Digital Sevice Management Emergency Model KALACAK 119
Puji Isyantoa,1*, Marceilla Suryanab
aBuana Perjuangan Karawang University Bekasi
b Bandung State Polytechnic
* corresponding author
I. Introduction
Whereas the increase in the number of victims / patients who die and experience disabilities in emergency cases is the impact of the less than optimal handling of victims / emergency patients.
That in order to improve the quality of services in the handling of victims / emergency patients, it is necessary to have an integrated and integrated victim / patient management system involving various parties.
Emergency / emergency is a clinical condition of a patient who requires immediate medical action to save lives and prevent disability (Regulation of the Minister of Health of the Republic of Indonesia Number 19 of 2016 article 1 paragraph 1 concerning Integrated Emergency Management System / SPGDT). The term SPGDT or the abbreviation of Integrated Emergency Management System. The background of this integrated emergency response system is due to the increasing number of victims / patients who die and experience disabilities in emergency cases which are the impact of the less than optimal handling of victims / emergency patients. In order to improve the quality of services in the handling of victims / emergency patients, it is necessary to have an emergency service management system in the form of handling victims / patients which is carried out in an integrated and integrated manner by involving various parties.
The definition of SPDT (integrated emergency response system) according to the Regulation of the Minister of Health of the Republic of Indonesia Number 19 of 2016 article 1 paragraph 3 is a mechanism for victim / emergency patient services that is integrated and based on a call center using telecommunications access 119 by involving the community. The purpose of SPGDT in article 2 of the Minister of Health Regulation Number 19 of 2016 is to improve access and quality of emergency services; and accelerate the response time for victims / emergency patients and reduce mortality and disability.
In addition, the objective of an integrated emergency service system is to optimize emergency services that focus on patient safety, optimize communication networks and coordination between governments, health facilities, educational institutions and the community in emergency management, improve access and quality. emergency services, accelerate response in handling victims and save lives and prevent disability.
ARTICLE INFO A B S T R A C T
Article history:
Received 02 Jan 2022 Revised 19 March 2022 Accepted 08 June 2022
Services to the community really need good skills and performance. The purpose of this study is to examine the implementation of the Kalacak 119 emergency service management model. The benefit of this study is to provide alternative solutions to community problems regarding the implementation of a fast and effective emergency service management model. This research method uses a descriptive phenomenon method, which describes the conditions that occur in people's lives about emergency service management.
That improving digital the quality of services to the community that is fast and precise is a model of emergency management services that continues to develop and needs innovation and creativity. The results of this study indicate that the emergency service management model through the Kalacak 119 call center can be applied in an integrated manner, but it still needs socialization and development of a service management model to help people get emergency services.
Copyright © 2017 International Journal of Artificial Intelegence Research.
All rights reserved.
Keywords:
Digital Management Service Emergency
The medium-term development plan for the Karawang regency, several strategic issues in the health sector include the inadequate achievement of indicators and minimum service standards in health services; limited health facilities and infrastructure and not optimal health services; the reach of health services through the Puskesmas / Pustu is still inadequate because it is still far from the ideal health service target where the standard of health services is 1 Puskesmas for 10,000 people, while in Karawang Regency with a population of 2,250,120 people with a total of 50 units of health centers, meaning 1 health center serving 45,002 residents, as well as the Puskesmas with Care Points (DTP), only 13 Puskesmas DTP out of 50 existing Puskesmas Units. Health workers are also still limited. The number of health personnel available when compared to the population is still far below the standard set by the Ministry of Health, the tariff for health services is relatively expensive, and not all levels of society are able to reach and utilize it.
The determination of the main performance indicators in the health sector in Karawang Regency can be seen as follows:
Table 1 Determination of Main Performance Indicators for Karawang Regency 2016-2021
No Indicator Target Year
2016 2017 2018 2019 2020 2021
1. Index health Karawang Regency (%)
79,28 79,32 79,37 79,41 79,46 79,51
2. Population growth rate (%) 1,02 0,99 0,97 0,95 0,93 0,91 3. Persentage village with status
underdeveloped village (%)
12,85%
(38 village)
12,55%
(37 village)
12,13%
(36 village)
11,80%
(35 village)
11,45%
(34 village)
11,13%
(33 village) Source : Document RPJMD Karawang Regency, 2016 – 2021.
In detail, the HDI (Human Develpoment Index) components based on calculations by the Central Statistics Agency (BPS) for 2011-2015 are as follows:
Table 2 Life Expectancy 2011-2015
Indicator Years
2011 2012 2013 2014 2015*
Life expectancy (tahun) 71,38 71,41 71,44 71,45 71,50 Source:BPS Karawang Regency, IPM New Methode.
*)= profisional figure
The health status of the Karawang Regency community continues to improve along with the increase in life expectancy during the 2011-2015 period. BPS data shows life expectancy achievements of 71.38 years in 2011, continuing to improve to 71.41 in 2012 and 71.44 in 2013, while the achievements in 2015 were 71.50 years. This fairly high degree of health has caused the increase to slow down relatively every year, although there are big challenges that will still be faced in the future.
Figure 1 Access to Health Service Facilities
From the picture above, it can be seen that access to Health Service facilities in Karawang Regency has been able to meet the need for basic health services. Judging from the number of
government health facilities and community-based health efforts, both in the form of poskesdes and polindes.
Table 3 Number of Health Facilities in Karawang Regency, 2011-2015
No Means Year
2011 2012 2013 2014 2015
1 RSUD Kabupaten 1 1 1 1 1
2 RS Swasta 15 15 16 18 19
3 RS Bersalin 1 2 1 1 0
4 Puskesmas 48 50 50 50 50
5 Pustu 69 69 69 70 71
6 Pusling+ kend. Operasional 94 99 111 373 388
7 PONED 10 19 28 28 28
8 Posyandu 2.218 2.227 2.233 2.255 2.271
9 Rumah bersalin 38 38 38 0 0
10 Apotik 179 190 246 248 260
11 Balai Pengobatan Mata 2 1 1 1 1
12 Balai Pengobatan Khusus 3 1 8 2 0
13 Balai Pengobatan Umum (Klinik Pratama) 222 181 449 291 261
14 Balai Pengobatan Perusahanan 12 28 44 0 35
15 Gudang Farmasi 1 1 1 1 1
Source: Health Service Office Karawang Regency, 2021.
From the graph above, it can be seen that the number of clinics in Karawang Regency is 297 facilities, with details of General Clinics (Medical Centers / BP): 187 facilities, Pratama clinics: 69 facilities, main clinics (specialist doctor clinics): 6 facilities, and company clinics: 35 facilities, as well as the Pratama clinic: 13 facilities. In addition to the clinic, the existing facilities in Karawang Regency are a pharmacy with 260 pharmacies scattered throughout the Karawang Regency, as well as a Maternity Home (RB, if the facility license expires, the RB must re-arrange its license to become a clinic or return to a midwife practice individuals) there are 38 units, Puskesmas 50 puskesmas, sub-health center (pustu) experienced an increase from the previous year which was only 69 in 2013 and 70 pustu in 2014 and in 2015 there were 71 units.
Figure 2 Number of Health Facilities in Karawang Regency 2011-2015
Based on the graph above, we can see the number of clinics in Karawang Regency as many as 297 clinics. From the graph above, it can be seen that there are several clinical categories. Prior to the issuance of Permenkes No.28 concerning clinics which was published in 2011, the clinic category was called the clinic. From the table above, the number of medical centers, both general and corporate, is 209 units. After the issuance of Permenkes No. 28/2011 and the issuance of Permenkes No. 9/2014 on CLINICS, clinic categories are divided into two types, namely Primary Clinic and Main Clinic. As referred to in Regulation of the Minister of Health No. 9 concerning Clinics in 2014, Primary Clinic is a clinic that provides basic medical services both general and special while the main clinic is a clinic that provides specialized medical services or basic and specialized medical services. So from the table above it can be concluded that the number of clinics
that have a license in Kab. Karawang as many as 297 clinics consisting of 6 main clinics, 82 Primary Clinics (General and Company), and 209 Medical Centers (general and corporate).
Table 4 Number of Health Workers in Karawang Regency, 2011-2015
No Description Year
2011 2012 2013 2014* 2015*
1 General Doctor 608 728 889 106 113 2 Specialist Doctor 156 158 160 0 0
3 Tooth Doctor 81 87 108 46 47
4 Nurse 1.600 1.900 1.600 265 281
5 Sanitation 42 46 46 25 32
6 Dentist 35 93 81 23 24
7 Midwife 813 815 1.086 694 725
8 Pharmacy 37 62 265 28 29
Source: Health Service Office Karawang Regency.
Note:*data employee in Health Service Office Karawang Regency, 2021
From the data above, the number of health workers in 2014 and 2015 were health workers who worked within the Karawang District Health Office (Health Service Office and Health UPTD), both those who were civil servants or who were still non-permanent employees. Data from outside the Health Office Environment is difficult to obtain so the amount is small. Unlike in 2011-2013, the number of personnel can be obtained easily because the issuance of health service delivery permits is still within the Health Office so that shifts and transfers of health workers can still be known, so the number can easily be obtained.
In order to improve the standardization of local government health services, strive to increase the number of health facilities that meet service standards as follows:
Table 5 Health Service Standardization, 2011-2015
No Description 2011 2012 2013 2014 2015
Number of means health standardization service
1 Hospital 16 16 19 19 20
2 Clinic 230 230 493 247 297
3 Puskesmas 48 50 50 50 50
Source: Health Service Office Karawang Regency.
All puskesmas already have medical procedures for basic health services, but they are not in accordance with the standards of Permenpan or Permenkes so this year a soup workshop is being held in accordance with Permenpan. Participants consist of representatives of puskesmas who want to be accredited in 2016, currently in the stage of preparing SOPs according to existing standards and socialized to all health centers and will be evaluated on an ongoing basis, while dental treatment does not yet have a treatment procedure this year will be made according to standards.
The percentage of inpatients who were healed only reached 87.3%, some health centers have incomplete data, inadequate equipment, limited drugs and limited human resource competence so that since 2014 and 2015 all doctors have been trained in emergency medical equipment fulfillment.
and drugs using capitation funds in several puskesmas.
The number of patients who use the universal housekeeping integrated clinic even though there has been a new increase of up to 6% of total visitors to the health center, this is because many patients who do not want to be referred to the counseling room still think that it takes a long time, do not understand the concept of prevention is better than treating and healthy patients do not. want to take advantage of the universal housekeeping clinic because they still have an understanding of the paradigm of sickness and not of the healthy paradigm so that continuous socialization activities are needed about the benefits of universal housekeeping and personal counseling using flipcharts and more complete examples.
In line with central government policies in the health sector, where the National Health Insurance program is something that has been implemented since 2014, with the management by the Social Security Management Agency (BPJS), RSUD Karawang starting in January 2014 serving BPJS patients consisting of PBI patients (Jamkesmas ) and Non PBI (PNS, TNI, POLRI and companies that have joined).
II. Result and Discussion
People who know and experience medical emergencies can report and / or ask for assistance via Call Center 119. The emergency service management system implemented in Karawang Regency is to use the special name Kalacak (Karawang Emergency Quick Service), which has been implemented since November 12 2017 and officially based on call center 119 which is integrated with NCC (National Command Center) 119 at the Ministry of Health of the Republic of Indonesia.
The public can report an emergency incident by calling call center 119 (Toll Free) or 08999700119 (HP / with credit). These emergency telephone calls can be made via cellular phones or landlines for 24 hours. The category of Emergency Events is a condition which is life threatening if you do not get immediate help, for example; respiratory distress, cardiac distress, seizures, coma, head trauma with decreased consciousness. An integrated emergency response system is an emergency patient response system consisting of elements of pre-hospital, hospital and inter-hospital services.
The main components of Kalacak include Call Center 119 which consists of Sijariemas, SPGDT Application, SIRANAP (Inpatient Information System), SISRUTE (Integrated Referral System).
The integrated emergency service system network includes all health centers, all hospitals and related sectors, such as the Regional Disaster Management Agency (BPBD), the Indonesian Red Cross (PMI), the Resort Police Traffic Accident Unit, Search and Rescue (SAR). , Educational institutions and others.
Communication between the Kalacak call center 119 network in Karawang Regency can use Community Phones (under development), Radiomedicine (HT), Whats App (WA), SPGDT group (WAG SPGDT), android application prototype SPGDT Kalacak 119. Integrated emergency service system tasks through the Kalacak 119 call center in Karawang Regency what can be provided is receiving emergency call dispatch from the National NCC Jakarta call center (forwarding calls to the nearest PSC to the scene), providing emergency services, providing stabilization and consultation advice, providing information on the nearest health facility, coordinating with health service facilities (puskesmas and hospitals), providing other information related to health.
The flow of the emergency handling process is as shown below:
Figure 3 Emergency handling process flow (Source: Health Service Office Karawang Regency)
The flow of the Kalacak 119 emergency service management process in Karawang Regency:
1. Call 119 immediately
2. The call center clarifies the victim's situation
3. Ambulance 119 and officers immediately go to the scene of the crime 4. Refer to hospital if necessary
To socialize the emergency service system, flyers were made and distributed through social media such as Facebook, Instagram, WhatsApp (WA) and other online media, as well as through health centers in all districts, so that the public can find out about emergency service information.
The emergency service system flyer is as follows:
Figure 4 Emergency Services Flyer (Source: Health Service Office Karawang Regency)
Emergency handling systems require competent human resources who are willing to serve quickly and responsively. So it requires personnel who are ready to work in full.
The emergency service system using Kalacak 119 makes it very easy for the community to access emergency services at any time. This service system still needs to be innovated and developed so that the public is aware of this system and it is easier to access this system according to their educational level abilities and knowledge. This system can also be integrated through online media portals and social media as part of information that is open to the public. This service system needs to be disseminated to all communities and all stakeholders so that its existence is widely and thoroughly known.
III. Conclusion
Based on the results of this study, it shows that the emergency service system uses Kalacak (Karawang Emergency Fast Service) based on call center 119 which is integrated with NCC 9 National Command Center 119 of the Ministry of Health of the Republic of Indonesia. People who experience an emergency incident can call 119 (toll free) or 08999700119 (HP / with credit), emergency calls can be made via cellular phones or landlines. The Kalacak system has been running well and is integrated with all stakeholders, thus realizing an integrated quality improvement of victim / patient handling services.
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