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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.
This thesis discusses about the evaluation of the suitability of the clinical pathway application of clinical pathway diarrhea in infants, with the aim of obtaining the results of an evaluation of the implementation of Clinical Pathway diarrhea in infants and the calculation of unit cost in cases of diarrhea in infants in Bhakti Rahayu General Hospital Denpasar. The research design used is the mix method, namely quantitative and qualitative research designs. The study was conducted in May 2019 to June 2020. The results obtained are still getting some variations in the services provided to patients so that the total cost of action in accordance with clinical pathway is Rp. 675,281, - with the real cost of services provided at Rp. 1,045,212 , - which means there is still a difference of Rp. 369,931, -.
Sejak kebijakan SIMRS di bagian rawat jalan diimplementasikan, SIMRS di RSU Bhakti Yudha belum pernah di evaluasi. Padahal, kebijakan harus diawasi, dan salah satu mekanisme pengawasan tersebut adalah evaluasi. Berdasarkan timing implementasi (Nugroho, 2011), seharusnya evaluasi dilakukan antara tahun ke-3 atau ke-5 sejak implementasi penuh suatu kebijakan, sedangkan saat ini implementasi kebijakan SIMRS Bhakti Yudha telah mencapai tahun ke-8. Penelitian mengenai evaluasi implementasi kebijakan SIMRS di bagian rawat jalan RSU Bhakti Yudha tahun 2012 menggunakan desain kualitatif interpretatif dengan wawancara mendalam, observasi, dan telaah dokumen. Penelitian ini menggunakan informan yang berjumlah 10 orang informan dari staf pelayanan rawat jalan hingga direktur rumah sakit. Dari hasil triangulasi sumber, metode, dan analisis diperoleh hasil bahwa saat ini kualitas sistem informasi manajemen secara keseluruhan masih belum efektif. Dari analisis Fit/Gap didapatkan hanya 11% dari aplikasi software yang digunakan yang sesuai dengan kebutuhan rumah sakit, dan 56% masih mengalami kesenjangan. Pada analisis QSPM yang didahului dengan menggunakan matriks EFAS dan IFAS serta SWOT, diperoleh bahwa rekomendasi kebijakan bagi sistem informasi manajemen RSU Bhakti Yudha adalah dengan meminimalisir kelemahan internal, yaitu dengan mengganti sistem informasi yang ada dengan sistem vendor, namun dengan penetapan rumusan kebijakan akan sistem informasi manajemen terlebih dahulu. Kata kunci: Sistem Informasi Manajemen Rumah Sakit, Evaluasi, Kebijakan, Implementasi, Rekomendasi.
The implementation of management information system policy in the outpatient ward in the RSU Yudha Bhakti has never been evaluated. In fact, the policy should be monitored, and one of these control mechanisms are evaluated. Based on the timing of implementation, the evaluation should be conducted between the third or the fifth since the full implementation of a policy, while the current policy implementation of management information system Yudha Bhakti has achieved year 8. This research on the evaluation of policy implementation in the outpatient Bhakti Yudha Hospital in 2012 wasa using an interpretive qualitative design with in-depth interviews, observation, and document review. This study used 10 informants from the operational staff of outpatient services, IT manager, hospital consultant, and the director of the hospital. From the sources, methods, and analyzes triangulation, the results obtained that the current quality of management information systems as a whole is still not effective. From the analysis of Fit / Gap, the research showed thatd only 11% of software applications used in accordance with the hospital needs, and 56% still have gaps. In the analysis that preceded QSPM by using matrix EFAs and IFAs, and SWOT, this research result in the recommendation that the management of information system in the outpatient ward of Bhakti Yudha RSU need to minimize its internal weaknesses, by replacing the existing information systems with vendor development, but with the determination of policy formulation for a system of information managementi in advance. Key words: Hospital Management Information Systems, Evaluation, Policy, Implementation, Recommendations
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.
This thesis discusses the evaluation of clinical pathway implementation, with the aim of knowing the implementation of Clinical Pathway and unit cost analysis of the Sectio Caesarea action at Bhakti Rahayu General Hospital Denpasar. The research design used is the mix method, namely quantitative and qualitative research designs, obtained from patient billing data and in-depth interviews. The study was conducted in April 2019 to July 2020. The results obtained are still variations in some of the services provided so that they get different costs between the total cost of action in accordance with the clinical pathway of Rp 1,920,000, - with the real cost of services provided at IDR 3,319,281, - which means there is still a difference of IDR 1,399,281, -.
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.
Appendectomy is a surgical procedure for appendicitis, which is the most frequent surgical emergency case, as many as 250,000 in the United States and 621,435 cases in Indonesia each year. According to data from XYZ Hospital in 2018, Appendectomy is one of the top five operations with a total of 107 cases and ranks first in high-cost procedures with the difference between hospital rates and INA CBGS rates of 363%. Clinical pathway is a framework in providing health services as an effort to control the quality and cost of health services, where clinical pathways are able to reduce variations that occur in health services. This study aims to evaluate the application of clinical pathway appendectomy at XYZ Hospital in 2019. The method used is a mix method research with quantitative and qualitative methods. Sampling used a total sampling technique from all appendectomy patient data at XYZ Hospital in January - December 2019 according to the inclusion and exclusion criteria and obtained a total of 85 patient bill data. From the research results, it was found that there was a mismatch between the services provided and the clinical pathway. The biggest gap in drug use is 42%. The variations obtained were in the provision of drugs and medical devices, medical and nursing actions, and supporting examinations, this resulted in the average length of stay being longer compared to the clinical pathway, namely 3.76 days. Variations that are not in accordance with the clinical pathway can affect the quality of service and the amount of hospital bills.
