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Tahun 1998 ketika RSUD Pasar Rebo berubah status menjadi kelas B, jumlah pejabat struktural bertambah yaitu menjadi 21 orang, kemudian Direktur/Pimpinan Rumah Sakit menetapkan Pejabat Struktural sesuai dengan kompetensi. Sejak itu pula terjadi kecaman-kecaman atau hujatam-hujatan pada pejabal struktural/manajemen.Penelitian ini bcrtujuan untuk memperoleh gambaran secara mendalam dan mengidentifikasi konflik yang berkaitan dengan kebijakan jabatan struktural di RSUD Pasar Rebo. Jenis penelilian ini adalah deskripsi analitik yang dilakukan dengan pendekatan cross-sectional secara kuantitatif dan kualitatif. Alat pengukur data kuantitatif yang disusun berdasarkan penskalaan Likert. Pengumpulan data kualitatif dilakukan dengan metode Fokus Group Diskusi (FGD). Variabel-valiabel yang diteliti adalah Z indikator konflik yang terdiri dari adu argumentasi, masalah komunikasi, kompetisi yang destruktif, sikap yang tidak fleksibel dan tidak sensitif, saling menyimpan informasi, kecaman yang tidak fair, dan hubungan menjadi sangat formal. Sampel dalam penelitian ini sejumlah 114 orang yang terdid dari : kelompok Medis 9 orang, kelompok Perawat 35 orang, Kelompok Non Medik 51 Orang dan Kelompok Struktural 19 orang.Hasil penelitian ini disimpulkan bahwa: variabel adu argumentasi, yang menyatakan ada konflik dari kelompok Non Medik 62,5% dan kelompok perawat 64,3% , pada variabel masalah komunikasi, yang menyatakan ada konflik dari kelompok non medik 39,2% dan kelompok perawat 34,2%, pada pada variabel kompetisi yang destruktif, yang menyatakan ada konflik dari kelompok non medik 33,3% dan kelompok perawat 37,l%, pada variabel sikap yang tidak fleksibel yang menyatakan ada konflik dari kelompok non medik 39,2% dan dari kelompok perawat 34,2%. Pada variabel menyimpan informasi yang menyatakan ada konflik pada kelompok non medik 29,4% dan pada kelompok pelawat 31,4%. Pada variabel kecaman yang tidak fair yang menyalakan ada konflik pada kelompok non medik l9,6% dan pada kelompok perawat 31,4%. Pada variabel hubungan yang sangat formal, yang menyatakan ada konflik pada kelompok non mcdik 30,2% dan pada kelompok Perawat 42,8%. Berdasarkan persepsi kelompok Non Medik dan Kelompgk Perawat, faktor penyebab konflik adalah adanya perbedaan pendapat lemahnya komunikasi dan gaya kepemimpinan. Posisi konflik yang paling tinggi terjadi pada kelompok Non Medik dan kelompok Perawat, Dampak konflik kearah negatif yaitu konflik yang merusak (disfungsional/destruktif). Hal ini berpengaruh terhadap motivasi kerja dan suasana kerja yang tidak kondusif.Saran dalam penelitian ini, adalah Direktur RSUD Pasar Rebo segera untuk merespon masalah ini secara cepat dan tepat, dengan melakukan persamaan persepsi dan memberikan informasi tentang kebijakan yang berkaitan dengan jabatan struktural. Selain itu guna meningkatkan ketrampilan terhadap pejabat struktural/manajemen perlu diberikan peladhan-pelatihan tentang manajemen.
In the year 1998 Pasar Rebo Hospital changed the status to class B hospital, the numbers of structtual staff becomes 21 staftf furthermore Directore of the Hospital decided the structural stat? selected according to the related competition rank and copability. From this assignment time, has rised a protest or slander destireci to management/or structural staff ofthe Pasar Rebo Hospital.This research purposed to achieve to get a clear pictures and to identifying thc conflict related with the role of function ofoocupation in Pasar Reho Hospital. The type of this research is descriptive-analytical which is conducted by means of quatitative and qualitative Cross-Sectional approach. The instrument for measureing the quantitative data structured questionnaire which is compiled based on Likert Scale. The qualitative data collection is conducted by means of Focus Group Discussion method. The variables which are researched are : unwarranted arguments among employees, communication problems, destructive competition, employees exhibiting inflexible and insensitive attitudes, colleagues withholding information, unfair criticims of certain individuals, excessively fomial interpersonal relationships between employees. The sample were ll4 persorw, which are : 9 persons hom medical group, 55 prsons from nurses, 51 persons from non medical and I9 persons hom structural.The result of this research was summarized that the variables unwarranted argument who has stated conflicts from non medik group is 62,5% and from nurses group is 64,3%. In the alterhand the variable commtmication problem who has stated cinflicts from non medik group is 39,2% and Hom nurses group is 34,2%. The variable destructive competition who has stated conflicts from non medik group is 33,3% and from nurses group is 37,1%. For the variable employees exhibiting inflekxible and inssitive attitudes who has stated conflicts from non medik group 39,2% and 34,2% for nurses group. For the variable colleagues withholding information who has stated conflicts is 29,-4% for non medik and 31,4% for nurses group. For the variable unfair criticims of certain individuals who has conflicts is l9,6% for non medik group and 3l,4% for nurses group. For the variable excessively formal interpersonal who has stated conflicts is 30,2% for non medik and 42,8% for nurses group. A factor of conflict due to diiiient ideas, cornmtuiication problems and style of leadeshipness In these kind of conflicts called disfungsiorial/destructive. Eventually the excess oh these conflicts influenced to motivation of working an uncondusively ol' comfortable working ethic.The recommendations should forward to : Directore of Pasar Rebo Hospital to response these conflicts problems seriously in order to react by uniforming of perceptions by giving them the correct information, regarding to the role of fimction which related with thc structural occupation in Pasar Rebo Hospital. ln other hands this efforts is to achieve or to improve the skilfull of the structural stall' or management staff whose needs to give them a change like a management training etc.
Instalasi Farmasi RSUD Pasar Rebo merupakan pusat pendapatan RS, Namun, realisasi anggaran Instalasi Farmasi selalu lebih tinggi dari perencanaannya selama lima tahun terakhir sejak 2007 sampai 2011 yang mungkin dipengaruhi oleh cost awareness, cost management, cost monitoring, dan cost incentive sebagai faktor-faktor dari cost containment. Tujuan penelitian ini untuk menganalisis cost containment di Instalasi Farmasi RSUD Pasar Rebo dengan mengetahui cost awareness, cost management, cost monitoring, dan cost incentive dan juga upaya cost containment yang dilaksanakan secara keseluruhan. Penelitian ini merupakan penelitian kualitatif dengan memanfaatkan dua teknik pengumpulan data yaitu data sekunder dan wawancara mendalam kepada pegawai level manajemen RS yang terkait erat dengan Instalasi Farmasi RSUD Pasar Rebo. Penelitian ini dilaksanakan selama Juli 2011 sampai Juli 2012. Hasil penelitian menunjukkan variabel cost awareness yaitu pelatihan belum mengarah pada efisiensi, serta pengkomunikasian harga melalui spanduk dengan slogan yang memotivasi pegawai ataupun acara khusus untuk pengenalan harga sediaan farmasi bagi pegawai pun belum ada. Variabel cost management yaitu budget dengan realisasi budget lebih tinggi dari perencanaan, pengkonsolidasian dokter melalui forum ?reboan? dihadiri sekitar 30 persen dokter, e-prescribing belum diaplikasikan, penyediaan obat dihitung dengan stok minimum dan maksimum tetapi belum ada pegawai yang ditunjuk untuk bertanggung jawab menghindari obat expired, pengurangan biaya operasional diterapkan dengan mematikan AC dan lampu yang tidak digunakan, pemanfaatan ulang kertas bekas, serta penyiapan obat dengan tepat, sementara dukungan eksekutif masih dipandang sebagai supervisi. Variabel cost monitoring yaitu pemonitoran keuangan berkelanjutan dalam hal ini cash flow masih belum mampu dimanfaatkan sebagai alat untuk memberi peringatan kepada Instalasi Farmasi untuk sejalan dengan perencanaan budget, selain belum kuatnya bargaining position RS walaupun margin obat generik dan obat non generik di atas 30 persen, dan masih terjadi selisih saat stock opname, pelayanan terintegrasi masih birokratis serta belum dapat meraih sense of belonging pegawai karena tidak sampainya informasi yang cukup, pengamanan obat penting dilakukan dengan pembedaan lemari serta adanya kartu stok. Variabel cost incentive yaitu pemberian insentif belum ditentukan oleh output kinerja melainkan kompetensi. Hal tersebut di atas menunjukkan upaya pengendalian biaya yang masih memprihatinkan di RSUD Pasar Rebo khususnya di Instalasi Farmasi. Kesimpulannya bahwa Instalasi Farmasi RSUD Pasar Rebo belum mengimplementasikan cost containment (cost awareness, cost management, cost monitoring, cost incentive) secara tepat.
The Pharmacy Installation of RSUD Pasar Rebo is a revenue centre for the hospital. Therefore, the Realisation of Budget of Pharmacy Installation had been higher than its planning for five years since 2007 until 2011 that might be influenced by cost awareness, cost management, cost monitoring and cost incentive as factors of cost containment. The objective of this research was to analyze the cost containment at The Pharmacy Installation of RSUD Pasar Rebo by knowing cost awareness, cost management, cost monitoring, and cost incentive and also the cost containment efforts for overall. This research was a qualitative research, conducted by utilizing two data collection techniques which were secondary data and in-depth interview on the entire management level of hospital which was related directly to The Pharmacy Installation of RSUD Pasar Rebo. This research conducted throughout the months of July 2011 ? July 2012. The result of the study revealed variables of cost awareness were the training program had not directed to efficiency and there were not the price communication by putting motivation statement on working area nor special event for making pharmacy staff knowing about price of pharmacy things. Variables of cost management were the budget which was realization higher than it plan, the doctor consolidation through "reboan" had admitted around 30 percent, the e-prescribing had not applied, the medicine reservation calculated by minimum and maximum stock but there was not a responsible staff to avoid expired medicine, the reducing operational cost was applied by turning off AC and lamp when unused, reuse paper, and preparation medicine correctly, the executive support was adjusted like a supervision not a support. Variables of cost monitoring were the monitoring financial continuely by cash flow was disable to warn The Pharmacy Installation strict to the budget planning nor had bargaining position in medicine principal even the generic and non generic margins upper 30 percent, moreover stock opname still had dismatch, the integrated service was birocratic and staff`s sense of belonging can?t be reached cause not enough information can be achieved, the security of important medicine through differentiating cupboard and stock card. Variable of cost incentive was the Insentive given had not determined by output of work but competences. It was revealed that cost containment efforts were still poorly implemented at RSUD Pasar Rebo especially at The Pharmacy Installation. The conclution was The Pharmacy Installation of RSUD Pasar Rebo had not yet properly implemented cost containment (cost awareness, cost management, cost monitoring, and cost incentive).
Factors Related with Implementation of Therapeutic Communication of the Nurses at Solok HospitalTherapeutic Communication was describe as the process by which nurses provide care for clients in needs of psychosocial intervention. This research study ilustrattes the interpersonal communication of the nurses at Solok Hospital.The Research used the cross sectional method by getting the sample of the total population of the nurses at Solok Hospital during the month of July until August 2002.The data were gathered from the given questionnaire at the respective respondents and was properly interpreted and explained on the basic of statistic reports with technical analysis distribution frequency, and chi square.The data analysis consist of univariat and bivariat. The analysis also implied that the relation of bivariat between age, gender, education, length of the data analysis consist of univariat and bivariat. The analysis also implied that the relation of bivariat between age, gender. education, length of work, employed status, knowledge, attitude, facility with perception of therapeutic communication.The result of this research showed there are 4 variables:( attitude, facility, length of work and employed status) have significant relationship with perception of therapeutic communication. Based on this research, it is recommendation is Focused on the achievement of the therapeutic communication of nurses and further development of there ability of therapeutic communication.References : 35 (1980-2000)
RSUD Pasar Rebo saat ini masih mengalami kekurangan tenaga perawat. Sejauh ini belum diketahui beban kerja dan pola waktu kegiatan perawat yang bertugas di RSUD Pasar Rebo khususnya di ruang rawat Inap. Karena itu rumah sakit harus memberikan perhatian terhadap beban kerja dan pola waktu kegiatan perawat untuk menghitung jumlah tenaga perawat secara tepat sesuai dengan kegiatan pelayanan di rawat inap.
Tujuan penelitian adalah menganalisis beban kerja, klasifikasi pasien, metode penugasan, kebijakan rumah sakit, dan karakteristik perawat di ruang rawat inap penyakit dalam dan bedah dalam upaya penghitungan jumlah tenaga perawat yang sesuai.
Jenis penelitian adalah deskriptif dengan analisis kualitatif dan kuantitatif. Penelitian dilakukan dengan cara pengamatan kegiatan perawat, pengisian kuesioner pada perawat di ruang rawat inap penyakit dalam dan bedah, dan wawancara mendalam pada manajer RSUD Pasar Rebo.
Hasil penelitian menunjukkan bahwa RSUD Pasar Rebo masih mengalami kekurangan tenaga perawat di ruang rawat inap penyakit dalam dan bedah berdasarkan penghitungan melalui analisis beban kerja perawat dan dari rasio jumlah perawat dengan jumlah pasien. Salah satu unsur yang tidak kalah penting untuk diperhatikan dalam penghitungan jumlah tenaga perawat adalah klasifikasi pasien dimana klasifikasi pasien di ruang rawat inap penyakit dalam dan bedah paling banyak adalah moderate care.
Kegiatan tindakan merupakan tindakan langsung yang menyita sebagian besar waktu perawat di ruang Cempaka dan Melati. Kegiatan komunikasi kepada pasien dan keluarga pasien di ruang Cempaka dan Melati masih kurang. Kurangnya komunikasi ini dapat menggambarkan bahwa kurang tenaga perawat dapat mengakibatkan ada kegiatan penting yang tidak dilaksanakan atau kurang dilaksanakan. Kegiatan administrasi pasien dan rekam medik menyita waktu sebagian besar kegiatan keperawatan tidak langsung. Kegiatan administrasi yang tidak dianjurkan adalah kegiatan administrasi keuangan karena perawat dapat terbebani dengan hal-hal yang seharusnya bukan kegiatannya.
Metode penugasan yang berlaku di ruang Cempaka dan Melati adalah kombinasi dari metode fungsional dan tim. Rencana ke depan akan diubah menjadi metode tim dengan dasar penyempurnaan dari metode penugasan yang berlaku sekarang. Dengan akan diberlakukannya metode penugasan tim maka harus diperhatikan perbandingan jumlah tenaga perawat dengan jumlah pasien untuk setiap tim.
Dengan adanya data tentang beban kerja perawat, klasifikasi pasien, metode penugasan, kebijakan rumah sakit dalam memenuhi jumlah tenaga perawat, dan karakteristik perawat yang ada. Data ini di masa yang akan datang dapat digunakan sebagai dasar perencanaan jumlah tenaga perawat yang sesuai dengan kebutuhan pelayanan kepada pasien rawat inap di RSUD Pasar Rebo.
Concerning with the enhancement of hospital services for facing competition among hospitals, hospital management has to consider human resources as the most influential asset. Human resources in health section is one of determining factor for hospital success. The largest number of human resources in health section is nurse. Lacking of nursing resources can influence hospital services and image.
RSUD Pasar Rebo, where this research was carried out, has been lacking of nursing resources. So far, it is still unknown about the nursing workload and work-time pattern of nurses' activities whose duty is giving medical care in the in-patient wards. Therefore, the hospital management has to pay attention to the workload and work-time pattern of nurses to determine the number of nurses needed to match the service activities in the in-patient wards.
The purpose of this research was to analyze nursing workload, patient classification, assignment method, hospital policy, and nurses' characteristics in the in-patient wards of internee and post surgery patients to calculate appropriate number of nursing resources.
The research method was descriptive with qualitative and quantitative analyses. The research was carried out by observing nursing activities, questionnaire, and in-depth interviews with hospital managers.
Results of the research indicate that RSUD Pasar Rebo has been lacking of nursing resources based on the calculation against nursing workload analysis. One of the important factor to be noted for calculating the number of nursing resources is patient classification which in the in-patient wards of internee and post surgery most of patients were classified in a moderate care.
The treatment activity is a direct treatment which takes the nurses? working time a lot at Cempaka and Melati wings. Communication with the patients and their family at these wings is still negligible. This can show the lack of nursing resources which can further be used as an indication that there is an important activity with no or little implementation. The administration procedure of the patient and medical recording indirectly take most of the nurses' working time. The unnecessary administrative duty is not financial as it means adding nurses' workload with a job not in line with their job's description.
The assignment method carried out at Cempaka and Melati wings is combination of functional and team method. In the future, this will be changed into team method only, based on the improvement of the current assignment method. Adopting team assignment method will require close attention to the ratio between the number of nurses and patients in each team.
The data resulted from this research, was the nurses' workload, patient classification, assignment method, hospital policy to meet the required number of nursing resources, and current nurses' characteristics. These data can be used in the future as the basis of planning program to meet appropriate number of nurses in order to provide excellent services for the in-patients at RSUD Pasar Rebo Jakarta.