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Quality health service is one of the basic needs that everyone needs. Rehabilitation services are part of health services with the aim of improving the health and quality of life of a person by overcoming problems due to the use of drugs. The limited quality and quantity of rehabilitation institutions in providing services has an impact on the recipients of rehabilitation services. This study aims to find a strategy to improve and guarantee the quality of rehabilitation services as a future direction and policy in improving the quality of rehabilitation services. The method used is qualitative research by involving policy makers and policy targets and conducting a CDMG (Consensus Decision Meeting Group). Based on the research results, it was obtained from the analysis of external environmental factors, the policies and rehabilitation standards were an opportunity, while the budget, coordination and synergy of Ministries / Agencies and community participation became a threat. Analysis of internal environmental factors that become strengths are vision and mission, organization, service recipient satisfaction and prevalence while weaknesses are accessibility, human resources, facilities and infrastructure, information systems and research and development. Currently the position of Deputy for Rehabilitation is in a position to grow and develop and is in the future. Based on the results of the analysis of environmental factors, the strategy needed to improve and guarantee the quality of rehabilitation services is to optimize a strength and opportunity and reduce or suppress weaknesses and threats through the strategy of implementing rehabilitation standards, increasing service recipient satisfaction and developing rehabilitation within the Deputy for Rehabilitation
Mutu layanan Perawatan, Dukungan, dan Pengobatan (PDP) HIV di tingkat pelayanan primer berperan strategis dalam mendukung pencapaian target eliminasi HIV nasional tahun 2030, khususnya dalam kerangka 95-95-95. Puskesmas Perumnas II merupakan puskesmas pertama di Kota Bekasi yang menyelenggarakan layanan PDP HIV dan melayani jumlah ODHIV terbanyak di wilayah tersebut. Penelitian ini bertujuan untuk menganalisis mutu layanan PDP HIV dengan menggunakan pendekatan model Donabedian yang mengevaluasi tiga komponen utama: struktur, proses, dan hasil (outcome). Metode yang digunakan adalah kualitatif deskriptif dengan rancangan studi kasus. Pengumpulan data dilakukan melalui wawancara mendalam terhadap informan kunci dari Dinas Kesehatan Kota Bekasi, petugas pelaksana program PDP HIV di puskesmas, dan pasien ODHIV; disertai observasi layanan serta telaah dokumen seperti SIHA dan catatan kegiatan program.
Hasil penelitian menunjukkan bahwa dari aspek struktur, Puskesmas Perumnas II memiliki dukungan kebijakan nasional dan lokal yang memadai serta sarana dasar layanan seperti ruang pelayanan dan ketersediaan ARV. Namun, keterbatasan masih ditemukan pada jumlah dan kompetensi SDM, serta tidak tersedianya sarana pemeriksaan viral load di tingkat puskesmas. Pada aspek proses, layanan berjalan sesuai pedoman nasional, namun belum konsisten, terutama dalam pelaksanaan konseling berkelanjutan, pendampingan psikososial, dan pelaporan data secara akurat melalui sistem SIHA. Aktivitas monitoring dan evaluasi juga belum terjadwal secara sistematis. Dari sisi outcome, sebagian besar pasien tercatat sebagai on-ARV, tetapi cakupan pemeriksaan viral load dan capaian supresi virus masih rendah akibat keterbatasan akses. Tingkat kepuasan pasien terhadap layanan cukup tinggi, khususnya terhadap sikap petugas dan ketersediaan obat, namun masih terdapat keluhan mengenai waktu tunggu, privasi, dan dukungan emosional.
Penelitian ini merekomendasikan penguatan struktur layanan melalui peningkatan jumlah dan kapasitas SDM, pemenuhan sarana penunjang, optimalisasi proses melalui sistem pencatatan yang akurat dan konseling berkelanjutan, serta pelaksanaan monitoring dan evaluasi rutin. Dengan berbagai praktik baik yang telah berjalan dan pengalaman dalam menjangkau jumlah pasien yang besar, Puskesmas Perumnas II memiliki potensi untuk dijadikan model praktik baik (best practice) bagi puskesmas lain di Kota Bekasi maupun wilayah lainnya dalam penyelenggaraan layanan PDP HIV di tingkat primer.
Infection prevention and control procedures must be implemented in hospitals includingthe inpatient care. It is intended to minimize and prevent infection in patients,healthcare workers, visitors, and the community surrounding the healthcare facility.Other than reducing mortality and morbidity rate associated with nosocomialinfections, the right implementation of Infection prevention and control program willalso reduce health costs due to reduced care duration which affects the decrease of thehealth cost expenditure. The purpose of this research is to understand the descriptive ofinfection prevention and control implementation at the inpatient care of the NationalBrain Center Hospital. This study uses a qualitative descriptive research method. In-depth interview, focus group discussion and observation are conducted with 13informants. Results of the study show that based on the structure, process and output,the infection prevention and control implementation at the inpatient care of theNational Brain Center Hospital has been done according to the guidelines of theinfection prevention and control that has been established.. The infection preventionand control implementation at the inpatient care is not yet optimized because of thepractices such as hand hygiene practice, use of personal protective equipment,separation of medical waste and safe injection that have not been done according tostandard and have not been monitored and evaluated routinely. The insufficient numberof healthcare workers, overlapping tasks and lack of training have an effect on theimplementation of Infection prevention and control tasks. Suggestions to be done arerestructuring of the Infection prevention and control organization, analysis ofworkload, the increase of training for healthcare workers and routine monitoring andevaluation of Infection prevention and control implementation.Keywords: Infection Prevention and Control,nosocomial infections.
Mutu pelayanan suatu organisasi merupakan hal yang penting dan telah menjadi kebutuhan bahkan tuntutan masyarakat. RevisiInternational Health Regulation Tahun 2005 mengharuskan setiap negara anggota untuk meningkatkan core capacity. Untuk melakukan perubahan, tentunya perlu diketahui kondisi pelayanan yang ada saat ini. Melakukan self assesment terhadap kondisi mutu yang ada perlu dilakukan dalam rangka upaya manajemen mutu terpadu (Total Quality Management).
Peneliti menggunakan 7 (tujuh) kriteria yang terdapat dalam Malcolm Baldrige Health Care Criteria for Performance Exxelence untuk mengetahui mutu pelayanan bidang upaya kesehatan dan lintas wilayah Kantor Kesehatan Pelabuhan Kelas I Tanjung Priok. Metoda yang digunakan dalam penelitian ini adalah kuantitatif.
Hasil yang diperoleh dalam penelitian ini adalah terdapat variabel proses yang mempunyai pengaruhpaling dominan untuk dilakukan peningkatan mutu organisasi. Dengan melihat pohon masalah, maka masalah prioritas dari variabel proses adalah Kurangnya panduan yang mendukung proses pelayanan dalam proses meningkatkan mutu organisasi yang lebih optimal. Bentuk nyata dari perbaikan tersebut adalah dengan membuat instrumen buat petugas seperti check proses yang harus dilakukan di setiap proses pelayanan pada bidang upaya kesehatan dan lintas wilayah Kantor Kesehatan Pelabuhan Kelas I Tanjung Priok.
Quality of organizational services is an absolute must, which has become a necessity even the public demands. Revision of International Health Regulation (2005)requires each member state to increase the core capacity. To make changes, certainly need to know the condition of the existing services at the present. Perform self assesment the existing quality conditions is necessary to be done in order to attempt Total Quality Management.
Researcher used 7 (seven) criteria contained in the Malcolm Baldrige Health Care Criteria for Performance Excellence to recognize quality service at Field of health effort and cross-regional, Port Health Office class I of Tanjung Priok.The method used in this study is a quantitative data analysis.
The results obtainedin this studyis the processvariablethat hasthe most dominant influence to do quality improvementorganization. By looking atthe problem tree, the priority issue is lack of guide supports the process of improving the quality of service.
Realfact of the improvements is to make instruments such as check process for officers should be done at every service process at the Field of health effort and cross-regional, Port Health Office class I of Tanjung Priok.
DKI Jakarta Province has several health challenges, one of which is Triple Burden Disease, in which Communicable Diseases (CD) remind high, then Non Communicable Diseases (NCD) are increasing, besides Emerging Infectious Diseases (EID)/ ReEmerging and/ or New Emerging. According to the Republic of the Indonesia Ministry of Health, PIE got special attention due to its serious impact on health and socioeconomics, particularly in the current digital era and globalization. Along the development of the situation and conditions of the pandemic, the Emergency Response Status for the COVID-19 Outbreak of the DKI Jakarta Province in 2020 requires innovation in improving the quality of public services and health care. DKI Jakarta Province has received many awards, one of which is the most innovative province. However, innovations in the health sector that are include in the top of 99 public service innovations are only 2%. Therefore, an in-depth analysis is needed regarding innovations in the health sector on the quality of services during the COVID-19 Pandemic. This type of research is mix method by using a combination type Sequential Explenatory. The independent variables include leadership, innovation culture, resource training, communication channels, networks and partnerships, rewards, complexity and relative advantage, perceived usefulness, and perceive ease of use, as well as the dependent variable consisting of aspects of quality with a structure, process, and output approach. The research was conducted at Community Health Center and DKI Jakarta Health Office in Mei-June 2021. The research locations in The Community Health Center in 5 Regencies at DKI Jakarta Province. Data analysis used univariate, bivariate (Chi Square) and multivariate with logistic regression. The result showed that the quality of health services during the pandemic was quite good about 71,8%. The results of the analysis found that there was a relationship between the factors of implementating innovation and the utilization of information technology in the health sector on the quality of services during the COVID-19 pandemic at the DKI Jakarta Provincial Health Center for the 2020-2021 Period are leadership, innovation culture, network and partnership, and reward. The most dominant variable is leadership which is interact with reward with OR value 7,64.
Adanya intervensi Global Fund di klinik IMS berupa pelatihan - pelatihan untuk menambah kualifikasi SDM, dana insentif petugas, dana untuk setting ruangan dan alat - alat kesehatan yang diharapkan dapat meningkatkan mutu pelayanan di klinik IMS. Pada kenyataannya ada klinik IMS Puskesmas yang mutu layanannya belum optimal. Tujuan penelitian ini untuk menganalisis inten/ensi Global Fund terhadap mutu layanan di klinik IMS Puskesmas Kecamatan Pasar Rebo dan Puskesmas Kecamatan Tamansari. Penelitian ini mengglmakan rancangan yang secara garis besar mempergunakan pendekatan kualitatif. Penekanan pada pendekatan kualitatif adalah pada upaya penggalian lebih dalam lagi apa yang dipikirkan dan dirasakan seseorang , terutarna penguna/cusoumer serta petugas kesehatan yang ada di klinik Infeksi Menular Seksual. Selain intervensi dari Global jimd (input), peran dukungan Kcpala Puskesmas, monitoring dan evaluasi, juga pada proses yaitu kepatuhan dan konsistensi petugas terhadap SOP sangat berperan untuk menghasilkan output dan dampak/impact yang dapat dilihat di outcome atau kepuasan pasien/customer. Penelitian ini berlangsung pada bulan Maret 2008, dan penelitian inj melibatkan 10 orang informan untuk Wawancara Mendalam/Indepth Interview clan 5 keiompok Focus Group Discussion/DKT (1 kelompok terdiri dari 6 orang) dari 2 (dua) Puskesmas. Informan Wawancara Mendalarn terdiri dari Kepala Puskesmas Kecamatan yang akan memberikan viinformasi strategis tentang kebijakan yang sudah dilaksanakan. Kriteria informan dokter, bidan, petugas laboratorium dan petugas administrasi adalah yang telah dilatih oleh Global Fund atau bertugas di klinik IMS. Sedangkan DKT dilaksanakan di 2 (dua) kelompok PSK yang pemah berobat di klinik IMS, 1 (satu) kelompok pelanggan PSK di wilayah Puskesmas Kecamatan Pasar Robo, serta 2 (dua) kelompok Waria di wilayah Puskesmas Kecamatan Tamansari dari kegiatan Penapisan (outreach). Hasil penelitian menunjukkan bahwa ouput klinik IMS Puskesmas Kecamatan Tamansari yaiiu, jumlah orang berkunjung, jumlah pasien/penderita IMS yang diobati, jumlah pasien/penderita yang diberi kondom dan jumlah pasien/penderita yang diberikan penyuluhan/KIE tahun 2007 prosentasenya menunm dibandingkan pada tahun 2006. Sedangkan Puskesmas Kecamatan Pasar Rebo prosentasenya mengalami kenaikkan yang signiiikan. Kepuasan pasien yang dilihat pada outcome di kedua Puskesmas baik, walaupun ada sedikit masukan untuk perbaikan pelayanan di klinik IMS dan di kegiatan penjangkauan/outreach. Pada outeome yang dioilai adalah akses(|angkauan pelayanan, kenyamanan, keamanan pelayanan, efisiensi, KIE, serta hubungan antar manusia./interpersonal. Klinik IMS am menjadi laaik jika dikelola Semi dengan pelayanan prima (Service Excellent) oleh petugas yang telah mendapatkan pelatihan. Salah satu tugas penting untuk tim kesehatan yang turun pada kegiatan penapisan yaitu mengintervensi kelompok pelanggan PSK dengan memberikan penyuluhan tentang kesehatan, penyakit IMS dan penggunaan kondom yang benar. Tim kesehatan yang melayani klinik IMS sebaiknya tersendiri, tidak mempunyai tugas pokok dan fungsi (Tupoksi) ditempat Iain. Sementara itu ada kegiatan yang harus tluun ke tempat/dacrah rawan HIV/AIDS. Sedangkan target omput dad Global Fund untuk klinik IMS Puskesmas tidak ada. Untuk mengetahui keberhasilan suatu kegiatan seharusnya sudah disusun Standard Pelayanan Minimal (SPM) dan target yang harus dicapai.
Global Fund's interventions in STI Clinic, which are aplicated through trainings for improving human resources qualiiication, funding in the form of officer incentive, funding for setting room and aid appliance, are expected to increase the clinical service quality at STI Clinic. Practically there is STI clinic in Primary Health Care which has not gain the noted service quality optimally. The purpose of this research is to analyze the intervention of Global Fund to the service quauiy of sri clinic in Primary Health care in PM Reba Subdistrict and Tamansari Subdistrict. Marginally, this research is utilized by qualitative approach. The qualitative approaches are given emphasizely. Those things are applicatcd by the deep interventioning to costumers mind and feeling, especially the care user and also the health officer at Sexual Transmitted Infection Clinic. The costumer satisfaction which is consider as the outcome of the research, is not merely detennined by the Global Fund Intervention but also by the role of Primary Health Care Head Officer, evalution and ixmonitoring activity, the consintency and compliance of the officers in doing the standar operational procedure during the process. This research is conducted in March 2008, included 10 persons as the object of lndepth interview and 5 Focus Group Discussion (1 groups is consist of 6 persons) from 2 Primary Health Care. The strategic information due to the conducted policy was derived from indepth interview with Chief of Primary Health Care Subdistrict. The criteria for the informan such as doctor , midwife, administration officer and laboratory officer are they who had been trained by Global Fund or work in clinic IMS . Focus Group Discussion (FGD) is conducted in 2 ( two) group of CSW which have ever medicinizocd in STI clinic , 1 ( one) group of CSW client who lived in the same region with Primary Health Care of Pasar Rebo Subdistrict, and also 2 (two) group of Trans sexual who lived in region Primary Health Car of Tamansari Subdistrict with the Censorship activity (outreach). The result from this research indicated that output of STI clinic Primary Health Care of Tarnansari Subdistrict that is, the amount of people visited the clinic, the amount of S'l`I patient have their medical attention, the amount of patient who had given for condom and the amount of patient who had given for education (CIE) of the year 2007 have decline on percentages compared to the year of 2006. While at Primary Health Care of Pasar Rebo Subdistrict the percentages has increase significantly. 1 The Patient Satisfaction that can be seen &om the outcome in both Primary Health Cares is good, despite of a few inputs for repair of services in STI clinics and in the outreach activity. For the outcome , the assesment are in the scope of the services, how comfort thc services, security of the services, efficiency, CIE, and also the relation between people (interpersonal).
