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Dalam menghadapi kompetisi dunia yang semakin tajam, Rumah Sakit X mulai Januari 2001 telah melakukan perubahan orientasi dengan melaksanakan Service Quality Improvement. Pihak rumah sakit berharap dengan orientasi baru ini rumah sakit akan dapat menambah jumlah kunjungan pasien dan pada akhirnya akan menambah keuntungan Rumah Sakit.Oleh sebab itu, kebutuhan akan perlunya dibuat suatu instrumen yang valid dan reliabel tidak dapat dihindari lagi. Instrumen ini diharapkan akan dapat menjadi landasan manajemen rumah sakit untuk membuat perubahan-perubahan yang akan meningkatkan kepuasan pasien.Penelitian pembuatan instrumen ini menggunakan 5 dimensi Servqual yang telah disesuaikan dengan keadaan di Rumah Sakit X. Penelitian ini dilakukan dari bulan April 2002 sampai dengan July 2002 dengan mengikut sertakan 203 orang responden dengan menggunakan metode systematik random sampling dan cross sectional design.Data yang didapat dianalisis dengan mengunakan metode univariate dan multi variate. Untuk mengukur validitas isi peneliti melakukan: (1) Penggunaan dimensi Servqual dalam pembuatan instrumen, (2) Melakukan elaborasi pasien dengan melakukan FGD, brainstorming dan ghost shopping. Dalam pengukuran validitas kriterium peneliti melakukan dua cara pengukuran: (1) Melihat nilai korelasi pearson diantara lima dimensi servqual , (2) Melihat nilai korelasi pearson antara nilai rasio harapan dan kenyataan secara keseluruhan dengan niat datang kembali. Kemudian didalam pengukuran konstruk validiti peneliti melakukan perbandingan nilai total item correlation dan nilai Alpha dengan nilai r tabel (dimana nilai r tabel untuk 203 responden adalah 0,138) sehingga apabila nilai item total correlation dan nilai Alpha lebih besar dari nilai r tabel dapat disimpulkan bahwa pernyataan tersebut valid dan realiabel.Hasil perhitungan validitas dan reliabilitas membuktikan bahwa 53 item pernyataan tentang kepuasan dapat digunakan dalam rangka pengukuran kepuasan pasien di Rumah Sakit X. Lebih jauh lagi dengan menggunakan kategori pembagian pasien dalam kategori puas dan tidak puas dengan cut point nilai median 0,9 terlihat bahwa proporsi responden yang puas lebih banyak dari yang tidak puas yaitu dengan proporsi 65% puas dan 35% yang tidak puas.Selain itu dari hasil penelitian didapat juga posisi item-item kepuasan pada diagram kartesius, sehingga dapat diketahui item-item mana saja yang merupakan prioritas perbaikan dan hal yang sudah mencapai harapan pasien.
Analysis Validity and Reliability of Ambulatory Patient's Satisfaction Instrument toward Services in the Installation Rehab Medic of Hospital X Jakarta 2002In front of global competition, Hospital X, from January 2001 has been altering their orientation for more concern with service quality improvement, with the new orientation the hospital wishes to gain more patients and get more income for the hospital.The requirement for measure patient satisfaction become essential for changing hospital facilities and management to be more consumer oriented facing the hospital patient. From these point of sight the management and researchers beginning to explore in making a valid and reliable instrument.This study applied Servqual instrument and modified it according to the situation in the hospital situation. The studies have been done on April until July 2002 and were drawn approximately 203 respondents using systematic random sampling and apply cross sectional design.The data has been analyzed with univariate and bivariate methods. Content validity have been done with: (1) Making instrument with five dimensions of Servqual, (2) Patient elaboration to get clarity, Criterion validity have been tested with two ways:(1) Value of Pearson correlation among five Servqual dimensions, (2) value of Pearson correlation between ratio wishes and reality of service and intent to come. Construct validity were tested by value of corrected item total correlation and alpha that compare with value of r table (for n = 203 value of the table is 0,138), if corrected item total correlation and alpha bigger than r table, we can conclude that these items were valid.This study proves that 53 items in the satisfaction instrument could be use for measuring patient satisfaction activity, because they are valid and reliable according to the test. More than those using 0,9 median as cut point, we conclude that 65% patients are satisfied and 35% are not satisfied.This thesis have also viewed Cartesius diagram which are useful for expanding patients satisfaction in the hospital.
Kata kunci:Kualitas pelayanan, sistem antrian, kepuasan pasien BPJS
This thesis discusses the relationship between service quality and queuing systemwith BPJS patient satisfaction in outpatients at Hermina Jatinegara Hospital. Thisstudy uses a quantitative method with a cross sectional approach. Data isprocessed through univariate, bivariate and multivariate analysis. The results ofthe study suggest that the Hermina Jatinegara Hospital must further improve thequality of service. In addition, the results of this study also suggested thatHermina Jatinegara Hospital implement an effective and efficient queuing systemso that BPJS patients can get health services faster.
Key words: Service quality, queuing system, patient satisfaction.
Kata kunci : Kepuasan, rawat jalan eksekutif, tangibles
Waiting times on regular outpatient at Fatmawati Central Hospital still exceeds minimun healthcare service standard (≤ 60 minute). Waiting times can becontributing factor influence outpatient dissatisfaction. In December 2016, Fatmawati Central Hospital opened excevutive outpaient for BPJS patients. Patient satisfaction can be one of the indicators for measurement health care service and evaluation. The purpose of this research is to know determinant factor on BPJS patient satisfaction in Griya Husada executive outpatient at Fatmawati Central Hospital 2018. This research uses cross sectional design with questionnare based on likert scale from 100 respondent. The result shows that patient satisfaction on BPJS patient is 95%. Factor that influence patient satisfaction is tangibles (OR=11,2 and p-value=0,024). Therefore, it is important for Fatmawati Central Hospital to improve in facilities and infrastructure in executive outpatient.
Keywords : Executive outpatient, satisfaction, tangibles
Latar Belakang: Salah satu langkah keselamatan pasien adalah perbaikan pelayanan kesehatan dari pelaporan insiden. Dalam praktiknya, laporan Insiden Keselamatan Pasien (IKP) yang terkumpul secara lingkup global dan di Indonesia masih terbatas dikarenakan berbagai faktor dan masalah, baik underreporting, time response, ataupun adanya insiden yang berulang terjadi. Studi ini bertujuan menganalisis akar masalah dari ketiga fenomena tersebut menggunakan kerangka root cause analysis oleh VHA National Center for Patient Safety.
Metode: Studi ini menggunakan pendekatan kualitatif dengan metode studi kasus pada Bulan Maret-April 2025 dengan wawancara mendalam terhadap 14 informan utama dan dua informan kunci dan dengan analisis konten menggunakan software Nvivo 15. Studi ini juga menggunakan data sekunder dari rumah sakit studi mengenai insiden yang masuk di sistem rumah sakit per Bulan Januari 2024 hingga Februari 202.
Hasil: Hasil studi menunjukkan bahwa faktor knowledge and skills, organizational factors, just culture, dan process and system reporting memiliki bobot pengkodean yang lebih banyak dibandingkan faktor lainnya. Dua insiden yang paling sering berulang adalah masalah identifikasi pasien dan medikasi. Human error adalah faktor utama dari kedua insiden berulang tersebut. Pengembangan sistem pelaporan, edukasi mengenai urgensi dan no-blaming culture, serta pemberlakuan komunikasi yang efektif menjadi rekomendasi action plan dari RCA yang dibentuk.
Kesimpulan: Pengembangan sistem, edukasi mengenai urgensi dan no-blaming culture, serta pemberlakuan komunikasi yang efektif menjadi rekomendasi dari akhir tahapan analisis masalah.
Kata Kunci: Root Cause Analysis, Pelaporan IKP, Blaming Culture, Senioritas, Umpan Balik
Background: One of the patient safety measures is improving healthcare services through incident reporting. In practice, Patient Safety Incident (PSI) reports collected globally and in Indonesia remain limited due to various factors and issues, including underreporting, time response, or recurring incidents. This study aims to analyze the root causes of these three phenomena using the root cause analysis framework by the VHA National Center for Patient Safety. Methods: This study employed a qualitative approach with a case study method conducted from March to April 2025, involving in-depth interviews with 14 primary informants and two key informants, utilizing content analysis with Nvivo 15 software. The study also incorporated secondary data from the hospital study regarding incidents recorded in the system from January 2024 to February 2025. Results: The study findings indicate that factors such as knowledge and skills, organizational factors, just culture, and process and system reporting had higher coding weights compared to other factors. The two most frequently recurring incidents were patient identification and medication issues. Human error was identified as the primary factor in both incidents. System development, education regarding urgency and no-blaming culture, and implementation of effective communication emerged as recommendations from the final stage of problem analysis. Conclusion: System development, education regarding urgency and no-blaming culture, and implementation of effective communication are recommended based on the final stage of problem analysis. Keywords: Root Cause Analysis, Patient Safety Incident Reporting, Blaming Culture, Seniority, Feedback
ABSTRAK Name : Aurora Sihombing Study Program : Health Economic Title of Reserach : “Analisa Biaya Satuan Tindakan Terapi Radiasi Eksternal Pada Pasien Kanker Payudara di Instalasi Radioterapi RS. Kanker Dharmais Tahun 2016”. Angka kasus kanker payudara di Indonesia, tinggi. Kunjungan pasien kanker payudara ke RS Kanker Dharmais mengalami peningkatan. Terapi Radiasi eksternal termasuk layanan unggulan untuk pengobatan kanker payudara di RS. Kanker Dharmais. Pemerintah membiayai tindakan terapi ini lewat tarif INA CBG’s sebesar Rp 1.014.906. Melalui metode perhitungan Activity Based Costing (ABC), peneliti ingin mengetahui berapa sebenarnya biaya satuan tindakan untuk terapi ini ; lalu dibandingkan dengan tarif INA CBG’ s yang berlaku. Hasil penelitian menunjukkan bahwa total biaya tindakan 1 siklus terapi radiasi eksternal kanker payudara di RS Kanker Dharmais tahun 2016 adalah sebesar Rp 36.482.930, dengan biaya satuan tindakan sebesar Rp 1.216,098,- Keywords : Unit Cost, Activity Based Costing (ABC), External radiation
ABSTRACT Name : Aurora Sihombing Study Program : Health Economics Title of Research : Analysis of Unit Cost of External Radiation Therapy for Breast Cancer Patient of Radiotherapy Installation at Rumah Sakit Kanker Dharmais in 2016. The number of breast cancer cases in Indonesia is at alarming rate. Breast cancer patients looking for treatment at Rumah Sakit Kanker Dharmais have continually increased for the last several years. The external radiation therapy of Rumah Sakit Kanker Dharmais has been considered as one of the best cancer treatment facilities in the country. Indonesian government subsidizes cost of the therapy based on INA- CBG’s tariff scheme of Rp 1.014.906. Using Activity Based Costing (ABC) approach, the researcher would like to investigate the real unit cost of the treatment; the result will then be compared to the INA- CBG’s tariff. The study showed that the total cost of one cycle of the external radiation therapy for breast cancer at Rumah Sakit Kanker Dharmais is Rp36.482.930 in 2016, while the unit cost is Rp 1.216,098,- for the same periode. Keywords: Unit Cost, Activity Based Costing (ABC), External Radiation
