Abstrak: Laboratorium Parasitologi Klinik FKUI merupakan laboratorium khusus rujukan nasional penyakit parasitik di Indonesia dan telah terakreditasi A, sebaiknya dapat menetapkan target KPI kepuasan pengguna jasa pengguna laboratorium setiap tahunnya lebih besar dari 82%. Hal tersebut tidak sesuai dengan Permenpan No. 14 Tahun 2017 Tentang Survey Kepuasan Masyarakat untuk mutu pelayanan mengenai kinerja unit pelayanan minimal 88,31%. Penelitian ini bertujuan untuk mengetahui kondisi terkait mutu layanan kesehatan Laboratorium Parasitologi Klinik FKUI berdasarkan 5 dimensi Servqual dengan desain metode penelitian kualitatif menggunakan desain studi kasus. Penelitian dilaksanakan pada bulan Oktober dan November 2020 di Laboratorium Parasitologi Klinik FKUI dengan total 13 orang informan yaitu kepala laboratorium, petugas laboratorium dan pasien yang melakukan pemeriksaan di laboratorium. Hasil penelitian menunjukkan dari dimensi kehandalan segi sumber daya manusia sebenarnya sudah mencukupi akan tetapi karena Laboratorium Parasitologi Klinik FKUI selain menerima pasien yang datang namun juga melakukan penelitian dan pendidikan sehingga menyebabkan terjadinya double job pada karyawan dan mengakibatkan salah satu penyebab lamanya waktu tunggu pada pelayanan laboratorium. Dimensi jaminan, petugas juga masih dianggap kurang ahli dalam melakukan tindakan dibandingkan di laboratorium lain. Dimensi bukti fisik yang ada di laboratorium masih pelu diperbaiki atau diperhatikan agar pelanggan dapat merasa nyaman. Peneliti menyarankan dapat mengefektifkan pengawasan pelaksanaan SOP oleh koordinator laboratorium, adanya indikator waktu tunggu untuk meningkatkan pelayanan laboratorium dan analisa beban kerja dan penyesuaian tenaga kerja sesuai dengan beban kerjanya

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The Laboratory of Clinical Parasitology, FKUI is a special national referral laboratory for parasitic diseases in Indonesia and has been accredited A, it should be able to set a KPI target for the satisfaction of laboratory users every year greater than 82%. This is not in accordance with Permenpan No. 14 of 2017 concerning the Community Satisfaction Survey for service quality regarding service unit performance of at least 88.31%. This study aims to determine the conditions related to the quality of health services in the Clinical Parasitology Laboratory of FKUI based on 5 Servqual dimensions with a qualitative research method design using a case study design. The study was conducted in October and November 2020 at the Clinical Parasitology Laboratory of FKUI with a total of 13 informants, namely the head of the laboratory, laboratory staff and patients who carried out examinations in the laboratory. The results showed that from the dimension of reliability in terms of human resources, it was actually sufficient, but because the Clinical Parasitology Laboratory of FKUI, apart from accepting patients who came, also carried out research and education, causing double jobs for employees and resulting in one of the causes of the long waiting time for laboratory services. The guarantee dimension is that officers are still considered less skilled in performing actions compared to other laboratories. The dimensions of physical evidence in the laboratory still need to be repaired or considered so that customers can feel comfortable. Researchers suggest that monitoring of SOP implementation by the laboratory coordinator can streamline, the existence of a waiting time indicator to improve laboratory services and workload analysis and workforce adjustment according to workload.

Abstrak: Waktu tunggu hasil pemeriksaan laboratorium sebagai ukuran kinerja pelayanan merupakan syarat penting membuktikan kualitas pelayanan laboratorium. Kecepatan waktu hasil pemeriksaan laboratorium mempengaruhi penetapan diagnosis serta terapi pasien. Indikator sasaran mutu laboratorium menetapkan target waktu tunggu pemeriksaan hasil laboratorium kimia 120 menit. Pencapaian sasaran indikator mutu di tahun 2020 baru 70% dari target yang ditetapkan, juga masih terdapat keluhan lambatnya hasil pemeriksaan. Studi pendahuluan bulan Januari sampai Febuari 2021 terdapat 18% waktu tunggu diatas 120 menit. Metode Lean six sigma fokus terhadap perbaikan dengan mendorong peningkatan secara tajam dalam kecepatan, kualitas dan profitabilitas. Penelitian ini merupakan operational research untuk memberikan rekomendasi perbaikan waktu tunggu pemeriksaan laboratorium dengan menggunakan pendekatan metode DMAIC terdiri dari siklus Define (mendefinisi), Measure (mengukur), Analyze (menganalisis), Improve (rekomendasi perbaikan), dan Control (pengendalian) Hasil penelitian mendapatkan gambaran terjadinya pemborosan di tahap pra analitik, analitik dan pasca analitik yang berdampak terhadap waktu tunggu hasil pemeriksaan laboratorium. Pemborosan yang paling dominan terjadi di tahap pra analitik. Persentase value added pelayanan pemeriksaan Laboratorium sebelum penerapan Lean six sigma sebesar 67.30% dan non value added sebesar 33.83%. Setelah penerapan Lean six sigma nilai value added meningkat 38.48% menjadi 91.32% dan value added menurun 28.42% menjadi 8.68 %. Ditemukan adanya delapan jenis pemborosan, sebagian besar merupakan pemborosan defect, over processing, delays (waiting time), over production. Pemborosan banyak terjadi di tahap pra analitik dan pasca analitik. Sumber terjadinya pemborosan berdasarkan hasil analisis fishbone adalah man dan method dikarenakan kuantitas ATLM (Analis Teknis Medik Laboratorium) belum mencukupi dan belum efektifnya penanganan spesimen laboratorium serta metode serah terima.Usulan perbaikan disusun menggunakan lean tools seperti standardized work, visual management, error profing, dan penerapan 5S (Short, Stabilize, Shine, Standardize, Sustain) Intervensi yang dilakukan dengan usulan alur pemeriksaan laboratorium, metode serah terima spesimen, serta edukasi ulang tentang penanganan spesimen laboratorium dan usulan pelatihan Flebotomi

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Waiting time for laboratory test results as a measure of service performance is an important requirement to prove the quality of laboratory services. The timing of the results of laboratory examinations affects the determination of the patient's diagnosis and therapy. The laboratory quality target indicator sets a target waiting time for the examination of chemical laboratory results of 120 minutes. The achievement of the quality indicator targets in 2020 is only 70% of the target set, there are also complaints about the slowness of the inspection results. Preliminary study from January to February 2021 showed 18% waiting time above 120 minutes.methods Lean six sigma focus on improvement by driving sharp improvements in speed, quality and profitability. This research is anoperational research to provide recommendations for improving waiting time for laboratory examinations using the DMAIC method approach consisting of a cycle of Define (defining), Measure (measure), Analyze (analyze), Improve (recommendation for improvement) and Control (Controlling). The results of the study get an overview of the occurrence of waste in the pre-analytical, analytical and post analytic stages which have an impact on the waiting time for laboratory results. The most dominant wastage occurred in the pre-analytic stage. The percentage of value added of laboratory inspection services before the implementation of Lean six sigma is 67.30% and non value added is 33.83%. After the implementation of Lean six sigma, the value added increased by 38.48% to 91.32% and the value added decreased by 28.42% to 8.68%. It was found that there were eight types of waste, most of which were defects, over processing, delays (waiting time), over production. A lot of waste occurs in the preanalytic and post-analytic stages. Sources of waste based on analysis results fishbone are man and method due to quantity of ATLM (Laboratory Medical Technical Analyst) and ineffective handling of laboratory specimens and handover methods. Improvement proposals are prepared using lean tools such as standardized work, visual management, error profiling, and the application of 5S(Short, Stabilize, Shine, Standardize, Sustain) Interventions carried out with the proposed flow of laboratory examinations, specimen handover methods, as well as re-education on handling laboratory specimens and proposed phlebotomy training

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Hasil pemeriksaan laboratorium yang cepat dan akurat sangat penting untuk pengarnbilan keputusan bagi dokter. Kesalahan hasil pemeriksaan laboratorium akan berdampak pada kesalahan dokter dalam mendiagnosis suatu penyakit serta penatalaksanaan pasien (pemantauan jalannya penyaldt dan evaluasi efektivitas pengobatan). Untuk itu upaya mencegah atau meminimalisasi faktor-faktor penyebab kesalahan analisis, harus dilkukan dengan kegiatan pengendalian mutu balk internal maupun eksternaI (uji profisiensi). Penelitian ini bertujuan untuk mengetahui faktor dominan pada kinerja laboratorium klinik di Provinsi Jawa Barat yang berperan dalam penyimpangan hasil pemeriksaan melalui uji profiiensi. Desain penelitian adalah cross sectional dengan pendekatan kuantitatif. Responden adalah petugas laboratorium klinik peserta uji profisiensi. Sampel penelitian berupa total populasi sebanyak 77 laboratorium. Pengumpulan data dilakukan dengan kuesioner dari melihat hasil evaluasi kegiatan pengendalian mutu eksternal laboratorium kesehatan provinsi Jawa Barat tahun 2007. Hasil penelitian menunjukan bahwa faktor manusia, alat, lingkungan, dan sistem memiliki hubungan yang bermakna dengan kinerja laboratorium. Hasil analisa multivariat menunjukan bahwa faktor manusia raerupakan faktor dominan penyebab kesalahan analisis di laboratorium klinik. Studi ini menyarankan agar pimpinan laboratorium dan dinas kesehatan provinsi Jawa Barat lebih meningkatkan kualitas tenaga laboratoriuna dengan mengikutsertakan path program pendidikan berkelanjutan sesuai keahlian dan spesifikasi pekerjaannya.

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A quick and precise clinical laboratory examination result was very important for a physician in making medical decision. Any inaccuracies of laboratory results could affect the medical decision suggested by the physician and as well as for the effectiveness of patient treatment.There were some efforts proposed to minimize laboratory examination inaccuracy, i.e., internal quality control and external quality control, called as proficiency test. The research objectives were to determine any factors which are involved in making of any inaccuracy in some clinical laboratories in West Java Province, using proficiency test. The research was designed as a quantitative approach of cross-sectional method. Respondents who involved in the research were laboratory technicians (called health analyst) taken from seventy-seven (77) clinical laboratories located around West Java Province. Data collecting were conducted using interviewing and questionnaires check-list, and also secondary data collecting from West Java Health Laboratory External Quality Control Program conducted in year 2007. The results have been concluded that individual skills (human factor), laboratory equipments, job environments and laboratory management system show a significant correlation with the laboratory performance. Statistical multivariate analysis has determined that individual skill (human factors) was as dominant factor in making inaccuracy of laboratory examination result. Based of the conclusion and discussion, the research recommended that West Java Health Agency and related stakeholders could make some efforts in improvement of laboratory's individual quality which is can be realized with academic upgrading based on their specific jobs.

Abstrak:

Strategi penanggulangan TB melalui strategi DOTS (Directly Observed Trearmem Shorlcourse) memprioritaskan penemuan pasien melalui pemeriksaan mikroskopis, oleh karena itu mutu pemeriksaan mikroskopis perlu dipantau tems. Hasil pemeriksaan mikroskopis sputum BTA ,oleh 54 pemugas laboratorium puskesmas (Puskesmas Ruiukan Mikroskopis dan Puskesmas Pelaksana Mandiri) di Provinsi Jambi pada tahun 2004 ada 29 puskesmas yang hasil error rate 25%, sedangkan pada tahun 2005 mcnjndi 32 puskcsmas yang hasil error rare-nya 25%. Untuk itu pcrlu dilakukan penilaian terhadap faktor-faktor yang berhubungan dengan mutu pemeiiksaan mikroskopis sputum BTA. Penelitian ini bertuiuan untuk mengetahui gambaran dan faktor-faktor yang berhubungan dengan mutu pemeriksaan mikroskopis sputum BTA pada laboratorium puskesmas (PRM dan PPM) di Provinsi Jambi tahun 2006, dengan menggunakan metodologi kuantitatif yang bersifat deskriptif dengam desaiu” penelitian berupa pcndckatan cross sectional, terhadap 56 petugas laboratorium puskesmas di PRM dan PPM (total populasi). Hasil pemeriksaan mikroskopis sputum BTA yang bermutu baik masih rendah, hanya 35,7%. Adapun faktor yang berhubungan signiiikan dengan mutu pemeriksaan mikroskopis sputum BTA adalah pelatihan (tanpa dikontrol), dan faktor pengalaman kelfia, supervisi, kepuasan kerja, dan penerapan SOP (dengan dikontrol). Faktor yang paling dominan bcrhubungan dengan rnutu pemeriksaan mikroskopis sputum BTA aclalah pencmpan SOP. Disarankan kepada puskcsmas agar petugas laboratorium selalu menerapkan SOP, meqiaga keamanan bckclja di laboratorium, dan merawat mikroskop dcngan bai[c. Kepada Dinas Kesehatan K.abupatenfKota agar pembinaan petugas laboratodum dilakukan torus-mcncms melalui peiaksanaan supenkisi yang baik. Kepada Dinas Kesehatan Provinsi agar dapat rpelatih semua petugas laboratoriurn puskesmas, melaksanakan pertemuan untuk pembinaan dan pcrnbekalan pengetahuan terhadap petugas TB kabupatenfkota dan petugas laboratorium puskesmas, dan juga perlu bckcrjasama dengan Balai Laboratorium Kesehatan untuk melakukan pembinaan di puskesmas (PRM dan PPND.

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TB prevention strategy with DOTS (Directly Observed Treatment Short course) give priority to patient’s invention by microscopic examination, therefore we must always control the microscopic examination. The result of BTA sputum microscopic examination by 54 government clinic laboratory assistant (Microscopic Reconciliation Government Clinic/PRM and Autonomy Execution Government Clinic/PPM) in Province of Jamb in year 2004, there was 29 local govemment clinic with error rate 25%, whereas in 2005 became 32 local government clinic with error rate 25%. Because of that, we need to evaluate about factors which related with quality of BTA sputum microscopic examination. The purpose of the research is to get the description and factors that related with quality of BTA sputum microscopic control, at PRM and PPM laboratories in Province of Jambi, in year 2006, by using quantitative methodology, which have descriptive characteristic with cross sectional approaching research design, toward 56 laboratory assistant at PRM and PPM (total population). The result of BTA sputum microscopic examination with good quality is still low, that is only 35.7% The factors that have a significant relation with quality of BTA sputum microscopic examination are training (without controlling), and work experience factor, supervision, work satisfaction, and SOP implementation (without controlling). The most dominant factor which related with quality of BTA sputum microscopic examination is SOP examination. We suggest to government clinic is laboratory assistant must implement SOP, maintain the security of laboratory, take good care of microscope. For public service in Regency, they must train laboratory assistant continually with good supervision. For public service in Province, they must train all laboratory assistant of local government clinic by meeting for founded and provided knowledge towards TB Regency officer and laboratory assistant of public government clinic, and also good cooperate with Health Laboratory Center to make founding at local government clinic (PRM and PPM).