” is very accurate in its
approach and suit all environments including large, medium or small sites. The
crucial points that “Electra” emphasis on are listed in the following paragraphs
which in turn justify your purchase.
You will require less number of Staff to cater more patients in same time or even
less. You would have the choice to re-deploy them at other suitable locations.
Hospital Management System not only provides an opportunity to the hospital
to enhance their patient care but also can increase the profitability of the
organization.
Electra would enable hospitals or Nursing Homes to serve the rapidly growing
number of health care consumers in a cost-effective manner.
Electra can also save extra money on your current computer hardware shopping.
Check up with our executive to more on this.
Hospital administrators would be able to significantly improve the operational
control and thus streamline operations.
This would enable to improve the response time to the demands of patient care
because it automates the process of collecting, collating and retrieving patient
information.
The senior Doctors would spend his precious time more in clinical activities than
to put in clerical activities otherwise.
This software interface would also save them a lot of time for special jobs only.
Accounting sometimes becomes awfully pathetic and complex. This product will
eliminate any such complexity, since the retrieval of information through its MIS
will become virtually on the tip of your fingers.
Very important for some, the reduced cost of the manpower would pay for the
cost of this product with in a short time after its implementation.
.
Sumber:
http://www.acgil.com/products/hospital_management_system_001.htm …..
Diunduh 6/4/2012
ELECTRA
Hospital Management System (HMS)(An electronic Management)
Hospital Management System (HMS)
(An electronic Management)
ELECTRA is a software product suite designed to improve the quality and
management of clinical care and hospital health care management in the areas
of clinical process analysis and activity-based costing. ELECTRA enables you
to develop your organization and improve its effectiveness and quality of work.
Managing the key processes efficiently is critical to the success of the hospital.
ELECTRA helps you manage your processes. ELECTRA provides all process
management tool elements: modeling, analysis, and simulation. Documentation
though an important part of a Hospital, is a non-productive exercise for the
intellectual human being, whose ability lies in core areas of excellence. Hence a
systematic approach to the way documents are managed, can transform your
Hospital resources to its highest utility and advantage.
HMS Benefits:
Electra enables hospitals and doctors to better serve their patients.
Improved quality of patient care
Increased nursing productivity
Reducing the time spent by staff filling out forms, freeing resources for more
critical tasks
Better quality of care, procedures and service to Patients.
Control over the costs incurred by diagnosis-related groups.
Sumber:
http://www.acgil.com/products/hospital_management_system_001.htm…..
Diunduh 6/4/2012
MODULES OF HOSPITAL MANAGEMENT SYSTEM
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
Sumber:
Registration and Enquiry Management
Appointment & Queue Management
EMR (Electronic Medical Record)
Casualty & Emergency Management
In-patient A-D-T (Admission-Discharge-Transfer)
Pharmacy Management
Laboratory Information System
Radiology and Nuclear Medicine
PACS Radiology
Operation Theatres Management
Nursing & Ward Management
Blood Bank Management
Service Order Processing
Ambulance Services Management
Bed Census Management
Quality Assurance
Stores and Inventory Management
Billing and Financial Accounting
TPA and Insurance Management
Patient Referral System
HR and Payroll Management
Duty Roster Management
Physiotherapy and Rehabilitation
Dietary Management
CSSD (Central Sterile and Supply Department)
House Keeping and Laundry Management
Bio-Medical Waste Management
MIS (Management Information System)
Telemedicine
http://www.acgil.com/products/hospital_management_system_001.htm…..
Diunduh 6/4/2012
MANAJEMEN RUMAH SAKIT : Pendahuluan
In recent times, health care concept of the people have undergone a tremendous
change which has lead to higher expectations and an increased demand for high
quality medical care and facilities. Here comes the importance of Health/ Hospital
Management. It is the latest concept in the field of management and one of the
most lucrative and important careers in the health sector. According to a recent
US survey, Hospital management is one among the top ten millennium professions
which provides a direct link between healthcare facilities and those supplying the
services they need. A career in Hospital Management involves ensuring effective
utilization of physical and financial resources of the hospital as well as creating an
organizational climate beneficial to the growth and development of the personnel. It
is a difficult, challenging, responsible and more over, a demanding job.
Professional services of trained manpower namely Hospital administrators/
managers have now become essential to manage hospitals and medical facilities.
It is the hospital administrators/ managers who manage hospitals, outpatient
clinics, hospices, drug-abuse treatment centers etc. They would be responsible for
overall patient care, education, research and community health care associated
with the organization, and make sure that they conform to the rules of the Hospital.
These people with the help of a team of assistants, look after the administrative
affairs i.e plan, coordinate and direct the delivery of health services within a
hospital. In early days, senior doctors used to perform the role of a hospital
manager. But now things have changed and the services of these qualified
professionals are required for the smooth functioning of hospitals. The services of
these professionals go a long way in making the hospital more productive,
profitable and comfortable for the patients.
Career opportunities in the field of Hospital Management are increasing very
rapidly not only because of the growing importance of hospital industry, but also
with the difference in the nature of work in hospitals. It is an apt career for those
who have an empathic nature along with a flair for organising, and an eye for
detail. A Hospital Manager requires good knowledge of finance and information
systems, interpretation of data, and must be able to keep up good communication
with the staff of various departments, and patients. They can work as Deans and
Directors of medical colleges, Hospital superintendents, Deputy superintendents,
Medical directors, Nursing directors, Heads of departments and as Administrators
with substantial managerial responsibilities. Hospital manager will be responsible
for the overall organization and management of the hospital to ensure its smooth
functioning with the objective of ensuring complete satisfaction.
.
Sumber:
http://career.webindia123.com/career/options/health_medicine/hospital_management/intro.
htm….. Diunduh 6/4/2012
FUNGSI RUMAH SAKIT
To provide care for the sick and injured:
This can be done by accommodating them according to their physical condition
and financial status. When we talk of physical condition, we mean that some
patients are seriously ill and require admission in Intensive Care Unit while others
are not seriously ill and can be accommodated elsewhere (e.g. in deluxe room,
single room with AC and without AC, semi-private room and general ward)
according to their financial status.
There may be some patients who may require isolation. In that case, they should
be kept in isolated rooms, but the building should be kept always in a good state
of repair, pleasing appearance and providing the patient every mental and
physical comfort. In every hospital, there should be sufficient diagnostic and
treatment facilities available such as medical laboratory, X-ray, ultrasound, MRI
and CT scan for diagnosis and operation theatre for surgery, labour rooms for
delivery, nursery for children, physical therapy for rehabilitation of patients, so
that they may be properly treated.
Training of physicians, nurses and other personnel:
They receive their training in both theory and practice in approved
schools and colleges. Therefore, a hospital being a complex and
specialized organization must employ highly trained personnel so that
they may train others. Particularly in the branch of medical and
paramedical education, different associations/councils play very
important roles. They make surveys of hospitals and accord their
approval. Only these approved hospitals can provide training in
medicine, nursing, dietetics, pharmacy, physiotherapy, administration,
medical social work, medical record library, X-ray and medical record
technology, etc. Capable boys and girls should be attracted to such
courses as a career which offers them fair remuneration, opportunities
for self-development and reasonable security.
Prevention of disease and promotion of health:
It is the duty of the hospitals to cooperate with the government
agencies. They can treat patients of communicable and noncommunicable diseases, notify to the recognized authorities of any
communicable disease of which it has knowledge, assist in
vaccination programmes of the government, etc.
Advancement of research in scientific medicine:
In light of the broad social responsibility for maintaining and
restoring the health, it is an important function, but no hospital is
permitted to do direct experiments on patients. It must resort to
necessary tests in laboratories and on animals.
They can do so by making observation of functions of the body in
health and in disease but they will have to maintain clinical record
of patients accurately for which they have to engage qualified and
trained medical record technicians who will preserve the record in
such a manner that it can be made available for study at any time
to physicians and surgeons.
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‘GREEN’ HOSPITALS: EFFECTIVE SOLUTION TO SAVE
POWER
‘Green’ healthcare is set to be the upcoming buzz in the construction industry. To
ensure sterile and clean environment to patients, hospitals in India tend to consume
large amount of electricity and end up spending exorbitant amount of money in this
segment. Therefore, experts are increasingly recommending green healthcare
operations.
“Energy is a significant expense in a hospital, apart from manpower and
consumables expenses. This clearly indicates that there is an opportunity for
hospitals to cut costs and thereby contribute to reducing the ecological carbon foot
print,” says Dr Vivek Desai, managing director of Hosmac India Pvt. Ltd, a leading
hospital planning and management consultancy firm based in Mumbai.
Green hospitals: The concept
Green hospitals are buildings that tend to make maximum use of natural light and
solar energy. Therefore, these buildings are constructed in a specific angle of
alignment with the sun to maximise the use of natural light. Apart from this, these
buildings aid in establishing a passive cooling system for the interiors. Windows
are also located at particular angles to ensure ventilation, increase access to natural
light and reduce heat.
Using simple operational measures such as installing unitary air conditioning
systems and sensors, among others also facilitate in electricity conservation in
various departments of the hospitals.
Survey reveals
To understand the consumption of electricity per bed across hospitals, Hosmac
recently conducted a survey among various healthcare facilities across metros.
According to the survey, the expenditure on electricity varies from 2-4% of the total
expenditure of a hospital, thereby making power a significant expense head.
Besides, note the following three striking revelations that came out of the survey:
High-end tertiary hospitals with 300 beds and above spend around 60% of their
power expenditure on services directly related to patient care (comprising OPD, IPD,
ICU, radiology, diagnostic services etc)
Hospitals with higher level of technology spend four times more than hospitals with
basic technology infrastructure
Hospitals with high dependence on artificial lighting spend three times more, when
compared with hospitals depending on natural lighting systems
Sumber:
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8Green%E2%80%99-hospitals-Effective-solution-to-save-power.html ….. Diunduh 6/4/2012
‘GREEN’ HOSPITALS: EFFECTIVE SOLUTION TO SAVE
POWER
Survey recommendation
The survey therefore recommends green hospitals to reduce
electricity consumption and slash operational costs considerably.
Furthermore, the survey points out that hospitals can undertake
initiatives to educate their staff about the various effective measures to
save power.
“Hospitals can undertake simple measures like switching off the air
conditioners when not in use, and if it is a centrally air-conditioned
building then the management can go for effective maintenance of the
filters, which eventually reduce chilled water pumping requirement and
in turn cuts electricity costs considerably,” says Sameer Mehta, COO of
Hosmac Projects, the infrastructure division of Hosmac India Pvt. Ltd.
Mr Mehta further added that the demand for green hospitals is going
strong currently and he went on to cite examples such as Kohinoor
Hospital, Kurla; Savla Hospital, Seawood etc.
Documented evidences
There are hospitals in India that have managed to reduce electricity
consumption by 27% and save up to Rs 40 lakh annually by greening
healthcare operations. In this regard, mention may be made of Punebased Jehangir Hospital and Kovai Medical Centre and Hospital in
Coimbatore.
Jehangir Hospital saved Rs 46.25 lakh with an investment of mere Rs
27.95 lakh. The hospital through its innovative strategies reduced
electrical energy consumption by 12.66%, water energy consumption by
53.9%, specific energy consumption for air conditioning by 17.9% and
lighting by 5.99%. Similarly, Kovai Medical Centre and Hospital through
its initiatives—monitoring energy utilisation, technology upgradation and
emphasis on the use of renewable energy resources—considerably
reduced its energy spending.
Sumber:
http://www.constructionbiz360.com/article/6/20100517201005171707129236b350247/%E2%80%9
8Green%E2%80%99-hospitals-Effective-solution-to-save-power.html ….. Diunduh 6/4/2012
Green Hospitals
Author: Nicole Wong
Published: April 11, 2011 at 12:54 pm
Read more: http://technorati.com/lifestyle/green/article/green-hospitals/#ixzz1rEAwtEod
It would never occur to us that hospitals are sites that generate a great deal of
polluting waste, but think of all the gauze, intravenous bags, paper, disposable
syringes, disposable paper gowns, plastic and glass bottles that contain medications,
and suddenly, hospitals look like major contributors of landfill mass.
With the increasing consciousness in eco-friendliness, some hospitals have
proactively chosen to minimize the waste they produce by recycling and also by
ordering medical supplies in kits that minimize packaging as well as ordering
adequate rather than excessive amounts of perishable supplies.
St. Joseph Medical Center is an example of how a hospital can earn recognition and
improve its image by practicing better waste management systems. Up to 2010, it
has successfully kept 217 tons of "waste" out of landfills.
The recognition comes from Practice Greenhealth, a national organization for healthcare facilities committed to promoting environmentally responsible operations in the
medical field.
The award is significant in that it recognizes any healthcare facilities that have
achieved improvements in their mercury elimination, waste reduction, and pollution
prevention programs and show leadership in the local community and in the healthcare sector for recycling efforts and waste reduction.
Few people realize that hospitals without a safe and efficient waste management
system become a source of mercury pollution.
It's a tad ironic that the very place that people go to in order to receive health care is
also a place that potentially sickens both the environment and people.
So long as a hospital is without any form of explicit pollution prevention program, it is,
by default, a polluter.
Which clinic or hospital do you and your loved ones visit? Does that facility have a
streamlined and monitored waste disposal system? These are important questions to
ask in order to ensure that our hospitals and clinics don't end up being the source of
our health concerns.
Read more: http://technorati.com/lifestyle/green/article/greenhospitals/#ixzz1rEB4wF2C
Sumber:
http://technorati.com/lifestyle/green/article/green-hospitals/….. Diunduh 6/4/2012
PROJECT: GREEN HOSPITALS
The green hospital movement began a few years ago following the U.S.
Green Building Council (USGBC)’s release of their Leadership in Energy
and Environmental Design (LEED) standards for building construction.
Although initial construction costs are higher, green hospitals have been
shown to reduce long-term energy costs. In addition, there is a growing
consensus among the health care profession that pollutants generated by
medical facilities must be reduced. Moreover, green hospital design has
been linked to better patient outcomes and staff retention. In the past few
years, a number of newly constructed and renovated hospital buildings
have strived for and received LEED certification. Boulder Community
Hospital (CO), the Children’s Hospital of Pittsburgh (PA), and Providence
Newberg Medical Center (OR) are among the nation’s hospitals that have
already achieved LEED certification. Many other hospitals will be striving
for LEED certification for their newly constructed facilities.
How to get started:
1.
2.
3.
Find out if any hospitals in your community are planning to remodel
or construct new facilities. Find out which individuals and/or hospital
board members are planning/overseeing the new
construction/remodeling.
Meet with local environment leaders, e.g. local green building
coalition, to ask for suggestions, collaboration, and other assistance.
Meet with members of the hospital board of trustees, including the
CEO if possible, to discuss the benefits of green hospitals. If the
hospital administrators appear receptive to the idea of green hospital
construction, tell them about LEED certification. If appropriate, try to
secure their commitment to a certain level of LEED certification for
the new building.
Sumber:
action.psr.org/site/DocServer/Project_Green_Hospitals.doc?docID...….. Diunduh
6/4/2012
KRITERIA BANGUNAN HIJAU
The Gold LEED certification building requirements include specific
commitments to minimize the use of resources, maximize energy
efficiency and release minimal waste into the surrounding environment.
The specifications to be met include criteria that fall under the following
categories:
1.
2.
3.
4.
5.
6.
Sustainability of the Site
Water Efficiency
Energy and Atmosphere
Materials and Resources
Indoor Environmental Quality
Innovation in Design
Designing our cancer center according to these requirements would not
only fulfill our obligation to the Cleveland area as an environmentally
friendly neighbor, but would also offer many economic advantages that
would serve the hospital well into the future. With reduced expenditures
on energy, water, and waste production the hospital would have great
potential to reduce our operating costs.
Sumber:
action.psr.org/site/DocServer/Project_Green_Hospitals.doc?docID...….. Diunduh
6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Efficiency and Cost-Effectiveness
1.
2.
3.
4.
5.
6.
7.
8.
9.
An efficient hospital layout should:
Promote staff efficiency by minimizing distance of necessary travel
between frequently used spaces
Allow easy visual supervision of patients by limited staff
Include all needed spaces, but no redundant ones. This requires
careful pre-design programming.
Provide an efficient logistics system, which might include elevators,
pneumatic tubes, box conveyors, manual or automated carts, and
gravity or pneumatic chutes, for the efficient handling of food and
clean supplies and the removal of waste, recyclables, and soiled
material
Make efficient use of space by locating support spaces so that they
may be shared by adjacent functional areas, and by making prudent
use of multi-purpose spaces
Consolidate outpatient functions for more efficient operation—on first
floor, if possible—for direct access by outpatients
Group or combine functional areas with similar system requirements
Provide optimal functional adjacencies, such as locating the surgical
intensive care unit adjacent to the operating suite. These adjacencies
should be based on a detailed functional program which describes
the hospital's intended operations from the standpoint of patients,
staff, and supplies.
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Flexibility and Expandability
Since medical needs and modes of treatment will continue to change,
hospitals should:
Follow modular concepts of space planning and layout
Use generic room sizes and plans as much as possible, rather than
highly specific ones
Be served by modular, easily accessed, and easily modified
mechanical and electrical systems
Where size and program allow, be designed on a modular system
basis, such as the VA Hospital Building System. This system also uses
walk-through interstitial space between occupied floors for mechanical,
electrical, and plumbing distribution. For large projects, this provides
continuing adaptability to changing programs and needs, with no firstcost premium, if properly planned, designed, and bid. The VA Hospital
Building System also allows vertical expansion without disruptions to
floors below.
Be open-ended, with well planned directions for future expansion; for
instance positioning "soft spaces" such as administrative departments,
adjacent to "hard spaces" such as clinical laboratories.
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Therapeutic Environment
Hospital patients are often fearful and confused and these feelings may
impede recovery. Every effort should be made to make the hospital stay
as unthreatening, comfortable, and stress-free as possible. The interior
designer plays a major role in this effort to create a therapeutic
environment. A hospital's interior design should be based on a
comprehensive understanding of the facility's mission and its patient
profile. The characteristics of the patient profile will determine the degree
to which the interior design should address aging, loss of visual acuity,
other physical and mental disabilities, and abusiveness. (See VA Interior
Design Manual.) Some important aspects of creating a therapeutic interior
are:
1. Using familiar and culturally relevant materials wherever consistent
with sanitation and other functional needs
2. Using cheerful and varied colors and textures, keeping in mind that
some colors are inappropriate and can interfere with provider
assessments of patients' pallor and skin tones, disorient older or
impaired patients, or agitate patients and staff, particularly some
psychiatric patients .
3. Admitting ample natural light wherever feasible and using colorcorrected lighting in interior spaces which closely approximates
natural daylight
4. Providing views of the outdoors from every patient bed, and
elsewhere wherever possible; photo murals of nature scenes are
helpful where outdoor views are not available
5. Designing a "way-finding" process into every project. Patients,
visitors, and staff all need to know where they are, what their
destination is, and how to get there and return. A patient's sense of
competence is encouraged by making spaces easy to find, identify,
and use without asking for help. Building elements, color, texture, and
pattern should all give cues, as well as artwork and signage.
Sumber:
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Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Cleanliness and Sanitation
1.
2.
3.
4.
5.
Hospitals must be easy to clean and maintain. This is facilitated by:
Appropriate, durable finishes for each functional space
Careful detailing of such features as doorframes, casework, and finish
transitions to avoid dirt-catching and hard-to-clean crevices and joints
Adequate and appropriately located housekeeping spaces
Special materials, finishes, and details for spaces which are to be kept
sterile, such as integral cove base. The new antimicrobial surfaces
might be considered for appropriate locations.
Incorporating O&M practices that stress indoor environmental quality
(IEQ)
SANITASI RUMAH SAKIT
Dalam lingkup Rumah Sakit (RS), sanitasi berarti upaya pengawasan berbagai faktor
lingkungan fisik, kimiawi dan biologik di RS yang menimbulkan atau mungkin dapat
mengakibatkan pengaruh buruk terhadap kesehatan petugas, penderita, pengunjung
maupun bagi masyarakat di sekitar RS.
Dari pengertian di atas maka sanitasi RS merupakan upaya dan bagian yang tidak
terpisahkan dari sistem pelayanan kesehatan di RS dalam memberikan layanan dan
asuhan pasien yang sebaik-baiknya, )(arena tujuan dari sanitasi RS tersebut adalah
menciptakan kondisi lingkungan RS agar tetap bersih, nyaman, dan dapat mencegah
terjadinya infeksi silang serta tidak mencemari lingkungan.
Dalam pelaksanaannya sanitasi RS seringkali ditafsirkan secara sempit, yakni hanya
aspek kerumahtanggaan (housekeeping) seperti kebersihan gedung, kamar mandi
dan WC, pelayanan makanan minuman. Ada juga kalangan yang menganggap
bahwa sanitasi RS hanyalah merupakan upaya pemborosan dan tidak berkaitan
langsung dengan pelayanan kesehatan di RS.
Sumber: http://tofan-nuralam.blogspot.com/2009/11/sanitasi-rumah-sakit.html
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Accessibility
All areas, both inside and out, should:
1. Comply with the minimum requirements of the Americans with Disability Act (ADA)
and, if federally funded or owned, the GSA's ABA Accessibility Standards
2. In addition to meeting minimum requirements of ADA and/or GSA's ABA
Accessibility Standards, be designed so as to be easy to use by the many patients
with temporary or permanent handicaps
3. Ensuring grades are flat enough to allow easy movement and sidewalks and
corridors are wide enough for two wheelchairs to pass easily
4. Ensuring entrance areas are designed to accommodate patients with slower
adaptation rates to dark and light; marking glass walls and doors to make their
presence obvious
Principles and a process that support accessible design include:
Laws, Codes, and Standards
Know what laws apply and which standards they reference:
Project developer (government vs. private entity)
Project use (residential, retail, office, etc.)
Funding sources (public vs. private)
Building type (new construction vs. renovation)
Housing type (Single family vs. multifamily)
Housing ownership (Condo vs. rental)
Planning for Access
Consider access early in the process and throughout all phases of the project.
Identify conflicts and synergies in context with other design objectives
Examples might include:
1. bollards as a way to address safety/security and its impact on access and
aesthetics
2. ramps vs. stairs for functional and access and aesthetics, etc.
3. retrofitting a historic building to meet access and historic preservation issues at
the same time
4. choosing sustainable materials, such as pervious pavers, consider the type of
paver selected. Those which must be installed with gaps or spaces between
them may not be suitable for use on accessible routes.
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Controlled Circulation
A hospital is a complex system of interrelated functions requiring constant
movement of people and goods. Much of this circulation should be
controlled.
1. Outpatients visiting diagnostic and treatment areas should not travel
through inpatient functional areas nor encounter severely ill inpatients
2. Typical outpatient routes should be simple and clearly defined
3. Visitors should have a simple and direct route to each patient nursing
unit without penetrating other functional areas
4. Separate patients and visitors from industrial/logistical areas or floors
5. Outflow of trash, recyclables, and soiled materials should be
separated from movement of food and clean supplies, and both
should be separated from routes of patients and visitors
6. Transfer of cadavers to and from the morgue should be out of the
sight of patients and visitors
7. Dedicated service elevators for deliveries, food and building
maintenance services
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Aesthetics
Aesthetics is closely related to creating a therapeutic environment
(homelike, attractive.) It is important in enhancing the hospital's public
image and is thus an important marketing tool. A better environment also
contributes to better staff morale and patient care. Aesthetic considerations
include:
1. Increased use of natural light, natural materials, and textures
2. Use of artwork
3. Attention to proportions, color, scale, and detail
4. Bright, open, generously-scaled public spaces
5. Homelike and intimate scale in patient rooms, day rooms, consultation
rooms, and offices
6. Compatibility of exterior design with its physical surroundings
Aesthetics is a branch of philosophy devoted to beauty. It dissects the visual
compositional elements like proportion and line, as well as other formal
qualities—auditory, tactile, olfactory, thermal, and even kinesthetic—that
achieve beauty. Moreover, aesthetics involves studying concepts that may
underlie the stamp of beauty, such as political context or expression of
status. In the case of architecture, underlying concepts may also include
imageable form, a sense of place, and interpretation of available technology.
Not surprisingly, then, theories of beauty vary to reflect currents of thought in
societies. It is free of specific values.
Sumber:
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Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
One way to become acquainted with the possibilities of an architectural
commission is to become familiar with a number of buildings of the
same type. In addition, this branch of the WBDG is designed primarily to
help those not familiar with architectural design terminology to
understand the basic process, techniques, and language by which
architectural concepts become reality. Toward that end, the following
strategies are recommended:
1.
Understanding the Appropriate Language and Elements of Design
Architects use specific terminology to describe fundamental
elements of a building, and to assess its design quality. A client's
fluency with this vocabulary improves the architect's application of
the elements it represents.
2.
Engage the Integrated Design Process
An integrated design process interlaces the multiple design
disciplines that inform a building. A series of steps can provide an
orderly flow to this dialogue, and the full and constructive
participation of all members of the design and delivery team will
help assure the best results.
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Security and Safety
In addition to the general safety concerns of all buildings, hospitals have
several particular security concerns:
1. Protection of hospital property and assets, including drugs
2. Protection of patients, including incapacitated patients, and staff
3. Safe control of violent or unstable patients
4. Vulnerability to damage from terrorism because of proximity to highvulnerability targets, or because they may be highly visible public
buildings with an important role in the public health system.
The design and construction of secure and safe buildings (free from danger or risk of
harm) continues to be the primary goal for owners, architects, engineers, project
managers, and other stakeholders .
In addition to those listed, other stakeholders include: construction managers, developers,
facilities managers, code officials, fire marshals, building inspectors, city/county/state
officials, emergency managers, law enforcement agencies, lenders, insurers, and product
manufacturers. Realizing this goal is often a challenge due to funding limitations,
resistance from the occupants due to impacts on operations, productivity and accessibility,
and the impacts on the surrounding environment and building architecture due to
perimeter security, hardening, and standoff requirements. Understanding the impact site
security has on the overall security of the building is important as well.
A balance between the security and safety goals and the other design objectives and
needs of the facility can be attained. The establishment of an integrated design process
where all of the design team members understand each other's goals can aid in
overcoming these challenges and will lead to the development of a solution which
addresses all of the requirements. Understanding the interrelationship with the other
WBDG design objectives (i.e., Sustainable, Aesthetics, Cost-Effective, Historic
Preservation, Accessible, Functional / Operational and Productive), early in the design
process, is an essential step in overcoming the obstacles commonly encountered in the
achievement of a secure and safe building.
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Sustainability
Hospitals are large public buildings that have a significant impact on
the environment and economy of the surrounding community. They
are heavy users of energy and water and produce large amounts of
waste. Because hospitals place such demands on community
resources they are natural candidates for sustainable design.
Building construction and operation have extensive direct and indirect impacts
on the environment. Buildings use resources such as energy, water and raw
materials, generate waste (occupant, construction and demolition) and emit
potentially harmful atmospheric emissions. Building owners, designers and
builders face a unique challenge to meet demands for new and renovated
facilities that are accessible, secure, healthy, and productive while minimizing
their impact on the environment.
Considering the current economic challenges, retrofitting an existing building
can be more cost effective than building a new facility. Designing major
renovations and retrofits for existing buildings to include sustainability
initiatives reduces operation costs and environmental impacts, and can
increase building resiliency.
The main objectives of sustainable design are to avoid resource depletion of
energy, water, and raw materials; prevent environmental degradation caused
by facilities and infrastructure throughout their life cycle; and create built
environments that are livable, comfortable, safe, and productive.
Sumber:
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Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
While the definition of sustainable building design is constantly changing,
six fundamental principles persist.
Optimasi Tapak / Struktur yang ada
Creating sustainable buildings starts with proper site selection, including
consideration of the reuse or rehabilitation of existing buildings. The
location, orientation, and landscaping of a building affect the local
ecosystems, transportation methods, and energy use. Incorporate Smart
growth principles in the project development process, whether it be a
single building, campus or military base. Siting for physical security is a
critical issue in optimizing site design, including locations of access roads,
parking, vehicle barriers, and perimeter lighting. Whether designing a new
building or retrofitting an existing building, site design must integrate with
sustainable design to achieve a successful project. The site of a
sustainable building should reduce, control, and/or treat stormwater
runoff.
Optimasi Penggunaan Energi
With America's supply of fossil fuel dwindling, concerns for energy
independence and security increasing, and the impacts of global climate
change arising, it is essential to find ways to reduce load, increase
efficiency, and utilize renewable energy resources in federal facilities.
Improving the energy performance of existing buildings is important to
increasing our energy independence. Government and private sector
organizations are committing to net zero energy buildings in the next
decade or so as a way to significantly reduce our dependence on fossil
fuel.
Konservasi Air
In many parts of the country, fresh water is an increasingly scarce
resource. A sustainable building should use water efficiently, and reuse or
recycle water for on-site use, when feasible.
Sumber:
http://www.wbdg.org/design/hospital.php….. Diunduh 6/4/2012
Building Attributes OF GREEN HOSPITAL
by Robert F. Carr
NIKA Technologies, Inc. for VA Office of Construction & Facility Management (CFM)
Revised by the WBDG Health Care Subcommittee
Last updated: 04-21-2011
Use Environmentally Preferable Products
A sustainable building is constructed of materials that minimize lifecycle environmental impacts such as global warming, resource
depletion, and human toxicity. Environmentally preferable materials
have a reduced effect on human health and the environment and
contribute to improved worker safety and health, reduced liabilities,
reduced disposal costs, and achievement of environmental goals.
Enhance Indoor Environmental Quality (IEQ)
The indoor environmental quality (IEQ) of a building has a significant
impact on occupant health, comfort, and productivity. Among other
attributes, a sustainable building maximizes daylighting; has
appropriate ventilation and moisture control; and avoids the use of
materials with high-VOC emissions. Additionally, consider ventilation
and filtration to mitigate chemical, biological, and radiological attack.
Optimize Operational and Maintenance Practices
Considering a building's operating and maintenance issues during the
preliminary design phase of a facility will contribute to improved
working environments, higher productivity, reduced energy and
resource costs, and prevented system failures. Encourage building
operators and maintenance personnel to participate in the design and
development phases to ensure optimal operations and maintenance
of the building. Designers can specify materials and systems that
simplify and reduce maintenance requirements; require less water,
energy, and toxic chemicals and cleaners to maintain; and are costeffective and reduce life-cycle costs. Additionally, design facilities to
include meters in order to track the progress of sustainability
initiatives, including reductions in energy and water use and waste
generation, in the facility and on site.
Sumber:
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. Even Hospitals are Going Green
Published: Monday, February 23, 2009, 2:40 PM Updated: Thursday, January 14, 2010,
3:19 PM
By Carol Ann Campbell The Star-Ledger
Jersey hospitals are creating healthier environments, inside and out. Vegetative
rooftop, solar panels, cogeneration units, giant sun-deflecting louvers, nontoxic
paints.
Could this be the latest headquarters for a high-tech start-up?
Well, not exactly. There is one other item -- the biodegradable bed pan -- that tells
you right away this is a "green" hospital.
New Jersey medical centers, some saddled with the country's oldest buildings, are
making efforts big and small to be kinder to the environment.
Hospital executives say measures to go green fit well with their mission to heal, and
often make economic sense.
"The health of our patients and the health of our environment are both important to
us," said Barry S. Rabner, president and CEO of Princeton HealthCare System, one
of two new hospitals being built with technology that will make them among the
greenest in the nation.
Rabner is overseeing creation of the new University Medical Center at Princeton, a
$442 million hospital in Plainsboro with all the latest environmentally conscious bells
and whistles. For example:
The building will face south to let natural light into hospital rooms. Sensors will
reduce artificial light in each room based on how much natural light is present. A
system of giant louvers will regulate how much sun comes into the building and
reduce the amount of energy needed.
Carbon dioxide sensors will adjust temperatures based on the number of people in
a room. The hospital system will create a 32-acre park that will restore the shoreline
of Millstone River, create a bike path and plant indigenous, low-maintenance
shrubs. There will be no vast lawns in need of insecticide and fertilizer.
The hospital, which should be completed by 2011, will have a rainwater collection
system and solar panels. No wonder other hospital executives with tight budgets
and old buildings may be, well, green with envy.
"When we set out to build this project in 2002, we developed a series of guiding
principles, and one was a commitment to creating an environmentally responsible
and sustainable building," Rabner said.
Virtua Health, with headquarters in Marlton, also is building a new hospital from the
ground up to replace the system's facility in Voorhees, Camden County.
Sumber:
http://www.nj.com/insidejersey/index.ssf/2009/02/surgical_green.html…..
Diunduh 6/4/2012
KONSEP GREEN HOSPITAL
Sustainable healthcare – for patients and the environment
Healthcare too has witnessed a paradigm shift regarding the use of
energy and raw materials. Both ecological and economical requirements
exacerbate the challenge of creating sustainable infrastructure solutions
for cities as well as rural areas. Siemens helps hospitals to pave the way
into a sustainable future – with Green+ Hospitals.
The modular Green+ Hospitals concept offers means to address both
economical and ecological demands in healthcare. This helps hospitals
reduce energy costs through energy optimization, building automation
and the use of energy-saving equipment, while simultaneously ensuring
more comfort for patients. In parts this can be achieved by low dose
technology in computed tomography. Over the years, Siemens has been
highly successful in integrating many innovations into its scanners that
significantly reduce radiation dose in comparison to other systems
available on the CT market. In addition Siemens has issued a “Guide to
Low Dose” that gives a detailed explanation of the functions currently
available to reduce the dose in radiological imaging from Siemens. A
smooth and safe workflow with structured clinical pathways, short
examination times and the comprehensive use of IT are also key to the
economic efficiency of a hospital.
In February 2010, the China Hospital Association and Siemens agreed
on a strategic paper on Green Hospital development. The aim is to
implement a Green Standard for China’s hospitals. Furthermore,
Siemens Healthcare and Huashan Hospital in Shanghai agreed to
develop integrated approaches combining in vivo and in vitro diagnostic
solutions.
Doctors also plan to combine the advantages of traditional Chinese
medicine with those of Western science. To keep medical technology at
the forefront of these changes, Siemens is working with Chinese
partners to develop new treatment methods.
Sumber: https://w1.siemens.com.cn/sustainable-city-en/sustainable-city.html ….. Diunduh
6/4/2012
Green plus Efficiency plus Quality: with Green+ Hospitals, each step toward
one success factor also impacts the other success factors – to achieve a
sustainable healthcare infrastructure..
Konsep Green+ Hospital
Efisiensi
Sustainable
Healthcare
Infrastructure
Hijau
Kualitas
Sumber: https://w1.siemens.com.cn/sustainable-city-en/sustainable-city.html ….. Diunduh
6/4/2012
Green Hospital of The Future
Efficiency, quality and innovation are landmarks in this process.“Influence
the influencers“ was an internal Intel philosophy some years ago. According
to Rick Fedrizzi, President, CEO and founding chairman of the U.S. Green
Building Council: “The health care industry can benefit from the practice of
Green Building design and construction.“ The reason why was clear: The
health care sector and especially the hospital, accounts for almost one tenth
of the country´s carbon-dioxide emissions. It needs to reduce its carbon
footprint, its volume of waste output, non-recycled water usage and energy
consumption, among other things. It was one of the best kept secrets in the
past but it’s out now: Hospitals present an even greater ecological hazard
than office buildings.
Sumber:
http://greenhospital-blog.com/?p=995….. Diunduh 6/4/2012
Future Scenarios for the Green Hospital of the Future
The most important drivers for the proposed-future scenario:
1.
2.
3.
4.
5.
6.
7.
8.
The consequences of global climate change will pose daunting
challenges, combined with a confluence of geopolitical hostilities
over the exhaustion of oil and fresh water reserves.
The downsizing and redeployment of healthcare accelerates the
functional deconstruction of the hospital. Medical care will be
widely dispersed across an increasing number of small-scale
micro-hospitals and clinics.
By 2050, the home and not the hospital, will become the center of
the healthcare universe. Health promotion (sickness prevention)
will be limited only by global discrepancies between high-tech
versus low-tech societies.
The physical space at present separating the individual from
contact with the natural environment, will gradually diminish.
Buildings for Health will increasingly express anthropomorphic
and organic forms …
The digital divide will continue to separate the haves from the
have-nots in the global healthcare landscape. The internet can
significantly advance patient-centred care and sickness
prevention but by 2050 the expert, empowered patient may exist
only in cultures wealthy enough to afford sophisticated technology.
Progressive architecture for health will express the compatible
values of both human and ecological health. Conservation will
need to find new uses for abandoned hospitals and to create
carbon-neutral healing environments.
A multifaceted discipline will merge design with the health
sciences.
Eco-humanist hospitals will advocate for quality of life issues and
sickness prevention.
Sumber:
http://greenhospital-blog.com/?p=995 ….. Diunduh 6/4/2012
TOGETHER FOR A GREEN HOSPITAL OF THE FUTURE
These networks serve to address all questions concerning the
challenges of the future. A hospital is not an island, it has to consider
hundreds maybe thousands of aspects in the creation of a Green
Hospital. This can only be achieved together. No hospital, no political
initiative, no industrial corporation, no organisation or health insurance
company can achieve this alone. What is required is the active support
and a sustained commitment by all, for a Green Hospital of the Future
to be realised. The Asklepios Hospital Group initiated the Green
Hospital Program for this reason.
The Green Hospital Program is an initiative that would like to present
hospitals and healthcare facilities with innovative models of efficiency
and quality, as well as relevant solution scenarios, that contribute
towards achieving the following objectives in new hospital
construction, renovation or modernisation measures:
1.
2.
3.
Significant environmental benefits through economically and
ecologically sensitive handling of natural resources in a Green
Hospital.
Protection and promotion of the health and wellbeing of the people
in the Green Hospital. Prevention in medical care.
Future-proof design and thus a more careful handling of natural
resources through environmentally responsible and sustainable
construction methods, based on energy-efficient technologies and
use of environmentally-friendly and ‘healthy’ building materials.
Sumber:
http://greenhospital-blog.com/?p=995….. Diunduh 6/4/2012
GREEN HOSPITAL PROGRAM
Everyone, however, who would like to play a role in significantly shaping
the future will need to approach, at greatly differing levels, the complex
relationships within the environmental system and the healthcare system.
Similar to a giant puzzle are the direct and indirect effects of the
construction and operation of a Green Hospital of the Future in relation to
its environmental impact, its medical and health-promoting facilities and
quality, and its social responsibilities that we have to analyse and then
implement when the time comes .
Here we have an overview of the key aspects and action levels of the
Green Hospital Program in each division: Green Health & Care, Green
Patient, Green Building und Green Healthcare IT.
Sumber:
http://greenhospital-blog.com/?p=995….. Diunduh 6/4/2012
GREEN HOSPITAL PROGRAM
Hospitals, in fact the entire health sector would lose the opportunity to
assume the leadership role I described earlier.
We must not only focus on a Green Building and its lifecycle, we need to see
the big picture here, a picture that places the Green Hospital in a meaningful
context with environmental changes, with social changes, with new ecological
challenges.
.
Sumber:
http://greenhospital-blog.com/?p=995 ….. Diunduh 6/4/2012
RUMAH SAKIT HIJAU DI MASA DEPAN
For a Green Hospital of the Future, for ecological sustainability and a
qualitative responsibility for the future of healthcare, for the protection
and wellbeing of the patient, and the environment. That is our objective,
that is our vision. And we are already making a start on it today – we
have commenced the Green Hospital Program in many of our hospitals.
In this context, GREEN can also be a part of the service mission of the
healthcare industry of tomorrow.
If we accept that we are at the beginning of a long and at times difficult
journey, the aim of which is to change a great many areas of our
contemporary health care system that need to change.
RUMAH SAKIT HIJAU
Adanya berbagai laporan mengenai dampak kerusakan lingkungan dan ekosistem
dunia pada dekade belakangan, seperti peningkatan suhu global dan efek rumah
kaca, banjir tahunan, gempa, dsb. akhirnya menyadarkan manusia untuk lebih
memperhatikan lingkungan dan keseimbangan ekosistem. Hal ini tidak luput dari
perhatian para pimpinan dan profesional di RSUP Persahabatan.
Pihak manajemen periode Direktur Utama Dr. Agung Sutiyoso mulai mengakomodir
prinsip “ramah lingkungan dan ekosistem” melalui pencanangan strategi pelayanan
rumah sakit berbasis kenyamanan dan keamanan lingkungan dengan tipologi
masyarakat perkotaan. Pendekatan mutu pelayanan paripurna yang telah
dilaksanakan di Rumah Sakit Persahabatan, dikembangkan lebih jauh menjadi rumah
sakit yang berwawasan ekologis, yaitu menjadikan lingkungan hijau rumah sakit
menjadi kekuatan (strength) untuk mendukung peningkatan mutu pelayanan rumah
sakit. Diharapkan dengan menciptakan lingkungan rumah sakit yang lebih hijau,
natural, alami, dan dekat dengan alam; dapat memberikan rasa nyaman dan aman
bagi pasien yang berkunjung dan yang dirawat, sehingga mempercepat proses
penyembuhan sekaligus sebagai sarana relaksasi tidak hanya bagi pasien, tetapi
juga untuk keluarga, pengunjung, dan pegawai RSUP Persahabatan sendiri.
(SUMBER:
http://www.persahabatan.co.id/index.php?option=com_content&view=article&id=93&It
emid=517)
Sumber:
http://greenhospital-blog.com/?p=995….. Diunduh 6/4/2012
04/11/2011 09:07:41 AM
PERSI (PERHIMPUNAN RUMAHSAKIT INDONESIA)
Komite Green Hospital
Keberadaan rumah sakit di suatu wilayah dengan daya dukung lingkungan yang terbatas sering
tidak menjadi perhatian manajemen rumah sakit, padahal paradigma terkini mengajarkan bahwa
pengelola rumah sakit wajib menempatkan aspek keseimbangan ekologi, sosial dan estetika
menjadi dasar pada setiap perumusan kebijakan melalui optimalisasi pengelolaan lingkungan
hidup dan pemberdayaan, sehingga keberadaan rumah sakit dengan kompleksitas kegiatannya
tidak menambah beban negatif berupa pencemaran lingkungan, bahkan memberikan manfaat
positif bagi kelestarian lingkungan masyarakat sekitar. Disisi lain pola
tuntutan kebutuhan masyarakat modern akan layanan rumah sakit juga telah bergeser kepada
tuntutan pelayanan kesehatan yang berbasis prinsip ramah lingkungan, karena masyarakat
menyadari bahwa jaminan kenyamanan dan keamanan lingkungan selama berinteraksi di
lingkungan rumah sakit merupakan bagian pelayanan yang akan mereka peroleh sebagai satu
kesatuan pelayanan prima di rumah sakit.
Rumah sakit ramah lingkungan saat ini menjadi salah satu kebutuhan dalam manajemen
perubahan yang sedang dikembangkan dibanyak rumah sakit. Penerapan rumah sakit ramah
lingkungan merupakan bagian dari alasan mengapa rumah sakit perlu berubah menuju pada
pemenuhan konsep industri pelayanan kesehatan sesuai kebutuhan pasar dan masyarakat.
Kebutuhan pasar dan masyarakat terkini akan industri pelayanan kesehatan telah bergeser
menuju industri dengan pelayanan yang memuaskan, aman, nyaman dan menjamin pengguna
tidak menerima akibat negatif dari kegiatan pelayanannya.
Perhimpunan Rumah Sakit Indonesia sangat perduli dengan masalah-masalah yang berkaitan
dengan mutu pelayanan, keselamatan pasien, maupun masalah lingkungan. Sebagai wujud dari
keperdulian dan komitmen PERSI dengan masalah lingkungan, maka sejak tahun 2009
dibentuklah komite Green Hospital yang memiliki visi dan misi sebagai berikut :.
Sumber:
http://www.pdpersi.co.id/content/news.php?mid=5&catid=8&nid=605…..
Diunduh 6/4/2012
INTEGRATED HOSPITAL MANAGEMENT SYSTEM
The Integrated Hospital Management System handles the day-to-day,
and budgetary activities of the hospital.
The purpose of the software is to manage the hospital and its
patients.
This relates to managing patient information, managing the
administration of the hospital, managing doctor itineraries, providing
the management with MIS information, etc.
The module description, and the workflows that are illustrated in this
document serve to assist in making an assessment, and to gain a
rudimentary understanding of the solution deliverables.
Module List
- Registration Management
- Appointments Management
- OPD Management
- Emergency Services Management
- Floor (Ward) Management
- IO Billing Module
- Laboratory Management
- Investigations Management
- Diet Management
- Operation Theatre Management
- Medical Records Maintenance
- Packages Management
- Pharmacy Management
- Blood Bank Management
- Central Sterile Supply Management
- Financial Accounts Management
- Accounts Receivables Module
- Accounts Payables Module
- Stores And Inventory Management
- Personnel And Payroll Management
- Time Attendance Module
- Gate Pass Management
- Statistical Analysis And Statutory Reports
- MIS Reports And Graphs.
Sumber:
http://www.indosoftsys.com/ihms.htm….. Diunduh 6/4/2012
HOSPITAL MANAGEMENT SYSTEM
.
Sumber:
http://nvish-hospital-management-system.blogspot.com/….. Diunduh 6/4/2012
BEBERAPA KONSEP DASAR TENTANG
MANAJEMEN RUMAH SAKIT
A. Rumah Sakit
1.
Pengertian Rumah Sakit
Beberapa pengertian rumah sakit adalah:
a. Menurut Assosiation of Hospital Care (1947) Rumah sakit adalah pusatdimana pelayanan
kesehatan masyarakat, pendidikan serta penelitiankedokteran diselenggarakan
b. Menurut American Hospital Assosiation (1974) rumah sakit adalah suatualat organisasi yang
terdiri tenaga medis professional yang terorganisir serta sarana kedokteran yang permanen
menyelenggarakan pelayanankedokteran, asuhan keperawatan yang berkesinambungan,
diagnosis sertapengobatan penyakit yang diderita oleh pasien.
c. menurut Wolper dan Pena (1997) rumah sakit adalah tempat dimanaorang sakit mencari dan
menerima pelayanan kedokteran serta tempatdimana pendidikan klinik untuk mahasiswa
kedokteran, perawat dantenaga profesi kesehatan lainya diselenggarakan
(Sumber: Azwar, Azrul. 1996. Pengantar Administrasi Kesehatan. Edisi III PT Bina Rupa
Aksara,Jakarta).
2.Fungsi rumah sakit
Permenkes RI No. 159b/Men kes/Per/1998, fungsi rumah sakit adalah :
a. Menyediakan dan menyelenggarakan pelayanan medik, penunjang medik.rehabilitasi,
pencegahan dan peningkatan kesehatan..
b. Menyediakan tempat pendidikan dan atau latihan tenaga medik danparamedik.]
c. sebagai tempat penelitian dan pengembangan ilmu dan teknologi bidangkesehatan.
Fungsi-fungsi ini dilaksanakan dalam kegiatan intramural (didalam rumah sakit)dan ekstramural (di
luar rumah sakit). kegiatan intramural dibagi menjadi 2 kelompok besar yaitu pelayanan rawat inap
dan pelayanan rawat jalan
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
DEFINISI RUMAH SAKIT
Rumah sakit itu sebuah tempat, tetapi juga sebuah fasilitas, sebuah
institusi, sebuah organisasi. Untuk dapat mengatur rumah sakit
dengan baik maka seseorang tentu harus dapat mendefinisikannya
dengan tepat pula.
Definisi yang paling klasik hanya menyatakan bahwa rumah sakit
adalah institusi (fasilitas) yang menyediakan pelayanan pasien rawat
inap, ditambah dengan beberapa penjelasan lain.
American Hospital Association tahun 1978 menyatakan bahwa rumah
sakit adalah suatu institusi yang fungsi utamanya adalah memberikan
pelayanan kepada pasien, diagnostik dan terapeutik untuk berbagai
penyakit dan masalah kesehatan, baik yang bersifat bedah maupun
non bedah.
SK menteri Kesehatan RI No. 983/Menkes/SK/XI/1992 menyebutkan
bahwa rumah sakit umum adalah rumah sakit yang memberikan
pelayanan kesehatan yang bersifat dasar, spesialistik dan sub
spesialistik.
Manajemen Rumah Sakit
Manajemen rumah sakit adalah koordinasi antara berbagai sumber
daya (unsur manajemen) melalui proses perencanaan,
pengorganisasian, ada kemampuan pengendalian untuk mencapai
tujuan rumah sakit seperti : Menyiapkan sumber daya, mengevaluasi
efektivitas, mengatur pemakaian pelayanan, Efisiensi, Kualitas.
Banyak definisi manajemen yang ada, dan masing-masing akan
menunjukkan penekanan tertentu, yang penting diambil pada pokok
fungsi manajemen dan unsur dari manajemen.
Sumber:
http://manaje-men.com/manajemen.rumah.sakit.html….. Diunduh 6/4/2012
MUTU PELAYANAN RUMAH SAKIT
Mutu pelayanan rumah sakit adalah derajat kesempurnaan rumah
sakituntuk memenuhi permintaan konsumen akan pelayanan
kesehatan yang sesuaidengan standart profesi dan standart
pelayanan dengan menggunakan potensisumber daya yang tersedia
di rumah sakit dengan wajar , efisien dan efektif serta diberikan secara
aman dan memuaskan sesuai dengan norma, etika,hukum dan sosio
budaya dengan memperhatikan keterbatasan dan
kemampuanpemerintah dan masyarakat konsumen.
Faktor - faktor yang menentukan mutu pelayanan rumah sakit yaitu:
1. Kehandalan yang mencakup dua hal pokok, yaitu konsistensi
kerja dankemampuan untuk dipercaya.
2. Daya tangkap, yaitu sikap tanggap para karyawan melayani saat
dibutuhkanpasien.
3. Kemampuan, yaitu memiliki keterampilan dan pengetahuan yang
dibutuhkanagar dapat memberikan jasa tertentu.
4. Mudah untuk dihubungi dan ditemui.
5. Sikap sopan santun, respek dan keramahan para pegawai.
6. Komunikasi, yaitu memberikan informasi kepada pelanggan
dalam bahasayang dapat mereka pahami, serta selalu
mendengarkan saran dan keluhanpelanggan.
7. Dapat dipercaya dan jujur.
8. Jaminan keamanan
9. Usaha untuk mengerti dan memahami kebutuhan pelanggan.
10. Bukti langsung yaitu bukti fisik dari jasa, bisa berupa fasilitas fisik,
peralatanyang digunakan, representasi fisik dan jasa.
(Sumber: Depkes RI. 1992. Standar Pelayanan Rumah Sakit, Dirjen Yanmed,
Depkes RI,Jakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
FAKTOR POKOK YANG MEMPENGARUHI MUTU
Parasuraman mengemukakan bahwa 10 faktor yang mempengaruhi
mutu yang ada dapat dirangkum menjadi 5 faktor pokok yaitu:
1.
2.
3.
4.
5.
Tangibles; bukti langsung meliputi fasilitas fisik, perlengkapan,
sarana danpenampilan pegawai.
Realibility; kehandalan yaitu kemampuan memberikan pelayanan
yang dijanjikan dengan segera, akurat dan memuaskan.
Responsiveness; daya tanggap yaitu keinginan para karyawan
dalammemberikan pelayanan dengan tanggap.
Assurance; jaminan mencakup pengetahuan, keterampilan,
kemampuan,kesopanan dan sikap dapat dipercaya dari para
karyawan, bebas daribahaya, resiko dan keragu-raguan.
Empathy; yaitu kemudahan dalam melakukan hubungan
komunikasi yangbaik, perhatian pribadi dan memahami kebutuhan
pelanggan.
(Parasuraman. A, Zeithhaml, Lavenia A, and Berry, Leonard L. 1988.
Serqual ItemScale for Measuring Consumer Perception of Servive
Quality , Journal of Retailing,64).
Sumber: http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit ….. Diunduh 6/4/2012
PELAYANAN RAWAT INAP
Pelayanan rawat inap adalah suatu kelompok pelayanan kesehatan
yangterdapat di rumah sakit yng merupakan gabungan dari beberapa
fungsipelayanan. Kategori pasien yang masuk rawat inap adalah
pasien yang perluperawatan intensif atau observasi ketat karena
penyakitnya.
Menurut Revans (1986 ) bahwa pasien yang masuk pada pelayanan
rawat inap akan mengalami tingkat proses transformasi, yaitu:
1.
2.
3.
4.
5.
Tahap Admission, yaitu pasien dengan penuh kesabaran dan
keyakinandirawat tinggal di rumah sakit.
Tahap Diagnosis, yaitu pasien diperiksa dan ditegakan
diagnosisnya.
Tahap treatment, yaitu berdasarkan diagnosis pasien dimasukan
dalamprogram perawatan dan therapi.
Tahap Inspection, yaitu secara continue diobservasi dan
dibandingkanpengaruh serta respon pasien atas pengobatan.
Tahap Control, yaitu setelah dianalisa kondisinya, pasien
dipulangkan.pengobatan diubah atau diteruskan, namun dapat
juga kembali ke prosesuntuk didiagnosa ulang.
(Tim Dep. Kes RI. 1991. Konsep dan Proses Keperawatan, Cetakan I,
Jakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
KUALITAS PELAYANAN RAWAT INAP
Menurut Jacobalis ( 1990 ) kualitas pelayanan kesehatan di ruang
rawat inap rumah sakit dapat diuraikan dari beberapa aspek,
diantaranya adalah:
1.
2.
3.
4.
Penampilan keprofesian atau aspek klinis. Aspek ini menyangkut
pengetahuan, sikap dan perilaku dokter dan perawatdan tenaga
profesi lainya.
Efisiensi dan efektifitas. Aspek ini menyangkut pemanfaatan
semua sumber daya di rumah sakit agar dapat berdaya guna dan
berhasil guna.
Keselamatan Pasien. Aspek ini menyangkut keselamatan dan
keamanan pasien.
Kepuasan Pasien. Aspek ini menyangkut kepuasan fisik, mental,
dan sosial pasien terhadaplingkungan rumah sakit, kebersihan,
kenyamanan, kecepatan pelayanan,keramahan, perhatian, biaya
yang diperlukan dan sebagainya.
(Sumber: Jacobalis Samsi. 2000. Kumpulan Tulisan terpilih tentang Rumah Sakit
Indonesiadalam Dinamika Sejarah, Transformasi, Globalisasi dan Krisis
Nasional , penerbit IDI, Jakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
MUTU LAYANAN RAWAT INAP
Menurut Adji Muslihuddin (1996), Mutu asuhan pelayanan rawat inap
dikatakan baik apabila :
1. Memberikan rasa tentram kepada pasienya yang biasanya orang
sakit.
2. Menyediakan pelayanan yang benar benar profesional dari setiap
stratapengelola rumah sakit. Pelayanan ini bermula sejak masuknya
pasien kerumah sakit sampai pulangnya pasien.
1.
2.
3.
4.
5.
6.
Sumber:
Dari kedua aspek ini dapat diartikan sebagai berikut:
Petugas penerima pasien dalam melakukan pelayanan terhadap
pasienharus mampu melayani dengan cepat karena mungkin pasien
memerlukanpenanganan segera.
Penanganan pertama dari perawat harus mampu membuat pasien
menaruhkepercayaan bahwa pengobatan yang diterima dimulai
secara benar.
Penanganan oleh para dokter yang profesional akan
menimbulkankepercayaan pasien bahwa mereka tidak salah
memilih rumah sakit.
Ruangan yang bersih dan nyaman, memberikan nilai tambah
kepada rumahsakit.
Peralatan yang memadai dengan operator yang profesional.
Lingkungan rumah sakit yang nyaman.
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
PELAYANAN TENAGA MEDIS
Tenaga medis merupakan unsur yang memberikan pengaruh
palingbesar dalam menentukan kualitas dari pelayanan yang diberikan
kepada pasiendi rumah sakit. Fungsi utamanya adalah memberikan
pelayanan medik kepadapasien dengan mutu sebaik baiknya,
menggunakan tata cara dan teknikberdasarkan ilmu kedokteran dan
etik yang berlaku serta dapatdipertanggungjawabkan kepada pasien
dan rumah sakit.
Donabedian (1980), mengatakan bahwa perilaku dokter dalam
aspekteknis manajemen, manajemen lingkungan sosial, manajemen
psikologi danmanajemen terpadu, manajemen kontinuitas, dan
koordinasi kesehatan danpenyakit harus mencakup beberapa hal ,
yaitu:
1.
2.
3.
4.
Ketepatan diagnosis
Ketepatan dan kecukupan therapi
Catatan dan dokumen pasien yang lengkap
Koordinasi perawatan secara kontinuitas bagi semua anggota
keluarga.
(Sumber: Donabedian, A.V. 1980. Exploration In Quality Assesment and
Monitoring, Michigan,USA).
Sumber:
….. Diunduh 6/4/2012
PELAYANAN TENAGA PERAWAT / PARAMEDIS.
Pelayanan perawatan di rumah sakit merupakan bagian integral
daripelayanan rumah sakit secara menyeluruh, yang sekaligus
merupakan tolokukur keberhasilan pencapaian tujuan rumah sakit,
bahkan sering menjadi faktor penentu citra rumah sakit di mata
masyarakat.
Keperawatan sebagai suatu profesi di rumah sakit yang cukup
potensialdalam menyelenggarakan upaya mutu, karena selain jumlahnya
yang dominan juga pelayananya menggunakan pendekatan metode
pemecahan masalahsecara ilmiah melalui proses keperawatan.
Asuhan Keperawat meliputi:
1.
2.
Pelayanan keperawatan (Nursing Service) adalah seluruh fungsi,
tugas,kegiatan dan tanggung jawab yang dilaksanakan oleh seorang
perawatdalam praktek profesinya.
Asuhan keperawatan ( Nursing Care ) adalh suatu pelayanan
keperawatanlangsung berupa bantuan , bimbingan, penyuluhan,
pengawalan atauperlindungan yang diberikan seorang perawat untuk
memenuhi kebutuhan pasien.
(Sumber: Tim Dep. Kes RI,. 1991. Konsep dan Proses Keperawatan,
Cetakan I, Jakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
PENYEDIAAN SARANA MEDIK, NON MEDIK, DAN OBAT
OBATAN
Standart peralatan yang harus dimiliki oleh rumah sakit sebagaipenunjang
untuk melakukan diagnosis, pengobatan, perawatan dan
sebagainyatergantung dari tipe rumah sakit, disamping tersedianya sarana
penunjangmedik juga perlu tersedia alat alat keperawatan.
Dalam rumah sakit, obat merupakan sarana yang mutlak diperlukan, bagian
farmasi bertanggung jawab atas pengawasan dan kualitas obat.
Persediaan obat harus cukup, penyimpanan efektif, diperhatikan tanggal
kadaluarsanya, dan sebagainya.
(Bouwhuizen,M. 1996. Ilmu Keparawatan, Bagian I, EGC Penerbit Buku
Kedokteran,Jakarta).
LAYANAN RUMAH SAKIT
Salah satu yang sangat dekat dengan masyarakat adalah pelayanan Rumah sakit
yang saat ini sedang menjamur diberbagai tempat. Bahkan banyak Rumah sakit
dibangun dan berlomba-lomba untuk meningkatkan mutu pelayanan di Rumah sakit,
dikarenakan persaingan yang kuat di tiap-tiap Rumah sakit.
Hal-hal yang perlu diketahui adalah : Sesungguhnya Rumah sakit dikota Jakarta saja
sudah mulai menjamur dan Rumah sakit harus memperhatikan didalam peningkatkan
mutu pelayanan yang ada.
Masyarakat bukan saja membutuhkan sebuah kesembuhan, tetapi juga sebuah
pelayanan yang sangat diharapkan oleh masyarakat, sehingga pada saat masyarakat
ke Rumah sakit untuk berobat maka masyarakat merasa nyaman dan tidak takut
atau curiga dikarenakan pihak Rumahsakit melayani sungguh-sungguh.
Ada 2 hal yang saling berkaitan didalam pelayanan peningkatan dan mutu pelayanan
RS yaitu : pelayanan medik dan penunjang medik.
Pelayanan medik menyangkut sebuah pelayanan medis dimana yang terlibat adalah
dokter dan pasien bagaimana membangun dan meningkatkan kepercayaan
masyarakat tehadap dokter. Sedangkan penunjang medis adalah hal-hal yang
menyangkut diatas seperti Apotik, Radiologi, Laboratorium , Front office, Rekam
Medis atau didalam penyimpanan data.
(SUMBER:
http://management.co.id/journal/index/category/strategic_management/246/0)
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit ….. Diunduh 6/4/2012
PERSEPSI DAN HARAPAN PELANGGAN RUMAH SAKIT
Menurut Gilson, dkk (1994), yang menjadi elemen penting dalam
menentukan harapan masyarakat terhadap pelayanan kesehatan:
1.
2.
3.
4.
5.
1.
2.
3.
4.
Kemanjuran obat, keterjangkauan biaya, tidak membutuhkan waktu
yanglama dalam proses perawatan.
Memperoleh obat merupakan faktor yang terpenting yang
mendasari polapemanfaatan pelayanan kesehatan.
Pandangan yang menyeluruh mengenai penampilan, seperti sikap
petugasyang baik, kecakapan petugas, dan hubungan petugas
dengan pasien.
Persepsi masyarakat terhadap kualitas sarana dan prasarana yang
meliputi jarak yang dapat dicapai, keadaan gedung, ruang tunggu,
privasi, dankelengkapan peralatan medis.
Persepsi masyarakat terhadap kualitas proses yang meliputi
keterampilanpetugas, kecukupan staf, biaya perawatan, dan
penjelasan pengobatan
Dalam konsep model kualitas yang dikemukakan oleh Parasuraman,
Zeithmal dan Berry (1990) yang dikenal dengan servqual
model menyatakanada empat faktor yang mempengaruhi persepsi dan
harapan pasien terhadap jasa pelayanan, yaitu:
Pengalaman dari teman (word of mouth)
Kebutuhan atau keinginan ( personal need )
Pengalaman masa lalu saat menerima jasa pelayanan ( past experience)
Komunikasi melalui iklan/ pemasaran (external communications
tocustomer).
(Parasuraman. A, Zeithhaml, Lavenia A, and Berry, Leonard L. 1988. Serqual Item Scale
for Measuring Consumer Perception of Servive Quality , Journal of Retailing,64).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
FAKTOR-FAKTOR KEPUTUSAN PELANGGAN RUMAH SAKIT
Di dalam masyarakat terdapat bermacam macam kelompok
yangmempunyai perbedaan yang menggambarkan nilai dan kekuatan
kelompoktersebut. Perbedaan ini akan mempengaruhi persepsi dan
harapan pasien. Menurut Anderson (1974) dalam buku Notoatmodjo
dkk (1989) terdapat tiga kategori utama yang mempengaruhi
pelayanan kesehatan, yaitu:
1.
Karakteristik PredisposisiMenggambarkan bahwa setiap individu
individu mempunyai kecenderunganyang berbeda beda dalam
menggunakan pelayanan kesehatan. Hal inikarena ada ciri ciri
demografi seperti jenis kelamin, umur, dan status marital,karena
struktur sosial, seperti tingkat pendidikan, pekerjaan, kesukuan
danlain lain serta keyakinan bahwa pelayanan dapat menolong
proseskesembuhan penyakit.
Karakteristik PendukungPenggunaan fasilitas pelayanan
kesehatan yang ada sangat tergantungpada kemampuan
konsumen untuk membayar.
Karakteristik KebutuhanTeori pemanfaatan pelayanan kesehatan
berkaitan erat dengan permintaanakan pelayanan kesehatan oleh
konsumen. Permintaan akan pelayanan kesehatan justru selama
ini yang meningkat. Hal ini dikarenakan penduduksudah benar
benar mengeluh sakit serta mencari pengobatan. Faktor
faktor yang mempengaruhi permintaan pelayanan kesehatan
diantaranya adalahpengetahuan tentang kesehatan, sikap
terhadap fasilitas kesehatan danpengalaman terhadap
kemampuan fasilitas kesehatan tersebut.
2.
3.
(Notoatmodjo Soekidjo. 1993. Metodologi Penelitian Kesehatan,
Rineke cipta,Jakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
PEMENUHAN PERMINTAAN PELANGGAN RUMAH SAKIT
Seringkali para manager lebih suka mengukur kepuasan
pelangganuntuk menaksir penampilan organisasinya dari pada
merencanakan strateginilai, mempelajari kebutuhan dan keinginan
pelanggan atau mengukur mutuproduk. Tingkat kepuasan pelanggan
dapat diukur dengan membandingkankesesuaian antara harapan/
keinginan dan pengalaman yang didapat merekaseperti dalam teori The
Expectancy Disconfirmation Model yang dikemukakanoleh Supranto
(1997), sebagai berikut:
Tki = Xi/Yi x 100%
Keterangan: Tki = Tingkat Kesesuaian; Xi = Skor Nilai Pengalaman; Yi =
Skor Nilai Harapan.
Bila Skor nilai pengalaman mendekati atau bahkan melebihi skor nilai
harapan/keinginan, maka pasien dapat dianggap puas terhadap mutu
pelayanan yang diterimanya. Sebaliknya, apabila skor nilai pengalaman
berada di bawah skor nilai haparan, berarti pasien tidak puas
terhadap mutu pelayanan yang diterimanya.
(Supranto, J. 2001. Pengukuran Tingkat Kepuasan Pelanggan untuk
Menaikan PangsaPasar , Rineka Cipta Cetakan II, Jakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit ….. Diunduh 6/4/2012
PEMANFAATAN RUMAH SAKIT
1. Tahap Proses Memilih Rumah Sakit
Proses membeli dari konsumen ada beberapa tahap, yaitu:
a.
b.
c.
d.
e.
Keinginan dan kebutuhan apa yang mendorong pelanggan
untukmenggunakan suatu jasa. (need arousal)
Apakah pelanggan mengumpulkan informasi berkaitan dengan
kebutuhanyang dirasakan. (information Gathering )
Bagaimana pelanggan mengevaluasi alternatif (decision
evaluation)
Bagaimana pelanggan memanfaatkan jasa rumah sakit.
(decision execution)
Bagaimana sikap pelanggan setelah memanfaatkan jasa rumah
sakit. ( post decision assessment )
(Sumber: Novi Syahrial, Drg, MARS. Mata Kuliah Manajemen
Pemasaran: AnalisisPeluang Pasar Rumah Sakit , Universitas
Indonesia, 2001.
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit ….. Diunduh 6/4/2012
Keputusan Setelah memanfaatkan jasa rumah sakit
Keputusan Setelah memanfaatkan jasa rumah sakit
Dampak setelah memanfaatkan fasilitas rumah sakit dapat berupa :
1.
2.
3.
Adanya kepuasan penuh
Adanya kepuasan sebagian
Sama sekali tidak puas terhadap fasilitas rumah sakit.
Kepuasan dikemukakan sebagai rasa lega atau senang karenaharapan atau hasrat
tentang sesuatu terpenuhi. Kepuasan mempunyaidimensi fisik, mental dan sosial.
Kepuasan pasien merupakan persepsimultidimensional yang terkait dengan struktur
proses dan outcome layanan.
Sedangkan ketidakpuasan merupakan kesenjangan anatara harapan/keinginan dan
kenyataan layanan yang diterima oleh pasien
(Jacobalis. S. 1993. Beberapa Teknis dalam Manajemen Mutu, Universitas
GadjahMada, Yogyakarta).
KEPUASAN PASIEN
Kepuasan pasien dapat dipengaruhi oleh mutu pelayanan kesehatan yang diberikan oleh
rumah sakit sebagai provider, dimana mutu pelayanan kesehatan bagi pasien berarti
empati, respek dan tanggap akan kebutuhannya, dalam hal ini kebutuhan pelayanan yang
diberikan oleh petugas kesahatan. Sedangkan mutu pelayanan kesehatan bagi petugas
berarti bebas melakukan segala sesuatu secara professional. untuk meningkatkan
derajad kesehatan pasien dan masyarakat sesuai dengan ilmu pengetahuan dan
ketrampilan yang memadai serta terlindungi aleh atuaran perundang-undangan yang
berlaku. Menurut Lori Di Prete Brown,et.al dalam bukunya Quality Assurance of
Health Care in Developing Countries, mutu pelayanan kesehatan merupakan fonomena
yang komprehensip dan multi facet. Kegiatan menjaga mutu dapat menyangkut satu atau
beberapa dimensi mutu baik untuk pelayanan klinis maupun managemen dalam
pelayanan kesehatan. Adapun dimensi mutu yang dimaksud adalah: kompentensi teknis
(technical competence), akses terhadap pelayanan (acces to service), efektivitas
(effectiveness), efisiensi (efficiency), kontinuitas (continuity), keamanan (safety),
hubungan antar manusia (interpersonal) dan kenyamanan (amenities) yang disebut
dengan delapan demensi mutu.
(SUMBER: http://ilmiahmanajemen.blogspot.com/2008/05/pengaruh-mutu-pelayananterhadap.html)
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
KONSEP KEPUASAN PELANGGAN / PASIEN
Ketidakpuasan adalah kekecewaan. Ketidakpuasan terhadap layanan
kesehatan diungkapkan dalam bentuk keluhan, protes,
kemarahan,surat terbuka dalam media masa, pengaduan kepada
ikatan profesi sampaipengaduan di pengadilan dengan tuduhan
malpraktek.
Kepuasan/ketidakpuasan layanan rumah sakit erat kaitanya dengan:
1. Dokter, perawat atau petugas lain di rumah sakit.
2. Aspek hubungan antar manusia.
3. Kemanusiaan.
4. Kenyamanan/ kemudahan fasilitas dan lingkungan
5. Peralatan dan perlengkapan.
6. Biaya pengobatan.
Dalam pengalaman sehari hari, ketidakpuasan pasien yang
palingsering dikemukakan ialah ketidakpuasan terhadap:
1.
2.
3.
4.
5.
6.
Sikap dan perilaku petugas rumah sakit atau karyawan.
Keterlambatan layanan oleh dokter/ perawat.
Dokter tertentu susah ditemukan.
Dokter kurang informatif dan komunikatif.
Lamanya proses masuk rawat.
Ketertiban dan kenyamanan lingkungan.
(Jacobalis. S. 1993. Beberapa Teknis dalam Manajemen Mutu,
Universitas GadjahMada, Yogyakarta).
Sumber:
http://www.scribd.com/doc/10911297/Nambah-Ilmu-Tentang-Manajemen-RumahSakit….. Diunduh 6/4/2012
PENERAPAN MANAJEMEN RUMAH SAKIT
Rumah sakit perlu menerapkan sistem manajemen yang berorientasi pada
kepuasan pelanggan. Untuk itu rumah sakit di Indonesia harus
menciptakan kinerja yang unggul. Kinerja yang unggul atau Performance
Excellence merupakan salah satu faktor utama yang harus diupayakan
oleh setiap organisasi untuk memenangkan persaingan global, begitu juga
oleh perusahaan penyedia jasa pelayanan kesehatan.
Banyak cara yang dapat dilakukan oleh para pengelola rumah sakit untuk
menciptakan kinerja yang unggul diantaranya melalui pemberian
pelayanan yang bagus serta tindakan medis yang akurat dan mekanisme
pengelolaan mutu tentunya.
Salah satu strategi yang dilakukan oleh pengelola rumah sakit swasta
dalam mempertahankan atau meningkatkan jumlah konsumen adalah
pelayanan. Tuntutan untuk mendapatkan pelayanan yang berkualitas dan
nyaman semakin meningkat, sesuai dengan meningkatnya kesadaran arti
hidup sehat. Keadaan ini dipengaruhi oleh tingkat pendidikan, sosial
budaya dan sosial ekonomi masyarakat yang perlu mendapat perhatian
dari pengelola rumah sakit.
Untuk memenuhi tuntutan masyarakat tersebut, di setiap kota besar seperti
Jakarta banyak sekali usaha rumah sakit dengan kualitas pelayanan dan
peralatan medis yang prima dapat kita temukan di setiap sudut kota,
sehingga masyarakat konsumen yang tadinya harus ke luar negeri demi
servis dan kualitas dokter yang prima, sekarang tidak perlu lagi ke luar
negeri.
Dalam usaha peningkatan kualitas pelayanan terhadap konsumen, rumah
sakit berusaha untuk mempunyai tenaga dokter ahli yang tetap, sekaligus
memperkerjakan dokter waktu dan dokter kontrak. Bahkan di beberapa
rumah sakit di kota besar seperti Jakarta dapat kita jumpai pelayanan Unit
Gawat Darurat (UGD) yang ditangani oleh dokter tetap maupun dokter
kontrak.
Sumber:
http://pkmbarambai.wordpress.com/2011/04/23/manajemen-rumah-sakit/ …..
Diunduh 6/4/2012
PENERAPAN MANAJEMEN RUMAH SAKIT
Bahkan ada rumah sakit yang menyediakan tempat dan sarana lengkap
seperti laboratorium dengan tenaga analis, radiologi dan tempat perawatan
yang serba lengkap. Sedangkan untuk tenaga dokternya mereka
mengambil dokter-dokter spesialis yang terkenal dan pengelola rumah
sakit menganggap dokter spesialis dan pasiennya sebagai “customer”
mereka
Untuk menjaga agar dokter spesialis ternama tersebut tetap menjadi
customer mereka, maka pihak rumah sakit melakukan strategi sedemikian
rupa. Diantaranya dengan menyediakan peralatan medis yang dikehendaki
oleh para dokter tersebut
Sedangkan untuk menghasilkan mekanisme pengelolaan mutu yang
bagus, perusahaan dalam hal ini rumah sakit perlu menerapkan metode
pengukuran yang efektif untuk dapat menganalisis dan menemukan
dimensi mutu 0 yang perlu diperbaiki atau ditingkatkan untuk mencapai
mutu yang tinggi. Salah satu model pengukuran yang sudah dikenal luas
dan terbukti secara efektif membantu keberhasilan penerapan sistem
manajemen mutu adalah sistem Malcolm Baldrige National Quality Award.
Malcolm Baldrige National Quality Awards (MBNQA) merupakan sistem
manajemen yang sangat efektif untuk menghasilkan loyalitas pelanggan
dan kinerja tinggi bila diterapkan dengan tepat.
Kriteria penilaian/pengukuran kinerja yang dimiliki oleh MBNQA juga dapat
digunakan oleh industri jasa pelayanan kesehatan, yang disebut dengan
Performance Excellence for Health Care based on MBNQA.
Kriteria Performance Excellence for Health Care based on MBNQA terdiri
dari 7 kategori, yaitu: Health Care Results, Patient -and Other CustomerFocused Results, Financial and Market Results, Staff and Work System Results,
Organizational Effectiveness Results, Governance and Social Responsibility
Results.
Dengan penerapan sistem manajemen mutu secara menyeluruh dan
model pengukuran tepat maka perusahaan akan menjadi perusahaan
kelas dunia yang siap memenangkan persaingan.
Dalam penerapannya, manajemen di rumah sakit dapat dilihat dari fungsi
perencanaan rumah sakit dan fungsi pergerakan dan pelaksanaan rumah
sakit.
Sumber:
http://pkmbarambai.wordpress.com/2011/04/23/manajemen-rumah-sakit/ …..
Diunduh 6/4/2012
INDIKATOR PENILAIAN MUTU ASUHAN KESEHATAN
Mutu asuhan kesehatan sebuah RS akan selalu terkait dengan struktur,
proses, outcome sistem pelayanan RS yersebut. Mutu asuhan
pelayanan RS juga dapat dikaji dari tingkat pemanfaatan sarana
pelayanan oleh masyarakat, mutu pelayanan dan tingkat efisiensi RS.
Aspek struktur
Struktur adalah semua masukan (input) untuk system pelayanan
sebuah RS yang meliputi tenaga, peralatan, dana dan sebagainya. Ada
sebuah asuransi yang mengatakan bahwa jika struktur sistem RS
tertata dengan baik, akan lebih menjamin mutu asuhannya. Baik
tidaknya struktur RS diukur dari tingkat kewajaran, kuantitas, biaya,
efisiensi, mutu dari masing – masing komponen struktur.
Proses
Proses adalah semua kegiatan dokter dan tenaga professional lainnya
yang mengadakan interaksi secara profesional dengan pasiennya.
Interaksi ini diukur antara lain dalam bentuk penilaian tentang pasien,
penegakan diagnosa, rencana tindakan pengobatan, indikasi tindakan,
penanganan penyakit, dan prosedur pengobatan.
Dalam hal ini juga dianut asumsi bahwa semakin patuh tenaga profesi
menjalankan ”standards of good practice” yang telah diterima dan diakui
oleh masing – masing ikatan profesi, akan semakin tinggi pula mutu
asuhan terhadap pasien. Baik tidaknya pelaksanaan proses pelayanan
di RS dapat diukur dari tiga aspek yaitu relevan tidaknya proses itu bagi
pasien, efektivitas prosesnya, dan kualitas interaksi asuhan terhadap
pasien.
Sumber:
http://pkmbarambai.wordpress.com/2011/04/23/manajemen-rumah-sakit/…..
Diunduh 6/4/2012
INDIKATOR PENILAIAN MUTU ASUHAN KESEHATAN
Outcome
Outcome adalah hasil akhir kegiatan dokter dan tenaga profesi lainnya
di RS terhadap pasien. Di sini diperlukan pedoman untuk mengukur
mutu asuhan pelayanan kesehatan. Indikator mutu pelayanan medis
meliputi :
1. Angka infeksi nosokomial
2. Angka kematian kasar (Gross Death Rate)
3. Kematian pasca bedah
4. Kematian ibu melahirkan ( Maternal Death Rate-MDR)
5. Kematian bayi baru lahir (Infant Death Rate-IDR)
6. NDR (Net Death Rate di atas 48 jam)
7. ADR (Anasthesia Death Rate)
8. PODR (Post Operation Death Rate)
9. POIR (Post Operative Infection Rate)
Indikator mutu pelayanan untuk mengukur tingkat efisiensi RS :
1. Unit cost untuk rawat jalan
2. Jumlah penderita yang mengalami dekubitus
3. Jumlah penderita yang jatuh dari tempat tidur
4. BOR (Bed Occupancy Rate)
5. BTO (Bed Turn Over)
6. TOI (Turn Over Interval)
7. ALOS (Average Length of Stay)
8. Normal Tissue Removal Rate
Sumber:
http://pkmbarambai.wordpress.com/2011/04/23/manajemen-rumah-sakit/…..
Diunduh 6/4/2012
INDIKATOR PENILAIAN MUTU ASUHAN KESEHATAN
Indikator mutu yang berkaitan dengan tingkat kepuasan pasien dapat
diukur dengan :
1. Jumlah keluhan dari pasien/keluarganya
2. Surat pembaca di koran
3. Surat kaleng
4. Surat masuk dari kotak saran, dan sebagainya
5. Survei tingkat kepuasan pengguna pelayanan
kesehatan RS.
Indikator cakupan pelayanan sebuah RS terdiri dari :
1.
2.
3.
4.
5.
6.
7.
8.
9.
Jumlah dan pesentase kunjungan rawat jalan/inap menurut
jarak PS dengan asal pasien
Jumlah pelayanan dan tindakan medik
Jumlah tindakan pembedahan
Jumlah kunjungan SMF spesialis
Pemfaatan oleh masyarakat
Contact rate
Hospitalization rate
Out patient rate
Emergency out patient rate.
Untuk mengukur mutu pelayanan sebuah RS, angka-angka standar
tersebut di atas dibandingkan dengan standar (indikator) nasional. Jika
tidak ada angka standar nasional, penilaian dialkukan dengan
menggunakan hasil pencatatan mutu pada tahun sebelumnya di RS
yang sama setelah dikembangkan kesepakatan pihak manajemen /
direksi RS yang bersangkutan dengan masing-masing SMF dan staf
lainnya yang terkait.
Sumber:
http://pkmbarambai.wordpress.com/2011/04/23/manajemen-rumah-sakit/…..
Diunduh 6/4/2012
INDIKATOR PENILAIAN MUTU ASUHAN KESEHATAN
Indikator mutu yang mengacu pada keselamatan pasien:
1. Pasien terjatuh dari tempat tidur/kamar mandi
2. Pasien diberi obat yang salah
3. Tidak ada obat/alat emergensi
4. Tidak ada oksigen
5. Tidak ada alat penyedot lendir
6. Tidak tersedia alat pemadam kebakaran
7. Pemakaian obat tidak sesuai standar
8. Pemakaian air, listrik, gas, dan sebagainya.
Mutu pelayanan medis dan kesehatan di RS sangat erat kaitannya
dengan manajemen RS (quality of services) dan keprofesionalan kinerja
SMF dan staf lainnya di RS (quality of care). Keduanya merupakan
oucome dari manajemen manjaga mutu di RS (quality assurance) yang
dilaksanakan oleh gugus kendali mutu RS. Dalam hal ini, gugus kendali
mutu dapat ditugaskan kepada komite medik RS karena mereka adalah
staf fungsional (nonstruktural) yang membantu direktur RS dengan
melibatkan semua staf SMF RS.
Human resource management is an approach to the management of people
based on the following fundamental principles:
1. Human resource management is concerned with integration by getting all
the members of the organization involved so that they may work together
with a sense of common purpose.
2. Human resource policies of the organization should be fair to all. They
should make a major contribution to the achievement of an organization’s
objectives as well as provide conducive atmosphere of working to the
employees so that their output is maximum.
3. Human resources are the most important assets and their tactful
management is the key to success of an organization.
4. The culture and values of an organization exert enormous influence on the
organization. Therefore, organizational values and culture should be
accepted and acted upon by one and all in the organization.
Sumber:
http://pkmbarambai.wordpress.com/2011/04/23/manajemen-rumah-sakit/…..
Diunduh 6/4/2012
RSU Daya Akan Dijadikan Rumah Sakit Hijau
Tribun Timur - Kamis, 29 September 2011 17:03 WIT
Rumah Sakit Umum Daya akan dijadikan sebagai rumah sakit hijau (green hospital)
berbasis kenyamanan dan keamanan lingkungan.
Di rumah sakit milik pemerintah ini akan diperbanyak pepohonan, AC hanya digunakan
di ruang tertentu, mengurangi bola lampu, jendela diperbanyak, dan atap diganti
dengan tanaman yang menjalar.
"Rumah sakit ini akan dijadikan rumah sakit hijau pertama di Makassar. Saat ini dalam
tahap persiapan menuju rumah sakit hijau," kata Direktur RS Umum Daya, dr St
Sainab (Kamis 29/9/2011).
Saat ini manajemen rumah sakit mulai memperbanyak tanaman.
Tanaman yang berdaun lebat akan ditanam di sekeliling rumah sakit.
Tanaman ini sebagian dibeli di Pulau Jawa.
Penulis : Edi Sumardi
Editor : Ridwan Putra
RSMM, Menuju RS Hijau & Asri
Upaya yang paling sering dilakukan yaitu dengan menanam pohon. Seperti yang dilakukan
pihak Rumah Sakit Marzoeki Mahdi (RSMM), bekerja sama dengan Koramil Bogor Barat,
RSMM melakukan penanaman ratusan pohon. Pada kegiatan yang dihadiri unsur
Kecamatan, Koramil, Polsek serta manajemen RSMM ini, ditanam berbagai jenis pohon.
Diantaranya pohon jambu merah yang bermanfaat untuk mengatasi penyakit DBD. Selain itu
juga berbagai tanaman keras yang bisa jadi pelindung dan penahan air dari jenis ketapang.
Ditanam pula pohon bunga seperti bougenville, aglonema dan bunga merah. Untuk
penanaman kali ini dilakukan di depan bangsal Dewi Ambar.
“Penanaman ini dilakukan dalam rangka mendukung program dunia untuk menjaga bumi
serta program pemerintah menanam satu juta pohon”. Hal ini sekaligus program Rumah
Sakit Hijau dan Asri, yang dicanangkan Kementerian Kesehatan.
Sejak awal 2012 ini, RS yang berlokasi di jalan Dr. Semeru kota Bogor- Jawa Barat ini,
memang telah mencanangkan program Rumah Sakit Hijau & Asri. “Agar pasien merasa
nyaman, apalagi ini Rumah Sakit, butuh kenyamanan”.
Keseriusan pihak RS dibuktikan juga dengan membentuk tim khusus untuk menangani
program penghijauan ini. Maka terciptalah taman-taman yang indah dan pepohonan yang
asri di RS ini
(sumber: http://www.jurnal-indonesia.net/index.php?option=com_content&view=article&id=715:rsmmmenuju-rs-hijau-a-asri&catid=69:info-bogoraya&Itemid=116)
Sumber:
makassar.tribunnews.com/.../rsu-daya-akan-dijadik...….. Diunduh 6/4/2012
Rumah Sakit ‘Hijau’ Masih Langka di Indonesia
7 Februari 2012 oleh Redaksi
Sudah seharusnya Rumah Sakit yang dibangun ramah lingkungan.
Namun di Indonesia, masih banyak rumah sakit yang tidak
memperdulikan keselamatan lingkungan, misalnya pembuangan
limbah.
"Hampir semua rumah sakit menuju 'green hospital' tapi belum ideal
sekali" ujar dr. Supriyantoro, Sp.P MARS, Dirjen Bina Upaya
Kesehatan saat konferensi pers peresmian ruang isolasi di Rumah
Sakit Umum Pusat Persahabatan, Rawamangun, Jakarta Timur.
Jum’at (3/2).
Kendala dari 'green hospital' ini ada pada proses. Hal utama yakni
perubahan dari teknologi dan budaya kerja yang ada. Dari data
yang ada, beberapa rumah sakit dikatakan 'merah', artinya masih
tidak memenuhi standar rumah sakit dalam mengolah limbah.
Beberapa rumah sakit yang masuk dalam daftar merah kebanyakan
rumah sakit yang tidak di bawah Kementerian Kesehatan. Rumah
sakit tersebut berada dibawah pemerintahan daerah.
‘Green hospital' bukan hanya bangunan rumah sakit yang dicat hijau
atau biru. Bukan juga yang asri dan banyak pepohonan, tetapi juga
harus tidak memiliki limbah yang merugikan masyarakat. Selain itu,
rumah sakit juga harus hemat energi dan air. Sumber daya yang ada
harus dikelola dengan efisien dan baik.
Rata-rata setiap rumah sakit sudah menerapkan sistem 'green
hospital' ini, namun ada beberapa yang belum.
Syaratnya saat ini bangunan rumah sakit tidak boleh menghadap ke
timur, tapi harus ke utara. Hal ini agar bangunan tidak banyak
menggunakan pendingin ruangan.
Sumber: http://himpalaunas.com/artikel/lingkungan/2012/02/07/rumah-sakit%E2%80%98hijau%E2%80%99-masih-langka-di-indonesia….. Diunduh 6/4/2012
RS DIDORONG TERAPKAN KONSEP HIJAU
| Sabtu, 4 Februari 2012 | 04:00 WIB
Rumah sakit didorong menerapkan konsep hijau dalam mengelola
gedung dan lingkungannya. Ini dilakukan agar tak menimbulkan
kerugian kepada warga sekitar akibat limbah yang dihasilkan.
Direktur Bina Upaya Kesehatan Kementerian Kesehatan Supriyantoro,
Jumat (3/2), di Jakarta, mengatakan, rumah sakit (RS) yang dikelola
baik tidak akan menimbulkan kerugian bagi masyarakat.
Rumah sakit yang berkonsep hijau tidak hanya banyak pohon, tetapi
juga tidak punya limbah yang berdampak kepada masyarakat.
Menurut Supriyantoro, konsep hijau juga terkait efisiensi penggunaan
listrik dan air. Dengan demikian, ongkos operasional RS menjadi hemat
dan berkelanjutan.
Terkait Program Penilaian Peringkat Kinerja Perusahaan dalam
Pengelolaan Lingkungan Hidup (Proper), akhir November 2011,
Kementerian Lingkungan Hidup mengumumkan 14 RS berkategori biru,
27 RS merah, dan 1 RS hitam.
Kategori biru berarti RS menjalankan standar pengelolaan lingkungan.
Kategori merah dan hitam berarti RS dinilai masih abai mengelola
lingkungan.
1.
2.
3.
4.
5.
Human resource management in hospitals has now become a
necessity and it has to achieve :
effective utilization of human resources;
desirable working relationships among all employees;
maximum employee development;
high morale in the organization; and
continuous development and appreciation of human assets.
Sumber:
http://nasional.kompas.com/read/2012/02/04/04004586/RS.Didorong.Terapkan.Konsep.Hijau
….. Diunduh 6/4/2012
GREEN HOSPITAL
by Solikah Sriningsih - Wednesday, 25 May 2011, 11:54 PM
Prinsip Dasar Rumah Sakit Hijau
1.
2.
3.
Sumber:
Protecting the immediate health of building occupants
The health of patients, staff, and visitors can be profoundly
affected by the quality of the indoor air which in turn is dependent
upon physical and mechanical design (such as ventilation and
location of wastes and toxics), the choice of building materials, the
management of construction emissions, and building operations
and maintenance. Additionally, access to daylighting has been
found to favorably affect staff productivity and patient outcomes.
Protecting the health of the surrounding community
Local air and water quality is also significantly affected by building
design choices. Off-gassing building materials and finishes,
construction equipment and HVAC systems directly emit VOCs,
particulates and other materials that can result in the formation of
ground level ozone (smog), and cause allergic attacks, respiratory
problems and other illnesses. Land use and transportation
planning, landscape and water management on the grounds and
water conservation efforts within the building will influence the
amount of toxic emissions released to the water and air throughout
the life of the building.
Protecting the health of the global community and natural
resources
The health impact of a building stretches far beyond its immediate
community. The production of building materials can result in the
release of persistent bioaccumulative toxic compounds,
carcinogens, endocrine disruptors and other toxic substances.
These compounds threaten communities where the materials are
manufactured, and, because of the long life of some of these
compounds, can risk the health of communities and ecosystems
far from their release..
http://elearning.mmr.umy.ac.id/mod/forum/discuss.php?d=275….. Diunduh
6/4/2012
BEBERAPA INDIKATOR KEBERHASILAN GREEN HOSPITAL.
Mengurangi KONSUMSI LISTRIK
1. pemanfaatan cahaya alami
2. menggunakan switch timer
3. menggunakan jenis lampu hemat enersi
4. menggunakan AC automatic control
5. membuat ventilasi alami berfungsi pada ruang tertentu dan saat tertentu
Hemat Konsumsi AIR BERSIH
-menggunakan kran otomatis
-menggunakan air bekas untuk flushing dan siram taman, cuci mobil
PENCEMARAN LINGKUNGAN
1. mengurangi penggunaan material polutant
2. mengubah perilaku manusia terhadap lingkungan
3. mengusahakan Ruang Terbuka Hijau
4. memperbanyak tanam pohon
5. membuat sumur resapan, biopori, kolam penampungan air hujan
EKSPLOITASI SUMBER ALAM
-menghemat penggunaan kertas dengan menggunakan teknologi informasi
-menghemat penggunaan bahan bakar
AIR BUANGAN CUCI DAN MANDI + AIR HUJAN DARI TALANG ATAP
•digunakan untuk flushing toilet
•digunakan untuk siram taman cuci mobil
•sebagai cadangan air pompa kebakaran
ENERSI PANAS YANG KELUAR DARI GENSET / TRAFO / BOILER
•dimanfaatkan sebagai sumber enersi lain
KERTAS BEKAS FOTO COPY
•digunakan kembali pada sisi belakangnya
•digunakan untuk keperluan lainnya
MENGUBAH PERILAKU MANUSIA TERHADAP LINGKUNGAN
1. Stop penggunaan bahan mengandung mercury dan PVC
2. Tidak menggunakan incenerator yg menghasilkan racun/polusi udara
3. Hemat penggunaan enersi (lampu, AC)
4. Hemat penggunaan air dan kertas
5. Memilah sampah di tempat pembuangan
Sumber: http://elearning.mmr.umy.ac.id/mod/forum/discuss.php?d=275 ….. Diunduh
6/4/2012
BEBERAPA INDIKATOR KEBERHASILAN GREEN HOSPITAL.
RENCANA AKSI
1.
MELAKUKAN SURVEY UNTUK PENDATAAN KONDISI
EKSISTING MELIPUTI :
* seluruh instalasi mekanikal elektrikal
* seluruh peralatan medis dan kantor
* seluruh jenis material finishing gedung
2.
MELAKUKAN PENGKAJIAN TERHADAP KONDISI EKSISTING,
MENENTUKAN BAGIAN APA YG PERLU DIPERBAIKI/ DIGANTI
DENGAN MATERIAL/SISTEM YANG RAMAH LINGKUNGAN :
* pertimbangan biaya
* pertimbangan waktu dan pentahapan
3.
MEMBUAT RENCANA DETAIL UNTUK PERUBAHAN SISTIM
UTILITAS YANG RAMAH LINGKUNGAN (AIR CONDITIONING,
WATER RECYCLING, WATER & ENERGY SAVING)
4.
MEMBUAT RENCANA DETAIL UNTUK MERUBAH JENIS
MATERIALNON TOXIC (flooring, painting, wall covering, roofing,
insulation etc)
5.
MELAKUKAN ‘PUBLIC CAMPAIGN’ DI LINGKUNGAN RUMAH
SAKIT UNTUK MERUBAH PERILAKU MANUSIA (karyawan, pasien
dan keluarga pasien)
Sumber: http://elearning.mmr.umy.ac.id/mod/forum/discuss.php?d=275 ….. Diunduh
6/4/2012
RUMAH SAKIT PENDIDIKAN UNILA GUNAKAN KONSEP
TEKNOLOGI HIJAU
“Selain ramah lingkungan, bangunan RSP ini juga hemat energi karena
untuk pencahayaannya didesain agar optimal menyerap cahaya matahari
sehingga hemat listrik (Sulastri, pembantu rektor UNILA).
RSP ini memiliki fungsi pendidikan, penelitian, dan pengabdian pada
masyarakat. Sehingga penggunaannya tidak untuk tujuan komersil.
Pada saat ini proyek pembangunan RSP pada lahan seluas 10,8 hektar
tersebut sudah memasuki tahap pertama, yakni land clearing dan
pembangunan struktur bangunan. “Pada tahap pertama, biayanya sudah
mencapai Rp. 52, 8Milyar. Bangunan ini diperkirakan akan menelan biaya
untuk bangunan fisik hingga Rp. 400 Milyar.
RS PENDIDIKAN
Rumah sakit pendidikan merupakan fasilitas yang sangat krusial dalam
pendidikan kedokteran. Di rumah sakit pendidikanlah mahasiswa
kedokteran langsung terjun untuk mendapatkan pengalaman dalam
menangani berbagai macam penyakit.
Misalnya, FKUI telah menjalin kerjasama dengan berbagai rumah sakit
yang dinilai layak untuk tempat penyelenggaraan kegiatan akademik
bagi para mahasiswa untuk semua jenjang program pendidikan FKUI.
Selain itu juga diharapkan agar dapat terjalin kerja sama yang aktif dan
efektif dalam meningkatkan mutu pelayanan, pendidikan, penelitian
kedokteran dan ilmu terkait lainnya.
(sumber:
http://www.fk.ui.ac.id/?page=content.view&alias=university_hospital)
Sumber: http://www.unila.ac.id/index.php/en/home-mainmenu-1/74-berit-depan/2204-rumahsakit-pendidikan-unila-gunakan-konsep-teknologi-hijau ….. Diunduh 6/4/2012
Lampung, Pelita ; Senin, 12 Desember 2011
Pemkab Meminta RSUD Menambah Ruang Hijau di Area
Rumah Sakit
Pemerintah Kabupaten Lampung Selatan (Pemkab) meminta Rumah Sakit
Umum Daerah (RSUD) untuk menambah ruang terbuka hijau di area
rumah sakit. Hal ini berkaitan dengan upaya mempertahankan predikat
Adipura mendatang. Berdasarkan evaluasi tahap pertama yang dilakukan
Badan Lingkungan Hidup (BLH) dan Dinas pasar, Kebersihan dan
Keindahan (DKK), di RSUD Kalianda penghijauan di tempat itu masih
rendah.
Kami berharap penghijauan di RSUD Kalianda dapat ditambah, hal ini
dilakukan selain dapat menambah keindahan, penghijauan juga berguna
untuk menyerap karbondioksida di lingkungan rumah sakit.
Berbagai item penilaian di RSUD Kalianda sebetulnya sudah cukup baik,
misalnya dari segi kebersihan, pengelola IPAL dan Uji Laboratorium sudah
mendukung.
Evaluasi penilaian Adipura ini juga dilakukan di sekolah-sekolah yang ada
di Kalianda, evaluasi yang kita laksanakan agar dalam penilaian
Ruang Terbuka Hijau
Secara umum ruang terbuka publik (open spaces) di perkotaan terdiri dari ruang
terbuka hijau dan ruang terbuka nonhijau. Ruang Terbuka Hijau (RTH) perkotaan
adalah bagian dari ruang-ruang terbuka (open spaces) suatu wilayah perkotaan
yang diisi oleh tumbuhan, tanaman dan vegetasi (endemik maupun introduksi) guna
mendukung manfaat ekologis, sosial-budaya dan arsitektural yang dapat
memberikan manfaat ekonomi (kesejahteraan) bagi masyarakatnya.
Ruang terbuka nonhijau dapat berupa ruang terbuka yang diperkeras (paved)
maupun ruang terbuka biru (RTB) yang berupa permukaan sungai, danau, maupun
areal-areal yang diperuntukkan sebagai genangan retensi.
Secara fisik RTH dapat dibedakan menjadi RTH alami yang berupa habitat liar
alami, kawasan lindung dan taman-taman nasional, maupun RTH nonalami atau
binaan yang seperti taman, lapangan olah raga, dan kebun bunga.
Sumber: http://www.pelitaonline.com/read-cetak/10253/pemkab-meminta-rsud-menambahruang-hijau-di-area-rumah-sakit/ ….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
PENGERTIAN KEPUASAN
Kepuasan menurut Kamus Bahasa Indonesia adalah puas; merasa
senang; perihal (hal yang bersifat puas, kesenangan, kelegaan dan
sebagainya). Kepuasan dapat diartikan sebagai perasaan puas, rasa
senang dan kelegaan seseorang dikarenakan mengkonsumsi suatu
produk atau jasa untuk mendapatkan pelayanan suatu jasa.
Menurut Oliver (dalam Supranto, 2001) mendefinisikan kepuasan
sebagai tingkat perasaan seseorang setelah membandingkan kinerja
atau hasil yang dirasakannya dengan harapannya. Tingkat kepuasan
merupakan fungsi dari perbedaan antara kinerja yang dirasakan
dengan harapan. Apabila kinerja dibawah harapan, maka pelanggan
akan sangat kecewa. Bila kinerja sesuai harapan, maka pelanggan
akan sangat puas. Sedangkan bila kinerja melebihi harapan
pelanggan akan sangat puas harapan pelanggan dapat dibentuk oleh
pengalaman masa lampau, komentar dari kerabatnya serta janji dan
informasi dari berbagai media. Pelanggan yang puas akan setia lebih
lama, kurang sensitive terhadap harga dan memberi komentar yang
baik tentang perusahaan tersebut.
Menurut Kotler (1988) kepuasan adalah tingkat kepuasan seseorang
setelah membandingkan kinerja atau hasil yang dirasakan
dibandingkan dengan harapannya. Jadi kepuasan atau
ketidakpuasan adalah kesimpulan dari interaksi antara harapan dan
pengalaman sesudah memakai jasa atau pelayanan yang diberikan.
Upaya untuk mewujudkan kepuasan pelanggan total bukanlah hal
yang mudah, Mudie dan Cottom menyatakan bahwa kepuasan
pelanggan total tidak mungkin tercapai, sekalipun hanya untuk
sementara waktu (Tjiptono, 1997).
Berdasarkan uraian dari beberapa ahli tersebut diatas, maka dapat
disimpulkan bahwa kepuasan adalah perasaan senang, puas
individu karena antara harapan dan kenyataan dalam memakai dan
pelayanan yang diberikan terpenuhi.
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayananrumah-sakit/ ….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
Pengertian kepuasan pasien
Memahami kebutuhan dan keinginan pasien adalah hal penting yang
mempengaruhi kepuasan pasien. Pasien yang puas merupakan aset yang
sangat berharga karena apabila pasien puas mereka akan terus melakukan
pemakaian terhadap jasa pilihannya, tetapi jika pasien merasa tidak puas
mereka akan memberitahukan dua kali lebih hebat kepada orang lain tentang
pengalaman buruknya. Untuk menciptakan kepuasan pasien suatu perusahaan
atau rumah sakit harus menciptakan dan mengelola suatu system untuk
memperoleh pasien yang lebih banyak dan kemampuan untuk mempertahankan
pasiennya.
Upaya untuk meningkatkan kepuasan konsumen dapat dilakukan dengan
berbagai strategi untuk dapat merebut pelanggan. Junaidi (2002) berpendapat
bahwa kepuasan konsumen atas suatu produk berhubungan erat dengan kinerja
yang dirasakan konsumen atas poduk tersebut. Jika kinerja produk lebih tinggi
dari harapan konsumen maka konsumen akan mengalami kepuasan.
Hal yang hampir serupa dikemukakan oleh Indarjati (2001) yang menyebutkan
adanya tiga macam kondisi kepuasan yang bisa dirasakan oleh konsumen
berkaitan dengan perbandingan antara harapan dan kenyataan, yaitu jika
harapan atau kebutuhan sama dengan layanan yang diberikan maka konsumen
akan merasa puas. Jika layanan yang diberikan pada konsumen kurang atau
tidak sesuai dengan kebutuhan atau harapan konsumen maka konsumen
menjadi tidak puas. Kepuasan konsumen merupakan perbandingan antara
harapan yang dimiliki oleh konsumen dengan kenyataan yang diterima oleh
konsumen dengan kenyataan yang diterima oleh konsumen dengan kenyataan
yang diterima oleh konsumen pada saat mengkonsumsi produk atau jasa.
Konsumen yang merasa puas atas suatu produk atau jasa dapat dikategorikan
ke dalam konsumen masyarakat, konsumen instansi dan konsumen individu.
Pasien adalah orang yang karena kelemahan fisik atau mentalnya menyerahkan
pengawasan dan perawatannya, menerima dan mengikuti pengobatan yang
ditetapkan oleh tenaga kesehatan (Prabowo, 1999). Sedangkan Aditama (2002)
berpendapat bahwa pasien adalah mereka yang di obati dirumah sakit.
Berdasarkan uraian diatas, maka dapat disimpulkan bahwa kepuasan pasien
adalah perasaan senang, puas individu karena terpenuhinya harapan atau
keinginan dalam menerima jasa pelayanan kesehatan.
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayananrumah-sakit/ ….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
Faktor yang mempengaruhi kepuasan pasien
Menurut Budiastuti (2002), pasien dalam mengevaluasi kepuasan
terhadap jasa pelayanan yang diterimanya mengacu pada beberapa
faktor, antara lain :
1.
2.
3.
4.
5.
Kualitas produk atau jasa. Pasien akan merasa puas bila hasil
evaluasi mereka menunjukkan bahwa produk atau jasa yang
digunakan berkualitas. Persepsi konsumen terhadap kualitas
poduk atau jasa dipengaruhi oleh dua hal yaitu kenyataan
kualitas poduk atau jasa yang sesungguhnya dan komunikasi
perusahaan terutama iklan dalam mempromosikan rumah
sakitnya.
Kualitas pelayanan. Memegang peranan penting dalam industri
jasa. Pelanggan dalam hal ini pasien akan merasa puas jika
mereka memperoleh pelayanan yang baik atau sesuai dengan
yang diharapkan.
Faktor emosional. Pasien yang merasa bangga dan yakin
bahwa orang lain kagum terhadap konsumen bila dalam hal ini
pasien memilih rumah sakit yang sudah mempunyai pandangan
“rumah sakit mahal”, cenderung memiliki tingkat kepuasan yang
lebih tinggi.
Harga. Harga merupakan aspek penting, namun yang
terpenting dalam penentuan kualitas guna mencapai kepuasan
pasien. Meskipun demikian elemen ini mempengaruhi pasien
dari segi biaya yang dikeluarkan, biasanya semakin mahal harga
perawatan maka pasien mempunyai harapan yang lebih besar.
Sedangkan rumah sakit yang berkualitas sama tetapi berharga
murah, memberi nilai yang lebih tinggi pada pasien.
Biaya. Mendapatkan produk atau jasa, pasien yang tidak perlu
mengeluarkan biaya tambahan atau tidak perlu membuang
waktu untuk mendapatkan jasa pelayanan, cenderung puas
terhadap jasa pelayanan tersebut.
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayananrumah-sakit/ ….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
Tjiptono (1997) kepuasan pasien ditentukan oleh faktor :
1. Kinerja (performance), berpendapat pasien terhadap karakteristik operasi dari
pelayanan inti yang telah diterima sangat berpengaruh pada kepuasan yang
dirasakan. Wujud dari kinerja ini misalnya : kecepatan, kemudahan, dan
kenyamanan bagaimana perawat dalam memberikan jasa pengobatan terutama
keperawatan pada waktu penyembuhan yang relatif cepat, kemudahan dalam
memenuhi kebutuhan pasien dan kenyamanan yang diberikan yaitu dengan
memperhatikan kebersihan, keramahan dan kelengkapan peralatan rumah sakit.
2. Ciri-ciri atau keistimewaan tambahan (features), merupakan karakteristik
sekunder atau karakteristik pelengkap yang dimiliki oleh jasa pelayanan,
misalnya : kelengkapan interior dan eksterior seperti televisi, AC, sound system,
dan sebagainya.
3. Keandalan (reliability), sejauhmana kemungkinan kecil akan mengalami
ketidakpuasan atau ketidaksesuaian dengan harapan atas pelayanan yang
diberikan. Hal ini dipengaruhi oleh kemampuan yang dimiliki oleh perawat
didalam memberikan jasa keperawatannya yaitu dengan kemampuan dan
pengalaman yang baik terhadap memberikan pelayanan keperawatan dirumah
sakit.
4. Kesesuaian dengan spesifikasi (conformance to spesification), yaitu sejauh
mana karakteristik pelayanan memenuhi standart-standart yang telah ditetapkan
sebelumnya. Misalnya : standar keamanan dan emisi terpenuhi seperti
peralatan pengobatan.
5. Daya tahan (durability), berkaitan dengan beberapa lama produk tersebut
digunakan. Dimensi ini mencakup umur teknis maupun umur ekonomis dalam
penggunaan peralatan rumah sakit, misalnya : peralatan bedah, alat
transportasi, dan sebagainya.
6. Service ability, meliputi kecepatan, kompetensi, serta penanganan keluhan yang
memuaskan. Pelayanan yang diberikan oleh perawat dengan memberikan
penanganan yang cepat dan kompetensi yang tinggi terhadap keluhan pasien
sewaktu-waktu.
7. Estetika, merupakan daya tarik rumah sakit yang dapat ditangkap oleh panca
indera. Misalnya : keramahan perawat, peralatan rumah sakit yang lengkap dan
modern, desain arsitektur rumah sakit, dekorasi kamar, kenyamanan ruang
tunggu, taman yang indah dan sejuk, dan sebagainya.
8. Kualitas yang dipersepsikan (perceived quality), citra dan reputasi rumah sakit
serta tanggung jawab rumah sakit. Bagaimana kesan yang diterima pasien
terhadap rumah sakit tersebut terhadap prestasi dan keunggulan rumah sakit
daripada rumah sakit lainnya dan tangggung jawab rumah sakit selama proses
penyembuhan baik dari pasien masuk sampai pasien keluar rumah sakit dalam
keadaan sehat.
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayanan-rumahsakit/ ….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
Menurut Moison, Walter dan White (dalam Haryanti, 2000), faktor
yang mempengaruhi kepuasan konsumen, yaitu :
1.
2.
3.
4.
5.
Karakteristik produk, produk ini merupakan kepemilikan rumah sakit yang
bersifat fisik antara lain gedung dan dekorasi. Karakteristik produk rumah
sakit meliputi penampilan bangunan rumah sakit, kebersihan dan tipe kelas
kamar yang disediakan beserta kelengkapannya.
Harga, yang termasuk didalamnya adalah harga produk atau jasa. Harga
merupakan aspek penting, namun yang terpenting dalam penentuan
kualitas guna mencapai kepuasan pasien. Meskipun demikian elemen ini
mempengaruhi pasien dari segi biaya yang dikeluarkan, biasanya semakin
mahal harga perawatan maka pasien mempunyai harapan yang lebih
besar.
Pelayanan, yaitu pelayanan keramahan petugas rumah sakit, kecepatan
dalam pelayanan. Rumah sakit dianggap baik apabila dalam memberikan
pelayanan lebih memperhatikan kebutuhan pasien maupun orang lain yang
berkunjung di rumah sakit. kepuasan muncul dari kesan pertama masuk
pasien terhadap pelayanan keperawatan yang diberikan. Misalnya :
pelayanan yang cepat, tanggap dan keramahan dalam memberikan
pelayanan keperawatan.
Lokasi, meliputi letak rumah sakit, letak kamar dan lingkungannya.
Merupakan salah satu aspek yang menentukan pertimbangan dalam
memilih rumah sakit. Umumnya semakin dekat rumah sakit dengan pusat
perkotaan atau yang mudah dijangkau, mudahnya transportasi dan
lingkungan yang baik akan semakin menjadi pilihan bagi pasien yang
membutuhkan rumah sakit tersebut.
Fasilitas, kelengkapan fasilitas rumah sakit turut menentukan penilaian
kepuasan pasien, misalnya fasilitas kesehatan baik sarana dan prasarana,
tempat parkir, ruang tunggu yang nyaman dan ruang kamar rawat inap.
Walaupun hal ini tidak vital menentukan penilaian kepuasan pasien, namun
rumah sakit perlu memberikan perhatian pada fasilitas rumah sakit dalam
penyusunan strategi untuk menarik konsumen.
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayananrumah-sakit/ ….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
Faktor kepuasan konsumen (lanjutan):
1.
2.
3.
4.
Image, yaitu citra, reputasi dan kepedulian rumah sakit terhadap lingkungan.
Image juga memegang peranan penting terhadap kepuasan pasien dimana
pasien memandang rumah sakit mana yang akan dibutuhkan untuk proses
penyembuhan. Pasien dalam menginterpretasikan rumah sakit berawal dari
cara pandang melalui panca indera dari informasi-informasi yang didapatkan
dan pengalaman baik dari orang lain maupun diri sendiri sehingga
menghasilkan anggapan yang positif terhadap rumah sakit tersebut, meskipun
dengan harga yang tinggi. Pasien akan tetap setia menggunakan jasa rumah
sakit tersebut dengan harapan-harapan yang diinginkan pasien.
Desain visual, meliputi dekorasi ruangan, bangunan dan desain jalan yang
tidak rumit. Tata ruang dan dekorasi rumah sakit ikut menentukan
kenyamanan suatu rumah sakit, oleh karena itu desain dan visual harus
diikutsertakan dalam penyusunan strategi terhadap kepuasan pasien atau
konsumen.
Suasana, meliputi keamanan, keakraban dan tata lampu. Suasana rumah
sakit yang tenang, nyaman, sejuk dan indah akan sangat mempengaruhi
kepuasan pasien dalam proses penyembuhannya. Selain itu tidak hanya bagi
pasien saja yang menikmati itu akan tetapi orang lain yang berkunjung ke
rumah sakit akan sangat senang dan memberikan pendapat yang positif
sehingga akan terkesan bagi pengunjung rumah sakit tersebut.
Komunikasi, yaitu tata cara informasi yang diberikan pihak penyedia jasa dan
keluhan-keluhan dari pasien. Bagaimana keluhan-keluhan dari pasien dengan
cepat diterima oleh penyedia jasa terutama perawat dalam memberikan
bantuan terhadap keluhan pasien. Misalnya adanya tombol panggilan didalam
ruang rawat inap, adanya ruang informasi yang memadai terhadap informasi
yang akan dibutuhkan pemakai jasa rumah sakit seperti keluarga pasien
maupun orang yang bekunjung di rumah sakit.
aka dapat ditarik kesimpulan bahwa faktor-faktor kepuasan pasien adalah :
kualitas jasa, harga, emosional, kinerja, estetika, karakteristik produk,
pelayanan, lokasi, fasilitas, komunikasi, suasana, dan desain visual .
Sumber:
….. Diunduh 6/4/2012
KEPUASAN PASIEN TERHADAP PELAYANAN RUMAH SAKIT
Posted on December 28, 2007 by klinis
Aspek – aspek yang mempengaruhi kepuasan pasien (Griffith , 1987):
1.
2.
3.
4.
5.
6.
7.
8.
9.
Sikap pendekatan staf pada pasien yaitu sikap staf terhadap pasien ketika
pertama kali datang di rumah sakit.
Kualitas perawatan yang diterima oleh pasien yaitu apa saja yang telah
dilakukan oleh pemberi layanan kepada pasien, seberapa pelayanan
perawatan yang berkaitan dengan proses kesembuhan penyakit yang
diderita pasien dan kelangsungan perawatan pasien selama berada
dirumah sakit.
Prosedur administrasi yaitu berkaitan dengan pelayanan administrasi
pasien dimulai masuk rumah sakit selama perawatan berlangsung sampai
keluar dari rumah sakit.
Waktu menunggu yaitu berkaitan dengan waktu yang diperbolehkan untuk
berkunjung maupun untuk menjaga dari keluarga maupun orang lain
dengan memperhatikan ruang tunggu yang memenuhi standar-standar
rumah sakit antara lain : ruang tunggu yang nyaman, tenang, fasilitas yang
memadai misalnya televisi, kursi, air minum dan sebagainya.
Fasilitas umum yang lain seperti kualitas pelayanan berupa makanan dan
minuman, privasi dan kunjungan. Fasilitas ini berupa bagaimana pelayanan
terhadap pemenuhan kebutuhan pasien seperti makanan dan minuman
yang disediakan dan privasi ruang tunggu sebagai sarana bagi orang-orang
yang berkunjung di rumah sakit.
Fasilitas ruang inap untuk pasien yang harus rawat. Fasilitas ruang inap ini
disediakan berdasarkan permintaan pasien mengenai ruang rawat inap
yang dikehendakinya.
Hasil treatment atau hasil perawatan yang diterima oleh pasien yaitu
perawatan yang berkaitan dengan kesembuhan penyakit pasien baik
berapa operasi, kunjungan dokter atau perawat.
Tingkat kepuasan antar individu satu dengan individu lain berbeda. Hal ini
terjadi karena adanya pengaruh dari faktor jabatan, umur, kedudukan
sosial, tingkat ekonomi, pendidikan, jenis kelamin, sikap mental dan
kepribadian.
Kepuasan pasien atau konsumen berdasarkan teori-teori diatas tidak hanya
dipengaruhi oleh jasa yang dihasilkan oleh suatu rumah sakit semata, tetapi
juga dipengaruhi oleh pelayanan yang diberikan oleh petugas rumah sakit
baik dokter, perawat, dan karyawan-karyawan lainnya.
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayananrumah-sakit/ ….. Diunduh 6/4/2012
ASPEK-ASPEK KEPUASAN PASIEN RUMAH SAKIT
Aspek-aspek yang mempengaruhi kepuasan pasien adalah :
1.
2.
3.
4.
Sikap pendekatan staf pada pasien yaitu sikap staf terhadap pasien
ketika pertama kali datang di rumah sakit.
Kualitas perawatan yang diterima oleh pasien yaitu apa saja yang
telah dilakukan oleh pemberi layanan kepada pasien, seberapa
pelayanan perawatan yang berkaitan dengan proses kesembuhan
penyakit yang diderita pasien dan kelangsungan perawatan pasien
selama berada dirumah sakit.
Prosedur administrasi yaitu berkaitan dengan pelayanan administrasi
pasien dimulai masuk rumah sakit selama perawatan berlangsung
sampai keluar dari rumah sakit.
Fasilitas – fasilitas yang disediakan rumah sakit yaitu fasilitas ruang
inap, kualitas makanan atau kios-kios penjual makanan yang terjamin
kesehatannya, privasi dan waktu kunjungan pasien.
Ada lima gap yang memungkinkan kegagalan penyampaian layanan jasa :
1. Gap antara harapan konsumen dan persepsi manejemen.
2. Gap antara persepsi menejemen dan spesifikasi kualitas jasa
3. Gap antara spesifikasi kualitas penyampaian jasa.
4. Gap antara penyampaian jasa dan komunikasi eksternal.
5. Gap antara jasa yang dipersepsikan dan jasa yang diharapkan.
Untuk mewujudkan dan mempertahankan kepuasan pelanggan organisasi
jasa harus melakukan empat hal (Fandi Tjiptono, 2006).
1. Mengidentifikasi siapa pelanggannya.
2. Memahami tingkat harapan pelanggan atas kualitas.
3. Memahami strategi kualitas pelayanan pelanggan.
4. Memahami siklus pengukuran umpan balik dari kepuasan pelanggan.
(sumber: e-journal.stie-aub.ac.id/index.php/excellent/.../99 -)
Sumber: http://klinis.wordpress.com/2007/12/28/kepuasan-pasien-terhadap-pelayananrumah-sakit/ ….. Diunduh 6/4/2012
Towards a Green Hospital
Subtitle:
The hospital as a concept and as a type of building, warrants reconsideration. Challenges and
considerations in planning Green Hospitals of the future.
Speaker:
Dr. Wolfgang Sittel, Head of Architecture and Design at Asklepios Hospital Group and initiator
of the Asklepios Green Hospital Program
Location:
Asia-Pacific Weeks Berlin
Date:
8. September 2011
The key topic of this session is „Towards a Green Hospital“. And in line with this, we’ve
just enjoyed a presentation on some very interesting facts and figures detailing solution
scenarios, economic aspects and the value of Green Hospitals.
Now, as you know, the Asklepios Hospital Group, with its more than one hundred and
eleven hospitals and welfare institutions, employing over thirty six thousand staff is one of
the largest and most successful group of hospitals in Europe.
I’m also here today because I would like to create a greater understanding of why this
initiative was created, why we actively support it and why Asklepios, from the perspective
of a Hospital Group, considers the Green Hospital concept to be eminently important for
the German hospital and healthcare market.
Furthermore, I’d also like to provide answers to questions such as: How do we achieve a
‘Green Hospital of the Future’ together? What is needed here? And: What is important?
In preparing for this presentation I did some research on the internet, among other
sources of information. There I found that many hospitals are described as ‚Green
Hospitals’, “Energy-Saving Hospitals”, as “Climate-Friendly Hospitals”.
Sumber:
http://greenhospital-blog.com/?p=995….. Diunduh 6/4/2012
"GREEN HOSPITAL" PROJECT SETTING STANDARDS IN
HEALTHCARE
Customer Challenge
Worldwide, the healthcare sector is faced with new challenges when it
comes to the planning of hospitals and healthcare institutions. As
natural resources dwindle and costs rise, ways to minimise the impact
that healthcare delivery has on the environment are in greater
demand than ever.
Solution
The "Green Hospital" project is based on a multi-dimensional
approach: the combination of ecology, economy and well-being of
people in a hospital. GE will provide the necessary innovative
solutions from its different businesses, optimising the efficiencies of
the design.
The GE technologies involved in this project are Power-Heat-Cooling
co-generation, solar heat, and cold, energy efficient medical
equipment and lighting as well as systems for water purification reuse.
As part of the implementation of the project, the aim is to increase
energy efficiency by 30 percent while at the same time reducing
energy consumption by 30 percent and expanding the proportion of
renewable energies in the energy mix by up to 30 percent. This 30-3030 model is geared towards the European Union's target for the
expansion of renewable energies.
The energy efficiency principles will be employed both in the
conversion of existing buildings and the construction of new facilities
with an expected finalisation of the project planned for 2013..
Sumber: http://www.ge-cities.com/files/projects/GE_CaseStudy_65_EN.pdf ….. Diunduh
6/4/2012
April 07, 2009
HOSPITALS: SETTING A GREEN STANDARD
by Eileen Weber
Hospitals are recycling light bulbs and batteries. They are using green cleaning
products. Even choosing to switch from cotton mop heads to microfiber saves
thousands of gallons of water every year. They are even incorporating nature as part
of the healing process with rooftop gardens and balconies open for fresh air. Studies
have shown that patients who have some connection to nature have lower stress
levels and recover more quickly.
But it doesn’t stop there. Practicing a healthy green business is great. But it’s even
better in a green building.
According to an article dated March 27th in The Boston Globe, more hospitals are
seeing the long-term benefit of renovating in an environmentally friendly way. They
have included everything from LED lighting to high efficiency glass to low VOC
paints and adhesives to roof top solar panels.
Here in Connecticut, there are a few hospitals in particular that stand out in their
quest to be green. Yale-New Haven and Bridgeport Hospitals have either renovated
their space to be energy efficient and LEED-certified or changed their daily routines
to be more environmentally-friendly.
According to their December 2007 press release, Yale-New Haven Hospital was the
first in the state to register for LEED certification. Smilow Cancer Hospital, the
hospital’s latest addition slated to open at the end of this year, boasts local building
materials, enhanced ventilation systems, low VOC paints and adhesives, as well as
a healing rooftop garden, to name a few. Yale-New Haven has long been associated
with environmentally friendly practices.
Bridgeport Hospital has been no slouch either when it comes to the environment.
According to an article dated August 20, 2008 in The Connecticut Post, the hospital
started going green about 10 years ago. The hospital is a member of Practice
Greenhealth, a non-profit organization geared toward sustainable health care. They
have focused on reducing their toxic waste as well as recycling equipment and using
eco-friendly products.
“We’ve taken a number of steps toward a green initiative,” said John Cappiello,
Media Relations Coordinator for Bridgeport Hospital. “We’ve done everything from
saving on electrical costs to recycling literally tons of stuff.”
“It is made up of staff from all over the hospital: nursing, operations, food and
nutrition, laboratory, radiology, etc. It is a very passionate and dynamic group of staff
who all are committed to providing a green environment.”
Brunetti also said the hospital reprocesses certain types of used surgical supplies.
They also return any unopened or unused pharmaceuticals. They even use green
cleaning products and have reduced the amount of chemicals used to clean the
floors by 85%.
Sumber: http://ctgreenscene.typepad.com/ct_green_scene/2009/04/hospitals-setting-agreen-standard.html ….. Diunduh 6/4/2012
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