Latar Belakang: Implementasi Clinical Pathway (CP) Sectio Caesarea (SC) merupakan instrumen strategis kendali mutu dan biaya era JKN. Clinical Pathway (CP) di RS Islam Namira pada kasus SC beberapa kali belum berjalan sehingga evaluasi pelayanan komprehensif mulai dari proses penyusunan hingga pelayanan yang ada penting dilakukan karena tingginya angka tindakan namun variasi pelayanan yang signifikan antar Dokter Penanggung Jawab Pelayanan (DPJP) masih ditemukan. Penelitian ini bertujuan mengevaluasi implementasi CP SC ditinjau dari praktik klinis, mutu, dan biaya. Metode: Studi kasus deskriptif evaluatif dengan pendekatan kuantitatif menilai pelayanan SC yang ada (melakukan telaah 123 rekam medis dan billing pasien SC elektif severity level 1 pada Agustus-Desember tahun 2025) dilanjutkan dengan pendekatan kualitatif dengan wawancara mendalam 15 informan terdiri dari manajemen dan klinisi serta kuantitatif di RSI Namira Lombok Timur. Hasil: Dokumen CP eksisting belum sesuai pedoman Kementerian Kesehatan karena didesain lebih kepada evaluasi tarif tanpa kolom evaluasi klinis dan kolom varians. Variabel input diperoleh cukup lemah karena ketiadaan SK Tim CP dan SPO pengembangan CP. Tahap proses berjalan top-down tanpa forum konsensus (FGD) dan sosialisasi formal sehingga proses lebih banyak dilakukan dari manajemen dengan keterlibatan pelaksana yang masih kurang. Pada dimensi output, masih ditemukan keberagaman pelayanan klinis mencapai 100%  berbeda dari CP yang sudah ada pada aspek obat-obatan dan BMHP (terutama benang bedah) karena dominasi preferensi personal dokter penanggung jawab pasien (DPJP). Capaian mutu mobilisasi pasca tindakan SC dengan metode ERACS berjalan baik (1–2 hari) meskipun masih ditemukan ketidakseragaman pengetahuan lama waktu perawatan oleh pelaksana. Seluruh sampel mengalami balance negatif dengan rata-rata selisih tarif rumah sakit berbanding klaim INACBGs mencapai sebesar -Rp1.723.939 (-31%) per pasien. Kesimpulan: Implementasi CP SC belum optimal untuk mendukung kendali mutu klinis dan efisiensi biaya akibat masih banyaknya variasi praktik klinis yang ditemukan sehingga perlunya perbaikan pada proses tata kelola klinis dan manajemen, penegakan regulasi, serta konsensus interprofesional.

Background: The implementation of the Clinical Pathway (CP) for Cesarean Section (CS) serves as a strategic instrument for quality and cost control under the National Health Insurance (JKN) system. The CS CP at Rumah Sakit Islam Namira has repeatedly failed to operate effectively. Therefore, a comprehensive evaluation covering the entire spectrum from the development process to the clinical services provided is critical, particularly given the high volume of procedures alongside significant variations in practices among the attending physicians. This study aims to evaluate the implementation of the CS CP in terms of clinical practice, quality, and cost. Methods: An evaluative descriptive case study utilizing a quantitative approach to assess the current CS services (reviewing 123 medical records and billing files of severity level-1 elective CS patients from August to December 2025), complemented by a qualitative approach consisting of in-depth interviews with 15 management and clinician informants at RSI Namira, East Lombok. Results: The existing CP document does not align with the Ministry of Health guidelines as it is primarily structured around tariff evaluations rather than clinical evaluations, and lacks a variance tracking section. Analysis of the input variables revealed a weak baseline due to the absence of official CP Team decrees and CP development SOPs. The process stage operates in a top-down mechanism, completely lacking consensus building forums (FGDs) and formal socialization, which results in management driven processes with insufficient engagement from frontline practitioners. In the output dimension, clinical service variations reached 100% divergence from the established CP regarding pharmaceuticals and medical supplies (specifically surgical sutures) due to the dominating personal preferences of the attending physicians. Regarding quality metrics, patient mobilization following the ERACS method performed well (1-2 days), despite non-uniformity in the practitioners' knowledge regarding the appropriate length of stay. Consequently, 100% of the sample incurred negative financial balances, with an average deficit between hospital tariffs and INA-CBGs claims reaching -IDR 1,723,939 (-31%) per patient. Conclusion: The implementation of the CS CP has not functioned optimally to support clinical quality control and cost efficiency due to the persistent variations in clinical practices. This underscores the urgent need for structural improvements in clinical and administrative governance, the enforcement of regulatory frameworks, and the establishment of an interprofessional consensus.