Clinical pathways are essential to control cost and quality performance. The data of its implementation in USU Hospital was absent. This study aimed to assess the compliance of DHF CP implementation on diagnostic, treatment and hospital cost. This study was using quasi-experimental design. An intervention of CP socialization was conducted in 2019. The data were obtained from CP, Medical Record, financial unit, and Hospital Information System. A total of 100 DHF grade 1 and 2 cases were analyzed using SPSS. We found that the intervention improved the compliance of intravenous solution (p=0.096), drugs (p=0.001); reduced hospital adjusted cost (Rp. 481,165.42, p=0.002), laboratory cost (Rp. 205,535, p=0.012) and LOS (0.64 day, p=0.019). There was no statistical difference in laboratory test compliance (p =0.3) and drug cost (p= 0.113) between the CP groups. In conclusion, the implementation of DHF CP improved the overall hospital cost and variance of drugs.

Introduction: Since its operation in 2016, the Universitas Sumatera Utara Hospital (USU Hospital) has implemented Medical Services for patients with cardiac arrest conditions by forming a Code Blue team. Based on data in 2018, the number of patients who received the Code Blue emergency was 240 patients. There are still many cardiac arrest events at USU Hospital, it is necessary to evaluate the implementation of the Code Blue services and create an early warning system (EWS) for patients who are potentially in cardiac arrest to prevent high cardiac arrest cases that will economically harm USU Hospital.Method: We analyze the secondary data from the Medical Record, an interview with the code blue team, and an analysis of the resuscitation form that has been completed.Result: The results of the study (n=30) which experienced the most stop breathing and cardiac arrest before the implementation of EWS were chronic diseases with 63.3% (n=19) and after the implementation of EWS there were still chronic diseases with 56.7% (n=17). A paired t-test was conducted with the result that code blue services on the numeric response time parameter was different in response time of 0.266 minutes after the implementation of EWS services (p=0.354). Meanwhile related to the length of time for cardiopulmonary resuscitation(CPR) there is a time difference of 10,767 minutes after the implementation of EWS services, (p=0.000).Conclusion: Interpretation of EWS implementation can affect the time of the CPR performed because the worsening condition of the patient has been monitored before respiratory and cardiac arrest occurred. The conclusion of making an early warning system (EWS) at USU Hospital can be immediately implemented as stated in the guidelines as a form of service in medical and nursing services.

BACKGROUND: Healthcare providers are facing challenges to deliver qualified and efficient health services in response to the current health system. Clinical pathways (CPs) are a tool to achieve the best clinical outcomes at the lowest cost. The implementation should be supported by healthcare professional’s capacity involved in the process. AIM: The aim of the study was to assess healthcare professionals’ knowledge, skills, motivation, and commitment to clinical pathways (CPs) implementation in Universitas Sumatera Utara (USU) Hospital. METHODS: This cross-sectional study was conducted at USU Hospital with 65 healthcare professionals as participants who consist of 10 specialist doctors, 50 nurses, and 5 pharmacists. These participants were selected using quota sampling and interviewed using a developed and structured questionnaire. This questionnaire was tested for its validity and reliability with r > 0.5 and Cronbach’s Alpha > 0.6. Pearson correlation test with p < 0.05 was used for analyzing the relationship among variables on CPs implementation. RESULTS: The healthcare professionals in USU Hospital had high knowledge, motivation, and commitment, but moderate skills in CPs implementation. There were positive correlations between knowledge and skill (p = 0.039), motivation and skill (p = 0.001), commitment and skill (p = 0.001), and motivation and commitment (p = 0.001) on CPs implementation. CONCLUSION: USU Hospital healthcare professional’s knowledge, motivation, and commitment to CPs implementation were adequate, but their skills were moderate. The motivation is substantially related to the healthcare professional’s commitment to CPs implementation. This study recommended the hospital explore and grow skills in communication, coordination, and affective commitment among individuals, teamwork, and leaders for the sake of willingness to achieve the values or goals of the CP implementation in their organization.

Hospital of Universitas Sumatera Utara has some services which are integrated with hospital management information system, but nutrition service has not been included yet. Actually, the nutrition service activities consist of nutrition assessment as well as diet orders of hospitalized patients which been done manually that could cause error. The aim of the study is to make an application of nutrition assessment and diet orders of hospitalized patients based on web, so it can minimize the error. The name of the application is "E-NRD" made with Waterfall method. The study design was research and development and was done for 8 months. The steps of the study were dieticians and nurses interviews, data collection, application establishment, dieticians and nurses workshops of application, and finally the implementation of the application. Hopefully "E-NRD" as a part of hospital management information system could improve the quality of nutrition service in hospital of Universitas Sumatera Utara.