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All Journal Majalah Kesehatan FKUB Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Medika Malahayati AKADEMIK: Jurnal Mahasiswa Humanis Jurnal Hukum dan Etika Kesehatan (JHEK) Cermin Dunia Kedokteran
Johan, Willy
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Religion Humanities Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences

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PENGKAJIAN MANAJEMEN BENCANA MELALUI ANALISIS ANGKA KEMATIAN DAN WAKTU TUNGGU PEMERIKSAAN PENUNJANG PASIEN DI IGD RSSA DALAM MENGHADAPI INSIDEN KORBAN MASAL TRAGEDI KANJURUHAN Agung, Suryanto Eko; Prasetyadjati, Ari; Johan, Willy
Jurnal Medika Malahayati Vol 8, No 1 (2024): Volume 8 Nomor 1
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jmm.v8i1.13802

Abstract

Abstrak: Pengkajian Manajemen Bencana Melalui Analisis Angka Kematian dan Waktu Tunggu Pemeriksaan Penunjang Pasien di IGD RSSA dalam Menghadapi Insiden Korban Masal Tragedi Kanjuruhan. Departemen emergensi merupakan aspek yang esensial dalam suatu rumah sakit dimana kesiapsiagaan darurat rumah sakit penting untuk menjaga integritas sistem pelayanan kesehatan selama bencana maupun insiden korban masal (MCI). Penelitian ini bermaksud untuk melakukan penilaian terhadap manajemen kedaruratan instalasi gawat darurat (IGD) RSUD dr Saiful Anwar (RSSA) melalui analisis angka kematian dan waktu tunggu pemeriksaan penunjang (foto toraks - CXR) seluruh pasien di IGD RSSA sebelum dan ketika fase respon pada MCI tragedi Kanjuruhan dengan studi potong lintang dimana analisis data dilakukan dengan uji Wilcoxon dan didapatkan bahwa Jumlah pasien pada 7 hari sebelum MCI di IGD RSSA sebanyak 440 pasien (45,98%) dan dalam 7 hari fase respon sebanyak 517 pasien (54,02%) dengan p=0,021 (p<0,05). Rata-rata angka kematian IGD sebanyak 4 dan 5 kasus, p=0,186 (p>0,05). Sedangkan waktu tunggu CXR adalah 2.60 dan 2.16 jam dengan p=0.73 (p>0,05). Peningkatan jumlah pasien yang signifikan pada MCI tragedi Kanjuruhan dan tidak diikuti peningkatan angka kematian dan waktu tunggu CXR pasien IGD RSSA pada periode yang sama menunjukkan bahwa manajemen mutu  pelayanan IGD tetap kondusif dalam menghadapi tragedi kanjuruhan
Laporan Kasus: KERACUNAN SENG FOSFIDA TERKAIT PERCOBAAN BUNUH DIRI Abdullah, Taufiq; Zaiyanah, Munsifah; Prasetyadjati, Ari; Johan, Willy
Majalah Kesehatan Vol. 10 No. 4 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2023.010.04.7

Abstract

Seng fosfida telah lama digunakan sebagai rodentisida. Seng fosfida yang tertelan dapat berubah menjadi gas fosfin di dalam tubuh sehingga setelah diabsorbsi melalui gaster dan intestinal akan terdistribusi melalui sistem sirkulasi  hingga mencapai hepar dan paru-paru. Gas fosfin memiliki sejumlah efek toksik metabolik dan non metabolik. Kolaps sirkulasi, hipotensi, gejala syok, miokarditis, perikarditis, edema paru akut, dan gagal jantung kongestif adalah gejala klinis yang sering ditemukan. Artikel ini mempresentasikan kasus seorang laki-laki berusia 44 tahun dengan keracunan seng fosfida terkait percobaan bunuh diri. Artikel ini bertujuan untuk menyajikan bahwa perawatan simtomatik dan suportif di Unit Gawat Darurat dapat menyelamatkan hidup walaupun tidak didapatkan riwayat keracunan yang memadai dan tidak ada antidot khusus untuk agen yang dikonsumsi.
Diskrepansi Pembayaran BPJS Kesehatan Terhadap Klaim Pelayanan IGD Berdasarkan PERMENKES Nomor 27 Tahun 2014 Johan, Willy; Yuyut Prayuti; Arman Lany
Jurnal Hukum dan Etika Kesehatan VOLUME 4 NO 1
Publisher : Magister Ilmu Hukum - Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/jhek.v4i1.172

Abstract

In realizing Universal Health Coverage (UHC), Indonesian government has launched a national health insurance program (JKN) organized by the Health Social Security Administering Agency (BPJS) starting from January 01, 2014. The policy of determining outpatient episodes for patients in the emergency department (ED) who receive treatment for less than 6 hours raises problems related to claims for services provided by service providers. Hospitals are required to provide health services in emergency situations to save lives and prevent disabilities, while also having profit objectives. This research aims to describe the output and impact in relation to the regulations. The research uses normative legal research methods with statute approach, conceptual approach and a non-judicial case study approach, presenting several cases related to discrepancies between ER services provided and claims paid, especially for patients who die in the ER within 6 hours, which is suspected to cause hospitals to be selective in handling emergency patients. The Minister of Health Regulation No. 27 of 2014 regarding INA-CBG creates dilemmas and challenges for hospitals in providing optimal services for emergency cases in the ER.
Gambaran Kasus Intoksikasi Di Instalasi Gawat Darurat (IGD) Rumah Sakit Saiful Anwar Malang Tahun 2021-2022 Abdullah, Taufiq; Prasetyadjati, Ari; Johan, Willy
Jurnal Ilmu Kedokteran dan Kesehatan Vol 11, No 12 (2024): Volume 11 Nomor 12
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v11i12.16476

Abstract

Indonesia merupakan negara berkembang dengan populasi yang padat dan masuk dalam 5 besar negara dengan kepadatan penduduk tertinggi di dunia. Sampai saat ini belum ada basis data terkait kasus keracunan yang tercatat secara resmi di Indonesia. Sudah saatnya kasus keracuanan mendapatkan perhatian lebih terkait diagnosis dan penatalaksanannya. Menggunakan metode penelitian deskriptif, peneliti mengumpulkan 68 sampel pada tahun 2021-2022, yang semuanya adalah pasien dengan intoksikasi yang datang ke IGD RS Saiful Anwar Malang. Berdasarkan variabel jenis kelamin, terdapat 38 pasien laki-laki dan 28 pasien perempuan.. Pada variabel triase didapatkan 6 pasien kategori hijau, 46 pasien kategori kuning, dan 16 pasien kategori merah Pada variabel dokter penanggung jawab yang merawat pasien kasus terbanyak di disposisi pada bagian penyakit dalam 56 kasus, bagian bedah 4 kasus, bagian mata 4 kasus, bagian anak 2 kasus, dan bagian paru 2 kasus. Pada variabel penyebab keracunan, yang terbanyak yaitu alkohol sebanyak 26 kasus, obat obatan sebanyak 15 kasus, agen kaustik sebanyak 14 kasus, pestisida sebanyak 5 kasus, asfiksian sebanyak 4 kasus, hidrokarbon 2 kasus, dan NAPZA sebanyak 2 kasus. Variabel terakhir mengkategorikan status keluar dari IGD RSSA, rawat inap (MRS) 41 kasus, pulang ats permintaan sendiri (PAPS) 16 kasus, KRS (dipulangkan) 9 kasus, meninggal 1 kasus dan masuk ruang operasi 1 kasus. Kasus keracunan terbanyak di IGD RSSA pada periode penelitian ini adalah keracunan alkohol dengan proporsi P1 yang lebih besar dibandingkan dengan intoksikasi lainnya. Sebagian besar pasien dengan kasus keracunan memerlukan rawat inap untuk observasi dan penanganan lebih lanjut
Penerapan ADR dan Potensi Arbitrase dalam Penyelesaian Sengketa Medis di Indonesia Anggraeni, Happy Yulia; Sagita, Praniko Imam; Yusmana, Fane Virginia; Reza, Muhamad; Sehafudin, Sultan; Johan, Willy
AKADEMIK: Jurnal Mahasiswa Humanis Vol. 5 No. 1 (2025): AKADEMIK: Jurnal Mahasiswa Humanis
Publisher : Perhimpunan Sarjana Ekonomi dan Bisnis

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37481/jmh.v5i1.1267

Abstract

Medical disputes in Indonesia often face challenges such as lengthy litigation processes, high costs, and low satisfaction among the parties involved. In this context, Alternative Dispute Resolution (ADR), particularly mediation and arbitration, offers a more efficient solution. Mediation has been regulated under Law No. 30 of 1999 on Arbitration and Alternative Dispute Resolution as well as Supreme Court Regulation (Perma) No. 1 of 2016. However, arbitration mechanisms still lack a specific legal framework, even though Law No. 17 of 2023 on Health emphasizes the importance of swift and fair dispute resolution in healthcare services. Unlike litigation, arbitration allows for final, expedited, and binding resolutions. Countries such as the United States, the United Kingdom, and Taiwan have successfully implemented arbitration in medical disputes. Taiwan, for instance, has specific regulations that facilitate medical arbitration processes, providing legal certainty for patients and healthcare providers. Indonesia can learn from these international experiences. By clarifying arbitration regulations in the healthcare sector, the government can strengthen a dispute resolution system that is responsive to societal needs. This enhancement can be achieved through the training of professional arbitrators and promoting the use of ADR, ensuring that medical disputes are resolved more fairly, quickly, and cost-effectively.
Model Prediktor Prognosis Pasien Trauma Multipel Berdasarkan Lokasi Anatomis Cedera di RSSA Malang, Indonesia: Sub-Studi dalam Penyusunan Model Multikomponen: Hasil Penelitian Prasetyadjati, Ari; Setijowati, Nanik; Irsan, Istan Irmansyah; Zaiyanah, Munsifah; Johan, Willy
Cermin Dunia Kedokteran Vol 52 No 9 (2025): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i9.1316

Abstract

Introduction: Management of trauma still poses a challenge in Indonesia without significant improvement in mortality rates in the last 12 years, especially in multiple trauma involving at least 2 organ systems. This study aims to predict the prognosis of multiple trauma patients treated at Saiful Anwar Hospital (RSSA) Malang based on the anatomical location of the injury. Methods: Retrospective cohort study of 506 multiple trauma patients in RSSA during 2021-2022. The analyses used a chi square test and logistic regression test to obtain a regression equation. Results: Multiple trauma cases in RSSA were dominated by males in productive age (15-54 years). Head injury was the most influential variable in predicting the prognosis of multiple trauma patients in hospital, followed by thoracic injury, spinal injury, and abdominal injury. The logistic regression model was quite capable of explaining the data (p=0.931; Hosmer-Lameshow test), while the area under the curve (AUC-ROC) for prognosis in hospital care from this equation was 0.706 with a 95% confidence interval of 0.653-0.759 (good category). Conclusion: Head injuries, thoracic injuries, abdominal injuries, and spinal injuries are predictors of mortality of trauma cases in hospital care in RSSA, Malang, Indonesia.
Studi Kualitatif Manajemen Strategi IGD RS A dalam Menghadapi COVID-19 sebagai Input untuk Tata Laksana Ancaman Wabah Penyakit Infeksi Johan, Willy; Ida Ayu Nitri Saraswati; Karunia Meilani Nurfatika; Dian Angger Suaner; Poppy Putri Pratiwi; Muhammad Arief Kusuma; Alphonsus Arya Arbikara; Veranita, Mira
Cermin Dunia Kedokteran Vol 51 No 8 (2024): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i8.1193

Abstract

Background: Reflecting on the COVID pandemic, many emergency departments (ED) experienced difficulties in responding to health crises caused by emerging infectious diseases. This qualitative research explores the strategic management of one of the hospital EDs assigned as a COVID referral hospital. Methods: In-depth interviews with 10 key informants, observation, and document analysis. Peer discussions with experts were also carried out to ensure the validity of the existing data. Results: The research results show that RS A prepared surge capacity (space, staff, supply, and system) before the crisis, and the disaster management system has been prepared and continuously updated. Conclusion: In addition to being designed to optimize medical services for emergency patients, emergency departments must also be prepared to deal with disasters. The spare capacity that has been prepared by the Hospital A Emergency Unit in the face of disasters can be fully utilized in the COVID-19 pandemic.
Gejala Akut Abdomen Terselubung pada Pasien Gagal Jantung Akut: Identifikasi Awal dengan Ultrasonografi Darurat: Laporan Kasus Nugroho, Hari Adityo; Prasetyadjati, Ari; Johan, Willy
Cermin Dunia Kedokteran Vol 52 No 4 (2025): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i4.1274

Abstract

Background: The use of USG (ultrasonography) in the ED (emergency department) has grown rapidly to aid decisions on management. Case: A 71-year-old woman with a history of heart disease, in shock condition, fever for 2 days, and diarrhea was referred with diagnosis of cardiogenic shock. On physical examination there were no signs of an acute abdomen, with suspicion of sepsis. Chest x-ray and urine examination did not find signs of infection. During treatment, consciousness and vital signs worsened; abdominal ultrasound showed signs of acute abdomen which was confirmed by 2-position abdominal x-ray. Discussion: In this case, the final diagnosis was septic shock with cardiogenic shock due to secondary peritonitis due to perforated viscous organ and electrolyte imbalance (mild hyponatremia and hypochloremia), altered mental state and geriatric problem. Surgery was not possible due to the patient’s condition. The patient succumbed on the 2nd day of treatment. Conclusion: Bedside ultrasound examination helps to establish an earlier diagnosis in patients especially with atypical symptoms and may be the key to providing better medical decisions in the ED.
Pengaruh Jumlah Kunjungan, Lama Tinggal (LOS), dan Kepadatan IGD terhadap Mortalitas di IGD RS Tersier Kota Malang: Hasil Penelitian Johan, Willy; Andriani, Rian; Mulyani, Kahar
Cermin Dunia Kedokteran Vol 51 No 11 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i11.1378

Abstract

Introduction: Emergency department (ED) mortality is a critical issue that has a major impact on individuals, society, and the entire health system and is one of the indicators of emergency department service performance. This research aims to provide input to hospital management regarding the impact of non-medical factors (number of visits, length of stay/LOS, and ED crowding) on patient mortality, related to improvement policy-making in ED patient services. Method: A retrospective study on 130 ED shifts from medical record data during 2022-2023. The independent variables were the number of visits, LOS, ED crowding measured by CEDOCS, and ED mortality as the dependent variable. Results: There were deaths in 38 out of 130 shifts in the ED, with a total mortality of 1.6%. Statistical tests showed a significant effect between crowding and ED mortality (p = 0.01), a non-significant effect between visits and ED mortality (p = 0.76), and a non-significant effect between LOS and ED mortality (p = 0.62). The results of the regression analysis were able to explain the data (p = 0.91; Hosmer-Lameshow test). The area under the curve (AUC) for prognosis in hospital treatment is 0.641 with a 95% confidence interval of 0.539-0.744 (medium category). Conclusion: The significant effect between crowding and patient mortality in the ED indicates that strategic management must be carried out to reduce ED crowding.
Co-Authors Agung, Suryanto Eko Alphonsus Arya Arbikara Arman Lany Dian Angger Suaner Ida Ayu Nitri Saraswati Irsan, Istan Irmansyah Karunia Meilani Nurfatika Muhamad Reza Muhammad Arief Kusuma Mulyani, Kahar Nanik Setijowati Nugroho, Hari Adityo Poppy Putri Pratiwi Prasetyadjati, Ari Prayuti, Yuyut Rian Andriani, Rian Sagita, Praniko Imam Sehafudin, Sultan Taufiq Abdullah, Taufiq Veranita, Mira Yusmana, Fane Virginia Zaiyanah, Munsifah