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Penelitian tentang analisis kepuasan kerja tenaga keperawatan di ruang rawat inap RSU Bhakti Yudha Depok pada tahun 2002 dilatarbelakangi dengan adanya hasil survei kepuasan kerja tenaga keperawatan di ruang rawat inap tahun 1999 yang menunjukkan tingkat rendah dan adanya peningkatan keluhan pasien rawat inap terhadap pelayanan tenaga keperawatan dari tahun 2000 sampai 2001. Penelitian ini bertujuan untuk melihat tingkat kepuasan kerja tenaga keperawatan di ruang rawat Inap. Tingkat kepuasan ini dinilai dengan cara mengukur tingkat kesesuaian antara kenyataan dan harapan berdasarkan komponen upah, wewenang, tuntutan tugas, kebijakan organisasi, interaksi, dan status profesional dari seluruh responden menurut karakteristik demografi (umur, status kawin, dan tingkat pendidikan) dan karakteristik pekerjaan (status kepegawaian, lama kerja, mutasi kerja, lama kerja, pengalaman kerja, dan jam kerja seminggu).Penelitian ini menggunakan disain penelitian non-eksperimental dengan pendekatan cross sectional. Penentuan besar sampel penelitian dilakukan seeara total sampling dan didapatkan besar sampel sebanyak 103 orang. Data penelitian yang diperoleh berasal dari hasil pengisian kuesioner oleh responden dan dari hasil wawancara dengan 5 (lima) orang informan serta data hasil pencatatan dan pelaporan rurnah sakit. Instrumen yang digunakan mengacu pada kuesioner Index of Work Satisfaction yang dibangun oleh Stamps yang dalam penelitian ini telah dimodifikasi oleh peneliti sesuai dengan kebutuhan penelitian.Hasil yang diperoleh dari penelitian ini diketahui bahwa berdasarkan karakteristik demografi rerata umur responden adalah sekitar 30 tahun, tingkat pendidikan sebagian besar (60%) adalah lulusan SPK/Bidan, dan sebagian besar (65%) berstatus kawin. Bila dilihat dari karakteristik pekerjaannya maka hampir seluruh responden (83,5%) merupakan pegawai tetap RS, sebagian besar (57,3%) menyatakan belum pernah dimutasi ke unit/ruang perawatan lain, dan rerata lama kerja di RSU Bhakti Yudha adalah 6 tahun. Selain itu, responden yang memiliki pengalaman bekerja dan yang tidak memiliki pengalaman bekerja di tempat lain sebelum bekerja di RSU Bhakti Yudha cukup berimbang, dan rerata jam kerja perawat dalam seminggu adalah sekitar 44 jam.Bila dilihat dari tingkat kepentingan kepuasan kerja, maka komponen yang paling penting dalam kepuasan kerja berdasarkan hasil penilaian responden adalah wewenang yang diikuti oleh komponen status profesional, upah, interaksi, kebijakan organisasi, dan yang paling rendah tingkat kepentingannya adalah komponen tuntutan tugas. Berdasarkan tingkat kepuasan kerja diketahui bahwa secara umum rerata tingkat kepuasan kerja responden adalah 75,80%. Komponen kepuasan kerja dengan tingkat kepuasan tertinggi ada pada komponen status profesional (86,10%) diikuti pada urutan selanjutnya adalah interaksi antarperawat (83,69%), wewenang (81,54%), tuntutan tugas (79,5%), kebijakan organisasi (72,28%), interaksi perawat-dokter (70,78%), dan tingkat kepuasan kerja terendah diperoleh pada komponen upah (58,31%). Pada diagram kartesius diketahui bahwa komponen kepuasan kerja yang perlu mendapat prioritas utama dalam kepuasan kerja responden untuk ditindaklanjuti adalah upah dan interaksi dokter-perawat, karena tingkat pelaksanaannya masih belum baik.Dari hasil uji statistik diketahui bahwa semua karakteristik demografi yang diteliti (umur, status kawin, dan tingkat pendidikan) memiliki hubungan yang signifikan. Sementara itu, karakteristik pekerjaan responden yang terbukti memiliki hubungan yang signifikan secara statistik dengan kepuasan kerja responden adalah variabel lama kerja.Mengacu pada hasil penelitian ini yang menunjukkan tingkat kepuasan terendah adalah pada komponen gaji dan interaksi perawat dan dokter maka saran yang diajukan peneliti adalah lebih mensosialisasi sistem pengupahan yang berlaku baik berdasarkan status kepegawaian (tetap dan kontrak), sistem kenaikan upah, pemberian insentif dan bonus pada tenaga keperawatan dan mengaktifkan/memberdayakan kembali perkumpulan perawat di RS yang sudah ada semua informasi yang dibutuhkan berkaitan dengan SDM keperawatan dapat ditemukan dengan mudah oleh seluruh anggotanya. Selain itu, kegiatan bersama antara tenaga medis dan perawat perlu diselenggarakan misalnya dengan pemberian pelatihan dari dokter RS kepada perawat, penyelenggaraan seminar umum kesehatan dengan kepanitiaan bersama antara dokter dan perawat. Saran lainnya adalah sebaiknya semua tenaga keperawatan di RSU Bhakti Yudha adalah tenaga tetap bukan tenaga kontrak karena jenis tenaga ini termasuk dalam bisnis inti yang sangat berperan terhadap pelayanan kesehatan di rumah sakit mengingat kewajibannya sebagai tenaga keperawatan di rumah sakit adalah sama. Selain itu, perlu ada penelitian lebih lanjut mengenai kepuasan kerja tenaga keperawatan di rumah sakit dengan metode dan instrumen yang berbeda untuk memperoleh informasi yang lebih mendalam tentang komponen lainnya yang mempengaruhi kepuasan kerja tenaga keperawatan sehingga hasilnya lebih komprehensif serta untuk mendapatkan alat ukur kepuasan kerja tenaga keperawatan yang sesuai dengan kondisi dan situasi perumahsakitan di Indonesia.
The background of this study was based on the results of nurses work satisfaction survey in inpatient ward conducted in 1999 that showed low of nurses work satisfaction and also the availability of patient complaint of nurse service that increased from year 2002 until 2001. The aim of this study was to assess the level of nurses work satisfaction in inpatient ward. The measurement of the level of work satisfaction used the appropriateness level between expectation and perception. It was based on work satisfaction components as follows: pay, autonomy, task requirements, organizational policy, interaction, and professional status of respondents according to demographic characteristics (age, marital status, and education level) and job characteristics (employee status, duration of work span, job mutation, working experience, and total office hours per week).The design of this study was non-experimental with cross sectional approach. It was conducted to 103 nurses as total sampling. Data resources were from filling in the questionnaire and doing interview with 5 informants and from hospital recording and reporting. The use of instrument was based on the modified of Index of Work Satisfaction questionnaire which built by Stamps.The result of this study showed that on the average the age of respondents was 30 years, the majority (60%) of them was graduated from Nursing School/Midwife School, and 65% of respondents were married. According to job characteristic, about 83,5% of respondents were full timer, 57,3% of nurses have never been mutated to other unit, and the average of duration of work span in Bhakti Yudha General Hospital was 6 years. The percentage of experienced and inexperienced employee stands balance enough and the average of nurse's working hours per week were about 44 hours.The highest importance level of the nurses work satisfaction component was autonomy, followed by professional status, pay, interaction, organizational policy, and the lowest importance level is task activity component. Based on the work satisfaction level known that 75,80% of respondents were satisfied. The highest satisfaction level goes to professional status component (86,10%) while the lowest satisfaction level is pay component (58,3%).Importance Performance Analysis which depicted as Kartesius Diagram, known that the main priority of nurses work satisfaction which should be intervened by the hospital management is pay and nurse-doctor interaction.All demographic characteristics (age, marital status, and education level) in this study were statistically related to the work satisfaction significantly. Meanwhile, job characteristic that related to the work satisfaction was duration of work span.It is recommended to Bhakti Yudha Depok General Hospital to socialize the pay system among nurses and to empower nurses association in Hospital. Besides, together activity between nurse-doctor should be held on such as training for the nurses by doctors, holding the health seminar in a together committee. The other recommendation is that all the nurse should be included as full time employee in hospital, not as contract employee considering this employee is a core business in the hospital who?s the same obligation and responsibility. Follow up study needs to be conducted to find other aspects related to nurses work satisfaction and to obtain the suitable instrument with the hospital condition and situation in Indonesia.
Diarrhea is a disease that is often found and causes 4% of all deaths in the world. Cases of acute diarrhea in children is a disease that includes high risk, high volume, and high cost. According to 2018 data, there were 938 cases of acute diarrhea and were in first place in the top 10 causes of hospitalization at Bhakti Yudha General Hospital. The implementation of clinical pathways is closely related to efforts to control the quality and cost of affordable and predictable health services. Cost control can be realized if the process of overall health services can be planned and standardized from the start. Clinical pathways if done properly and correctly can reduce the cost of health services, reduce the length of stay, and improve patient clinical outcomes. The existence of a mismatch in the application of clinical pathways can affect the number of billing patients. This study aims to determine the appropriateness of the application of clinical pathways of mild acute diarrhea - moderate inpatient children in Bhakti Yudha General Hospital. The mixed-method research design is quantitative descriptive and qualitative case studies. The results showed that doctor compliance was still lacking in the provision of medical management. There are still discrepancies between clinical pathways and services provided. These discrepancies include variations in drug therapy, supporting examinations, and nursing actions. This variation was made because the patient's condition needed different treatments. The biggest gap in the use of drugs is 145% wherein real billing is greater than the bill according to the clinical pathway due to the use of drugs that are not following the clinical pathway. The number of variants that do not fit the clinical pathway will affect the amount of the hospital bill.
Penelitian ini menggunakan pendekatan kuantitatif dengan rancangan crosssectional yang dilakukan pada periode rawat 4-15 Maret 2013 pada 114 pasien sebagai responden. Tujuan penelitian ini adalah mengetahui faktor-faktor yang berhubungan dengan persepsi pasien terhadap efektivitas komunikasi terapeutik perawat di ruang rawat inap RSU Bhakti Yudha Depok.
The study was a quantitative cross sectional study conducted during the periodMarch 4th to March 15th 2013 and covering 114 client. The aim of the study was to determine the factors associated with patient's perceptions about effectiveness of therapeutic communication nursing inpatient unit.
Dalam menjawab keluhan perawat mengenai besarnya beban kerja di ruang rawat inap Cattleya B RSU Bhakti Yudha, perlu dilakukan analisis kebutuhan tenaga perawat dengan menggunakan beberapa formula yaitu, Workload Indicator Staff Needs (WISN), formula Gillies, PPNI, dan formula Ilyas. Penelitian dilakukan di ruang rawat inap Cattleya B menggunakan pendekatan kuantitatif dan kualitatif dengan melakukan observasi terhadap aktivitas perawat menurut metode work sampling serta in-depth interview pada 21-30 Mei 2012. Hasil penelitian menyatakan beban kerja perawat pada kategori produktif (80%) dengan hanya 33.98% yang merupakan aktivitas keperawatan langsung dan 47.4% merupakan aktivitas keperawatan tidak langsung. Penggunaan waktu untuk kegiatan pribadi dan non produktif perawatmasih di dalam standar ILO (14.98%) Formula Gillies dan PPNI, dan Ilyas tidak menggambarkan sejumlah kegiatan keperawatan tidak langsung dari perawat seperti administrasi dan pencatatan laporan, yang justru pada saat observasi membutuhkan proporsi yang lebih besar. Sebaliknya metode WISN yang menghasilkan jumlah perawat sebesar 35 orang ditambah dengan 1 kepala ruangan dianggap lebih tepat dan sesuai dengan RS karena menggambarkan beban kerja nyata. Diharapkan pihak manajemen dapat memberikan toleransi seperti pemberian hari kepelatihan bagi perawat, menambah jumlah tenaga baik perawat dan non perawat sesuai kebutuhan untuk meningkatkan mutu pelayanan.
In order to answer the concern of high workload nursing care at Cattleya B Ward of Bhakti Yudha Hospital, there is a need to analyze the requirement of nursing staff with some formulas:Workload Indicator Staff Needs (WISN), Gillies?, PPNI, and Ilyas? Formula. This Research was held in Cattleya B Ward of Bhakti Yudha Hospital on May 21st-30th 2012 using Quantitative and Qualitative approach with an observation to nursing activity based on work sampling method and also in-depth interview with some informants to gain any information for analysis. The result of this research proved that nursing workload is in productive state (80%) with only 33.98% are direct nursing care activities and 47.4% are indirect nursing care activities. The usage of time for individual activity and non-productive activity are still in the ILO Standard (14.98%) Gillies?, PPNI, and Ilyas? Formula did not described some of indirect activity like administration, and making nursing report which in observation need higher proportions than others. In the contrary, WISN, which results 35 nurses as staff with 1 additional nurse as the head of Cattleya B ward, is suitable with hospital because described the real work load in the ward. In the future, hopefully manager can give any tolerance like training day for nurse; add some staff both nursing staff and non-nursing staff as needs for service quality.
ABSTRAK Nama : Ni Wayan Kesumawati Program Studi : Kajian Administrasi Rumah Sakit Judul : Analisis Piutang Pada Pasien Rawat Inap Jaminan Kesehatan di Rumah Sakit Umum Famili Husada Periode 2015-2016 Pergeseran skema pembayaran biaya kesehatan ke rumah sakit telah bergeser dari majoritas biaya sendiri dibayar tunai ke pembayaran melalui pihak penyelenggara jaminan kesehatan, yang menyebabkan rumah sakit harus mengelola piutang dengan baik karena penerimaan pendapatan rumah sakit dibayar non-tunai. Keterlambatan pembayaran piutang dan atau kegagalan pengelolaan piutang dapat mempengaruhi posisi arus kas, yang kalau ini berlanjut mengakibatkan terganggunya kegiatan operasional rumah sakit. Tujuan penelitian ini untuk mengetahui posisi gambaran piutang pada pasien jaminan kesehatan di RSU Famili Husada periode tahun 2015 – 2016 dimana rumah sakit telah memutuskan untuk melayani pasien BPJS Kesehatan. Selain itu perlu juga diketahui jumlah piutang dan kebijakan pemberian kredit yang ada agar dapat dijadikan masukan untuk perbaikan manajemen kedepan. Penelitian ini menggunakan metode penelitian deskriptif kualitatif dengan melibatkan seluruh pegawai yang bekerja di bagian keuangan, kasir, front office dan manajemen, sebanyak 14 orang sebagai informan. Data dikumpulkan dengan teknik wawancara mendalam dan observasi partisipan, kemudian dianalisis menggunakan content analysis. Hasilnya menunjukkan bahwa terdapat peningkatan saldo piutang pasien rawat inap pasien jaminan kesehatan pada tahun 2015 – 2016 terutama untuk pasien JKN yaitu dari sebasar 17% meningkat menjadi 30,66%, sedangkan rata – rata persentase pembayaran piutangnya sebesar 45% yang artinya pembayaran piutang dari pasien BPJS Kesehatan belum lancar sehingga bila ini tidak dikelola dengan baik akan menimbulkan terganggunya arus kas dan akhirnya kegiatan opreasional rumah sakit pun terganggu. Kesimpulan yang dapat diambil bahwa seiring dengan terjadinya peningkatan jumlah piutang rumah sakit terdapat ketebatasan secara kuantitas maupun kualitas dari sumber daya manusia dalam pengelolaan piutang; belum ada standar prosedur operasional yang mengatur secara khusus tentang pemberian kredit dan kebijakan pengumpulan piutang. Berdasarkan hasil penelitian ini, disarankan agar melakukan evaluasi terhadap kebijakan pemberian kredit dan penagihan piutang yang berlaku, evaluasi beban kerja petugas pengelola piutang dan lakukan pelatihan – pelatihan khusus di bidangnya, serta lakukan pendekatan pada pihak debitur. Kata Kunci: Jaminan Kesehatan, Piutang
ABSTRACT Name : Ni Wayan Kesumawati Study Program : Hospital Administration Title : Accounts Receivable Analysis In Inpatient Patients Health Insurance at Famili Husada Public Hospital Period 2015-2016 The shift in health-care payment schemes to hospitals has shifted from the majorities of their own expenses paid in cash to payments through health insurance providers, which causes hospitals to manage receivables well because hospital revenue is paid non-cash. Delinquent receivables and / or failure of receivables management may affect cash flow position, which if this continues to result in disruption of hospital operations. The purpose of this study is to know the position of the description of receivables in health insurance patients at RSU Famili Husada period 2015 - 2016 where the hospital has decided to serve the patient BPJS Health. In addition, it is also necessary to know the amount of receivables and lending policies available to be used as input for future management improvement. This research uses qualitative descriptive research method by involving all employees who work in finance, cashier, front office and management, as many as 14 people as informant. Data were collected by in-depth interview technique and participant observation, then analyzed using content analysis. The results show that there is an increase in the balance of accounts receivable of patient in health care patient in 2015 - 2016 especially for JKN patient that is from sebasar 17% increase to 30,66%, whereas the average of payment percentage of receivable equal to 45% which mean payment of receivable from patient BPJS Health has not been smoothly so that if it is not managed properly will cause disruption of cash flow and finally hospital operational activities were disrupted. The conclusion can be made that in line with the increase of the number of hospital receivables there are limitations in quantity and quality of human resources in the management of receivables; there is no standard operating procedure that specifically regulates the provision of credit and collection policy of receivables. Based on the result of this research, it is suggested to evaluate the crediting policy and receivable billing, evaluation of workload of receivable management officer and do special training in the field, and approach the debtor. Keywords: Health Insurance, Accounts Receivable
With the aim of streamlining the inpatient's discharge process at the Elizabeth HospitalBekasi, this study analyzed the efficiency of discharge process using the Lean Six Sigmamethod. Six Sigma method tries to reduce time variation in each step of the discharge processfollowed by identifying the appropriate time. The Lean method identifies the non valuesactivities (waste) to be reduced. For that, qualitative approach using observation wasimplied. The study resulted with 238 minute as average total timing of discharge and thegreatest impact to reduce it will be the one day earlier written discharge instruction preparedby the physician.
Penelitian ini merupakan penelitian kualitatif yang didahulukan oleh studi dokumenter (documentary study) dengan memeriksa kelengkapan rekam medis menggunakan alat bantu daftar tilik yang dibuat oleh peneliti. Motivasi ekstrinsik akan mempengaruhi tenaga medis dalam pengisian rekam medis, diantaranya kerjasama tim dan beban kerja. Motivasi intrinsik seperti pengetahuan dan persepsi dalam pengisian rekam medis juga akan mempengaruhi ketidaklengkapan pengisian rekam medis di suatu pelayanan kesehatan. Motivasi dari pekerja kesehatan berpotensi mempengaruhi penyediaan layanan kesehatan. Semangat rendah diantara pekerja dapat merusak kualitas penyediaan layanan, sementara kehadiran pekerja yang bermotivasi tinggi dan berkualitas merupakan aspek kunci dari kinerja sistem kesehatan.
Kata kunci : Rekam medis, motivasi ekstrinsik, motivasi intrinsik
A medical record is containing data and information to be made by a health service that contains a patient's medical history during the patient is receiving services, from anamnesis, history of the disease, physical examination and other investigations, diagnosis, treatment to action medical services. The completeness of a medical record is desperately needed as a valid proof that a patient is properly receiving health care, especially medical resume can be used as hospital claim sheets to insurance in collaboration with hospitals. The low number of completeness medical record in Bhakti Yudha Depok Hospital is the basis for the researcher to conduct the research. The incomplete filling of medical records is due to many factors, including the motivation possessed by the medical personnel responsible for the medical record.
This research is a qualitative research which takes precedence by documentary study by examining the completeness of medical record using the check list tool made by the researcher. Extrinsic motivation will affect medical personnel in filling out medical records, including teamwork and workload. Intrinsic motivation such as knowledge and perception in filling medical record will also affect the incomplete filling of medical record in a health service. The motivation of health workers has a potential affect the provision of health services. Low morale among workers can damage the quality of service provision, while the presence of highly motivated and qualified workers is a key aspect of health system performance.
Key words : Medical record, extrinsic motivation, intrinsic motivation
