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Fitri Dwi Anggraini; Pembimbing: Yaslis Ilyas; Penguji: Puput Oktamianti, Anhari Achadi, Irma Rismayanty, Danyel Suryana
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Keselamatan adalah isu fundamental bagi rumah sakit, dimana keselamatan pasien merupakan prioritas utama karena berkaitan dengan kualitas dan nama baik rumah sakit. Pelaksanaan keselamatan pasien di rumah sakit dipengaruhi oleh berbagai faktor, antara lain faktor individu, faktor psikologis dan faktor organisasi. Pada tahun 2021, RSIA Bina Medika telah melakukan pengukuran budaya keselamatan pasien dimana diketahui bahwa budaya keselamatan pasien di RSIA Bina Medika masih tergolong rendah. Selain itu, pada tahun 2021 tercatat telah terjadi 37 insiden keselamatan pasien di RSIA Bina Medika, dimana tercatat telah terjadi 1 kejadian sentinel. Oleh sebab itu, penelitian ini dilakukan untuk mengetahui gambaran penerapan keselamatan pasien di RSIA Bina Medika pada tingkat individu dengan melakukan tela?ah dokumen Ongoing Professional Practice Evaluation (OPPE). Penelitian ini juga dilakukan untuk mengetahui gambaran sikap petugas terhadap keselamatan pasien dan hubungannya, serta gambaran pengetahuan petugas terhadap keselamatan pasien dan hubungannya. Selain itu, penelitian ini dilakukan untuk menemukan strategi yang tepat yang harus dilakukan manajemen rumah sakit dalam rangka meningkatkan keselamatan pasien di RSIA Bina Medika. Penelitian ini adalah penelitian mix method dengan pendekatan cross-sectional, dimana dilakukan survei kuesioner terkait sikap (dengan SAQ-INA) dan pengetahuan, serta wawancara mendalam, Focus Group Discussion (FGD) dan tela?ah dokumen terkait termasuk OPPE bagian Keperawatan tahun 2021. Dari hasil penelitian diketahui bahwa 54% petugas menerapkan keselamatan pasien dengan baik. Lalu, diketahui bahwa 56% petugas bersikap negatif terhadap keselamatan pasien dan 78% petugas berpengetahuan baik. Tidak ada hubungan yang signifikan antara sikap petugas dengan keselamatan pasien, begitu pula pengetahuan (p =1 dan p=0,08). Dari wawancara mendalam diketahui terdapat beberapa kendala dalam pelaksanaan keselamatan pasien di RSIA Bina Medika. Dari FGD didapatkan berbagai strategi peningkatan keselamatan pasien di RSIA Bina Medika yang akan diterapkan kedepannya. Dari keseluruhan penelitian ini diketahui bahwa penerapan keselamatan pasien di RSIA Bina Medika masih belum baik karena terdapat beberapa kendala dalam pelaksanaan keselamatan pasien di RSIA Bina Medika. Mayoritas petugas sudah berpengetahuan baik, namun masih banyak petugas yang bersikap negatif terhadap keselamatan pasien. Selain sikap dan pengetahuan, diketahui banyak faktor lainnya yang juga turut berkontribusi dalam pelaksanaan keselamatan pasien di RSIA Bina Medika.
Safety is a fundamental issue for hospitals, where patient safety is a top priority because it relates to hospital?s quality and reputation. The implementation of patient safety in hospitals is influenced by various factors, such as individual factor, psychological factor and organizational factor. In 2021, RSIA Bina Medika had measured patient safety culture where the result showed that patient safety culture at RSIA Bina Medika was still relatively low. In addition, in 2021 there was 37 patient safety incidents at RSIA Bina Medika, where 1 sentinel incident had been recorded. Therefore, this research was conducted to find out the description of the implementation of patient safety at RSIA Bina Medika at individual level by conducting a review of the Ongoing Professional Practice Evaluation (OPPE) document. This study was also conducted to describe staff?s attitude towards patient safety and its relationship, as well as an overview of the staff's knowledge of patient safety and its relationship. In addition, this research was conducted to find the right strategy that hospital management must implement in order to improve patient safety at RSIA Bina Medika. This research was a mixed method research with a cross-sectional approach, in which a questionnaire survey was carried out regarding attitudes (with SAQINA) and knowledge, as well as in-depth interviews, Focus Group Discussion (FGD) and a review of related documents including the 2021 OPPE of Nursing section. The research results showed that 54% of staff implement patient safety well. Then, it was known that 56% of staff had a negative attitude towards patient safety and 78% of staff had good knowledge. There was no significant relationship between staff?s attitudes and patient safety, as well as knowledge (p = 1 and p = 0.08). From in-depth interviews it was known that there were several obstacles in implementing patient safety at RSIA Bina Medika. From the FGD, various strategies were obtained to improve patient safety at RSIA Bina Medika which will be implemented in the future. From all of this research it was known that the implementation of patient safety at RSIA Bina Medika was still not good because there were several obstacles in implementing patient safety at RSIA Bina Medika. The majority of staffs had good knowledge, but there were still many staffs who had negative attitude towards patient safety. Apart from attitude and knowledge, it was known that there were many other factors that also contribute to the implementation of patient safety at RSIA Bina Medika.
B-2304
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Elsa Adila Ramadhian; Pembimbing: Ede Surya Darmawan; Penguji: Rico Kurniawan, Wachyu Sulistiadi, Ivoni Pollatu, Setiaji
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Transformasi digital di sektor kesehatan menghadirkan tantangan serius terhadap keamanan sistem informasi, terutama di rumah sakit yang menyimpan data pasien bersifat sensitif. Rendahnya kesadaran staf terhadap keamanan informasi dapat meningkatkan risiko kebocoran data dan pelanggaran etika profesional. Penelitian ini bertujuan untuk menganalisis tingkat kesadaran keamanan sistem informasi di kalangan sumber daya manusia RSIA Bina Medika serta memberikan rekomendasi strategi peningkatannya. Penelitian menggunakan pendekatan kuantitatif dengan desain potong lintang dan melibatkan 134 responden yang merupakan sumber daya manusia pengguna rekam medis elektronik. Pengumpulan data dilakukan melalui kuesioner berbasis model Knowledge, Attitude, Behavior (KAB) dan dianalisis secara univariat, bivariat, dan multivariat. Hasil penelitian menunjukkan bahwa 48% responden memiliki tingkat kesadaran sistem informasi rumah sakit yang rendah. Dimensi pengetahuan, sikap, dan perilaku menunjukkan hubungan signifikan terhadap tingkat kesadaran keamanan (masing-masing p < 0,001). Model regresi logistik menunjukkan bahwa perilaku menjadi faktor dominan yang mempengaruhi kesadaran keamanan sistem informasi. Kesimpulan dari penelitian ini adalah bahwa peningkatan kesadaran keamanan sistem informasi tidak hanya memerlukan penguatan aspek pengetahuan dan sikap, tetapi juga pembiasaan perilaku aman melalui pelatihan aktif, audit berkala, dan dukungan kebijakan manajemen rumah sakit.
Digital transformation in the health sector presents serious challenges to information system security, especially in hospitals that store sensitive patient data. Low staff awareness of information security can increase the risk of data leakage and violations of professional ethics. This study aims to analyze the level of information system security awareness among human resources at RSIA Bina Medika and provide recommendations for strategies to improve it. The study used a quantitative approach with a cross-sectional design and involved 134 respondents who were human resources who used electronic medical records. Data collection was carried out through a questionnaire based on the Knowledge, Attitude, Behavior (KAB) model and analyzed univariately, bivariately, and multivariately. The results showed that 48% of respondents had a low level of hospital information system awareness. The dimensions of knowledge, attitude, and behavior showed a significant relationship to the level of security awareness (each p <0.001). The logistic regression model showed that behavior was the dominant factor influencing information system security awareness. The conclusion of this study is that increasing information security awareness requires not only strengthening aspects of knowledge and attitude, but also habituation of safe behavior through active training, periodic audits, and support for hospital management policies.
B-2541
Depok : FKM UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Uyainah Zaini Nasir; Pembimbing: Pujiyanto; Penguji: Adang Bachtiar, Rina. A. Anggorodi, Arjaty Wahidah Daud
B-949
Depok : FKM UI, 2006
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Febi Lenita; Pembimbing: Sandi Iljanto; Penguji: Wahyu Sulistiadi, Moh. Baharuddin, Amila Megraini
Abstrak:
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ABSTRAK Tesis ini bertujuan menganalisis hubungan bauran promosi (word of mouth dan non word of mouth) dengan pengetahuan pasien terkait pelayanan di poliklinik RSIA Budi Kemuliaan. Adapun variabel confounding karakteristik pasien (usia, pendidikan, pekerjaan, penghasilan) juga dianalisis hubungannya dengan pengetahuan tersebut. Jenis penelitian adalah penelitian kuantitatif dengan pendekatan cross sectional. Sampel penelitian terdiri dari 100 responden yang mewakili poliklinik pelayanan berjenjang lantai 2, pelayanan pribadi lantai 3 pagi, dan sore. Hasil penelitian menunjukkan bahwa tidak ada hubungan antara bauran promosi dengan pengetahuan pasien sehingga tidak efektif promosi yang dilakukan terhadap pengetahuan pasien. Hanya variabel confounding pendidikan yang berpengaruh terhadap pengetahuan pasien.
ABSTRACT The aim of this study is to analyze the correlation between promotion mix (word of mouth and non word of mouth) with knowledge related to patient services at polyclinic RSIA Budi Kemuliaan. The confounding variables of patient characteristics (age, education, occupation, income) were also analyzed to do with that knowledge. This type of study is a quantitative study with cross sectional approach. Sample consisted of 100 respondents representing polyclinic 2nd floor, 3rd floor in the morning, and afternoon. The results showed that there was no correlation between patient’s knowledge of the promotion mix with so promotion in polyclinic not efective for patient's knowledge. Only education confounding variables that influence the patient's knowledge.
B-1487
Depok : FKM UI, 2013
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Teguh Kuncoro; Pembimbing: Dumilah Ayuningtyas; Penguji: Amal C. Sjaaf, Purnawan Junadi, Budi Hartono, Amila Megraini
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Keselamatan pasien rumah sakit adalah sistem rumah sakit untuk membuat asuhan pasien lebih aman. Aman dari kemungkinan terjadinya risiko Insiden Keselamatan Pasien (IKP). Keselamatan pasien merupakan bagian dari manajemen risiko klinis rumah sakit. Salah satu tujuan terpenting implementasi sistem keselamatan pasien rumah sakit adalah mencegah dan mengurangi risiko terjadinya Kejadian Tidak Diharapkan (KTD) terkait dengan proses pelayanan kesehatan. Sistem keselamatan pasien rumah sakit di Indonesia masih menghadapi permasalahan dalam implementasinya. Materi sistem keselamatan pasien rumah sakit dalam penerapannya di rumah sakit mengacu pada panduan nasional sistem keselamatan pasien, pedoman pelaporan IKP dan materi Joint Commission International (JCI) yang meliputi International Patient Safety Goals (IPSG) 1sampai dengan 6. Penelitian ini menggunakan pendekatan kuantitatif dengan rancangan cross sectional bertujuan untuk mengetahui bagaimana gambaran pengetahuan, sikap, kualitas kehidupan kerja dan kinerja perawat dalam penerapan sistem keselamatan pasien di rumah sakit berkaitan materi tersebut serta apakah ada hubungan di antara variabel-variabel tersebut. Perawat menjadi subyek penelitian berkaitan dengan proses pelayanan kesehatan kepada pasien di rumah sakit. Hasil penelitian dari 57 responden perawat tentang materi sistem keselamatan pasien menunjukkan nilai pengetahuan subyek klasifikasi baik lebih banyak dibanding klasifikasi kurang, demikian pula sikap perawat menunjukkan klasifikasi baik lebih banyak dibanding klasifikasi kurang, tetapi kualitas kehidupan kerja menunjukkan nilai hampir sama antara klasifikasi baik dengan klasifikasi kurang. Kinerja perawat menunjukkan klasifikasi baik jauh lebih banyak dibanding klasifikasi kurang. Hasil uji statistik dengan Chi-Square Test menunjukkan tidak ada korelasi secara signifikan antara pengetahuan, sikap dan kualitas kehidupan kerja dengan kinerja perawat dalam penerapan Sistem Keselamatan Pasien (SKP) di rumah sakit XY tahun 2011. Dengan uji Fisher Exact Test menunjukkan ada korelasi secara signifikan antara komponen partisipasi dengan kinerja perawat. Direkomendasikan untuk meningkatkan kualitas kehidupan kerja rumah sakit XY dengan memperbaiki cara-cara penyelesaian masalah dengan tidak menyalahkan dan menghukum.
Patient Safety is a system whereby the hospital made a patient?s safer. The safety is in the firm of occurrence patient safety incidents (IKP). Patient Safety can be defined as prevention and amelioration of adverse outcomes or injuries stemming of the health care process in hospital. Patient Safety is a part of clinical risk management hospital. One of the most important purpose the implementation of hospital patient safety system is to prevent and reduce of the risk of the occurence of unexpected events (KTD) associated eith the healthcare process. Patient safety system of hospital in Indonesia still faces problem and implementation substantial system of hospital patient safety in its application in the hospital refering to national patient safety guidance system, reporting guidelines IKP and substantial Joint Commission International (JCI) which includes the International patients Safety Goals (IPSG) 1 to 6. This research using quantitiative approach with cross sectional design aims to know how crosssectional picture of the knowledge, attitude, quality of work life and work performance of the nurse in the application system patient safety related substantial materials. The nurses is a subject the research related to an identify whether any relationship among variables health service to the patient in the hospital. The results of 57 respondents about nurse patient safety system substantial showed the value of knowledge and attitude of a better classification is more than a less classification, however the quality of work life showed that a better classification remains somewhat similiar to a less classification. Work performance of nurses demonstrating well classification is much more on appeal the less classification. The statistical test results with Chi-square test shows there are no significant correlation among knowledge, attitude and quality of work life with the work performance in the implementation of the system of nursing patient safety (SKP) in XY private hospital in 2011. Using Fisher exact test indicate that there is a significant correlation among variables of participations with work performance of a nurse. Recommended for develop of quality of work life of the XY hospital with improve problem solving and no blaming culture.
B-1417
Depok : FKM UI, 2012
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Natalia Suzana; Pembimbing: Adang Bachtiar; Penguji: Wachyu Suilistiadi, Vetty Yulianty Permanasari, Made Koen Virawan, Ida Ayu Oka Purnama Wati
Abstrak:
Keselamatan pasien merupakan hal yang sangat mendasar dalam pelayanankepada pasien di rumah sakit. Sebagai langkah awal dalam upaya meningkatkankeselamatan pasien di rumah sakit adalah dengan mengukur budaya keselamatanpasien. Tujuan penelitian ini adalah untuk mengetahui hubungan kepemimpinantransformasional, kerjasama tim, dan kesadaran individual dengan budaya keselamatanpasien di Rumah Sakit Prima Medika (RSPM) Denpasar. Metode yang digunakanadalah metode campuran (mix method). Pendekatan kuantitatif menggunakan jenispenelitian potong-lintang (cross-sectional). Kuesioner dibagikan kepada sampelsebanyak 218 responden. Pada pendekatan kualitatif dilakukan penelusuran lebih lanjutterhadap hal-hal yang dirasa masih belum terjawab, untuk melengkapi penjelasan hasilpenelitian kuantitatif. Analisis statistik menggunakan Structural Equation Modelling(SEM), dengan program STATA-SE 12.1. Wawancara mendalam dilakukan denganDireksi RSPM dan pegawai yang terkait, untuk konfirmasi hasil penelittian. Hasilanalisis menunjukkan variabel independen yang saling berhubungan yaituKepemimpinan Transformasional, Kesadaran Individual, dan Kerjasama Tim, danketiganya berhubungan secara bemakna dengan variabel dependen BudayaKeselamatan Pasien (p<0,001). Variabel kesadaran individual mempunyai hubunganpaling besar (77,8%) dengan budaya keselamatan pasien dibandingkan variabel lainnya.Disarankan untuk meningkatkan budaya keselamatan pasien di RSPM, maka perludiadakan pelatihan keselamatan pasien secara rutin, meningkatkan komunikasi yangefektif, kompetensi dan kewaspadaan terhadap risiko, belajar dari kesalahan, danevaluasi beban kerja, agar tercipta budaya keselamatan pasien yang diinginkan.Kata kunci: budaya keselamatan pasien, structural equation modeling, kepemimpinantransformasional, kerjasama tim, kesadaran individual.
Patient safety is very basic in the service to patients in the hospital. As a firststep in improving patient safety in hospitals is by measuring the patient's safety culture.The purpose of this research is to know the relationship of transformational leadership,teamwork, and individual awareness to patient safety culture at Prima Medika Hospital(RSPM) Denpasar. The method used is mix method. The quantitative approach usescross-sectional research. Questionnaires were distributed to a sample of 218respondents. In a qualitative approach, further searches on things that remainunanswered, to complement the explanation of the results of quantitative research.Statistical analysis using Structural Equation Modeling (SEM), with STATA-SE 12.1program. In-depth interviews were conducted with the RSPM Board of Directors andrelevant employees, to confirm the results of the study. The results of the analysis showthat the independent variables are Transformational Leadership, Individual Awareness,and Team Cooperation, and all three are related significantly to the dependent variableof Patient Safety Culture (p <0.001). The individual consciousness variable had thegreatest relation (77,8%) with patient safety culture compared to other variable. It isrecommended to improve patient safety culture in RSPM, it is necessary to conductroutine patient safety training, improve effective communication, risk competence andawareness, learn from mistakes, and evaluate workload, in order to create desiredpatient safety culture.Keywords: patient safety culture, structural equation modeling, transformationalleadership, teamwork, individual awareness.
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Patient safety is very basic in the service to patients in the hospital. As a firststep in improving patient safety in hospitals is by measuring the patient's safety culture.The purpose of this research is to know the relationship of transformational leadership,teamwork, and individual awareness to patient safety culture at Prima Medika Hospital(RSPM) Denpasar. The method used is mix method. The quantitative approach usescross-sectional research. Questionnaires were distributed to a sample of 218respondents. In a qualitative approach, further searches on things that remainunanswered, to complement the explanation of the results of quantitative research.Statistical analysis using Structural Equation Modeling (SEM), with STATA-SE 12.1program. In-depth interviews were conducted with the RSPM Board of Directors andrelevant employees, to confirm the results of the study. The results of the analysis showthat the independent variables are Transformational Leadership, Individual Awareness,and Team Cooperation, and all three are related significantly to the dependent variableof Patient Safety Culture (p <0.001). The individual consciousness variable had thegreatest relation (77,8%) with patient safety culture compared to other variable. It isrecommended to improve patient safety culture in RSPM, it is necessary to conductroutine patient safety training, improve effective communication, risk competence andawareness, learn from mistakes, and evaluate workload, in order to create desiredpatient safety culture.Keywords: patient safety culture, structural equation modeling, transformationalleadership, teamwork, individual awareness.
B-1971
Depok : FKM-UI, 2018
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Mas Aditya Soebangil; Pembimbing: Ascobat Gani; Penguji: Adang Bachtiar, Prastuti Soewondo, Danyel Suryana, Supriyantoro
Abstrak:
Kementerian Kesehatan Republik Indonesia merencanakan percepatan digitalisasi di sektor kesehatan, yang salah satunya adalah penerapan rekam medis elektronik di seluruh fasilitas kesehatan. Namun, seperti yang kita ketahui dengan semakin berkembangnya proses digitalisasi di dunia kesehatan, semakin besar pula ancaman terhadap kebocoran data medis. Hingga saat ini belum ada suatu standar terkait praktik keamanan sistem informasi rumah sakit yang diatur dalam regulasi. Pada penelitian ini, standar ISO 27001:2013 digunakan sebagai alat evaluasi penilaian praktik keamanan sistem informasi rumah sakit RSIA Bina Medika. Didapatkan pada hasil penelitan bahwa dari 6 kontrol ISO 27001:2013 yang dipilih (manajemen aset, kontrol akses, perlindungan fisik dan lingkungan, keamanan operasional, keamanan komunikasi dan keamanan sumber daya manusia), 4 diantaranya sudah sesuai dengan standar dan 2 masih belum lengkap. Belum adanya kebijakan terkait pelabelan informasi serta belum adanya pelatihan rutin terkait praktik keamanan sistem informasi kepada pegawai menjadi poin yang belum dilaksanakan oleh rumah sakit. Hal ini membuka risiko ancaman kebocoran data medis terutama terkait dengan pengelolaan data medis secara internal rumah sakit.
Indonesia’s Ministry of Health is currently enacting a plan to further accelerate the digitalization of the healthcare sector. One of the plans is to ensure the application of Electronic Medical Record (EMR) in all healthcare facilities across Indonesia. Though it is known that the further we accelerate digitalization, the higher the risk of data breaches. The current regulations do not state any standard to adopt as a framework for hospital cybersecurity. Thus, this research aims to implement ISO 27001:2013 standards as one of the means to evaluate the practice of hospital cybersecurity at Bina Medika Maternal and Children Hospital. The results are, according to 6 controls chosen in this research (asset management, access control, physical and environmental security, operational security, communication security, and human resources security), that 4 of the controls are practiced according to the standards. 2 controls that are still not practiced according to the standards, lack the practice and regulation regarding information labeling and routine training of the employees regarding the practice hospital cybersecurity. This opens a risk of medical data breach particularly from inside the organization due to the mishandling of medical information by employees.
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Indonesia’s Ministry of Health is currently enacting a plan to further accelerate the digitalization of the healthcare sector. One of the plans is to ensure the application of Electronic Medical Record (EMR) in all healthcare facilities across Indonesia. Though it is known that the further we accelerate digitalization, the higher the risk of data breaches. The current regulations do not state any standard to adopt as a framework for hospital cybersecurity. Thus, this research aims to implement ISO 27001:2013 standards as one of the means to evaluate the practice of hospital cybersecurity at Bina Medika Maternal and Children Hospital. The results are, according to 6 controls chosen in this research (asset management, access control, physical and environmental security, operational security, communication security, and human resources security), that 4 of the controls are practiced according to the standards. 2 controls that are still not practiced according to the standards, lack the practice and regulation regarding information labeling and routine training of the employees regarding the practice hospital cybersecurity. This opens a risk of medical data breach particularly from inside the organization due to the mishandling of medical information by employees.
B-2360
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Lili Susanti; Pembimbing: Ede Surya Darmawan; Penguji: Helen Andriani, Acim Heri Iswanto, Vica Claudia Budiono
Abstrak:
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Proses distribusi obat ke rawat inap merupakan salah satu proses kritis dalam pelayanan rumah sakit yang berpengaruh terhadap kesinambungan terapi dan mutu pelayanan pasien. Di RSIA Bina Medika, proses distribusi obat pasien baru rawat inap masih menghadapi permasalahan berupa panjangnya lead time pelayanan yang disebabkan oleh dominasi aktivitas non value-added, khususnya aktivitas menunggu dan koordinasi lintas unit. Penelitian ini bertujuan untuk menganalisis dan meningkatkan efektivitas waktu distribusi obat ke rawat inap menggunakan pendekatan Lean Six Sigma. Penelitian ini menggunakan desain before–after study dengan kerangka kerja DMAIC (Define, Measure, Analyse, Improve, Control). Pengumpulan data dilakukan melalui observasi langsung dan pencatatan waktu proses pada sistem informasi rumah sakit (SIMRS) terhadap 25 resep pasien baru rawat inap sebelum dan sesudah intervensi. Analisis data meliputi Value Stream Mapping, analisis Pareto, analisis akar masalah menggunakan metode 5 Whys, serta uji statistik non-parametrik Mann–Whitney U. Hasil penelitian menunjukkan bahwa pada kondisi pre-intervensi, aktivitas non value-added mencapai 82,65% dari total waktu proses, dengan pemborosan utama berasal dari aktivitas menunggu perawat ke farmasi dan menunggu verifikasi resep. Rata-rata lead time distribusi obat sebelum intervensi masih tinggi dengan variasi waktu proses yang besar. Setelah dilakukan intervensi berupa penataan ulang alur kerja, perbaikan pembagian tugas tenaga kesehatan, serta penerapan standar operasional prosedur distribusi obat berbasis SIMRS, terjadi penurunan lead time distribusi obat yang bermakna secara statistik (p < 0,05). Penurunan signifikan terutama terjadi pada aktivitas non value-added utama, termasuk menunggu perawat ke farmasi, konfirmasi resep ke dokter, dan aktivitas komunikasi manual, sementara aktivitas value-added tetap stabil. Kesimpulan penelitian ini menunjukkan bahwa penerapan Lean Six Sigma efektif dalam meningkatkan efisiensi proses distribusi obat ke rawat inap sehingga dapat dijadikan pendekatan strategis dalam upaya peningkatan mutu pelayanan farmasi rumah sakit secara berkelanjutan.
The inpatient medication distribution process is a critical component of hospital services that affects the continuity of therapy and overall quality of care. At RSIA Bina Medika, the distribution process for newly admitted inpatients experienced prolonged lead times due to the dominance of non–value-added activities, particularly waiting and cross-unit coordination. This study aimed to analyze and improve the effectiveness of inpatient medication distribution time using the Lean Six Sigma approach. A before–after study design was applied using the DMAIC (Define, Measure, Analyse, Improve, Control) framework. Process time data were collected through direct observation and hospital information system (SIMRS) records from 25 newly admitted inpatient prescriptions before and after the intervention. Data analysis included Value Stream Mapping, Pareto analysis, root cause analysis using the 5 Whys method, and non-parametric statistical testing using the Mann–Whitney U test. The results showed that prior to intervention, non–value-added activities accounted for 82.65% of the total process time, with the main sources of waste being waiting for nurses to collect medications and waiting for prescription verification. The average medication distribution lead time before intervention was relatively high with considerable process variation. Following interventions involving workflow restructuring, improved task allocation among healthcare staff, and the implementation of a SIMRS-based standard operating procedure for medication distribution, a statistically significant reduction in lead time was observed (p < 0.05). Significant reductions were primarily observed in major non–value-added activities, including waiting for nurses, prescription clarification, and manual communication, while value-added activities remained stable. This study concludes that the application of Lean Six Sigma effectively improves the efficiency of inpatient medication distribution and can serve as a sustainable quality improvement strategy for hospital pharmacy services. Keywords: Lean Six Sigma, medication distribution, inpatient, lead time, hospital pharmacy
B-2594
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Muchamad; Pembimbing: Mieke Savitri; Penguji: Dumilah Ayuningtyas, Puput Oktamianti, Budiman Widjaja
Abstrak:
Keselamatan pasien adalah merupakan suatu sistem yang memberikan keamanan asuhan kepada pasien. Keselamatan pasien merupakan masalah yang serius dalam kesehatan masyarakat secara global. Kewajiban setiap fasilitas kesehatan memberikan pelayanan sesuai dengan Standart Prosedur operasional (SPO) keselamatan pasien telah diatur dalam beberapa peraturan dan undang undangyang berlaku. Dalam penelitian sebelumnya telah disampaikan pelaksanaan SPO keselamatan pasien oleh perawat masih rendah. Masih rendahnya pelaksanaan SPO keselamatan pasien oleh perawat di RSIA H amarinda menjadi dasar peneliti melakukan penelitian. Pelaksanaan SPO keselamatan pasien oleh perawat masih rendah disebabkan oleh beberapa faktor. Analisis faktor penyebab menggunakan teori sarana manajemen 5M (Men, Machines, Money, Methods, Materials) sebagai unsur input, dan atas dasar teori sistem yang terdiri dari unsur input,proses,output. Faktor yang menyebabkan kendala dalam pelaksanaan SPO keselamatan pasien rawat inap adalah unsur input 5M, dan unsur proses yang terdiri dari proses perencanaan, pengorganisasian, pelaksanaan, pengawasan, dan evaluasi. Unsur input dan proses adalah faktor yang penting mempengaruhi dalam pelaksanaan kegiatan manajemen. Jenis penelitian ini merupakan penelitian kualitatif dengan menggunakan acuan wawancara mendalam, telaah dokumen dan observasi kesesuaian pelaksanaan SPO keselamatan pasien. Hasil penelitian penyebab rendahnya pelaksanaan SPO keselamatan pasien oleh perawat adalah pada unsur input kurang tersedianya dana, sarung tangan baik dari jumlah dan variasi ukuran, serta sabun pencuci tangan, tidak ada borang komunikasi perawat kepada pasien, materi isi SPO tidak sesuai dengan standart. Pada unsur proses, masih rendahnya komunikasi dan sosialisasi dari pihak manajemen ke perawat dan perawat ke manajemen, kurangnya motivasi dari pihak manajemen, rendahnya komitmen perawat, kurangnya koordinasi antar perawat, rendahnya kedisiplinan perawat, kurangnya pelatihan keselamatan pasien, kurangnya pengawasan oleh tim, belum diadakan evaluasi dan revisi isi dari SPO keselamatan pasien serta evaluasi inadequate policy . Pada unsur output memberikan hasil di observasi kesesuaian pelaksanaan SPO keselamatan pasien oleh perawat di unit rawat inap RSIA H Samarinda masih rendah
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B-2048
Depok : FKM UI, 2019
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Faisal; Pembimbing: Dumilah Ayuningtyas; Penguji: Anhari Achadi, Puput Oktamianti, Edi Kusnadi, Wahyu Hapsari
Abstrak:
Langkah awal membangun keselamatan pasien adalah melakukan penilaianterhadap budaya keselamatan pasien yang mana sebagai panduan dalammenerapkan keselamatan pasien.Penelitian ini di lakuakan di RSIA KurniaCilegon dengan sampel tenaga medis 79 responden yang terdiri dari dokter umum,dokter gigi,dokter spesialis, bidan dan perawat dengan metode kuantitatif potonglintang dengan menggunakan instrument AHRQ mengukur persepsi budayakeselamatan pasien dilanjutkan metode kualitatif ini bertujuan untuk mengetahuifaktor-faktor penghambat dan faktor-faktor pendukung serta mengetahui langkah-langkah upaya peningkatan budaya keselamatan pasien di RSIA Kurnia .Hasilpenelitian ini didapatkan gambaran budaya keselamatan pasien sedang di RSIAKurnia tahun 2015 dengan saran Tim KPRS melakukan sosialisasi tentangkeselamatan pasien, memberikan reward dan selalu mensosialisasikan responnon-punitive terhadap kesalahan, melakukan Inhouse Training keselamatanpasien, menyusun jadwal pertemuan rutin bulanan, dan melakukan investigasidisetiap ruangan dengan melakukan ronde keselamatan pasien secara rutin gunameningkatkan pelaporan insiden keselamatan pasien dan meningkatkan budayakeselamatan di RSIA Kurnia.Kata kunci : budaya keselamatan pasien ; instrument AHRQ; persepsi tenagamedis
The initial step to build patient safety is assessing patient safety culture in whichas a guide in implementing patient safety. The research was done in RSIA KurniaCilegon with a sample of medical personnel 79 respondents consisting of generalpractitioners, dentists, specialists, midwives and nurses with quantitative methodscross-sectional by using instrument AHRQ measure perceptions of patient safetyculture continued qualitative method aims to find out factors inhibiting andsupporting factors and knowing the steps efforts to improve patient safety culturein RSIA Kurnia results of this study, it was shown in patient safety culture is beingRSIA Kurnia 2015 with Tim advice KPRS socialize patient safety, reward andalways socialize a non-punitive response to faults, do Inhouse Training patientsafety, scheduling regular monthly meetings, and conduct an investigation in eachroom to do patient safety rounds regularly to improve the reporting of patientsafety incidents and improve safety culture at RSIA Kurnia.Keywords: patient safety cultur;AHRQ instrument;, medical personnel perception.
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The initial step to build patient safety is assessing patient safety culture in whichas a guide in implementing patient safety. The research was done in RSIA KurniaCilegon with a sample of medical personnel 79 respondents consisting of generalpractitioners, dentists, specialists, midwives and nurses with quantitative methodscross-sectional by using instrument AHRQ measure perceptions of patient safetyculture continued qualitative method aims to find out factors inhibiting andsupporting factors and knowing the steps efforts to improve patient safety culturein RSIA Kurnia results of this study, it was shown in patient safety culture is beingRSIA Kurnia 2015 with Tim advice KPRS socialize patient safety, reward andalways socialize a non-punitive response to faults, do Inhouse Training patientsafety, scheduling regular monthly meetings, and conduct an investigation in eachroom to do patient safety rounds regularly to improve the reporting of patientsafety incidents and improve safety culture at RSIA Kurnia.Keywords: patient safety cultur;AHRQ instrument;, medical personnel perception.
B-1756
Depok : FKM-UI, 2016
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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