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Penelitian dilaksanakan di Instalasi Kamar Bedah RS Husada tanggal 11- 17 Desember 2012. Penelitian yang dilakukan merupakan penelitian deskriptif kuantitatif-kualitataif, analisa data kuantitatif dengan menggunakan metode Time and motion study, dimana aktifitas perawat bedah diteliti pada kegiatan perioperatif, serta kegiatan diluar operasi. Kemudian dengan menggunakan metode Formula Unit Ruang Bedah dihitung jumlah kebutuhan perawat bedah berdasarkan beban kerja. Penelititan kuatitatif dengan wawancara mendalam mengenai kompetensi yaitu pengetahuan, ketrampilan, dan sikap perawat bedah, kepada 3 responden yaitu Kepala Bagian Bedah, Kepala Perawat, dan perawat bedah di Instalasi Kamar Bedah untuk mengetahui jumlah kebutuhan berdasarkan kompetensi perawat bedah.
Research was conducted at the Hospital Surgery Room Installation Husada on 11 to 17 December 2012. Research conducted a quantitative-qualitative descriptive research, quantitative data analysis using the Time and motion study, which investigated the activities of a surgical nurse perioperative events and activities outside of surgery. Then using the Formula Unit Ruang Bedah calculated amount need based surgical nurse workload. Qualitative research in-depth interviews about the competence of the knowledge, skills, and attitudes of surgical nurses, to the third respondent, Head of Department of Surgery, Head Nurse Installation, and surgical nurse at Surgical Room Installation.
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.
Back Ground Reference is a system of health service implementation, which results a delegation of responsibility on both sides toward a disease case or health problem vertically or horizontally, with an aim to increase any health level through a complete heath service based on the approach of improvement, prevention, curing and recovery. Rumah Sakit Umum Fatmawati since year 2000 has had a status as a service company hospital, however for the next future the status will be changed into Public Service Division (BLU). The status change of this hospital refers to an organization program as a business so this hospital has to start to change its management and be more oriented toward business management. Objective The aim of this research is to find out a mechanism Reference procedure which has been applied by RSUP Fatmawati Jakarta considering it has been pointed as a Reference Center of Orthopedics Surgery Service Methods The informants are referrals of on going patients and on stay patients that were conducted in July 2005. The measuring tools of the results were questionnaire, interview guidelines and check list. The variable of the research includes input, process and output. Results The result of the finished research shows that the policy is not really understandable, the Standard Operational Procedure (SOP) is not socialized well by RSUP Fatmawati Jakarta as the giver of the service, Human Resource in qualitatively and quantitatively of medical specialists is on the proper standard, skilled nurses are lacking, media and facilitation of room location are dispersed, health equipments are still uncompleted, and there is no first class room for a stay service. In some observation and document check, there is found something that the return reference to the hospital sender has not been given. The procedure of the patient reference is not suitable with its available guidelines. Conclusions Conclusion, the service of RSUP as a National Superior Hospital and Reference Center for Orthopedics Surgery Service, is not optimum yet in applying its system. There are enough medical Human Resources but lacking of skilled nurses, media and medical facilitation and socialization to the public. Suggestion, RSUP Fatmawati could improve its commitment more to carry out the reference system, and make a serious effort for the smoothness of communication with the whole reference levels. Keywords : Reference procedure, Hospital
Cipto Mangunkusumo Eye Center (CMEC) merupakan suatu wadah pelayanan kesehatan mata terpadu yang merupakan pengembangan dari pelayanan kesehatan mata di Rumah Sakit Dr. Cipto Mangunkusumo. Status rumah sakit sebagai badan layanan umum memberikan keleluasaan bagi rumah sakit untuk menerapkan praktek-praktek bisnis yang sehat untuk meningkatkan pelayanan kepada masyarakat. Dilihat dari besarnya pasar pelayanan untuk kelas menengah ke atas dan belum tercapainya target pelayanan pada segmen tersebut di Departemen Mata RSCM maka dibutuhkan upaya pengembangan sarana, prasarana, sumber daya dan strategi pemasaran. Tesis ini merupakan penelitian di bidang manajemen pemasaran rumah sakit, yang bertujuan untuk melakukan analisis segmen, target, posisi pasar dan bauran pemasaran pada pengembangan Cipto Mangunkusumo Eye Center. Penelitian ini merupakan penelitian deskriptif dengan metodologi penelitian kualitatif yang didukung data kuantitatif untuk proses segmentasi pasar. Dengan metode ini diharapkan dapat mendukung tercapainya tujuan penelitian yaitu merumuskan bauran pemasaran yang tepat untuk pelayanan di Cipto Mangunkusumo Eye Center. Berdasarkan hasil penelitian maka ditetapkan segmen utama untuk pelayanan di Cipto Mangunkusumo Eye Center yaitu masyarakat di wilayah Jakarta dan sekitarnya, kelompok pelanggan dengan usia diatas 41 tahun, bekerja sebagai karyawan swasta / pemerintah dan berpenghasilan 3 – 5 juta rupiah per bulan serta mendapatkan jaminan kesehatan dari tempat kerja dalam bentuk asuransi kesehatan. Adapun pola pasar sasaran yang dipilih yaitu selective specialization dan positioning yang diambil ialah sebagai market challanger. Kata Kunci : Segmentasi, Targeting, Positioning
Cipto Mangunkusumo Eye Center (CMEC) is an integrated eye health service which is the development of eye health services at the Dr. Cipto Mangunkusumo Hospital. Status of RSCM as a public service agency provides flexibility for hospitals to implement sound business practices to improve the service. The potential size of the upper middle class and under achievement of service targets in that segment force Department of Ophthalmology RSCM to development facilities, infrastructure, resources and marketing strategies. This thesis is a study of hospital marketing management, which aims to perform the analysis of segment, target, market positioning and marketing mix in the development of Cipto Mangunkusumo Eye Center. This study is a descriptive study with qualitative research methodology that supported the quantitative data for market segmentation process. With this method is expected to support the achievement of research goals is to formulate the appropriate marketing mix for services in Cipto Mangunkusumo Eye Center. Based on the results of studies have established the main targets for the service at Cipto Mangunkusumo Eye Center is the community in Jakarta and surrounding areas, customer groups with age above 41 years, working as employees of private / government and earn 3-5 million dollars per month and get health insurance from their workplace. The pattern of the selected target market is selective specialization and positioning which is taken as Market Challanger. Keywords : Segmentation,Targeting, Positioning
Bisnis perumahsakitan mengalamj perubahan mendasar berkaitan dengan peningkatan daya saing rumah sakit dalam meraih pangsa pasar pada saat ini dan masa mendatang. Salah satu produk rumah sakit yang sangat berkembang sejak tahu 80-an adalah rawat jalan. Bedah rawat jalan (BRJ) merupakan bagian dari layanan rawat jalan yang saat ini merupakan Iayanan yang terus meningkat karena banyak memberikan keuntungan seperti biaya yang lebih murah, rendahnya tingkat infeksi, berkurangnya kecemasan pasien dan pasien merasa lebih nyaman. Di Amerika BRJ mencapai 70-75 % dari seluruh pembedahan. Di Indonesia BRJ teiah dilakukan diberbagai rumah sakit tetapi umumnya belum menjadi Iayanan yang terencana baik, hanya merupakan pelayanan baru atau tarnbahan yang diadakan karena adanya kebutuhan dari masyarakat dan belum ada pelaporan tersendiri untuk pelayanan ini. Melihat potensi layanan ini di masa mendatang dan untuk mengetahui bagaimana sebaiknya pelayanan ini diberikan dilakukan penelitian di RS Haji Jakarla mengingat angka pelayanan BRJ masih rendah dan untuk mendapatkan gambaran kesiapan rumah sakit terutama kamar bedah dalam melaksanakan BRJ. Tujuan penelitian adalah untuk mengetahui dukungan manajemen, kesiapan SDM baik dokter maupun perawat, dan kesiapan fasilitas untuk mendukung pelayanan BRJ. Juga dinilai kesiapan kamar bedah melaksanakan pelayanan ini dibandingkan standar yang ada. Peneiitian ini menggunakan pendekatan kualitatif. Informasi yang didapat berupa data primer melalui wawancara mendaiam dan observasi dan data sekunder melalui telaah dokumen. Hasil penelitian menunjukkan kamar bedah secara umum telah siap melakukan pelayanan BRJ., tetapi dukungan manajemen masih belum maksimal. Dari segi SDM baik perawat dan dokter siap melakukan pelayanan BRJ. Dari fasilitas dan layanan pendukung layak melakukan BRJ. Saran kepada manajemen adalah selain BRJ dicantunkan dalam rencana strategis berikutnya, harus dibuat konsep dan disain BRJ yang biak dan dijabarkan dalam pelaksanaan strategi serta ada evaluasi untuk tindakan koreksi.
The hospital businesses are having a basic changes linked by the increased hospital competition abilities in reaching the market-section nowadays and future. One of the Hospitals products which is very popular since 80's is the ambulatory care. Ambulatory surgery is a part of the ambulatory care programs which is popular because it gives a lot of benefits to the hospital and the patients, such as cheaper , low-infection level, less of anxiety and the patients feels more comfortable. In United State ambulatory surgery achievement till 70-75 % from whole surgery. ln Indonesia ambulatory surgery have done by various hospital but generally the care not to be good planned, only the new care because the people need the service and not yet different report for the care. Observe the potential this care for future and how the good standar for this practice, had done study at Haji Hospital Jakarta keep in mind ambulatory surgery achievement still low and for observe readiness operathing theater bring about the ambulatory surgery. The aim of the study is to find out management support, human resources readiness whether nurse or doctor, and facility readiness to support the ambulatory surgery. Operating theater readiness also to be compare with available standard. The study using a qualitative approach, and the information obtained are a primary data from in-depth interview and observation, and secondary data from documents review. The study found that generally operating theater ready for servicing ambulatory surgery, but management support not yet maximum. From human resources whether nurse or doctor is ready to serve. From facility and service support good too. Suggestion for management is ambulatory surgery persisten included in the strategic planning furthermore and must be made ambulatory surgery concept and design and conversion to the realize strategi and evaluation have to made for corrective action.