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Puskesmas is the leading of primary health services in Indonesia and required to implement patient safety in the services provided. The initial step in implementing patient safety at the puskesmas is to measure the patient's safety culture. This study aims to determine the description of patient safety in officers whose working at accredited Puskesmas in Bekasi. This study used a quantitative method to measure the patient safety culture using the MOSPSC (Medical Office Survey on Patient Safety Culture) instruments from AHRQ (Agency of Health Research and Quality), then followed by qualitative methods to determine the supporting factors and inhibiting factors of patient safety implementation in puskesmas. The results of the study showed a patient safety culture in puskesmas officers in the medium culture category. There is no difference in patient safety culture in the group of workers based on the profession, all of which are in the moderate category. Team work was a component of safety culture with the highest score and including good categories (84,2%). The lowest score of patient safety culture at the puskesmas was in the component of work pressure and pace (36,3%). The central and regional governments need to reconsider the compatibility between the programs charged to the puskesmas and the number of staff available at the puskesmas. This is needed so that the puskesmas can carry out its duties and functions optimally including the application of a patient safety culture at the Puskesmas
Puskesmas is one of the first-level types of governments health care services in Indonesia. In 2016 and 2019, occurred a decrease in outpatient visits to the puskesmas by 29,4% in Pariaman. Patiens satisfaction or dissatisfaction with a service will affect subsequent patiens behavior such as product repurchase or revisit interest. This research aims to determine differences in service quality satisfaction in the interest of patients to revisit puskesmas in the Pariaman in 2019. This study design is a cross-sectional and the data was collected from 156 people who had visited the last 3 (three) weeks to the puskesmas in Pariaman. Statistical analysis using chi-square. The research results obtained 88.5% of respondents said they would make a revisit; the highest average satisfaction of respondents is in the empathy dimension that is equal to 88.05%, and the lowest in the reliability dimension that is equal to 84.22%; there are differences in the satisfaction dimensions of responsiveness, and assurance on the respondents' interest in visiting the puskesmas; age, gender, education, and accessibility are confounding on responsiveness and assurance dimensions. The work is only confounding on the assurance dimension.puskesmas is expected to prioritize efforts for improving the pharmacy service, nurse services and and to maintain things that are considered good customers
The hospital as an organization engaged in the field of health services is required to always improve the quality of the services. A parameter for assessing the quality of hospitals is the assessment of accreditation by institutions that have been national and international certified. The focus of assessment on the accreditation process is continuous quality improvement that prioritizes patient safety. This study aims to analysis description of the behavior of health workers to adhere the service standards that prioritize patient safety so that the risk of patient safety incidents had been reduced and have impact on better service quality. This research was conducted with a mix method study of field observation and quantitative study with a cross sectional design. The study sample used simple random sampling with a total sample of 161 respondents. Secondary data collection was carried out through field observations and document studies while the primary data was carried out through filling in questionnaires. The results of the study revealed that the behavior of officers who supported patient safety at 90% compliance that amount of 64%. Factors that have a relationship with the behavior of supporting patient safety are education (p value 0.001), profession (p value 0.047), knowledge (p value 0.029), attitude (p value 0.001), supervision (p value 0.001) and teamwork (p value 0.001) with the dominant variable from the results of multivariate analysis is attitude (OR 12,382) and confounding factor are age, education, profession, knowledege, supervision and team work, in the otherside not found interaction of that varaible. The problems that are still low on behavior are related to workloads there are still who force work when conditions are tired and the concentration is reduced, the other who work that is beyond their authority. To improve behavior related to patient safety is to mapping and calculate employee workload, especially the unit of patient services, make educational materials related to patient safety through audio visual media, incorporate behaviors related to patient safety into employee performance indicator, create programs that can support employees to try make safety behavior to be a work culture
Kepuasan pasien merupakan salah satu indikator untuk melihat mum pelayanan kesehatan. Puskesmas merupakan tempat pelayanan kesehatan publik yang saat ini dimanfaatkan oleh seluruh lapisan masyarakat. Rendahnya kcpuasan pasien menggambarkan kualitas pelayanan belum maksimal dan belum sesuai dengan standar, sehingga harus diperbaiki. Kepuasan pasien dapat dipengaruhi oleh banyak faktor, misalnya karakteristik pasien sendiri Serta biaya yang ada untuk mendapatkan pelayanan tersebut. Penclitian ini dilakukan di enam Puskesmas DTP di Kabupaten Bekasi dan dua Puskesmas DTP di Kota Bckasi. Penelitian ini bertujuan untuk mclihat perbandingan tingkat kepuasan pasien Puskesmas DTP di Kabupatcn dan Kota Bekasi, melihat karakteristik pasien pengguna jasa pelayanan Puskesmas, serta mclihat faktonfaktor karakteristik mana yang berhubungan dengan tingkat kcpuasan pasien. Disain penelitian adalah cross sectional pada 480 responden. Dilakukan selarna 3 bulan dari Februari sampai April 2007. Secara keseluruhan kamkteristik pasien di kedua tempat diatas adalah sama, perbedaannya ada pada tingkat pendidikan, jenis pekerjaan dan pendapatan pasien. Tingkat kepuasan pasien di Kabupaten Bekasi (gratis) 2,14 kali lebih rendah dibandingkan tingkat kepuasan pasien di Kota Bekasi (bayar). Jumlah pasien yang puas di Kota Bekasi 64,2% sementara di Kabupaten Bekasi 45,5%. Tidak ada hubungan yang bermakna antara faktor-faktor karakteristik pasien dengan tingkat kepuasan di kedua tempat diatas, serta tidak ada faktor-faktor karakteristik yang menjadi faktor konfonding. Dari Importance and Pewrmance Anabvsis unsur yang harus diperhatikan di Kabupaten Bekasi adalah jadwal perikasa dokter tiap hari tepat waktu, obat diresepkan tersedia di Puskesmas, petugas segera memenuhi keinginan pasien serta dokter menjadi pendengar yang baik bagi pasien. Sementara itu di Kota Bekasi unsur-unsur yang hams diperhatikan adalah ruang rawat inap, sarana kamar mandi/WC, keberadaan petugas di mang rawat inap/jalan, ruang tunggu, suasana lingkungan, lantai dalam/luar ruangan, pelayanan oleh dokter, obat yang diresepkan tersedia di Puskesmas. -Iasil penelitian ini diharapkan dapat dimanfaatkan oleh Dinas Kcsehatan Kabupaten Bekasi dan Kota Bekasi dalam mengambil kebijakan serta Puskesmas DTP di Kabupatzh dan Kota Bekasi dalam meningkatkan kualitas pelayanan.
The patient's satisfaction was one of the indicators to see the quality of the health service. The community health centre was the place of the health service of the public at this time used by all social stratums. The low level of the patients satisfaction depicted the quality of the service was not yet maximal and did not yet be in accordance with the standard, so as to have to be improved. The patient satisfaction could be affected by many factors, for example the characteristics of the patient personally as well as the available cost to get this service. This research was carried out in six inpatient facility in the Bekasi Regency and two inpatient facilities in the Bekasi City. This research aimed at seeing the level comparison of patient satisfaction of the inpatient facility in the Regency and the Bekasi City, saw the characteristics of the user's patient in community health centre service, as well as saw what characteristics factor that was connected with the level of the patients satisfaction. 'Ihe design of the research was cross sectional to 480 respondents. Carried out for 3 months hom February to April 2007. On the whole the characteristics of the patient in the two places above was same, its difference was in the level of education, the work kind and the income ofthe patient. The level of the patient?s satisfaction in the Bekasi Regency (ti-ee) 2.14 times was lower compared with the level ofthe patient?s satisfaction in the Bekasi City (paid). The number of patients who was satisfied in the Bekasi City 64, 2% now in the Bekasi Regency 45, 5%. There is no relation that was significant between characteristics factors ofthe patient and the level of satisfaction in the two places above, as well as did not have characteristics factors that became the factor confounding. From Importance and Performance Analysis the element that must be paid attention to in the Bekasi Regency was the doctor schedule right on time, prescription medicine was available in the community health centre, the ofiicial immediately filled the patients wish as well as the doctor to become listeners who were good for the patient. In the meantime in the Bekasi City elements that must be paid attention to were space inpatient facilities, bathroom means/the Toilet, the existence of the official in room, the waiting room, the atmosphere of the environment, the floor in/outside the room, the service by the doctor, prescription medicine was available in the community health centre. From this research, we recommended for District Health Service of Bekasi Regency and Bekasi City in taking the policy, inpatient facility in the Regency and the Bekasi City in increasing the quality ofthe service.
Untuk meningkatkan pelayanan kesehatan yang bermutu salah satu hal yang dinilai dalam Quality assurance adalah tingkat kepatuhan petugas. Tingkat kepatuhan petugas terhadap standar pemeriksaan pasien ISPA merupakan penilaian terhadap kinerja petugas. Kota Bandar Lampung merupakan salah satu daerah proyek penerapan QA. Dan Laporan Puskesmas uji coba tingkat kepatuhan petugas terhadap standar pemeriksaan masih rendah yaitu 56,0 %. Tujuan penelitian ini adalah memperoleh informasi tentang faktor-faktor yang berhubungan dengan tingkat kepatuhan petugas standar pemeriksaan ISPA di Puskesmas Kota Bandar Lampung tahun 2002. Penelitian ini menggunakan disain cross-sectional dengan pendekatan kualitatif dan kuantitatif dengan jumlah sampel total populasi sebanyak 102 petugas pemeriksa di Balai Pengobatan. Pengumpulan data untuk memperoleh gambaran faktor yang berhubungan dengan kepatuhan, petugas diminta mengisi kuesioner, sedangkan untuk memperoleh tingkat kepatuhan petugas dengan mengamati petugas selama memeriksa pasien ISPA dengan menggunakan daftar tilik. Hasil penelitian memperlihatkan dari 102 petugas pemeriksa pasien di BP yang diteliti maka hanya 30,4 % petugas yang patuh, pendidikan berlatar belakang medis 28,4 %, yang memiliki beban kerja ringan hanya 19,6 %, kepala Puskesmas yang mempunyai kepemimpinan kondusif hanya 59,8 %, pengetahuan tentang program ISPA 55,9 % pengetahuan baik, 62,7 % petugas mempunyai motivasi baik, 40,2 % pernah mengikuti pelatihan, 40,2 % petugas mengatakan pernah memperoleh pembinaan dan sarana minimal pemeriksaan dipuskesmas yang lengkap 27,5 %. Dari 8 variabel yang diuji stastististik dengan kai kuadrat diperoleh hubungan yang bermakna antara kepatuhan dengan kepemimpinan, pengetahuan petugas, motivasi, pelatihan, pembinaan dan sarana minimal dengan nilai P < 0,05. Sedangkan untuk analisis multivariat dengan regresi logistik ganda hanya tiga variabel yang secara signifikan berhubungan dengan kepatuhan yaitu kepemimpinan, pelatihan dan sarana minimal, dengan nilai P<0,05. Kepemimpinan merupakan variabel yang paling dominan dengan OR 19,8361 kali. Untuk uji interaksi antara ketiga variabel dipemleh hasil yaitu tidak ada hubungan interaksi antara ketiga variabel tersebut. Kesimpulan secara umum kepatuhan petugas terhadap standar pemeriksaan pasien ISPA di Puskesmas Seluruh Kota Bandar Lampung masih rendah, disarankan kepada Depkes untuk menyederhanakan daftar tilik agar dalam penerapan dilapangan lebih operasional. Kepada Dinas Kesehatan hendaknya dalam penempatan kepala puskesmas harus benar-benar kepala puskesmas mempunyai visi untuk kemajuan puskesmas dan dalam melakukan pembinaan kepada puskesmas secara rutin dan terstruktur dan untuk semua petugas harus membudayakan budaya mutu dalam setiap kegiatannya.
In order to improve the quality of health service the one that should be examined in quality assurance is the level of the health worker compliance. The level of health worker compliance to the examining standard of ARI patient is assessment to health worker?s performance. Lampung City is one of the rural projects in implementing the QA. Based on the report of Health Center model to the standard of examining is still low, that was 56,0%. The objective of this study is to obtain the information on the factors that related with the level compliance of the health worker, who giving the examining standard of ARI patient at the Health Center of Bandar Lampung in 2002. This study design used cross-sectional, with qualitative and quantitative approaches. The number of sample and population was 102 examiner workers at the Health Center. The data were collected to obtain the description of factor that related with the compliance, the worker asked to fill-out the questionnaire, while to obtain the level of worker compliance by observation to the worker during the examining of ARI patient, the observation used checklist. The result of this study shows that out of 102 patients who examining by the workers at the Health Center which studied, it was only 30,4% whose compliance. Their education background in medical was 28.4%. The ones who having light work loading are 19,6%. Head of the Health Center who's having conducive leadership only 59.8%, the knowledge on ARI program was good 55,9%. The workers who having good motivation was 62,7%, 40,2% ever followed the training, 40,2% workers said that they ever obtained the development and minimal utility of full examining at the Health Center was 27,5%. Four variables, that are education, staffs knowledge, the facility of examining, leadership, work load, supervision, training, and motivation statistically significant associated with compliance, and minimum equipment with p<0,05. While for multivariate analysis by double logistic regression, only three variables that significantly having relationship to compliance, i.e. leadership, training and minimal utility, with p<0,05. The leadership was variable those the most dominant with OR 19,8361 times. For interaction test among the three variables, it obtained the result; i.e. there was not any relation among those three variables. The conclusion in general, the health worker compliance to the examining standard of ARI patient at the Health Center throughout Bandar Lampung City was still low, It is suggested to the MOH to make simple the examining list in order the implementation at the field more professional. To Local Health Office, when he placed the head of Health Center should be the real of head of Health Center who's having vision to the development of the Health Center and in doing the development to Health Center routinely and structurally. For entire of the health workers should be socialized the quality in each activity.
Puskesmas pada hakekatnya mempunyai tugas pokok menyelenggarakan pelayanan kesehatan dasar yang bermutu, terjangkau oleh masyarakat dan sebagai motor pembangunan kesehatan di daerah kerjanya, sedangkan pelayanan yang dilakukan secara garis besar terdiri dari pelayanan medik dan pelayanan kefarmasian. Pelayanan kefarmasian merupakan pelayanan penunjang untuk membantu mencapai penyediaan obat yang bermutu, tersedia dalam jumlah yang cukup, mudah didapat dengan harga yang terjangkau. Obat merupakan komponen esensial dari suatu pelayanan kesehatan, sehingga persepsi masyarakat tentang hasil dari pelayanan kesehatan adalah diterimanya obat setelah berkunjung ke sarana pelayanan kesehatan. Ada tiga faktor utama yang mempengaruhi perilaku yaitu faktor individu, psikologis dan organisasi antara lain meliputi pengetahuan, sikap, nilai dan persepsi , umur, jenis kelamin, ketrampilan, ketersediaan sumber daya. pedoman sarana dan prasarana, serta pengalaman kerja.. Oleh karena itu dalam penelitian ini ingin melihat gambaran kinerja petugas pengelola obat puskesmas di Kota Bekasi Tahun 2004 dan hubungan antara variabel bebas (independent) meliputi jenis kelamin, umur, masa kerja, pendidikan, pengetahuan, pelatihan, motivasi, supervisi, imbalan, fasilitas dan beban kerja dengan variabel terikat (dependen) yaitu kinerja petugas pengelola obat puskesmas. Penelitian ini menggunakan pendekatan kuantitatif dan didukung pendekatan kualitatif dengan rancangan cross sectional. Populasi dalam penelitian ini adalah semua petugas pengelola obat puskesmas di Kota Bekasi. Sampel dalam penelitian ini adalah seluruh petugas pengelola obat puskesmas di Kota Bekasi yang merupakan total sample sebesar 31 orang. Pengumpulan data kuantitatif dilakukan dengan cara memperoleh data primer yaitu pengamatan menggunakan kuesioner. Data kualitatif dilakukan menggunakan wawancara. Pengolahan data dengan menggunakan perangkat lunak pengolah data dan rekapitulasi hasil wawancara. Semua responden mempunyai kinerja yang berada pada kelompok sedang dan baik. Lebih dari dua pertiga responden mempunyai skor yang berada pada kelompok sedang, dengan nilai mean 28,52 dan median 29,00 dari skala 0 sampai dengan 38, maka dapat disimpulkan bahwa pengelola obat puskesmas di Kota Bekasi mempunyai kinerja yang cuk-up baik. Terdapat hubungan yang bermakna antara faktor internal (pendidikan) dengan kinerja pengelola obat puskesmas di Kota Bekasi. Tidak terdapat hubungan yang bermakna antara faktor eksternal (supervisi, imbalan, fasilitas dan beban kerja) dengan kinerja pengelola obat puskesmas di Kota Bekasi. Untuk meningkatkan kinerja petugas pengelola obat puskesmas disarankan agar pemerintah kota Bekasi mengalokasikan tenaga farmasis sebagai tenaga pengelola obat nimal 1(satu) orang asisten apoteker untuk satu puskesmas.
Truthfully, the health center has main task to provide a quality primary health care and to be a health development motor in its working area. The main service of health center consists of medical and pharmacy services. Pharmacy service is a supporting service to attempt a quality and adequate quantity of drugs supply, as well as affordable. Drugs are the essential component in health care. So, the perception of community about the output of health care is drugs received soon after visiting the health care facilities. There are three major factors affected the behavior: individual, psychological, and organizational factors that consist of knowledge, attitude, value, perception, age, sex, skill, resources availability, guidelines, facilities, and working experience. For that reason, the study was conducted to assess the working performance of pharmacy officers at health centers in the City of Bekasi in 2004. It was also conducted to assess the relation between independent variables consisted of age, sex, period of working span, education, skill, training, motivation, supervision, compensation, facilities, and working load, and dependent variable that consisted of the working performance of pharmacy officers. This study used quantitative and qualitative approach with cross sectional design. The population of this study was all pharmacy officers at health centers in the City of Bekasi. The sample of this study was total sampling that comprised of all pharmacy officers at health centers in the City of Bekasi as many as 31 respondents. Quantitative collecting was conducted by obtaining primary data that is interviewing respondents using questionnaire. While qualitative data was obtained by conducting in-depth interview. In this study, data processing used a software and recapitulation of interview result. All respondents had the working performance that lain between a fair group and a good group. More than two third of respondents had score in a fair group with mean 28.52 and median 29 out of scale between 0 and 38. The result above showed that pharmacy officers at health centers in the City of Bekasi had good working performance. Statistically, the result of this study showed that there was significant relation between internal factor (education) and working performance of pharmacy officers at health centers in the City of Bekasi. Meanwhile, there was no relation between external factors (supervision, compensation, facilities, and working load) and the working performance of pharmacy officers at health centers in the City of Bekasi. In order to increase the working performance of pharmacy officers at health centers, it was recommended that the local government should allocate the pharmacist as pharmacy officer at least one pharmacy assistant in each health center.
Selama tahun 2003 - 2005 jumlah kunjungan meningkat namun tidak seimbang dengan laju pertumbuhan penduduk dan pada tahun 2006 jumlah kunjungan pasien bayar ke Puskesmas Wisma Jaya mengalami penurunan. Indikator keberhasilan fungsi puskesmas sebagai pusat pelayanan kesehatan strata pertama antara lain melalui cakupan pelayanan dan kepuasan pasien. Pemanfaatan pelayanan kesehatan oleh masyarakat dipengaruhi oleh faktor kebutuhan terhadap sarana pelayanan kesehatan yang bermutu. Kepuasan paéien bayar atas mutu pelayanan kesehatan yang diselenggarakan oleh Puskesmas Wisma Jaya mempengaruhi pola perilaku pasien bayar selanjutnya untuk mengambil tindakan dengan berniat melakukan kunjungan ulang atau sebaliknya. Penelitian ini bertujuan membuktikan adanya hubungan kepuasan pasien bayar tcrhadap mutu pelayanan dengan minat kunjungan ulang ke Puskesmas Wisma Jaya Kota Bekasi Tahun 2007. Desain penelitian merupakan penelitian analilik dengan pcndekatan cross sectional, yang dilakukan di Puskesmas Wisma Jaya Kota Bekasi. Data dikmnpulkan dengan responden adalah pasien bayar (219 responden) yang berkunjung ke Puskesmas Wisma Jaya Kota Bekasi pada tahun 2007 dengan tehnik consequtive sampling quota. Analisis data menggunakan analisis univariat, bivariat dengan uji chi square dan multivariat dengan Kepuasan pasicn bayar mampu meningkatkan minat pasien bayar untuk mclakukan kunjungan ulang ke Puskesmas Wisma Jaya. Perlunya Pcmcrintah Kota dan Dinas Kesehatan Kota Bekasi mengunakan indikator bcrupa cakupan pelayanan dan kepuasan pasien untuk menilai keberhasilan kinexja puskesmas melalui fungsi puskcsrnas scbagai pusat pelayanan kesehatan strata pertama. Serta rnemprioritas pcrnbangunan fisik, menjaga kebersihan dan penambahan sumber daya manusia khususnya Puskesmas Wisma Jaya sesuai urutan nilai terendah kepuasan perlu menjadi perhatian semua pihak yang terkait. uji regresi logistik ganda. Hasil penelitian menunjukkan bahwa proporsi responden yang berminat melakukan kunjungan ulang ke Puskesmas Wisma Jaya sebesar 93,2%, proporsi responden yang puas terhadap pelayanan kesehatan Puskesmas Wisma Jaya sebesar 53,0%, tersedianya tempat parkir merupakan faktor kepuasan pasien bayar yang memiliki nilai terendah. Ada hubungan yang bermakna antara kepuasan pasien bayar dengan minat kunjungan ulang ke Puskesmas Wisma Jaya setelah mengendalikan variabel-variabel penganggu (variabelpendidikan dan variabel pengeluaran). Kepuasan pasien bayar mempunyai peluang 8,2 kali untuk berminat melakukan kunjungan ulang ke Puskesmas Wisma Jaya sebesar. Kepuasan pasien bayar mampu meningkatkan minat pasien bayar untuk mclakukan kunjungan ulang ke Puskesmas Wisma Jaya. Perlunya Pcmcrintah Kota dan Dinas Kesehatan Kota Bekasi mengunakan indikator bcrupa cakupan pelayanan dan kepuasan pasien untuk menilai keberhasilan kinexja puskesmas melalui fungsi puskcsrnas scbagai pusat pelayanan kesehatan strata pertama. Serta rnemprioritas pcrnbangunan fisik, menjaga kebersihan dan penambahan sumber daya manusia khususnya Puskesmas Wisma Jaya sesuai urutan nilai terendah kepuasan perlu menjadi perhatian semua pihak yang terkait.
During 2003 - 2005, number of customer visits increasing altough uneven with the population growth. Then in 2006, number of charged customer visits to Puskesmas Wisma Jaya had decreasing. Efficacy indicator of Puskesmas to its main function in providing public health services at the bottom level are scope of services type and customer satisfaction. Utilization of health service by society influenced by the need of qualified health service factor. Charged customer’s satisfaction to the quality of health services held by Puskesmas Wisma Jaya influencing their future behavior in having revisit or on the contrary. This research aim to determine the relationship of charged customer’s satisfaction to the quality of health services and revisit interest at Puskesmas Wisma Jaya Bekasi, in year of 2007. Research designed as analytic description research with cross sectional approach. Research held at Puskesmas Wisma Jaya Bekasi. Data collected using consecutive sampling quota from 219 respondent who belong to charged customer whom visiting Puskesmas Wisma Jaya during 2007. Data analysis using univariat analysis, bivariat with chi-square test and multivariate analysis with multiple logistic regression test. The result shows proportion of respondent who interest to revisit Puskesmas Wisma Jaya were 93,2 % in amount. The proportion of charged customer who satisfied with health services held by Puskesmas Wisma Jaya were 53,0 % in amount. The available of parking area become the charged customer’s satisfaction factor which has lowest score. There is significant relation between charged customer’s satisfaction with revisit interest after eliminating and controlling the dummy variable (respondent’s education and expenses). Satisiied charged customer have at 8,2 possibility to revisit Puskesmas Wisma Jaya in possibility value. The satisfaction of charged customer has able to raise their interest in having revisit in the future. Local Government and Local Public Health Service need to use scope of service and customer satisfaction as indicator to asses the efficacy performance of each Puskesmas through their function in providing public health services at the bottom level. Also giving priority in physical development and addition of human resources especially Puskesmas Wisma Jaya on low scored satisfaction indicator.