Lesson Learnt

Dr. Budi Yunanto, MPH

Head of Section of Quality and Risk
Management Mayapada Hospital
Jakarta Selatan

 Regulation of the quality of care is a key challenge for governments,

particularly because of the complexities of defining and measuring
quality. However, with the introduction of national health insurance
scheme and the move towards universal health coverage, there is
increasing recognition of the need to address quality of care as part
of these reforms.
Hospital accreditation has been established in many high-income
countries, and some low and middle-income countries, as an
approach to improving quality of care that combines the two
elements of quality assurance and quality improvement
While hospital accreditation was originally introduced and manageg
as a professional and industry voluntary self-improvement initiative,
recent reforms, such as mandatory requirements, have tended to
increase government control of accreditation schemes, and to shift
towards a more explicit regulatory role.

Accreditation in Indonesia
A mixed public-private health system and collective
government responsibility for health accros national and
regional jurisdictions.
The Indonesian system of government is a devolved rather
than federal system, with all three levels of government
having significant responsibilites for health care and
regulation of central hospitals, provincial government for
provincial hospitals (both government and private) and
district and municipality governments for their level of
hospitals (government and private)
In 2014, of the 2362 hospitals registered in Indonesia, 1501
or 64 percent were in the private sector, while the
remainder were in the government sector (Dirjen BUK
2014)

 Various form of health insurance covered

approximately 63 percent of the population in
2011. These included the national social
health insurance (jamkesmas) covering 32
percent, local government health insurance
(jamkesda) 13.5 percent. Other state
insurance schemes (9.5 percent) and private
insurance (7.7 percent) (Coordinating Ministry
of Social Welfare, 2012)

 According to World Bank data, the growing of middle

income population is considerably high. To date, 56.5
percent from 236.6 milion Indonesia populations is
middle income. Out of this, 14 milion people spend 620 USD per day, 91 million spend 2-4 USD per day.
According to the Boston Consulting Group, the
Indonesian middle class may reach 141 milion people
in 2020.
Indonesia economic growth in 2013 is reaching 6.2
percent.
Positive economy sign.

Introduction
Accreditation introduction
National healthcare strategy direction 2014
Creating a world class hospital
Improving healthcare service quality
Seizing regular customers and re-capturing patients that are going
abroad to get healthcare treatment
Seizing potential loss of customers going to an internatial hospital
(looking through

Organization standard compliance

The hospital accreditation system change from ... into 2012
national accreditation system (quality and patient safety)
adopting from Joint Commission International accreditation
standard manual 4th edition
Overview a little bit about the standard + MDGs

Lesson Learnt
Government Sectors
The MOH initiative projects to have world class hospitals from accrediting 8
public hospitals by international hospital accreditation (JCI) by 2014 and
getting the national hospital accreditation body internationally recognized by
RSCM (JCI accredited)
Strong commitment from hospital leaders
Integrated plan of hospital management + medical faculty university of Indonesia
Staff commitment, strategic planning, cultural transformation

RS Sanglah (JCI accredited)

RS Sardjito
RS Wahidin
RS Adam Malik
RS Gatot Subroto
RS Fatmawati (JCI accredited)

Private Sectors

 To date 17 organizations in Indonesia have been

accredited by Joint Commission International
Awal Bros Hospital Batam, Awal Bros Bekasi, Awal
Bros Pekanbaru, Awal Bros Hospital Tangerang, Eka
Hospital, Eka Hospital Pekanbaru, Fatmawati General
Hospital, JEC@ Kedoya Eye Hospital, RS Premier
Bintaro, RS Premier Jatinegara, RS Premier Surabaya,
RSUP Sanglah, RSUPN Dr. Cipto Mangunkusumo, RS
Pondok Indah Puri Indah, RSPAD Gatot Soebroto
Ditkesad, Santosa Bandung Central, Siloam Hospital
Lippo Village
The number is growing

The shifting accreditation system

From 16 Chapters KARS into KARS 2012
hospital accreditation standard manual which
adopted from JCI
Looking through the standard

Moving Forward
Hospital Quality Improvement
Maintaining quality and patient safety indicators
Improving by time

Regulation changes or improvements

2015-2019 National Health Strategic Direction
Universal Healthcare Coverage
MDGs
Sistem Kesehatan Nasional

Electronic National Hospital Quality Indicators Database

Trend of population
Capturing the growing middle income population
Seizing regular/loyal customers
Competiting through quality standard and modern techniques and
devices

INDONESIA HEALTH STRATETIG

DIRECTION
RPJMN I
2005 -2009
Pengembangan
kesehatan
diarahkan untuk
meningkatkan
akses dan mutu
yankes

RPJMN II
2010-2014
Akses masyarakat
thp yankes yang
berkualitas telah
lebih berkembang
dan meningkat

RPJMN III
2015 -2019
Akses masyarakat
terhadap yankes
yang berkualitas
telah mulai
mantap

RPJMN IV
2020 -2025
Kes masyarakat
thp yankes yang
berkualitas telah
menjangkau dan
merata di
seluruh wilayah
Indonesia

KURATIFREHABILITATIF

PROMOTIF - PREVENTIF

VISI:
MASYARAKAT
SEHAT
YANG MANDIRI
DAN
BERKEADILAN

Arah pengembangan upaya kesehatan, dari kuratif bergerak ke arah

promotif, preventif sesuai kondisi dan kebutuhan

11

I.ISU STRATEGIS RPJMN 2015-2019

1.

Meningkatkan akses dan kualitas pelayanan kesehatan ibu, bayi, balita,

remaja dan lansia
2. Meningkatkan akes terhadap pelayanan gizi masyarakat
3. Meningkatkan pengendalian penyakit dan penyehatan lingkungan
4. Meningkatkan ketersediaan, keterjangakauan, pemerataan dan kualitas
farmasi, alat kesehatan
5. Meningkatkan pengawasan obat dan makanan
6. Meningkatkan Promosi kesehatan dan pemberdayaan masyarakat
7. Mengembangkan Jaminan Kesehatan Nasional
8. Meningkatkan ketersediaan, penyebaran dan kualitas sumber daya
manusia kesehatan
9. Mengembangkan pelayanan kesehatan primer
10. Menguatkan pelayanan kesehatan rujukan yang berkualitas
11. Menguatkan manajemen dan sistem informasi kesehatan
12. Meningkatkan efektifitas pembiayaan kesehatan

Future Challenges

Maintaning Quality Standards

Free Area Trade
Universal Healthcare Coverage
The growing number of middle income
population