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POLICIES AND PROGRAM OF HPH IN POLICIES AND PROGRAM OF HPH IN INDONESIA TO SUPPROT GREEN AND

HEALTH LIFE STYLE TO PROMOTE WELLHEALTH LIFE STYLE TO PROMOTE WELL-BEING OF COMMUNITY IN WEST JAWA

LOGODR. HJ. ALMA LUCYATI, M.KES, MSI, M.KES

LOGOBACKGROUND

The Health Promoting Hospital (HPH)is a concept for hospital development is a concept for hospital development which build upon the concept of health promotionpromotion

Based on the Ottawa Charter, the first conceptual developments on HPH started in 1988.

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LOGOBACKGROUND

Five priority action for health promotion (Ottawa Charter) :promotion (Ottawa Charter) :

1. Build Healthy Public Policy2. Create supportive environments for 2. Create supportive environments for

health3 Strengthen community action for health3. Strengthen community action for health4. Develop personal skills5 R i h l h i5. Re-orient health services

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LOGOBACKGROUND

Re-orient health services:

the role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Reorientation of health services also requires stronger attention to health research, as well as changes in professional education and training.

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LOGOBACKGROUND

Hospital is health service institution h l /h lthat carry out complete/holistic

personal health service which pprovide outpatient, inpatient dan emergency serviceemergency service

HOSPITAL LAW 44/2009 HOSPITAL LAW 44/2009

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LOGOBACKGROUND

Hospital Fuctions (article 4)

b Care function and increasing dan b.Care function and increasing dan peningkatan personal health through

h i h lth i t th comprehensive health services at the second or third level depends on medical needs;

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LOGOHEALTH PROMOTION CLAUSE AT THE HOSPITALHOSPITAL

Hospital Building – Article 10Community Health Counseling Room at the Hospital

Article 29 – ObligationArticle 29 Obligation Implementing No Smoking Area in all Hospital

premisespremises Promoting health services provided in the

hospital based on legal regulation/lawhospital based on legal regulation/law

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LOGOPATIENT RIGHTS – Article 32

a. Getting information concerning rules and regulation that apply at the hospitalregulation that apply at the hospital

b.Receiveing information about patients rights and obligations : getting information about diagnosis and

medical proceduresed ca p ocedu es the aim of medical procedures or alternative

proceduresprocedures Risk and complication that might happen

i d di l bill prognosis and medical billspromkes diskes jabar 8

LOGOHOSPITAL UTILIZATION

Sick Healthy Sick Community

Healthy Community

O t ti t Medical Check Up,

Health Outpatient, inpatient, medical

support

Health Consultation, imunization,

fitness, Family Planning

Health Promotion

Planning

Health Promotion Health Promotion support Clean and Healthy Lifestyle,

curative and rehabilitation

Health Promotion support Clean and Healthy Lifestyle,

and disease preventionrehabilitation prevention

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LOGOTARGET OF HPH

Sick Individual / Groups Healthy Individual / Groups Healthy Individual / Groups Hospital staff groups Hospital staff groups

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LOGOHEALTH PROMOTION AT THE HOSPITAL

Hospital effort to increase patient, client or i bili h community ability so that :

Patient can be independent on speed up healing and rehabilitation process Client and community group can be y g p

independent to prevent health problems, and develip Community based health effort p y(UKBM) Impelmenting through learning process from-Impelmenting through learning process from

by – together based upon social cultural and public policiespublic policies

(Kepmenkes 1426/MENKES/SK/XII /2006 Juknis PKRS)promkes diskes jabar 11

LOGOHEALTH PROMOTING HOSPITAL

Inside Hospital Building

Registration / Administration Waiting room Outpatient ward examination room Inpatient ward Laboratory, radiology, morgue Healthy client consultation/counseling Billing room

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LOGOHEALTH PROMOTING HOSPITAL

Outside Hospital Parking Lot Hospital Park Hospital Park Hospital outer wall Hospital canteen/cafetaria

P i Praying room Hospital borderp

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LOGO

HPH ASESMENT IN WEST JAVA PROVINCE YEAR 2010PROVINCE – YEAR 2010

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LOGOASSESMENT INDICATORS INPUT( 30 %)

1 Master plan for Health Promoting Hospital1. Master plan for Health Promoting Hospital2. Operational plan for Health Promoting Hospital3. a. HPH coordinating unitg

b. HPH coordinating unit human resorces4. Staff trainig :

a. HPH staff at the hospitalb. Other hospital staff

5 Infrastrucure and Facilities5. Infrastrucure and Facilitiesa. Infrastructure and facilitiesb. Media

6. Budgeting7. HPH guidelines

15promkes diskes jabar

LOGOASSESMENT INDICATORS

PROCESS ( 40 %)1. HPH activities inside hospital building

a. Individual counceling for sick clientb. Individual counseling for healthy clientc Group counseling at the inpatient waitingc. Group counseling at the inpatient waiting

roomd G li i h i id. Group counseling in the waiting roome. Printing media counselingf. Electronic media counseling

16promkes diskes jabar

LOGOASSESMENT INDICATORS

Process ( 40 %)Process ( 40 %)2. HPH outside hospital building

a. Printing media counseling b. Group counseling/home visitp g

3 Rooms/Wards that already implementing3. Rooms/Wards that already implementing PHBS

17promkes diskes jabar

LOGOASSESMENT INDICATORS

Result( 30 %)Result( 30 %)1. Hospital Management

% t ff d t d b t HPHa. % staff understand about HPHb. % patient know about HPHc. % budgeting

2. Patient Assesment result2. Patient Assesment resulta. % risk factor assesment for patientb % i l i k f t t fb. % special risk factor assesment for

patientc. Patient satistaction scotr

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LOGOASSESMENT INDICATORS

Result (30 %)Result (30 %)3. Information and intervention that has been already

k b th ti t di hi /h h lthknow by the patient regarding his/her health conditiona % patient trained on self managementa. % patient trained on self management

for his/her diseaseb % pasien trained on risk factorsb. % pasien trained on risk factors

modification and treatment option oni hi /h di l ditimanaging his/her medical condition

c. Survey score based on patient experience withh lth i f ti d di l i t tihealth information and medical intervention

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LOGO

ASSESMENT INDICATORSASSESMENT INDICATORS

Result (30 %)Result (30 %)4. Health Promotion in working place

a. % of staff who doesn’t smokeb. % of staff who quit smokingc. Survey score on staff working experienced % staff absenced. % staff absencee. Average of working accident

5. Sustainability and Collaboration5. Sustainability and Collaborationa. % letter of discharging or referal to MD or referalclinic within 2 weeks or given to the patient while dischargeddischargedb. Average for re registration on sensitive case on the last 5 daysc. Survey score for patient discharging plan

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LOGOHEALTH PROMOTION ORGANIZING SCORE(INPUT-PROCESS- OUTPUT-TOTAL)

AT THE HOSPITAL 2010AT THE HOSPITAL 2010

4550

%

354045

202530

101520

Input Proses Out Put Total05

% 44,24 40,87 29,83 38,57promkes diskes jabar 21

LOGOINPUT SCOREU SCO

PENGELOLAAN PROMKES RS 2010

70

%

50

60

30

40

10

20

Renc Um Pengem Prom di 

RS

Renc op Prom PKRS

Unit koor PKRS

Tng unit koor PKRS

Pelat tng Prom RS

Pelat tng kes

Srn & peral prom

mediaDana prom di 

RS

Ped PKRS yg dibuat

Input

0

RS

% 51,09 48,91 53,26 46,74 58,7 17,39 40,22 53,26 42,39 30,43 44,24

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LOGOPROCESS SCOREPENGELOLAAN PROMKES RS 2010

%

50

60

%

40

50

20

30

10

20

Penyul indv/KIP‐K, psn skt

Penyul indv/KIP‐K, klien sht

Penyul klp di ruang tungg rwt 

jln

Penyul klp di ruang tungg rwt

Penyul mell media ctk

Penyul mell media 

elektronik

Pemb klp khusus

Penyul mell media ctk/luar ruang

Penyul klp/kunj rmh klp binaan

Ruangan yg sdh melak PHBS di sarkes

Proses

0

% 54,35 29,35 34,78 0 39,13 14,13 47,83 16,35 14,13 47,83 40,87

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LOGO

OUTPUT SCOREOUTPUT SCORE

60

%

40

50

20

30

0

10

20

% ptgs phm kebij PKRS

% pasien tahu PKRS

% biaya PKRS

% pasien dilkk ass ttg fakt rsk 

% pasien dilkk ass ttg fakt rsk 

Skor kepuasan 

pasien

% pasien terlatih ttg 

penyny

%% pasien terlatih modifikasi

Skor survey pglm pasien

% ptgs tdk 

merokok

% ptgs berhent

i meroko

k

Skor survey pglmn ptgs

% absensi

Rata2 kjd kecel kerja

Skor skala Burnou

t

% srt rujukan referal

Rata2 pendaf ulang kasus

Skor survey ke 

plgan psn

Out Put

0

um khus aasi k psn

% 44,57 23,91 17,39 35,87 33,7 40,22 18,48 20,65 16,3 32,61 8,7 18,48 51,09 40,22 25 46,74 34,78 28,26 29,83

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LOGOTOTAL SCORE

90100

%

60708090

30405060

102030

0

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INPUT SCOREINPUT SCORE

120

%

80

100

40

60

20

0

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LOGOPROCESS SCORE

%

100120

%

6080

02040

0

Cian

jur

msudin

t.Ban

jar

rawan

gD Kt.Tsk

t.Bekasi

D Dep

oknu

ngjati

Kab.Bks

arwan

giramayu

Provinsi

Ciba

bat

yu Asih

alen

gka

Berung

nangun

uningan

Sorean

gD Ciamis

med

ang

b.Bo

gor

 Slam

etCieren

g

RSUD 

RSUD Sya

RSUD kt

RSUD Ka

RSUD

RSUD Kt

RSUD

RSUD Gun

RSUD K

RSUD Seka

RSUD Indr P

RSUD C

RSUD

 Ba

RSUD M

aja

UD Ujung

 UD Arjowin

RSUD Ku

RSUD

 SRSUD

RSUD Su

mRSUD Kab

RSUD

RSUD C

R R R R RRSU

RSU

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LOGO

OUTPUT SCOREOUTPUT SCORE

%

8090

%

40506070

0102030

0

amsudin

ab.Bekasi

Kt.Bekasi

UD Kt.Tsk

D Cianjur

D De

pok

kaew

angi

unun

gjati

araw

ang

dram

ayu

D Cideres

Provinsi

D Banjar

D Cibabat

D Ciereng

D Kab.Bgr

D Ciam

isg Berung

D Slam

etBayu

 Asih

umedang

winangun

Kuningan

Soreang

RSUD Sy

RSUD Ka

RSUD K

RSU

RSUD

RSU

RSUD Sek

RSUD Gu

RSUD K

RSUD Ind

RSUD

RSU

RSUD

RSUD

RSUD

RSU

RSUD Ujung

RSUD

RSUD B

RSUD Su

RSUD Arjow

RSUD K

RSUD 

R R

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LOGOPHBS Indicators in Health Institution PHBS Indicators in Health Institution

(Hospital, Puskesmas, Pustu, Clinic, etc) (Hospital, Puskesmas, Pustu, Clinic, etc)

1. Using clean water2. Using clean and healthy toilet3. No litteringg4. No smoking5 No spitting 5. No spitting 6. Eradicate mosquitos

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LOGOEMPOWERMENT

Core activity in HPHHelping and fasilitatiting

patien/client:patien/client: So that the have the knowledge, ability

d d iand desire To prevent dan overcome current p

problem

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LOGOPATIENT ORIENTED CORE STRATEGIES

1. Health promotion preserve positive health behaviour during hospitalization

2. Health promotion collaborate patient – staff on treatment / medication processtreatment / medication process

3. Health promotion creating condusive hospital condition for patient, family and communityp , y y

4. Health promotion improving patient disease management- implemented after being di h ddischarged

5. Health Promotion enhance patient life style6 Health P omotion de eloped pengembangan 6. Health Promotion developed pengembangan

community group for certain patient/survivor

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LOGOSTAFF ORIENTED CORE STRATEGIES

1. Health Promotion support working 1. Health Promotion support working environemnt for Hospital staff

2. Health Promotion support staff ppcolaboration in working process

3. Health promotion develop hospital condition that support healthy behaviour

4. Health promotion management for diseases ffamong staff

5. Health promotion develop good healthy lifest le fo stafflifestyle for staff

6. Health promotion develop staff community

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LOGOCOMMUNITY ORIENTED CORE STRATEGIES

1 Promote community access to hospitals1. Promote community access to hospitals2. Health promotion collaborate with health

services in its surrounding areaservices in its surrounding area3. Health promotion suppeot hospital

environmet for communityenvironmet for community4. Health promotion support disease

management for communityg y5. Health promotion develop community

healthy life style6. Health promotion develop healthy groups

for community

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LOGOPHP Methods

Role model/giving examples :Role model/giving examples : environment, toilets, bathrooms,

b k fl t ff dgarbage, park, flower, staff andUtilization of printing media andUtilization of printing media and

electronic mediaDi t C li (i di id lDirect Counseling (individual, group, mass)

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LOGOCONTINOUS ACTIVITIES

Hospital Board Action PlanHospital Staff Commitment

Establish HPH Unit

Hospital Board Action Plan p

Monitoring, Evaluation and

di

Establish HPH Unit

Training for HPH recording Training for HPH Team HPH HPH

Creating Operational Plan PHP Implementation

Media CreationTraining for Hospital Staff

Promkes Jabarpromkes diskes jabar 35

LOGOTHANK YOU

LOGO