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Umi Kulsum; Pembimbing: Amal Chalik Sjaaf; Penguji: Ede Surya Darmawan, Adang Bachtiar, Andi Basuki Prima B., Ari Purwohandoyo
Abstrak:
Konsep green hospital merupakan manajemen perubahan yang menjadi kebutuhan di rumah sakit yang dapat mengurangi konsumsi energi secara signifikan, meningkatkan kenyamanan dan produktivitas dan menjaga kelestarian sumber daya alam berkelanjutan Dalam memberikan pelayanan kesehatan, Rumah sakit menggunakan sejumlah energi baik listrik, air, bahan bakar, makanan pasien dan bahan bangunan. Selain itu, rumah sakit juga memproduksi limbah medis dan non medis. Hal tersebut dapat menjadi kontribusi terhadap perubahan iklim apabila tidak dikelola dengan baik. Penelitian ini menilai kesiapan Rumah Sakit Pusat Otak Nasional Prof Dr. dr. Mahar Mardjono Jakarta yang mengacu pada standar nasional Greenship Green Building Council Indonesia (GBCI). Penelitian ini adalah sebuah studi kasus dengan menggunakan pendekatan metoda penelitian kualitatif dengan melakukan observasi untuk mengamati dan menelaah berbagai objek dalam penelitian, melakukan pengukuran dan mengisi ceklis pada instrumen/tools. Dari hasil penelitian diketahui bahwa RSPON baru dapat memenuhi total nilai nilai 58 atau 49,57% dari maksimal 117 nilai dari total kriteria yang dipersyaratkan dalam Greenship. Berdasarkan perolehan nilai tersebut maka sesuai dengan peringkat Greenship GBCI, gedung RSPON mendapatkan peringkat Silver (Perak). Untuk memperbaiki peringkat, masih dapat dengan cara menyediakan parkir sepeda, menambah luasan ruang terbuka hijau (RTH), recommissioning, pemasangan sistem pemantauan energi, melakukan daur ulang sampah organic, melakukan daur ulang air olahan IPAL melakukan konservasi air bersih, mencoba menggunakan teknologi panel surya (solar cell) serta mengintegrasikan efisiensi energi ke dalam program pemeliharaan
The green hospital concept is a change management that is a necessity in hospitals that can significantly reduce energy consumption, increase comfort and productivity and preserve sustainable natural resources. In providing health services, hospitals use a number of energy, including electricity, water, fuel, patients food and building materials. In addition, hospitals also produce medical and non-medical waste. This can be a contribution to climate change if it is not managed properly. This study assesses the readiness of Prof. Dr. dr. Mahar Mardjono National Brain Center Hospital Jakarta which refers to the national standard of Greenship Green Building Council Indonesia (GBCI). This research is a case study using a qualitative research method approach by making observations to observe and examine various objects in the study, take measurements and fill out checklists on the instruments/tools. From the research results, it is known that the new RSPON can meet the total value of 58 or 49,54% of the maximum 117 values of the total criteria required in Greenship. Based on the acquisition of these values, in accordance with the GBCI Greenship rating, the RSPON building received a Silver rating. To improve the ranking, it can still be done by providing bicycle parking, increasing the area of green open space (RTH), recommissioning, installing energy monitoring systems, recycling organic waste, recycling treated water from WWTPs, conserving clean water, trying to use solar panel technology. and integrating energy efficiency into maintenance programs
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The green hospital concept is a change management that is a necessity in hospitals that can significantly reduce energy consumption, increase comfort and productivity and preserve sustainable natural resources. In providing health services, hospitals use a number of energy, including electricity, water, fuel, patients food and building materials. In addition, hospitals also produce medical and non-medical waste. This can be a contribution to climate change if it is not managed properly. This study assesses the readiness of Prof. Dr. dr. Mahar Mardjono National Brain Center Hospital Jakarta which refers to the national standard of Greenship Green Building Council Indonesia (GBCI). This research is a case study using a qualitative research method approach by making observations to observe and examine various objects in the study, take measurements and fill out checklists on the instruments/tools. From the research results, it is known that the new RSPON can meet the total value of 58 or 49,54% of the maximum 117 values of the total criteria required in Greenship. Based on the acquisition of these values, in accordance with the GBCI Greenship rating, the RSPON building received a Silver rating. To improve the ranking, it can still be done by providing bicycle parking, increasing the area of green open space (RTH), recommissioning, installing energy monitoring systems, recycling organic waste, recycling treated water from WWTPs, conserving clean water, trying to use solar panel technology. and integrating energy efficiency into maintenance programs
B-2220
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Dwi Dharmaningsih; Pembimbing: Helen Andriani; Penguji: Masyitoh, Pujiyanto, Hadijah Tahir, Endang Adriyani
Abstrak:
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Waktu tunggu pelayanan resep termasuk salah satu indikator dalam menjaga mutu pelayanan rumah sakit, waktu tunggu yang terlalu lama akan menimbulkan keluhan dari pasien yang dapat mengakibatkan penilaian negatif bagi rumah sakit. Waktu tunggu pelayanan resep obat jadi dan obat racikan di depo Farmasi Rawat Jalan Reguler RSPON Jakarta belum mencapai SPM yang ditetapkan dalam Kepmenkes Nomor 128 Tahun 2009 yaitu ≤30 menit untuk obat jadi dan ≤60 menit untuk obat racikan. Penelitian ini bertujuan mengurangi waktu tunggu pelayanan resep rawat jalan di depo farmasi rawat jalan reguler RSPON Jakarta dengan menggunakan pendekatan Lean Hospital. Penelitian ini menggunakan metode operational research dengan pendekatan kualitatif, pengambilan data dilakukan pada Mei-Juli 20223 di depo farmasi rawat jalan reguler, dengan jumlah sampel 25 resep obat jadi dan 5 resep obat racikan. Observasi langsung dilakukan dengan metode time motion study menggunakan lembar observasi VSM, wawancara dengan informan terpilih dan telaah dokumen. Pada kondisi current state waktu yang dibutuhkan untuk pelayanan setiap 1 resep (lead time) untuk resep obat jadi adalah 46,7 menit, dengan perbandingan aktivitas value added terhadap total waktu pelayanan 25%:75%, sedangkan lead time untuk resep racikan adalah 98,9 menit dengan perbandingan aktivitas value added terhadap total waktu pelayanan 27%:73%. Pada analisis kegiatan non value added, waste tertinggi pada kategori waste waiting dan waste overprocessing. Beberapa faktor penyebab terjadinya waste adalah inefisiensi SDM, jadwal praktek dokter yang bersamaan, belum adanya sistem pemisahan petugas pelayanan resep rawat jalan reguler dan rawat jalan eksekutif, perlunya optimalisasi e-resep, jaringan sistem informasi yang terkadang lambat di jam sibuk dan seringnya interupsi dari pasien yang bertanya di loket farmasi. Intervensi lean hospital yang dicoba untuk diterapkan adalah proses balancing, Heijunka dengan modifikasi shift petugas farmasi dan 5S. Pada kondisi future state terjadi penurunan lead time sebesar 28% untuk resep obat jadi menjadi 33,3 menit, sedangkan untuk resep racikan lead time turun sebesar 32% menjadi 67,1 menit. Kesimpulan penelitian ini Lean Hospital merupakan metode atau tool yang dapat digunakan untuk menurunkan lead time dengan mengurangi waste dan meningkatkan nilai tambah untuk pasien. Saran peneliti mendorong rumah sakit meneruskan sebagai langkah awal continuous improvement diiringi dengan pemenuhan kebutuhan SDM serta fasilitas pendukung.
Waiting time for prescription services is one of the indicators in maintaining the quality of hospital services, waiting times that are too long will cause complaints from patients which can result in a negative assessment of the hospital. The waiting time for ready-made and concocted drug prescription services at the Jakarta RSPON Regular Outpatient Pharmacy depot has not reached the SPM stipulated in Kepmenkes Number 128 of 2009, namely ≤30 minutes for finished drugs and ≤60 minutes for concocted drugs. This study aims to decrease the waiting time of outpatient prescription services at the regular outpatient pharmacy depots at RSPON Jakarta using Lean Hospital. This study used the operational research method with a qualitative approach, data collection was carried out in May-July 20223 at a regular outpatient pharmacy depot, a sample of 25 prescription drugs and 5 prescription drug concoctions. Direct observation was carried out using the time motion study method using VSM observation sheets, interviews with selected informants and document review. Under current state conditions, the lead time for each prescription (lead time) for finished drug prescription is 46.7 minutes, with a ratio of value added activity to total service time of 25%:75%, while the lead time for concoction recipes is 98.9 minutes with a ratio of value added activity to total service time of 27%:73%. In the analysis of non-value added activities, the highest waste is in the waste waiting and overprocessing waste. Some of the factors that cause waste are HR inefficiency, doctors' practice schedules that coincide, there is no separate system for regular outpatient prescription service officers and executive outpatient care, the need for optimizing e-prescriptions, information system networks that are sometimes slow during rush hours and frequent interruptions from patients asking questions at the pharmacy counter. The lean hospital intervention that was tried to be implemented was the balancing process, Heijunka with modifications to pharmacy staff shifts and 5S. In the future state, the lead time decreased by 28% for finished drug prescriptions to 33.3 minutes, while for mixed prescriptions the lead time decreased by 32% to 67.1 minutes. The conclusion of this study is that Lean Hospital is the right method or tool to reduce lead time by reducing waste and increasing added value for patients. The researcher's suggestion encourages the hospital to continue as the first step of continuous improvement accompanied by meeting the needs of human resources and supporting facilities.
B-2381
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Indri Permanasari; Pembimbing: Puput Oktamianti; Penguji: Jaslis Ilyas, Vetty Yulianty Permanasari, Eka Musridharta, Novita Dwi Istanti
Abstrak:
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Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang memengaruhi kolaborasi antar profesi kesehatan di Instalasi Rawat Intensif RSPON Prof. Dr. dr. Mahar Mardjono Jakarta. Penelitian ini menggunakan desain cross sectional dengan pendekatan kuantitatif. Jumlah sampel 110 orang dari berbagai profesi yang bertugas di Instalasi Rawat Intensif RSPON Prof. Dr. dr. Mahar Mardjono Jakarta selama bulan November 2023. Kuesioner AITCS II digunakan untuk menilai tingkat kolaborasi dan Structural Equation Modeling - Partial Least Squares (SEM-PLS) untuk menilai faktor-faktor yang dianggap berhubungan dengan kolaborasi seperti Budaya Organisasi, Komunikasi, Penghargaan dan Kepercayaan, Peran dan Tanggung Jawab, Ketersediaan Waktu dan Sumber daya, Dukungan Manajemen dan Kepemimpinan. Hasilnya menunjukkan tingkat kolaborasi baik dengan rata-rata skor AITCS II sebesar 4,14. Kesimpulan : Budaya organisasi, komunikasi, dan pemahaman terhadap peran dan tanggung jawab mempengaruhi secara signifikan terhadap kolaborasi antar profesi. Temuan ini menjadi masukan bagi rumah sakit untuk meningkatkan efektivitas layanan kesehatan dengan mengoptimalkan peran dan tanggung jawab tenaga kesehatan di rumah sakit. Budaya kolaboratif dan komunikasi efektif juga menjadi kunci dalam meningkatkan hasil perawatan pasien.
This research aims to identify factors that influence collaboration between health professionals at the RSPON Prof. Intensive Care Installation. Dr. Dr. Mahar Mardjono Jakarta. This research uses a cross sectional design with a quantitative approach. The total sample is 110 people from various professions who work at the RSPON Prof. Intensive Care Installation. Dr. dr. Mahar Mardjono Jakarta for November 2023. The AITCS II questionnaire was used to assess the level of collaboration and Structural Equation Modeling - Partial Least Squares (SEM-PLS) to assess factors considered to be related to collaboration such as Organizational Culture, Communication, Respect and Trust, Roles and Responsibilities, Availability of Time and Resources power, Management and Leadership Support. The results show a good level of collaboration with an average AITCS II score of 4.14. Organizational culture, communication, and understanding of roles and responsibilities significantly influence collaboration between professions. These findings provide input for hospitals to improve the effectiveness of health services by optimizing the roles and responsibilities of health workers in hospitals. A collaborative culture and effective communication are also key to improving patient care outcomes.
B-2435
Depok : FKM-UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Nadya Adina Zuhdi; Pembimbing: Ede Surya Darmawan; Penguji: Jaslis Ilyas, Puput Oktamianti, Enny Mulyatsih, Sandry Tri Sumarni
Abstrak:
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Penyakit saraf adalah gangguan pada sistem saraf yang dapat menurunkan fungsi tubuh. Berdasarkan data Survei Kesehatan Indonesia (2023), salah satu penyakit dengan prevalensi tertinggi adalah penyakit saraf, yaitu stroke yang memiliki biaya pengobatan tertinggi ketiga setelah penyakit jantung dan kanker. Akupunktur memiliki dampak yang signifikan pada pengobatan berbagai penyakit saraf. Rumah Sakit Pusat Otak Nasional menangani kasus neurologi (kesehatan otak dan saraf) yang semakin meningkat dan kompleks. Akupunktur medik menjadi salah satu layanan perawatan penunjang di RS PON yang sudah tersedia sejak tahun 2021. Berdasarkan laporan capaian layanan 3 tahun terakhir, tren jumlah pasien tahun 2021-2023 berturut-turut adalah sebagai berikut: 496 pasien, 727 pasien, dan penurunan pada tahun 2023 dengan jumlah 575 pasien. Penurunan angka kunjugan ini berbanding terbalik dengan jumlah kunjungan pasien secara total di RS PON pada periode 2020-2024 yang mengalami peningkatan. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan keinginan pasien rawat jalan di RS PON terhadap layanan akupunktur medik. Penelitian ini merupakan penelitian observasional dengan uraian hasil penelitian deskriptif. Jenis penelitian yang dipilih, yaitu penelitian cross sectional (potong lintang) yang dilakukan dengan menggunakan kuesioner sebagai instrumen pengumpulan data. Teori yang digunakan sebagai kerangka konsep pada penelitian ini adalah teori Capability, Opportunity, Motivation – Behavior (COM-B). Berdasarkan hasil analisis data pada penelitian ini, sejumlah 130 responden (58% dari total responden) memiliki keinginan terhadap layanan akupunktur medik, sisanya, taitu sejumlah 94 responden (42%) tidak memiliki keinginan terhadap layanan akupuntur medik. Persepsi layanan menjadi faktor yang paling mempengaruhi keinginan terhadap layanan akupunktur medik.
Neurological diseases are disorders of the nervous system that can reduce body function. Based on data from the Indonesian Health Survey (2023), one of the diseases with the highest prevalence is neurological disease, namely stroke which has the third highest medical cost after heart disease and cancer. Acupuncture has a significant impact on the treatment of various neurological diseases. The National Brain Center Hospital handles increasingly complex neurology (brain and nerve health) cases. Medical acupuncture is one of the supporting care services at the PON Hospital which has been available since 2021. Based on the service achievement report for the last 3 years, the trend in the number of patients in 2021-2023 is as follows: 496 patients, 727 patients, and a decrease in 2023 with a total of 575 patients. This decrease in the number of visits is inversely proportional to the total number of patient visits at the PON Hospital in the 2020-2024 period which has increased. The purpose of this study was to determine the factors related to the desires of outpatients at the PON Hospital for medical acupuncture services. This study is an observational study with a description of the results of descriptive research. The type of research chosen is cross-sectional research conducted using a questionnaire as a data collection instrument. The theory used as a conceptual framework in this study is the Capability, Opportunity, Motivation – Behavior (COM-B) theory. Based on the results of data analysis in this study, a number of 130 respondents (58% of total respondents) have a desire for medical acupuncture services, the rest, namely 94 respondents (42%) do not have a desire for medical acupuncture services. Perception of service is the factor that most influences the desire for medical acupuncture services.
Neurological diseases are disorders of the nervous system that can reduce body function. Based on data from the Indonesian Health Survey (2023), one of the diseases with the highest prevalence is neurological disease, namely stroke which has the third highest medical cost after heart disease and cancer. Acupuncture has a significant impact on the treatment of various neurological diseases. The National Brain Center Hospital handles increasingly complex neurology (brain and nerve health) cases. Medical acupuncture is one of the supporting care services at the PON Hospital which has been available since 2021. Based on the service achievement report for the last 3 years, the trend in the number of patients in 2021-2023 is as follows: 496 patients, 727 patients, and a decrease in 2023 with a total of 575 patients. This decrease in the number of visits is inversely proportional to the total number of patient visits at the PON Hospital in the 2020-2024 period which has increased. The purpose of this study was to determine the factors related to the desires of outpatients at the PON Hospital for medical acupuncture services. This study is an observational study with a description of the results of descriptive research. The type of research chosen is cross-sectional research conducted using a questionnaire as a data collection instrument. The theory used as a conceptual framework in this study is the Capability, Opportunity, Motivation – Behavior (COM-B) theory. Based on the results of data analysis in this study, a number of 130 respondents (58% of total respondents) have a desire for medical acupuncture services, the rest, namely 94 respondents (42%) do not have a desire for medical acupuncture services. Perception of service is the factor that most influences the desire for medical acupuncture services.
B-2550
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Nurul Rakhmawati; Pembimbing: Amal Chalik Sjaaf; Penguji: Anhari Achadi, Puput Oktamianti, Mursyid Bustami, Andi Basuki Prima Birawa
Abstrak:
Clinical Pathway (CP) merupakan perangkat alat multidisiplin ilmu yang digunakan untuk perawatan kesehatan berbasis bukti (evidence based). CP memiliki fungsi menyeragamkan terapi sehingga mampu meminimalkan komplikasi dan kesalahan pengobatan. Rumah Sakit Pusat Otak Nasional (RS PON) merupakan rumah sakit rujukan otak dan persarafan nasional. Stroke perdarahan menjadi penyakit kedua tertinggi di RS.PON. Keberagaman keputusan dilakukannya operasi atau tidak, meskipun sudah masuk indikasi, menjadi poin penting untuk menganalisis implementasi pelaksanaan Clinical Pathway ini.
Tujuan penelitian: menilai implementasi CP stroke perdarahan yang telah dijalankan sehingga diharapkan mampu menjadi dasar penentu kebijakan rumah sakit jejaring maupun rumah sakit seluruh Indonesia. Menilai hubungan antara variabel-variabel dalam clinical pathway terhadap Length of Stay (LOS), morbiditas dan mortalitas
Metode: Penelitian ini menggunakan metode mixed method, dengan pendekatan retrospektif. Dalam penelitian kuantitatif dilakukan analisis univariat dan multivariat, dimana menggunakan data sekunder dari rekam medis pasien stroke perdarahan yang dirawat di RS PON pada januari 2020 - Desember 2021. Dari total populasi 1254 pasien setelah dilakukan kriteria inklusi dan inklusi didapatkan 1001 pasien. Penelitian kuantitatif, dilakukan dengan menganalisis pengaruh implementasi CP terhadap lama hari rawat, morbiditas (nilai NIHSS) dan mortalitas. Faktor risiko dan efek atau penyakit yang terjadi di masa lampau diukur melalui catatan historis. Sementara pengumpulan data secara kualitatif menggunakan kuisioner dan wawancara secara mendalam kepada Kepala Bidang Pelayanan Medis, Kepala Komite Medis, Kepala Komite Keperawatan, Kepala Divisi Vaskular, Dokter Spesialis Neurologi, Dokter Spesialis Bedah Saraf, Dokter IGD, Perawat, Fisioterapi, Terapi wicara, Gizi dan Farmasi untuk mengetahui tahapan proses Clinical Pathway di RS PON. Total responden 129 orang. Penelitian kualitatif menilai pengetahuan tenaga medis dan paramedis terkait CP, implementasi, supervisi, monitoring dan evaluasi.
Hasil: penelitian kuantitatif menemukan adanya hubungan antara beberapa variabel yang berada dalam CP, seperti pemeriksaan penunjang, terapi sesuai indikasi dan penyakit komorbid terhadap LOS, morbiditas dan mortalitas. Sementara pada penelitian kualitatif menilai implementasi CP di RS PON memerlukan perbaikan dari segi sosialisasi, implementasi, monitoring dan evaluasi.
Kesimpulan: Implementasi CP berhubungan dengan outcome klinis pasien stroke perdarahan.
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Tujuan penelitian: menilai implementasi CP stroke perdarahan yang telah dijalankan sehingga diharapkan mampu menjadi dasar penentu kebijakan rumah sakit jejaring maupun rumah sakit seluruh Indonesia. Menilai hubungan antara variabel-variabel dalam clinical pathway terhadap Length of Stay (LOS), morbiditas dan mortalitas
Metode: Penelitian ini menggunakan metode mixed method, dengan pendekatan retrospektif. Dalam penelitian kuantitatif dilakukan analisis univariat dan multivariat, dimana menggunakan data sekunder dari rekam medis pasien stroke perdarahan yang dirawat di RS PON pada januari 2020 - Desember 2021. Dari total populasi 1254 pasien setelah dilakukan kriteria inklusi dan inklusi didapatkan 1001 pasien. Penelitian kuantitatif, dilakukan dengan menganalisis pengaruh implementasi CP terhadap lama hari rawat, morbiditas (nilai NIHSS) dan mortalitas. Faktor risiko dan efek atau penyakit yang terjadi di masa lampau diukur melalui catatan historis. Sementara pengumpulan data secara kualitatif menggunakan kuisioner dan wawancara secara mendalam kepada Kepala Bidang Pelayanan Medis, Kepala Komite Medis, Kepala Komite Keperawatan, Kepala Divisi Vaskular, Dokter Spesialis Neurologi, Dokter Spesialis Bedah Saraf, Dokter IGD, Perawat, Fisioterapi, Terapi wicara, Gizi dan Farmasi untuk mengetahui tahapan proses Clinical Pathway di RS PON. Total responden 129 orang. Penelitian kualitatif menilai pengetahuan tenaga medis dan paramedis terkait CP, implementasi, supervisi, monitoring dan evaluasi.
Hasil: penelitian kuantitatif menemukan adanya hubungan antara beberapa variabel yang berada dalam CP, seperti pemeriksaan penunjang, terapi sesuai indikasi dan penyakit komorbid terhadap LOS, morbiditas dan mortalitas. Sementara pada penelitian kualitatif menilai implementasi CP di RS PON memerlukan perbaikan dari segi sosialisasi, implementasi, monitoring dan evaluasi.
Kesimpulan: Implementasi CP berhubungan dengan outcome klinis pasien stroke perdarahan.
B-2268
Depok : FKM-UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Vika Wahyudi Anggiri; Pembimbing: Jaslis Ilyas; Penguji: Ede Surya Darmawan, Septiara Putri, Iin Dewi Astuty, Hadijah Tahir
Abstrak:
Resep elektronik merupakan salah satu sistem informasi berpusat kepada pelayanan dengan menghubungkan antara dokter dan apoteker yang bertujuan untuk meningkatkan keselamatan pasien, mengurangi ketidakefisienan dan mengurangi kesalahan pemberian obat. Penyelenggaraan resep elektronik bertujuan untuk memudahkan pengguna dalam melaksanakan tugasnya sehari-hari. Namun, faktor kegunaan dan manfaat dari teknologi ini akan bergantung dari penerimaan pengguna dalam memanfaatkan teknologi yang ada. Tujuan penelitian untuk mengetahui dan menganalisa pengaruh penerimaan penggunaan terhadap resep elektronik dengan pendekatan Technology Acceptance Model di RS PON Prof. Dr. dr. Mahar Mardjono. Penelitian dilakukan pada bulan Juni sampai Juli tahun 2020 menggunakan desain penelitian studi cross sectional dengan pendekatan metode kuantitatif. Uji hipotesis menggunakan analisis Partial Least Square dengan probabilitas dua arah dimana nilai T-statistik lebih besar dari 1,96 maka hasil signifikan dengan memiliki pengaruh yang bermakna. Penerimaan teknologi resep elektronik di RS PON Prof. Dr. dr. Mahar Marjono dikategorikan cukup dengan nilai 69,6%. Hasil penelitian menunjukan bahwa persepsi kemudahan penggunaan dipengaruhi oleh desain layar, terminologi dan pelatihan serta sikap terhadap penggunaan dan kecenderungan penggunaan dipengaruhi oleh persepsi kegunaan. Kondisi nyata penggunaan sistem terjadi penurunan jumlah penggunaan resep elektronik dan didapatkan nilai rata-rata penggunaan resep manual sebesar 5,4%. Implementasi resep elektronik di RS PON Prof. Dr. dr. Mahar Mardjono sudah berjalan cukup baik dan diperlukan peningkatan kemampuan sistem dengan tujuan meningkatkan kinerja dan kualitas layanan rumah sakit.
Electronic prescribing is one of the information systems focusing on automated service that connects doctors and pharmacists, which potentially improves safety care, reduces inefficiencies and prescription errors. Electronic prescribing assists users in delivering their daily works. However, the usefulness factor and benefits of electronic prescribing relies on the user acceptance to optimize the advantages of this technology. This research aims to find and to analyze the effect of user acceptance towards electronic prescribing by using Technology Acceptance Model approach at National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital. The research was conducted in June to July 2020 by employing cross sectional research design and quantitative method approach. The hypothesis testing is developed by using Partial Least Square analysis with a twoway probability where if the value of T-Statistics is higher than 1,96, the effect is significant and meaningful. User acceptance towards electronic prescribing at National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital is categorized as sufficient with a value of 69,6%. The research finds that perceived ease of use was influenced by screen design, terminology and training, while attitude towards using and behavioral intention were influenced by perceived usefulness. The actual system use signifies a decline in electronic prescribing usage and the average value of using manual prescribing was 5,4%. Implementation of electronic prescribing at National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital has been running quite well and it is necessary to increase system capabilities with the aim of improving the performance and quality of hospital services.
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Electronic prescribing is one of the information systems focusing on automated service that connects doctors and pharmacists, which potentially improves safety care, reduces inefficiencies and prescription errors. Electronic prescribing assists users in delivering their daily works. However, the usefulness factor and benefits of electronic prescribing relies on the user acceptance to optimize the advantages of this technology. This research aims to find and to analyze the effect of user acceptance towards electronic prescribing by using Technology Acceptance Model approach at National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital. The research was conducted in June to July 2020 by employing cross sectional research design and quantitative method approach. The hypothesis testing is developed by using Partial Least Square analysis with a twoway probability where if the value of T-Statistics is higher than 1,96, the effect is significant and meaningful. User acceptance towards electronic prescribing at National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital is categorized as sufficient with a value of 69,6%. The research finds that perceived ease of use was influenced by screen design, terminology and training, while attitude towards using and behavioral intention were influenced by perceived usefulness. The actual system use signifies a decline in electronic prescribing usage and the average value of using manual prescribing was 5,4%. Implementation of electronic prescribing at National Brain Center Prof. Dr. dr. Mahar Mardjono Hospital has been running quite well and it is necessary to increase system capabilities with the aim of improving the performance and quality of hospital services.
B-2160
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Syanti Puspitasari; Pembimbing: Masyitoh; Penguji: Hadijah
Abstrak:
Peningkatan mutu dan keselmatan pasien merupakan dua hal yang tidak bisadipisaahkan dan harus berkesinambungan. Upaya peningkatan mutu dan keselamatanpasien di Instalasi Farmasi Rumah Sakit Pusat Otak Nasional Prof. DR. dr. MaharMardjono digambarkan melalui capaian indicator pelayanan menurut Standar PelayananMinimal Rumah Sakit yang belum mencapai standar. Penelitian ini dilakukan untukmenganalisis waktu tunggu pelayanan obat jadi pasien JKN dan aktivitas risikoterjadinaya medication error dengan prinsip lean thinking dan swiss cheese model. Jenispenelitian ini adalah operational research dengan pendekatan kualitatif dan kuantitatif.Data kualitatif diperoleh melalui proses observasi dan telaah dokumen, sedangkankuantitatif berdasarkan data waktu tunggu dari electronic health record dan waktutunggu hasil observasi. Hasil penelitian menunjukan waktu tunggu adalah 1 jam 3 menit11 detik, dengan waktu tunggu terlama adalah pada proses penerimaan resep (30 menit42 detik). Kegiatan VA (79%) yaitu 13 menit 13 detik. Aktivitas NVA (21%) denganwaktu 49 menit 21 detik. Waste terbanyak adalah pada kegiatan waiting denganpresentasi waktu 92% dari waktu NVA. Bottleneck pada penelitian ini diambil dariproses waktu tunggu terlama dan hasil analisis swiss chesse model pada tahapanpengkajian dan pemeriksaan sediaan obat.Usulan perbaikan berdasarkan hasil analisisproses pengkajian dan pelayanan resep obat jadi ini adalah perlu adanya penyusunanregulasi pengkajian dan pelayanan obat sesuai standar pelayanan kefarmasian, telaahprofil indicator waktu tunggu obat jadi sesuai SPM rumah sakit, perlu adanya analisisbeban kerja, dan monitoring supervise kajian pelayanan resep obat. Usulan perbaikandigambarkan dalam future state map dengan mereduksi aktivitas NVA yang dapatsecara langsung dihapuskan tanpa dilakukan intervensi.
Kata kunci: lean thinking, , medication error, swiss chesse model waktu tunggupelayanan
Quality improvement and patient safety are two things that cannot separated and mustbe continuous. Effort to improve quality and patient safety at Outpatient PharmacyPusat Otak Nasional Prof. DR.dr. Mahar Mardjono Hospital is described through theachievement of service indicators according to the hospital minimum service standardsthet have not resched the standard. This study was conducted to analyze the waitingtime for JKN patient medication services and risk activities of medication errors usingprinciples of lean thinking and the swiss cheese model. This type of research isoperational research with qualitative and quantitative approaches. Qualitative data isobtained through the process of observation and document review, while quantitativedata is based on waiting time data from electronic health records and waiting time forobservations. The result showed that the waiting time was 1 hour 3 minutes 11 seconds,with the longest waiting time was in the process of receiving the recipe (30 minutes 42seconds). Value_added activity (79%) was 13 minutes 13 seconds, non value addedactivity (21%) for 49 minutes 21 second. Most of waste is in waiting activities with apresentation time of 92% of the time for non value added. The bottleneck in this studywas taken from the longest waiting time process and the result of the swiss cheesemodel analysis at the assessment and examination stage of drug preparations.Reviewing the waiting time indicator profile for the finished medicine according to theSPM of the hospital. There is a need for workload analysis, and monitoring of thereview of prescription services. Proposed improvements are described in a future statemap by reducing non value added activity which can be directly eliminated withoutintervention.
Key words: lean thinking, medication error, swiss chesse model, medication error,service waiting time.
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Kata kunci: lean thinking, , medication error, swiss chesse model waktu tunggupelayanan
Quality improvement and patient safety are two things that cannot separated and mustbe continuous. Effort to improve quality and patient safety at Outpatient PharmacyPusat Otak Nasional Prof. DR.dr. Mahar Mardjono Hospital is described through theachievement of service indicators according to the hospital minimum service standardsthet have not resched the standard. This study was conducted to analyze the waitingtime for JKN patient medication services and risk activities of medication errors usingprinciples of lean thinking and the swiss cheese model. This type of research isoperational research with qualitative and quantitative approaches. Qualitative data isobtained through the process of observation and document review, while quantitativedata is based on waiting time data from electronic health records and waiting time forobservations. The result showed that the waiting time was 1 hour 3 minutes 11 seconds,with the longest waiting time was in the process of receiving the recipe (30 minutes 42seconds). Value_added activity (79%) was 13 minutes 13 seconds, non value addedactivity (21%) for 49 minutes 21 second. Most of waste is in waiting activities with apresentation time of 92% of the time for non value added. The bottleneck in this studywas taken from the longest waiting time process and the result of the swiss cheesemodel analysis at the assessment and examination stage of drug preparations.Reviewing the waiting time indicator profile for the finished medicine according to theSPM of the hospital. There is a need for workload analysis, and monitoring of thereview of prescription services. Proposed improvements are described in a future statemap by reducing non value added activity which can be directly eliminated withoutintervention.
Key words: lean thinking, medication error, swiss chesse model, medication error,service waiting time.
S-10439
Depok : FKM UI, 2020
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Ahmad Bajri; Pembimbing: Adang Bachtiar; Penguji: Wahyu Sulistiadi, Jaslis Ilyas, Bambang Hermanto, Jupni
Abstrak:
Di Indonesia sampai tahun 2018 tercatat ada 300 Rumah Sakit Islam, 40 Rumah Sakit Isalam sudah menjadi rumah sakit syariah, 5 Rumah Sakit pemerintah juga sudah menjadi rumah sakit syariah, Manajemen Syariah dulu dikenal hanya pada jasa keuangan perbankkan namun saat ini sudah masuk pada pelayanan kesehatan seperti rumah sakit, perusahaan obat makanan, pusat perbelanjaan, rumah makan, perhotelan, transportasi dan lain-lain, Rumah sakit pemerintah yang sudah terakreditasi SNARS berpeluang mengusulkan untuk menjadi rumah sakit syariah. Tujuan: Penelitian ini untuk melihat komitmen pemangku kepentingan RSUD Prof. Dr. H.M. Chatib Quzwain Sarolangun Jambi untuk menuju rumah sakit syariah Metode: kualitatif, Data dikumpul dengan wawancara mendalam kepada informan yang terdiri dari pemangku kepentingan RSUD- CQ Sarolangun Jambi, dokter spesialis, komite medik, kepala ruangan, petugas kerohanian. Pemilihan informan pada penelitian ini berdasarkan prinsip kesesuaian (appropriate) dan kecukupan (adequacy). Kesimpulan: Langkah awal dari pelaksanaan syariah di rumah sakit pemerintah adalah komitmen pemangku kepentingan.
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B-2115
Depok : FKM UI, 2019
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Mohammad Zakir Chohan; Pembimbing: Ede Surya Darmawan; Penguji: Helen Andriani, Vetty Yulianty Permanasari, Temmasonge Radi Paki, Titi Anggraeni
Abstrak:
Perawat mempunyai fungsi kolaborasi dalam pemberian asuhan keperawatan dan kemampuan dalam penerapan 6 tepat pemberian obat meliputi : tepat pasien, tepat obat, tepat dosis, tepat waktu, tepat cara, dan tepat dokumentasi.Tujuan penelitian mengetahui perilaku profesional perawat dalam penerapan 6 tepat benar obat dan hubungan dengan karakteristik, pengetahuan, sikap,pemahaman etis&hukum serta humanisme dan kultur kompetensi yang mempengaruhi kinerja selama masa pandemic Covid-19. Penelitian menggunakan pendekatan kuantitatif metode cross sectional dengan total sampel 50 perawat di ruang Intensive Care RSPI Prof Dr Sulianti Saroso. Analisis bivariat dengan Contiunity Corretion dan multivariat dengan regresi logistic berganda. Hasil penelitian menunjukan hubungan yang signifikan antar humanisme dan kultur kompetensi dengan perilaku profesional dalam penerapan 6 tepat pemberian obat (p Value 0,000) sejumlah 74.2%, dan pemahaman etis dan hukum dengan perilaku profesional perawat dalam penerapan 6 tepat pemberian obat (p value 0,043) sejumlah 63,39%. Hasil multivariat variabel humanisme dan kultur kompetensi menjadi faktor dominan perilaku profesional perawat dalam 6 tepat pemberian obat. Perilaku profesional perawat dalam penerapan 6 tepat pemberian obat mendukung peningkatan pelayanan terhadap keselamatan pasien dalam pemberian obat yang aman. Perilaku professional perawat menjadi penilaian sangat mendasar dalam proses kredensi untuk seleksi karyawan.Upaya penerapan.prinsip ini dapat dilakukan dengan pendidikan keperawatan berkelanjutan dan meningkatkan supervisi.
Nurses have a collaborative function in providing nursing care and the ability to implement appropriate 6 drugs, including: the right patient, the right drug, the right dose, the right time, the right way, and the right documentation. the relationship with the characteristics, knowledge, attitudes, ethical & legal understanding as well as humanism and the culture of competence that affect performance during the Covid-19 pandemic. This study used a quantitative approach with cross sectional method with a total sample of 50 nurses in the Intensive Care Room at RSPI Prof. Dr. Sulianti Saroso. Bivariate analysis with Contiunity Corretion and multivariate analysis with multiple logistic regression. The results showed a significant relationship between humanism and a culture of competence with professional behavior in the correct application of medication (p value 0.000) amounting to 74.2%, and ethical and legal understanding with professional behavior of nurses in the correct application of 6 drugs (p value 0.043). 63.39%. The multivariate results of humanism and competency culture variables are the dominant factors in the professional behavior of nurses in administering drugs. The professional behavior of nurses in the proper application of drug administration supports the improvement of services for patient safety in safe drug administration. The professional behavior of nurses is a very basic assessment in the credential process for employee selection. Efforts to implement this principle can be done by continuing nursing education and increasing supervision.
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Nurses have a collaborative function in providing nursing care and the ability to implement appropriate 6 drugs, including: the right patient, the right drug, the right dose, the right time, the right way, and the right documentation. the relationship with the characteristics, knowledge, attitudes, ethical & legal understanding as well as humanism and the culture of competence that affect performance during the Covid-19 pandemic. This study used a quantitative approach with cross sectional method with a total sample of 50 nurses in the Intensive Care Room at RSPI Prof. Dr. Sulianti Saroso. Bivariate analysis with Contiunity Corretion and multivariate analysis with multiple logistic regression. The results showed a significant relationship between humanism and a culture of competence with professional behavior in the correct application of medication (p value 0.000) amounting to 74.2%, and ethical and legal understanding with professional behavior of nurses in the correct application of 6 drugs (p value 0.043). 63.39%. The multivariate results of humanism and competency culture variables are the dominant factors in the professional behavior of nurses in administering drugs. The professional behavior of nurses in the proper application of drug administration supports the improvement of services for patient safety in safe drug administration. The professional behavior of nurses is a very basic assessment in the credential process for employee selection. Efforts to implement this principle can be done by continuing nursing education and increasing supervision.
B-2221
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nilandari; Pembimbing: Kurnia Sari; Penguji: Pujiyanto, Puput Oktamianti, Andi Basuki Prima Birawa
Abstrak:
Keterlambatan pengajuan klaim BPJS berakibat pada turunnya cashflow rumahsakit. Proses klaim saat ini berjalan tidak efisien dan efektif. Tujuan daripenelitian ini adalah mendapatkan hasil analisis dan usulan perbaikan alur prosesdokumen klaim BPJS pasien rawat jalan dengan menerapkan konsep LeanHospital. Penelitian dengan pendekatan kuantitatif dan kualitatif inimengobservasi waktu yang dibutuhkan untuk menyelesaikan dokumen klaimsebelum diberikan kepada verifikator BPJS serta melakukan wawancaramendalam, observasi proses, dan telaah dokumen. Hasil penelitian menunjukkanterjadi waste terbesar di unit mobilisasi dana yaitu selama 32,5 hari 18,8 menitdalam penyelesaian dokumen klaim. Jenis waste terbanyak adalah waiting dantransportation. Berdasarkan VSM diketahui Lead Time dari proses klaim saat iniadalah 33,9 hari. Usulan perbaikan yang diberikan dari penelitian ini adalahdengan optimalisasi tim Casemix yang baru saja dibentuk, sehingga lead timepengerjaan klaim yang dibutuhkan menjadi 6,44 menit. Standardisasi kerja danpenilaian kinerja berupa KPI, IKI, dan IKU dinilai perlu diterapkan agar kinerjapetugas menjadi optimal.
Kata Kunci: Lean Thinking, BPJS, klaim, value added activity, non value addedactivity, waste
Delay in the submission of BPJS claims resulted in decreasing hospital cash flow. The currentclaim process is not efficient and effective.The objective of this reseach is to analize and proposeimprovement in the claim process by applying Lean Hospital concept. This research usedquantitative and qualitative approaches to observed the time required to complete the claimprocess before submitted to the BPJS verificator and also have an in-depth interview, observe theprocess, and document review. The result showed most waste happened in mobilisasi dana unitfor 32.5 days 18.8 minutes in the settlement BPJS document claims. Based on Value StreamMapping, Lead Time of the claim process at this time is 33.9 day. Most types of waste arewaiting and transportation. Proposed improvement provided from the study is to optimizing thecasemix team which newly formed. By optimizing the casemix team, Lead Time required tocomplete the claims process is 6.44 minutes. Standardize work and performance appraisal (KPI,IKI, and IKU) consider to apply to reach employee best performance.
Keywords: Lean Thinking, BPJS, claim, value added activity, non value added activity, waste
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Kata Kunci: Lean Thinking, BPJS, klaim, value added activity, non value addedactivity, waste
Delay in the submission of BPJS claims resulted in decreasing hospital cash flow. The currentclaim process is not efficient and effective.The objective of this reseach is to analize and proposeimprovement in the claim process by applying Lean Hospital concept. This research usedquantitative and qualitative approaches to observed the time required to complete the claimprocess before submitted to the BPJS verificator and also have an in-depth interview, observe theprocess, and document review. The result showed most waste happened in mobilisasi dana unitfor 32.5 days 18.8 minutes in the settlement BPJS document claims. Based on Value StreamMapping, Lead Time of the claim process at this time is 33.9 day. Most types of waste arewaiting and transportation. Proposed improvement provided from the study is to optimizing thecasemix team which newly formed. By optimizing the casemix team, Lead Time required tocomplete the claims process is 6.44 minutes. Standardize work and performance appraisal (KPI,IKI, and IKU) consider to apply to reach employee best performance.
Keywords: Lean Thinking, BPJS, claim, value added activity, non value added activity, waste
B-1795
Depok : FKM UI, 2016
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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