Analysis of Compliance Appendectomy Integrated Care Pathway (ICP) and Evaluation of Its Implementation at Awal Bros Batam Hospital Year 2016
Abstract
Integrated Care Pathway is an integrated service planning concept that uses evidencebased medical service standard aimed at improving service quality. Appendectomy ICP was formed in 2013 at Awal Bros Batam Hospital. This research uses quantitative and qualitative approach based on the seven criteria of Malcolm Baldrige with sequential explanatory method. The criteria and feedback of the Baldrige assessment are based
on two dimensions of evaluation – Process and Result dimensions. Four factors were used to evaluate the Process dimension. They are: Approach, Deployment, Learning, and Integration (ADLI); while the four factors used to evaluate the results include Level, Trend, Comparison, and Integration (LeTCI). The result shows that the compliance of ICP implementation decreases the patients’ length of stay (P-value = 0.001). It also derives that there is no relationship with patient outcomes (P-value = 0.318). The discussion of the Problem Tree based on Baldrige criteria indicates that leaders are the first foundation in an organization. They set the vision, mission, and organizational goals. Leaders build the organization’s culture through words, actions,
and behaviours. Good leadership can improve strategic planning, focus on workforce, customer focus and organizational performance. Leadership strategies and roles contribute significantly to the implementation of ICP development. In conclusion, the implementation of leadership, strategic planning, workforce focus, customer focus, focus on process, measurement, analysis and knowledge management, and good
organizational performance play important role to support the achievement of ICP implementation through Baldrige criteria.
Keywords: Integrated Care Pathway (ICP), patient outcomes, Malcolm Baldrige criteria
References
[1] Davis, N. (2005). Integrated Care Pathways A Guide To Good Practice. Wales, England: National Leadership and Innovation Agency for Healthcare.
[2] Firmanda, D. (2006). Clinical Pathways Kesehatan Anak. Sari Pediatrics, vol. 8, no. 3, pp. 195–208.
[3] European Pathways Association. (2005). Care Pathways. Retrieved from http://ep-a.org/care-pathways/ (accessed on 30 March 2016).
[4] Graeber1, S., et al. (2007). Clinical Pathways in General Surgery Development, Implementation, and Evaluation. Homburg/Saar, Germany: Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University.
[5] Noha, et al. (2007). Are The outcomes of clinical pathways evidence-based? A Critical appraisal of clinical pathway evaluation research. Journal of Evaluation in Clinical Practice 2007, Europe. Retrieved from http://www.rug.nl/research/ (accesed on 31 March 2016).
[6] Almond, S. L., et al. (February 2008). It is not what you do, it is the way that you do it: Impact of a care pathway for appendicitis. Journal of Pediatric Surgery, vol. 43, no. 2, pp. 315–319, Liverpool, UK.
[7] Rotter, T. (2013). Clinical Pathways in Hospitals: Evaluating Effects and Costs. Erasmus University Rotterdam.
[8] Ronellenfitsch, U., Rössner, E., Jakob, J., et al. (2008). Clinical pathways in surgery: Should we introduce them into clinical routine? A review article. Langenbeck’s Archives of Surgery, vol. 393, no. 4, pp. 449–457.
[9] Baldrige Performance Excellence Program. (2015). 2015–2016 Baldrige Excellence Framework (Health Care): A Systems Approach to Improving Your Organization’s Performance. Gaithersburg, Maryland, United States.
[10] Indonesian Quality Award Foundation. (2013). Kriteria Kinerja Ekselen 2013-2014.
[11] Schyve, P. M. (2009). Leadership In Healthcare Organization: A Guide To Joint Commission (A Governance Institute White Paper). San Diego: The Governance Institute.
[12] Michael, W. (2015). Leadership and Leadership Development in Healthcare: The Evidence Base. London: Faculty of Medical Leadership and Management.