Instalasi gawat darurat (IGD) rumah sakit adalah bagian dari rumah sakit yangmemberikan layanan terdepan. Di Rumah Sakit dr. Mohammad Hoesin (RSMH)Palembang sudah terdapat IGD berdasarkan SK Direktur Utama Rumah Sakit yangmenetapkan struktur organisasi, tugas dan tanggung jawab, visi dan misi, danprosedur tetap pelayanan gawat darurat. IGD RSMH Palembang dikepalai olehseorang dokter spesialis bedah urologi dibantu oleh dua orang kepala ruangan.Standar pelayanan di IGD sudah menerapkan standar layanan sesuai dengan standarakreditasi KARS 2012.IGD keberadaannya di rumah sakit diatur oleh Kepmenkes RI No.856/Menkes/SK/IX/2009 tentang Standar IGD. Kepemenkes ini mengatur tentangstandarisasi pelayanan gawat darurat di rumah sakit, dalam Kepmenkes tersebutdiatur standar organisasi, sumber daya manusia, pelayanan, kelengkapan saranaprasarana di IGD. Di RSMH Palembang telah dilaksanakan dokter spesialis jaga onsite di IGD sejak 30 Januari 2014 sebagai tindak lanjut Kepmenkes RI tersebut.Sejak dilaksanakan kebijakan dokter spesialis jaga on site di IGD masih dijumpaikepatuhan para dokter masih belum optimal dan walaupun mutu layananan semakinmembaik sejalan dengan telah terakreditasi paripurna rumah sakit versi KARS 2012.Penelitian ini bertujuan untuk mengetahui bagaimana implementasi kebijakandokter spesialis jaga on site di IGD sudah dilaksanakan sesuai dengan tujuan yangdiharapkan sesuai dengan Kepmenkes. Penelitian dilakukan dengan metode kualitatifmelalui wawancara mendalam pada informan. Informan yang diwawancarai adalahjajaran Direktur RSMH Palembang, Ketua Komite Medik, Kabag. Keuangan, Kepalaruangan IGD dan para dokter spesialis. Penilaian hasil wawancara menggunakankerangka fikir model implementasi kebijakan George Edward III dengan variabelsumber daya, komunikasi, disposisi dan struktur organisasi.Dari hasil penelitian ini didapatkan implementasi kebijakan dokter spesialisjaga on site belum berjalan dengan baik, disebabkan karena faktor komunikasi,disposisi dan struktur organisasi belum berjalan baik dan masih banyak perludukungan sumber daya. Usulan yang diberikan adalah penambahan dan kompetensitenaga sesuai standar, revisi SOP, penyediaan media komunikasi, perbaikan fasilitas,meningkatkan koordinasi dan fungsi pengawasan secara berkala, advokasi keKemenkes RI.Kata kunci:Implementasi, Instalasi gawat darurat, George Edward III

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Emergency department (ED) is a part of hospital which giving advancedservices. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own anemergency department based on SK director of the hospital whom establishes theorganizational structure, duties and responsibilities, vision and mission, and standardoperating procedures emergency services. ED RSMH Palembang is lead by aspecialist urology and assisted by two heads of the room. Standard service of ED hasimplementing service standards according to accreditation standards KARS 2012.ED in the hospital arranged Indonesian health minister No.865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulatesthe standardization of emergency services at the hospital, which managing standardorganizations, human resources, services, completeness infrastructure in ED. RSMHPalembang has been implemented specialist doctors duty on site in the ER sinceJanuary, 30th 2014 as a follow-up of the head of the Indonesian health minister. Eversince implemented a policy specialist on duty in the ER site still found thecompliance of the doctors are still not optimal and although the quality of service hasimproved in line with acreditation hospital KARS version 2012.This research aims to determine how the implementation of policy specialistsdoctors on site in the ER has been implemented in accordance with the expectedgoals in accordance with the head of health minister. Research done with qualitativemethod by performing in-depth interviews on informants. Informants interviewed areRSMH Palembang board of directors, chairman of the medical committee, chieffinancial officer, head of the ED room and specialist doctors. Assessment interviewresults are using logical framework policy implementation model George Edward IIIwith variable resources, communications, disposition and organizational structure.From the results of this study, the implementation of policy specialist doctorson site guard has not run well, due to the communication factor, disposition andorganizational structure has not been going well and much needed resource support.The given proposal is the addition of appropriate power and competence standards,the revised SOP, provision of communication media, improvement of facilities,improving the coordination and monitoring functions regularly, advocacy to the headof the Indonesian health minister.Keywords:Implementation, Emergency Department, George Edward III