Akreditasi Rumah Sakit dan Sarana

Kesehatan (KARS)

Jurusan Gizi
Poltekkes Denpasar
Prodi DIV A

Tahun Ajaran 2019/2020

 Nyoman Ayu Anjani (P07131216020)
01

Ni Putu Devianasari (P07131216022)

02
Nama
Anggota Ida Ayu Karina Cintya Atmika (P07131216028)
03
PETA KONSEP
 Akreditasi Rumah Sakit dan Sarana Kesehatan
(KARS)

Persiapan,
Akreditasi pelaksanaan,,
Nasional Rumah penilaian survei
Sakit akreditasi oleh KARS

4 5
1

3
Akreditasi Komite
asil kegiatan setelah
Rumah Sakit Akreditasi
survei akreditasi oleh
Rumah Sakit
KARS
(KARS)

Pengertian
Akreditasi
Rumah Sakit
Akreditasi rumah sakit
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pemerintah kepada
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Pengertian
Akreditasi Nasional
Rumah Sakit
Akreditasi rumah sakit
adalah satu pengakuan
yang diberikan oleh
pemerintah kepada
rumah sakit karena telah
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Akreditasi
Internasional oleh
Joint Commission
International (JCI)]
Akreditasi adalah proses
penilaian organisasi pelayanan
kesehatan dalam hal ini rumah
sakit utamanya rumah sakit
non pemerintah, oleh lembaga
akreditasi internasional
berdasarkan standar
internasional yang telah
ditetapkan
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Akreditasi Rumah Sakit

VISI
Instrumen Menuju Indonesia Sehat 2010 melalui
continuous quality improvement pelayanan
perumahsakitan

MISI

1. Menjadi landasan utk memelihara &

meningkatkan pelayanan kesehatan yang
bermutu, merata & terjangkau;
2. Bermanfaat untuk masyarakat (public good
and private good)

TUJUAN
Tujuan Umum :
.Rumah Sakit di Indonesia >>> memenuhi standar
yang ditetapkan >>>mutu pelayanan rumah sakit
dapat dipertanggungjawabkan.
 Memberikan pengakuan dan penghargaan
kepada Rumah Sakit yang telah mencapai
tingkat pelayanan kesehatan sesuai
dengan standar yang telah ditetapkan.

Memberikan jaminan kepada petugas

Rumah Sakit bahwa semua fasilitas,
Tujuan Khusus Akreditasi tenaga dan lingkungan yang diperlukan
Rumah Sakit tersedia

Memberikan
. jaminan dan kepuasan
kepada pelanggan dan masyarakat
 UU No Here
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dibahas mengenai Akreditasi pada pasal 40 yang

berbunyi :

Landasa
n Hukum
Akeditasi
Akreditasi rumah sakit
Dalam upaya peningkatan mutu sebagaimana dimaksud pada
pelayanan Rumah Sakit wajib ayat (1) dilakukan oleh suatu Lembaga independen
sebagaimana dimaksud pada
Rumah
dilakukan akreditasi secara lembaga independen baik dari
berkala minimal 3 (tiga) tahun dalam maupun dari luar negeri ayat (2) ditetapkan oleh
sekali. berdasarkan standar akreditasi menteri.

Sakit yang berlaku.

 MANFAAT AKREDITASI RUMAH SAKIT
1. Negosiasi klaim asuransi kesehatan
dengan Rumah Sakit.
2. Memberi gambaran, Rumah Sakit mana
yang dapat dijadikan mitra kerja
.
Status akreditasi merupakan status simbol bagi
Rumah Sakit dan dapat meningkatkan citra dan
01
kepercayaan masyarakat kepada Rumah Sakit.
03

03 01
Bagi Bagi Rumah
05 05 perusahaan Sakit
1. Petugas Rumah Sakit merasa lebih Bagi Pegawai Asuransi
senang dan aman serta terjamin di RS
bekerja.
2. Self assessment akan menambah
kesadaran akan pentingnya
04
pemenuhan standar dan
peningkatan mutu sehingga dapat
Bagi
masyarakat 02 02
memotivasi pegawai. 04 Bagi
Salah satu pendekatan untuk
pemerintah
Masyarakat dapat mengenal dan
mengingkatkan dan membudayakan
memilih Rumah Sakit yang konsep mutu pelayanan Rumah Sakit
dianggap baik pelayanannya
Instrumen Akreditasi Rumah
Sakit

Standar pelayanan rumah sakit

Akreditasi tingkat dasar dengan
5 (lima) Pelayanan
terdiri dari 20 pelayanan.
Dari 20 (dua puluh) pelayanan
rumah sakit ini kemudian disusunlah
4 1 instrumen
berjumlah
akreditasi
16 (enam
lengkap
belas)
pelayanan dan bukan 20 (dua puluh)
pelayanan
Menteri Kesehatan dengan SK
Menkes Nomor 436/93 Tentang
Berlakunya Standar Pelayanan
Rumah Sakit dan Standar
Pelayanan Medis

Akreditasi tingkat lanjut

dengan 12 (dua
Pelayanan
.
belas)
3 2 Akreditasi dengan 16 (enam
belas) pelayanan
 Komite Akreditasi Rumah Sakit (KARS)

Misi
1. Membimbing dan membantu rumah sakit untuk
meningkatkan mutu pelayanan dan keselamatan
pasien melalui akreditasi.
2. Memperoleh pengakuan internasional sebagai
badan akreditasi berkelas internasional oleh ISQua
(International Society Quality in Healthcare) dan
memperoleh pengakuan masyarakat baik ditingkat
nasional maupun internasional.
KARS (Komisi Akreditasi Rumah Sakit)
merupakan lembaga resmi yang ditunjuk dan
berwenang untuk melakukan survei verifikasi
dan survei akreditasi, untuk selanjutnya
memutuskan predikat Akreditasi yang tepat
untuk suatu Rumah Sakit.

Visi
Menjadi badan akreditasi yang
memiliki kredibilitas tinggi ditingkat
nasional dan internasional.
 NILAI KARS

Integritas
TUJUAN KARS
Profesionalisme

1. Diperolehnya pengakuan Komitmen

internasional oleh ISQua
(International Society Teamwork
Quality in Healthcare) dan
masyarakat.
2. Meningkatnya mutu
pelayanan rumah sakit
melalui akreditasi.
3. Meningkatnya keselamatan
pasien di rumah sakit
melalui akreditasi.
 Persiapan Survei
Akreditasi oleh KARS

Persiapan survei akreditasi dimulai setelah

Komisi Akreditasi Rumah Sakit (KARS)
menerima surat permohonan untuk dilakukan
1 survei akreditasi rumah sakit dan isian
lengkap Berkas Permohonan Survei
Akreditasi Rumah Sakit.

Mengunduh Berkas Permohonan Survei

Akreditasi Rumah Sakit di web site 2
KARS (www.kars.or.id)

KARS menyediakan beberapa jenis kegiatan

3 untuk membantu RS menyiapkan akreditas
diantaranya : seminar, lokakarya
(workshop), bimbingan dan survei simulasi
akreditasi
 PELAKSANAAN SURVEI
AKREDITASI OLEH KARS

Pembukaan pertemuan.

Telaah rekam medis pasien Peningkatan Mutu dan

secara tertutup (pasien sudah Keselamatan Pasien dan MDGs.
pulang)

.
Verifikasi dan masukan Perencanaan survei

Telaah dokumen.
 PELAKSANAAN SURVEI
AKREDITASI OLEH KARS

Kunjungan ke area pelayanan pasien

yang dipandu oleh kegiatan telusur.

Pertemuan penutup survei

dengan pimpinan Kegiatan survei yang terarah

Telaah dari lingkungan;

.
Persiapan surveior membuat laporan bangunan; sarana dan
prasarana.

Wawancara dengan pimpinan

 Penilaian Hasil Survei Akreditasi oleh KARS
Proses akreditasi terdiri dari kegiatan
survei oleh Tim Surveior dan proses
pengambilan keputusan kelulusan
akreditasi oleh Ketua KARS, melalui
Tim Penilai Laporan Survei Akreditasi
Rumah Sakit
15 KRITERIA YANG DINILAI
1. Sasaran Keselamatan Pasien Rumah Sakit
2. Hak Pasien dan Keluarga (HPK)
3. Pendidikan Pasien dan Keluarga (PPK)
4. Peningkatan Mutu dan Keselamatan Pasien (PMKP)
5. Millenium Development Goals (MDGs)
6. Akses Pelayanan dan Kontinuitas pelayanan (APK)
7. Asesmen Pasien (AP)
8. Pelayanan Pasien (PP)
9. Pelayanan Anestesi dan Bedah (PAB)
10. Manajemen Penggunaan Obat (MPO)
11. Manajemen Komunikasi dan Informasi (MKI)
12. Kualifikasi dan Pendidikan Staf (KPS)
13. Pencegahan dan Pengendalian Infeksi (PPI)
14. Tata Kelola, Kepemimpinan dan Pengarahan (TKP)
15. Manajemen Fasilitas dan Keselamatan (MFK)
 TINGKATAN KELULUSAN & KRITERIA

Tingkat Dasar
Apabila kriteria no 1-4, nilai minimum 80%, dan
kriteria no 5-15 nilai minimum 20 %.
. Tingkat Dasar Tingkat Madya
Tingkat Madya
Apabila kriteria no 1-8, nilai minimum 80% dan
kriteria 9-15, nilai minimum 20% 1 2
Tingkat Utama
Apabila kriteria no1-12, nilai minimum 80% dan
3 4
kriteria 13-15, nilai mimimum 20% Tingkat Utama Tingkat
.
. Paripurna
Tingkat Paripurna
Seluruh kriteria 1-15, nilai minimum 80%
 Tujuan Umum
Surveior membuat laporan Mendorong manajemen RS
dengan format yang sudah untuk meningkatkan mutu
ditetapkan KARS pelayanan

Mengirim laporan paling Tujuan Khusus

lambat 1 minggu setelah
survei dilakukan 1. Memantau rumah sakit dalam hal
Hasil Kegiatan Pembinaan pelaksanaan rekomendasi
setelah Survei Paska surveior.
Akreditasi oleh Akreditasi 2. Memberikan arahan untuk dapat
Laporan hasil survei KARS memenuhi rekomendasi surveior
akreditasi akan ditelaah 3. Melakukan evaluasi terhadap
oleh tim penilai yang penerapan standar di rumah
dibentuk oleh Ketua Kars sakit
4. Meningkatkan interaksi antara
Rumah Sakit, Dinas Kesehatan
Tim penilai mengusulkan status Provinsi dan KARS
survei akreditasi kepada Ketua
KARS dan menerbitakan sertfikat
kelulusan akreditasi
 Your Picture Here

RS kurang memahami Masalah  Dalam Kegiatan pelayanan

bagaimana melakukan administrasi dan
self assesment yang Pelaksanaan manajemen yang umumnya
baik meskipun sudah
ada pembinaan oleh
Akreditasi dianggap hanya sebagai
kegiiatan administrasi atau
Dinas Kesehatan sekertariat RS
Provinsi

Padahal pelayanan administrasi dan manajemen merupakan “payung” untuk

seluruh kegiatan pelayanan yang ada di rumah sakit. .
 KEPUTUSAN STATUS AKREDITASI
Akreditasi Bersyarat
Nilai total >65%, tidak ada
Tidak Diakreditasi <=60% kemudian 1 tahun
dinilai lagi

Akreditasi Penuh
Nilai total >= 75%, tidak ada
<=60% dan masa berlaku 3
tahun
Akreditasi Istimewa
Masa berlaku 5 tahun dan
didapat setelah 3 kali
berturut-turut
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