Dalam rangka mewujudkan prinsip efisiensi dan produktivitas pada pengelolaan RSUD Budhi Asih, dibutuhkan pegawai dengan komitmen organisasi yang tinggi, Menurut Greenberg dan Baron (2000:), pegawai dengan komitmen yang tinggi akan menunjukkan sikap dan keinginan yang tinggi pula untuk berbagi dan mempersembahkan sesuatu yang dibutuhkan organisasi. Komitmen yang kuat dapat dicapai dengan meningkatkan kualitas kehidupan kerja (quallty of work life).Para ahli telah mengembangkan program-program peningk:atan kualitas kehidupan kelja untuk meningkatkan motivasi, kepuasan. dan komitmen pegawai, yang mana faktor-faktor ini berperan dalam meningkatkan perfonna organisasi. Berdasarkan penelitian yang dilakukan oleh Alvin (2{){)6)waktu kerja produktif pegawai administrnsi RSUD Budhi Asih banya 64.6%. Selain itu, aspek­ aspek kualitas kehidupan keJja di RSUD Budhi Asih masib kurang dikembangkan., dengan kondisi kerja seperti ini, dikhawatirkan akan terjadi penurunan komitmen organisasi pegawai yang akan berdampak buruk bagi Rumah Sakit. Permasalahan utama yang diajukan dalam penelitian ini adalah gambaran hubungan aspek kualitas kehidupan kerja berdasarkan Cassio (2006) yang terdiri dari partisipasi karyawan, pengembangan karir, rasa bangga terhadap perusahaan, lingkungan kerja, penyelesaian masalah dan komunikasi, dengan komitmen organisasi pegawai administrasi instalasi Rawat Jalan bagian front office dan Laboratorium RSUD Budhi Asih. Komitmen organisasi dilihat dari masing-masing komponen berdasarkan Allen dan Meyer (1990), yaitu komitmen efektif, komitmen rasional, dan komitmen normatif. Peneltian ini dilakukan dengan pendekatan kualitatif dan kuantitatif. Dalam penelitian ini, penulis berupaya memperoleh jawaban atau informasi mendalam dari pegawai administrasi instalasi Rawat Jalan bagian front office dan Laboratorium RSUD Budhi Asih yang seluruhnya berjumlah 37 orang. Untuk memperoleh data digunakan instrumen berupa pedoman wawancara mendalam dan dokumen yang berhubungan dengan topik penelitian. Hasil wawancara mendalam menunjukkan bahwa dari 37 pegawai terdapat 11 orang dengan kualitas kehidupan kerja tinggi, 23 orang sedang, dan 3 orang rendah. Untuk komitmen, didapatkan hasil, yaitu:3 orang komitmen afektif, 29 orang komitmen rasional, dan 5orang komitmen normatif. Hasil penelitian menunjukkan tidak ada hubungan antara kualitas kehidupan kerja dengan komitmen organisasi pegawai. Tidak berhubungannya kedua varlabel dalam penelitian kurangnya validitas internal pada instrumen penelitian. Bagi pihak manajemen rumah sak:it, disarankan untuk melakukan program­ program peningkatan kualitas kehidupan kerja dan komitmen organisasi pegawai. Untuk meningkatkan kualitas kehidupan keria pegawai, dapat dilakukan peningkatkan partisipasi pegawai terhadap program dan kegiatan rumah sakit melalui pembagian angket/kuesioner, serta perwakilan pegawai pelaksana dalam rapat besar. Perlu diadakan rekreasi dan kegiatan kegiatan kekeluargaan non formal, rnenegakkan sistem reward dan punishment, mempertimbangkan program pendidikan dan pelathan bagi pegawai front office, memperbaiki situasi ruang kerja front office dari segi keamanan dan keselamatan kerja dan mengadakan program konseling bagi pegawai. Untuk meningkatkan komitmen organisasi, sebaiknya pihak manajemen mengetahui kebutuhan-kebutuhan dominan pegawai melalui pembagian angket, yang selanjutnya hal ini dapat menjadi masukan bagi pihak manajemen untuk peningkatan motivasi pegawai. Pembinaan dan pengembangan kompetensi juga perlu dilakukan, sehingga pegawai merasakan adanya dukungan dan kemudahan dalam bekerja. Untuk peneliti yang akan datang, sebaiknya meningkatkan va1iditas internal instrumen penelitian dengan disesuaikan budaya infonnan, yaitu dengan melakukan pengelompokan berdasarkan karakteristik pribadi.

In order to fulfill the efficiency and productivity principles on the running of RSUD Budhi Asih, it is necessary to find employees with high organizational commitment. According to Greenberg and Baron (2000), employees with high organizational commitment will show some good manner and high needs to share and give the best to the organization. A strong commitment can be obtain by improving the quality of work life. Many experts have developed quality of work life improvement programs to improve motivation, satisfaction, and employees' commitment by which these factors take a very crucial part on the performance improvement scenario of the organization. Based on the research done by Alvin (2006), productive work time of RSUD Budhi Asih, clerical employees is only 64.6%. Besides, their quality of work life is not yet well-developed. With this working condition, it is possible that there will be some organization commitment degradation in the future which may affect baldy for the hospital. The main problem proposed by this research is the description of possible conection between the quality of work life aspects based on Cassio (2006) ? employee participation, carer development, pride, equitable, compensation, job security, wellness, safe environment, conflict resolution, and communication with organizational commitment of Out Patient's front office and Laboratory employees of RSUD B udhi Asih. Organizational commitment, rational commitment, and normative commitment. This research is done with some qualitative and quantitative approach. The researcher is trying to gather in-depth answer or information from front officers and Laboratory clerical employees which sum up for a total of 37 persons. To gain data the researcher used in-dept interview and documents related to research topic. In-depth interview showed that II out of 37 employees have high quality of work life. Commitment, that is: 3 people with affective commitment, 29 people with rational commitment, and 5 people with normative commitment. Analysis output showed that there is no significant relation between the quality of work life and employee's organizational commitment. This fact ls caused by the lack of internal validity on the research instruments. As for the hospital, it is suggested to do some employees commitment and quality of work life improvement programs. To improve the employee?s quality of work life, hospital management suggested to improve the employees participation on hospital programs and activities, and representativeness of employees on hospital meeting's. Hospital suggested to make recreation programs and non*forma1 activities. establish reward an punishments front officers, fix the situation of front officers working area related to safety environment. and make a counsellng's program for employees. To improve the employee's organizational commitment, hospital management should find the employee's dominant needs by questionaire, this way can be useful for hospital's management to improve employee's motivation. Competency improvement is important also, in order to support and make the job easy. For future research., it is suggested to improve internal validity on the research instruments, depend on the informans culture, by categorized the informans based on their internal characteristics.

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)

Dewasa ini pola penyakit cenderung mengalami perubahan. Penyakit-penyakit yang disebabkan oleh perubahan gaya hidup misalnya trauma semakin meningkat. Sedangkan di Indonesia trauma merupakan penyebab kematian tertinggi pada usia 15-45 tahun dan kematian yang disebabkan kecelakaan menempati urutan keempat tertinggi. Propinsi Lampung, terletak pada daerah yang merupakan perlintasan arus transportasi darat dari dan menuju Pulau Jawa dan Sumatera, daerah ini memiliki tingkat resiko kecelakaan lalu lintas yang tinggi, dan ini terlihat dan banyaknya kasus trauma yang ditangani di IGD RSAM lebih dan 4000 kasus pertahun. Sebagai rumah sakit rujukan tertinggi di propinsi ini maka RSAM berkeinginan untuk mengembangkan IGD nya menjadi pusat pelayanan trauma di Propinsi Lampung. Tujuan penelitian ini adalah mendapatkan gambaran situasi Instalasi Gawat Darurat RSUD Dr. H. Abdul Moeloek untuk menjadi pusat pelayanan trauma di Propinsi Lampung. Penelitian ini menggunakan pendekatan kualitatif informasi yang didapat berupa data primer melalui observasi dan wawancara mendalam dan data sekunder melalui telaah dokumen. Hasil penelitian menunjukkan bahwa Pemda Propinsi Lampung memberikan dukungan sepenuhnya baik (dari segi anggaran maupun politis guna mewujudkan pusat pelayanan trauma ini, dengan jumlah total penderita trauma yang dilayani di IGD RSAM mencapai diatas 4100 pertahun, sekitar 1500(37%) penderita pertahun merupakan kasus trauma yang membutuhkan perawatan dari suatu pusat pelayanan trauma, dan dan jumlah tersebut I044 (69%) adalah penderita trauma serius/trauma parah. Dengan jumlah seperti ini menurut informan maka RSUD Dr. H. Abdul Moeloek sudah memerlukan tersebut 1044 (69%) adalah penderita trauma serius/ trauma parah. Dengan jumlah seperti ini menurut informan maka RSUD Dr. H. Abdul Moeloek sudah memerlukan penanganan oleh Tim Trauma dan dengan 460 tempat tidur dan BOR 85% memenuhi kriteria pusat pelayanan trauma tingkat dua. Sumber Daya Manusia yang dimiliki dari kompetensi dokter spesialis sudah memenuhi standar jumlah dan tenaga pendukung nonmedis masih kurang. Untuk dokter umum dan tenaga paramedik jumlahnya sudah memenuhi standar tetapi kompetensi yang dimiliki belum memenuhi standar. Untuk fasilitas fisik sudah memenuhi standar, kecuali kemiringan ramp lebih dari 20°, tidak memiliki pintu khusus untuk pasien dengan alat pengangkut, untuk fasilitas alat medik sudah memenuhi standar pusat pelayanan trauma, hanya belum memiliki alat torakosintesis, dan pada ruang resusistasi belum memiliki kotak pemanas cairan infus, gantungan infus dari langit-langit serta alat komunikasi khusus, sedangkan fasilitas layanan intensif belum memenuhi standar karena belum memiliki HCU, depo penyediaan darah dan untuk layanan CT Scan pada radiologi belum memenuhi standar karena hanya melayani pada pagi hari. Kesimpulan secara umum dengan memperhatikan komponen penderita dan komponen umum berdasarkan kondisi saat ini maka pusat pelayanan trauma RSUD Dr. H. Abdul Moeloek berada pada tingkat tiga menuju dua, dan pada tahun 2006 ini dapat di realisasikan. Saran kepada Pemda Propinsi Lampung, selain anggaran untuk investasi juga dialokasikan anggaran khusus untuk operasional pusat pelayanan trauma tersebut. Dinas Kesehatan Propinsi harus melakukan sosialisasi kepada rumah sakit-rumah sakit kabupaten/ kota tentang penanganan penderita trauma dan kriteria kasus trauma yang perlu dirujuk ke Pusat PeIayanan Trauma RSUD Dr. H. Abdul Moeloek. Kepada RSUD Dr. H. Abdul Moeloek, dilakukan penambahan dokter spesialis dan penambahan tenaga non medik, pelatihan khusus trauma untuk dokter umum dan paramedik, memperbaiki kekurangan pada fasilitas fisik dan melengkapi fasilitas alat medik serta untuk fasilitas layanan pendukung layanan CT Scan diberikan dalam 24 jam, melengkapi sarana prasarana HCU dan menyiapkan depo penyediaan darah.

In recent days, the pattern of the disease or illness is tending to change. Diseases caused by the changing of lifestyle, such as trauma, are likely to increase. in Indonesia, trauma has been a highest leading cause of death among people age 15 to 45, and death cause by accident is the forth highest. Province of Lampung is located on the area of cross-land transportation from and to the island of Java and Sumatera, and having a very high risk of road accident. It can be seen from the high number of trauma cases handled in the Emergency Room (ER) of District General Hospital of Dr. H. Abdoel Moeloek (DGHAM), which are as high as 4,000 cases per-year. Therefore, as the highest referral hospital in the province, DGHAM need to develop its ER and shifted to be a Trauma Service Center (TSC) for the province of Lampung. The aim of the study is to find out the description of situation on the ER of DGHAM that will shift to be a TSC. The study using a qualitative approach, and the information obtained are a primary data from observation and in-depth interview, and secondary data from documents review. The study found that District Authority (Pemda) of Lampuitg Province is giving fully supports both on budgeting and politically, in order to develop the TSC to become a reality. With the total cases handled at the ER of DGHAM are more than 4,100, about 1,500 (37%) of those are patients of trauma that need advance and intensive care form a trauma service center, and from those numbers, about 1,044 (69%) are having serious and severe trauma_ Informant from the DGHAM stated, with a figure as explained above the DGHAM is suppose to be have its own Trauma Team, and with 460 beds and BOR as high as 85% that makes DGHAM have a criterion for the level two of TSC. Regarding to the human resources, DGHAM has reach the standard of competency for its specialist doctors, but still have a lack on number of non-medic supporting staffs. It also has an adequate number on GPs and paramedic personnel, but they have not yet reach their standard of competency. DGHAM also has reached the standard for facilities, physically, but still have some exception, such as: the slope of the building is more than 20°, and there is no special entrance for patient that carried by cart. The facility on medical instruments and utensils has fulfilled the standard for TSC, but there is no instruments for thoracosinthesys, and at the resuscitation room, there is not yet have a warmer box for warming liquid infuse, infuse hanger at the ceiling, and a communication device. However, facilities for the intensive service has not fulfill the standard for an intensive services because there is no HCU instrument, blood reserve depot, and CT Scan services at the radiology department is only gave services in the morning. In general conclusion, with regard to the components on the situation of patients and condition of ER at DGHAM, it can be said that DGHAM have status for being a TSC level three to become a TSC level two, and it is hoped that in this year of 2006 can be brought into reality. Suggestion for Pemda of Lampung Province, beside the budget for investment, it is also needed to have special budget for the operational of the TSC. For DGHAM, there is a need to increase the number of specialist doctors and non medic supporting staffs, special trauma training for the GP and paramedic personnel, to improve the facilities on the building, and to complete the medical instruments, to provide 24 hours service for CT Scan, and also to supply the HCL' instrument and to have the blood reserve depot.