Lama Rawat Kurang dari Empat Jam di Instalasi Gawat Darurat sebagai Indikator Mutu Pelayanan dan Penerapannya di Indonesia

Tinjauan Pustaka

Penulis

  • Septo Sulistio Fakultas Kesehatan Masyarakat Universitas Indonesia
  • Ascobat Gani Departemen Administrasi dan K ebijakan Kesehatan, Fakultas Kesehatan Masyarakat Universitas Indonesia, Jakarta, Indonesia

DOI:

https://doi.org/10.55175/cdk.v52i12.1917

Kata Kunci:

Indikator mutu, instalasi gawat darurat, lama rawat

Abstrak

Instalasi gawat darurat (IGD) menyediakan layanan medis darurat selama 24 jam sehari dan 7 hari dalam seminggu, namun seiring dengan meningkatnya jumlah kunjungan, adanya keterlambatan dalam pengkajian dan pengobatan pada pasien dapat berdampak pada kualitas pelayanan. Salah satu indikatornya adalah lama rawat pasien di IGD kurang dari 4 jam. Target ini telah diterapkan di berbagai negara, seperti Inggris dan Australia, sebagai upaya meningkatkan efisiensi serta kelancaran alur pasien di IGD. Di Indonesia, lama rawat 4 jam juga digunakan sebagai indikator mutu di rumah sakit vertikal dengan target capaian 90%. Akan tetapi, hanya sebagian kecil rumah sakit yang berhasil mencapainya. Meskipun masih terdapat pro dan kontra, penerapan lama rawat kurang dari 4 jam sebagai indikator mutu IGD tetap relevan. Implementasi indikator ini memerlukan dukungan dari seluruh pemangku kepentingan agar dapat tercapai dan kualitas pelayanan di IGD dapat terus ditingkatkan. Tinjauan pustaka ini bertujuan untuk mengeksplorasi kemampulaksanaan dan tantangan target ini di seluruh bagian Indonesia.

Unduhan

Data unduhan belum tersedia.

Referensi

Nahidi S, Forero R, Man N, Mohsin M, Fitzgerald G, Toloo GS, et al. Impact of the four-hour rule/national emergency access target

policy implementation on emergency department staff : a qualitative perspective of emergency department management changes.

Emerg Med Australas. 2019;31(3):362−71. doi: 10.1111/1742-6723.13164.

Ngo H, Forero R, Mountain D, Fatovich D, Man N, Sprivulis P, et al. Impact of the four-hour rule in Western Australian hospitals: trend

analysis of a large record linkage study 2002−2013. PLoS One. 2018;13(3):e0193902. doi: 10.1371/journal.pone.0193902.

Cameron PA, Cooke MW. Lessons from the 4-hour standard in England for Australia. Med J Aust. 2011;194(1):4−5. https://doi.

org/10.5694/j.1326-5377.2011.tb04134.x.

Mason S, Weber EJ, Coster J, Freeman J, Locker T. Time patients spend in the emergency department: England’s 4-hour rule - a case

of hitting the target but missing the point? Ann Emerg Med. 2012;59(5):341–9. http://dx.doi.org/10.1016/j.annemergmed.2011.08.017.

Kementerian Kesehatan Republik Indonesia. Indikator waktu pelayanan rumah sakit vertikal [Internet]. Jakarta: Kemenkes; 2023.

Available from: https://docs.google.com/spreadsheets/d/1-38ITw3BTwdfEuSer_GllTFBX02r86XqFDVk7XWyE-k/edit?usp=drivesdk.

Kementerian Kesehatan Republik Indonesia. KPI transformasi rumah sakit vertikal tahun 2024. inisiatif 2. Perbaikan waktu

layanan [Internet]. Jakarta: Kemenkes; 2024 [cited 2025 Mar 7]. Available from: https://docs.google.com/spreadsheets/d/1-

ITw3BTwdfEuSer_GllTFBX02r86XqFDVk7XWyE-k/edit?gid=1513720914#gid=1513720914.

Sullivan C, Staib A, Khanna S, Good NM, Boyle J, Cattell R, et al. The national emergency access target (NEAT) and the 4-hour rule: time to review the target. Med J Aust. 2016;204(9):354. doi: 10.5694/mja15.01177.

Sullivan C, Staib A, Griffin B, Bell A, Scott I. The four hour rule: the national emergency access target in Australia. time to review. Aust

Heal Rev. 2016;40(3):319–23. doi.org/10.1071/AH15071.

Australian Institute of Health and Welfare. Emergency department care access [Internet]. 2024 [cited 2025 Mar 8]. Available from:

https://www.aihw.gov.au/reports-data/myhospitals/intersection/access/ed.

Boyle A, Higginson I, Sarsfield K, Kumari P. RCEM acute insight series: crowding and its consequences. Royal College of Emergency

Medicine [Internet]. 2021 [cited 2025 Mar 7]. Available from: https://www.rcem.ac.uk/RCEM/Quality_Policy/Policy/RCEM_CARES/

RCEM/Quality-.

Campbell P, Boyle A, Higginson I. Should we scrap the target of a maximum four hour wait in emergency departments? BMJ. 2017;

:j4857. doi: 10.1136/bmj.j4857.

National Health Service England. Delivery plan for recovering urgent and emergency care services-January 2023 [Internet]. 2023.

Available from: https://www.england.nhs.uk/publication/delivery-plan-for-recovering-urgent-and-emergency-care-services/.

National Health Service. Clinically-led review of NHS Access standards interim report from the NHS National Medical Director

[Internet]. 2019. Available from: https://www.england.nhs.uk/wp-content/uploads/2019/03/CRS-Interim-Report.pdf.

Samavedam S. How long can you stay in emergency department (ED)? Indian J Crit Care Med. 2021; 25(11):1213–4. https://doi.

org/10.5005/jp-journals-10071-24028.

Tim Kerja Pengendali Layanan Operasional RSCM. Evaluasi program intensifikasi gedung a dan ruang rawat emergensi IGD RSCM.

Schull MJ, Guttmann A, Leaver CA, Vermeulen M, Hatcher CM, Rowe BH, et al. Prioritizing performance measurement for

emergency department care: consensus on evidencebased quality of care indicators. Can J Emerg Med. 2011;13(5):300–9. doi:

2310/8000.2011.110334.

Nahidi S, Forero R, Man N, McCarthy S, Man N, Gibson N, et al. Qualitative analysis of perceptions and experiences of emergency

department staff in relation to implementation and outcomes of the four-hour rule/national emergency access target in Australia.

Emerg Med Austral. 2019;31(3):378−86. doi: 10.1111/1742-6723.13166.

Cecchi E. Emergency department length of stay (ED ‑ LOS) as synonymous with critical and clinical risk. Intern Emerg Med.

;17(1):191–2. https://doi.org/10.1007/s11739-021-02893-8.

Otto R, Blaschke S, Schirrmeister W, Drynda S, Walcher F, Greiner F. Length of stay as quality indicator in emergency departments:

analysis of determinants in the German Emergency Department Data Registry (AKTIN registry). Intern Emerg Med. 2022;17(4):1199–

https://doi.org/10.1007/s11739-021-02919-1

NSW Health. Emergency Department care providing people with access to timely, safe and quality emergency care [Internet]. 2021.

Available from: https://www.health.nsw.gov.au/Performance/Pages/emergency.aspx.

Andersson J, Nordgren L, Cheng I, Nilsson U, Kurland L. Long emergency department length of stay: a concept analysis. Int Emerg

Nurs. 2020; 53:100930. doi: 10.1016/j.ienj.2020.100930.

Unduhan

Diterbitkan

2025-12-05

Cara Mengutip

Sulistio, S., & Gani, A. (2025). Lama Rawat Kurang dari Empat Jam di Instalasi Gawat Darurat sebagai Indikator Mutu Pelayanan dan Penerapannya di Indonesia: Tinjauan Pustaka. Cermin Dunia Kedokteran, 52(12), 839–842. https://doi.org/10.55175/cdk.v52i12.1917