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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Cermin Dunia Kedokteran Jurnal ARSI : Administrasi Rumah Sakit Indonesia Cermin Dunia Kedokteran
Sulistio, Septo
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Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Medicine & Pharmacology Public Health Social Sciences

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Faktor-Faktor Penyebab Pengembalian Berkas Resume Medis IGD RSCM oleh Verifikator BPJS Kesehatan Habib, Hadiki; Mulyana, Radi Muharris; Albar, Imamul Aziz; Sulistio, Septo
Cermin Dunia Kedokteran Vol 45, No 4 (2018): Cidera Kepala
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (578.818 KB) | DOI: 10.55175/cdk.v45i4.198

Abstract

Pendahuluan: Sejak  dijalankan  tahun  2014,  program  Jaminan  Kesehatan  Nasional  (JKN)  yang  diselenggarakan  oleh  Badan  Penyelenggara Jaminan Sosial (BPJS) Kesehatan terus mengalami perbaikan. Penyebab klaim tidak dapat diproses perlu dianalisis, diidentifikasi, dan diperbaiki, oleh karena itu perlu didentifikasi. Penelitian dilaksanakan di RSCM bulan Januari sampai November 2017, atas data rekam medis, berupa resume medis, hasil koding, dan rincian biaya. Dari 855 resume medis yang gagal verifikasi, diambil sampel 270 berkas secara acak. Sebanyak 215 (79,6%) resume medis dapat dibaca dengan baik, sehingga memudahkan proses telaah. Sebanyak 206 (76,3%) resume medis lengkap. Hampir separuh (49%) kasus tidak gawat darurat. Dari resume medis yang memang melaporkan pengelolaan kasus gawat darurat, hanya 58% diagnosis yang menggambarkan kegawatdaruratan. Masih ada 22,6% koding yang tidak sesuai dengan diagnosis yang tertulis di resume medis.
Towards The Four-Hour Rule: Impact of Observation Units and Emergency Medicine Specialists in an Indonesian Tertiary Hospital Sulistio, Septo; Gani, Ascobat
Jurnal ARSI : Administrasi Rumah Sakit Indonesia Vol. 11, No. 3
Publisher : UI Scholars Hub

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Abstract

Emergency Department (ED) overcrowding is a global challenge. In response, the government of Indonesia mandates an ED Length of Stay (LOS) of ≤4 hours. This study aims to evaluate the impact of implementing an Emergency Department Observation Unit (EDOU) combined with an Emergency Medicine (EM) specialist-led disposition process on ED LOS at a national referral hospital in Indonesia. This was a retrospective, pre-post analysis comparing all ED visits in 2023 (pre-intervention, n = 26,282) with all visits in 2024 (post-intervention, n = 31,483). The primary outcome was the proportion of patients with an ED LOS ≤4 hours. Secondary outcomes included median ED LOS and the odds ratios (OR) for yellow zone patients achieving the ≤4-hour target based on the intervention period and the deciding physician's specialty. Following the intervention, the median ED LOS decreased from 16.4 hours to 8.0 hours (p-value = <0.05). Yellow zone patients in the post-intervention period had 6.37 times the odds of achieving a ≤4-hour LOS compared to the pre-intervention period (95% CI [5.72–7.09]). When the decision to admit to the EDOU was made by an EM specialist, the odds of achieving the target were 1.86 times higher than for other specialists (95% CI [1.43–2.42]). The combined implementation of an EDOU and EM specialists-led disposition significantly reduced ED LOS and dramatically increased the odds of meeting national performance targets. The success was driven by both increased downstream bed capacity and streamlined, specialist-led disposition processes.
Rekomendasi Sistem Stroke Pendekatan 8D dalam Penanganan Stroke Iskemik Akut Permana, Affan Priyambodo; Nafisah, Zharifah Fauziyyah; Mesiano, Taufik; Yunus, Reyhan Eddy; Sulistio, Septo; Habib, Hadiki; Mulyana, Radi Muharris; Albar, Imamul Aziz
Majalah Kedokteran Indonesia Vol 71 No 1 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.1-2021-162

Abstract

Stroke is the leading cause of death in Indonesia and leading cause of long-termdisability in the world. Ischemic stroke include 85% of all stroke cases. Ischemic stroke is caused by thromboembolic blockage or arterial stenotic by atherosclerotic plaque. Current practice shows that ischemic stroke can be treated. Treatment using intravenous thrombolytic (IV-tPA) and mechanical thrombectomy will provide better outcomes for the patient. It can be achieved when treated kurang dari 4.5 hours since onset for IV-tPA and kurang dari 6-24 hours for large vessel occlusions using mechanical thrombectomy. However, only a small number of patients can achieve this treatment due to lack of society knowledge about the sign and symptoms, transportation problems, and the stroke management system that has not been well established. Every one minute stroke patient is left untreated, 1.9 millions neurons in the brain are dead. An integrated management of the stroke system can provide better outcomes, lower the length-of-stay of the patients in hospital and reduce the cost spent for treatment. One system that is recommended for managing stroke cases is 8D that consist of detection, dispatch, delivery, door, data, decision, drug/device, and disposition. This system will help health care providers to collaborate through a multidisciplinary system for managing acute ischemic stroke cases comprehensively so that stroke patients can get proper handling and better outcomes.
Terapi Non-Invasive Continuous Positive Airway Pressure (CPAP) Ventilation pada Keracunan Gas Karbon Monoksida Simangunsong, Dedy Kristofer; Sulistio, Septo; Simbolon, Eirene; Simangunsong, Erwin Kristianto
Cermin Dunia Kedokteran Vol 51 No 2 (2024): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i2.1022

Abstract

Carbon monoxide (CO) poisoning is one of the leading environmental emergencies with high mortality and morbidity. The brain and heart are especially at-risk organs of being affected. Clinical manifestations may closely mimic various nonspecific viral illnesses. Diagnosis is made based on of clinical symptoms, patient history, and the location’s circumstances. Current therapy recommendations for CO poisoning are 100% normobaric oxygen (NBO) or hyperbaric oxygen (HBO). Non-invasive ventilation CPAP (continuous positive airway pressure) method is effective as a therapy for CO poisoning in the emergency room because it can provide tissue oxygenation and eliminate CO quickly.
Lama Rawat Kurang dari Empat Jam di Instalasi Gawat Darurat sebagai Indikator Mutu Pelayanan dan Penerapannya di Indonesia: Tinjauan Pustaka Sulistio, Septo; Gani, Ascobat
Cermin Dunia Kedokteran Vol 52 No 12 (2025): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i12.1917

Abstract

The emergency department (ED) operates 24 hours in a day, 7 days, in a a week, to provide emergency medical care, but with the growing number of visits, delays in patient assessment and treatment can impact care quality. A common performance indicator used to measure ED efficiency is the length of stay (LOS) of less than four hours, reflecting both service quality and patient flow management. This target has been widely implemented in a few countries, such as the United Kingdom and Australia to enhance ED operations. In Indonesia, a similar target has been set for national referral hospitals, aiming for 90% compliance. However, initial evaluations show that only a small fraction of hospitals meet this target, raising concerns about its feasibility. Despite these challenges, the four-hour LOS remains a relevant quality indicator in EDs. Achieving this goal requires collaborative efforts from allhealthcare stakeholders to improve ED efficiency and patient care. This literature review explores the feasibility and challenges of this target in all parts of Indonesia.
Co-Authors Albar, Imamul Aziz Ascobat Gani Hadiki Habib, Hadiki Mesiano, Taufik Mulyana, Radi Muharris Nafisah, Zharifah Fauziyyah Permana, Affan Priyambodo Simangunsong, Dedy Kristofer Simangunsong, Erwin Kristianto Simbolon, Eirene Yunus, Reyhan Eddy