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Inaz Kemala Dewi; Pembimbing: Helen Andriani; Penguji: Puput Oktamianti, Vetty Yulianty Permanasari, Anisah, Evi Yuniawati
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WHO memiliki target untuk mengeliminasi tuberkulosis pada 2035. Pembangunan dunia bebas TB tidak cukup dengan perluasan cakupan penegakkan diagnosis dan pengobatan saja, melainkan butuh sistem kesehatan yang bermutu tinggi di dalamnya. Rumah Sakit Khusus Paru Kabupaten Karawang sebagai rumah sakit rujukan TB di Kabupaten Karawang yang diharapkan dapat membantu eliminasi TB di Kabupaten Karawang. Penelitian ini bertujuan untuk melakukan optimalisasi mutu pelayanan TB dengan menggunakan kombinasi Framework High Quality Health System dan Quality of Tuberculosis Service Assessment. Penelitian ini merupakan penelitian studi kasus dengan pendekatan kualitatif untuk menganalisis mutu pelayanan TB mulai dari segi pondasi sistem pelayanan tuberkulosis, proses perawatan serta dampak mutu pelayanan tuberkulosis. Data primer didapatkan melalui wawancara mendalam dengan pemangku jabatan, penyedia pelayanan kesehatan dan pasien serta observasi lapangan. Data sekunder didapatkan dari data kunjungan, laporan serta SPO yang digunakan dalam pelayanan TB. Hasil penelitian didapatkan bahwa dari segi pondasi sistem pelayanan tuberkulosis masih memiliki kelemahan di aspek penganggaran khusus penanggulangan TB, sosialisasi kebijakan pelayanan TB serta peningkatan jejaring internal dan eksternal. Proses perawatan tuberkulosis yang berjalan masih kurang dari segi komunikasi interaksi pasien-penyedia pelayanan di Instalasi Rawat Inap serta monitoring follow up pasien sehingga mengakibatkan hambatan dalam pelayanan. Sehingga permasalahan dari segi pondasi dan proses perawatan yang bermutu kurang baik memberikan dampak berupa rendahnya angka keberhasilan pengobatan pasien TB serta adanya peningkatan pasien loss to follow up, tidak dievaluasi dan meninggal dunia. Penguatan pondasi sistem kesehatan tuberkulosis disertai implementasi proses perawatan yang berkelanjutan dan terintegrasi akan menghasilkan hasil pengobatan yang baik serta kepuasan bagi pasien.
By 2035, the WHO aims to end TB. Expanding diagnosis and treatment options alone won't be enough to create a world free of TB, but it requires a high-quality health system within it. Karawang Lung Hospital serves as a TB referral hospital and is anticipated to aid in the eradication of TB in Karawang Regency. This study aims to optimize the quality of TB services by using a combination of the High Quality Health System Framework and the Quality of Service Tuberculosis Assessment. This study is a case study with a qualitative approach to analyze the quality of TB services starting from the foundation of the tuberculosis service system, the treatment process and the impact of the quality of tuberculosis services. Primary data were obtained through in-depth interviews with stakeholders, health service providers and patients as well as field observations. Secondary data was obtained from visit data, reports and procedurs used in TB services. The results of the study showed that in terms of the tuberculosis service system, it still has weaknesses in the aspect of special budgeting for TB control, policies on socializing TB services and increasing internal and external networks. The current tuberculosis treatment process is still lacking in terms of patient-service provider interaction in the Inpatient Unit and patient follow-up monitoring resulting in obstacles in service. So that problems in terms of treatment and care processes that are of poor quality have an impact in the form of a low success rate of treatment for TB patients as well as an increase in patient loss to follow-up, not being evaluated and death. Strengthening the foundation of the tuberculosis health system along with implementing a sustainable and integrated treatment process will result in good treatment outcomes and patient satisfaction.
B-2351
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Maya Setyawati; Pembimbing: Puput Oktamianti; Penguji: Masyitoh Bashabih, Helen Andriani, Budi Raharjo, Alvin Kosasih
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Waktu tunggu pelayanan resep di instalasi rawat jalan merupakan salah satu indikator penilaian kinerja instalasi farmasi yang mempengaruhi mutu pelayanan rumah sakit sehingga rumah sakit perlu melakukan upaya agar waktu tunggu pelayanan resep di instalasi rawat jalan dapat memenuhi Standar Pelayanan Minimal (SPM). Melalui metode Lean dengan pendekatan Value Stream Mapping penelitian ini bertujuan untuk mengetahui prosedur pelayanan resep di instalasi rawat jalan RSKO Jakarta, mengidentifikasi value added serta waste yang terjadi sehingga dapat dianalisis faktor penyebab waste yang dapat dicegah melalui rekomendasi usulan perbaikan yang diberikan. Penelitian ini merupakan penelitian kualitatif dengan pengumpulan data yang didapatkan melalui pengamatan dan pencatatan waktu tunggu pelayanan resep obat jadi dan obat racikan di instalasi rawat jalan RSKO Jakarta yang sudah menggunakan e-resep, penggalian informasi secara mendalam kepada informan serta telaah dokumen. Dilakukan pengamatan terhadap 20 resep obat jadi dan 10 resep obat racikan. Pemilihan informan dilakukan menggunakan teknik puposive sampling dan dilakukan wawancara kepada pasien untuk mendapatkan value dari perspektif customer sesuai prinsip dari metode Lean. Data yang didapatkan kemudian dianalisis untuk mendapatkan faktor penyebab lamanya waktu tunggu pelayanan resep menggunakan fishbone diagram kemudian dilakukan sistem skoring dengan menilai aspek urgency, severity serta growth penyebab masalah sehingga dapat dirumuskan prioritas rekomendasi yang perlu dilakukan. Hasil penelitian yang dilakukan pada bulan April-Mei 2023 mendapatkan bahwa rata-rata waktu tunggu pelayanan resep obat jadi adalah 49.25 menit (dengan nilai VAR 17.5%), dan untuk obat racikan 80.2 menit (dengan nilai VAR 33%) yang berarti masih melebihi SPM yang ditetapkan KMK No 128 tahun 2009 (obat jadi < 30 menit, obat racikan < 60 menit). Beberapa faktor penyebab terjadinya waste adalah inefisiensi SDM, sistem inventory farmasi yang belum otomatisasi, kurang optimalnya evaluasi/pemantauan penggunaan obat, tidak adanya sistem pemisahan pelayanan resep IGD dengan instalasi rawat jalan, SPO pelayanan resep yang belum disesuaikan dengan pelaksanaan e-resep dengan penetapan baku mutu respon time setiap proses, jaringan sistem informasi yang sering down/loading berulang dan seringnya interupsi permintaan informasi dari pasien. Diharapkan ke depannya dapat dilakukan strategi perbaikan untuk memperbaiki waktu tunggu pelayanan resep yaitu meningkatkan efisiensi SDM melalui pengaturan agar saat jam sibuk SDM farmasi fokus mengerjakan tupoksi pelayanan resep, adanya fasilitasi sistem inventory farmasi dengan sistem otomatisasi, penerapan sistem evaluasi pemantauan penggunaan obat dengan lebih efektif agar perencanaan pengadaan menjadi lebih akurat, pengaturan pemisahan pelayanan resep dari IGD, penyusunan SPO sesuai dengan pelaksanaan pelayanan resep, pemisahan penggunaan jaringan sistem informasi untuk pelayanan dengan perkantoran serta penyediaan dashboard informasi yang mudah terlihat oleh pasien (visual management)
Analysis of Outpatient Installation Pharmacy Waiting Time at Special Hospital of Drug Addiction Jakarta in 2023 Abstract Prescription services waiting time in outpatient installations is one of the indicators for evaluating the performance of pharmaceutical installations that affects the quality of hospital services. Hospitals need to effort that prescription services waiting time meet the Minimum Service Standards (SPM). Through the Lean method with the Value Stream Mapping approach, this study aims to determine the prescription service procedures at the outpatient installation of RSKO Jakarta, identify value added and non-value added and waste that occurs so that factors that cause waste can be analyzed which can be prevented through the strategy recommendations obtained. This is a qualitative research with data collection obtained through observing and recording the e-prescriptions services waiting time at the RSKO outpatient installation, extracting in-depth information from informants and reviewing documents. Observations were made on 20 concoction medicine recipes and 10 concoction medicine recipes. The selection of informants was carried out using a purposive sampling technique and interviews were conducted with patients to obtain value from the customer's perspective according to the principles of the Lean method. The data obtained is then analyzed to obtain the factors affecting the prescription services waiting time duration using a fishbone diagram then a scoring system is carried out by assessing the urgency, severity and growth aspects of the cause problem so that priority recommendations can be formulated. The results of research conducted in April-May 2023 found that the average waiting time for prescription drug services was 49.25 minutes (VAR 17.5%) and for concoction drugs 80.2 minutes (VAR 33%), which means that it still exceeds the SPM set by KMK No. 128 of 2009 (no concoction drug recipe < 30 minutes, concoction drug recipe < 60 minutes). Some of the factors that cause waste are inefficiency in human resources, pharmaceutical inventory systems that have not been automated, inadequate evaluation/monitoring of drug use, the absence of a separate system for emergency prescription services, prescription service SPO that has not been adjusted with the establishment of prescription response time quality standardsfor each process, networks information system that frequently down/loads repeatedly and patient’s interruption for asking information. It is hoped that in the future an improvement strategy can be carried out to improve the waiting time for prescription services; increasing HR efficiency through arrangements so that during peak hours pharmaceutical HR focuses on working on the duties and functions of prescription services, facilitating a pharmaceutical inventory system with an automated system, implementing an evaluation system for monitoring drug use more effectively so that procurement planning becomes more accurate, regulation separates prescription services from the emergency room, providing SPO in accordance with prescription service implementation, separate the information system network between patient services and office and providing reachable information for pastient (visual management).
B-2338
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Agustina Syahroel; Pembimbing: Sandi Iljanto; Penguji: Jaslis Iljas, Mieke Savitri, Budi Hartono, Deden Sudendi
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Tesis ini membahas hubungan kualitas pelayanan di unit rawat jalan kebidanan dengan loyalitas pasien terhadap Rumah Sakit Umum Daerah Kabupaten Karawang tahun 2013.
Tujuan umum penelitian ini adalah mengetahui faktor penentu loyalitas pasien di Unit Rawat Jalan Kebidanan RSUD Karawang. Penelitian ini merupakan penelitian cross section dengan menggunakan metode kuantitatif dengan melakukan survei terhadap para pasien yang datang di Unit Rawat Jalan Kebidanan. Sifat penelitian ini adalah deskriptif dan verifikatif. Dalam penelitian ini, hipotesis yang akan diuji adalah hubungan antara kualitas pelayanan dengan loyalitas pasien terhadap pelayanan di unit rawat jalan kebidanan RSUD Karawang. Penelitian ini dilakukan dengan metode survey explanatory yang terdiri dari variable bebas yang mewakili kualitas pelayanan kesehatan yang terdiri dari lima subvariabel dan variable terikat yang mewakili loyalitas pasien. Survey ini dilakukan terhadap 100 orang responden melalui pengisian kuesioner yang pernyataan-pernyataannya mewakili variabel-variabel tersebut dengan penilaian menggunakan skala likert. Hasil analisis deskriptif variable kualitas pelayanan dan loyalita sdiperoleh skor rata-rata 3,542 -3,741 yang tergolong kategorip uas/loyal. Hasil analisis korelasi dengan menggunakan korelasi Pearson diperoleh antar variabel yang diteliti semuanya berkorelasi positip bermakna(p<0,001). Hasil analisis penelitian dengan metode Regresi Linier Multipel diperoleh hasil variabel X5 (emphaty) merupakan faktor yang paling kuat berhubungan dengan loyalitas pasien dengan koefisien B = 0,426, kemudian menyusul X2 (responsiveness), X1 (tangible),dan X3 (reliability), sedangkan variabel X4 (assurance) secara multivariabel tidak berhubungan bermakna(p=0,121).
This tesis discusses the relationship beetwen service quality in obstetric out patient unit with patient loyalty in Karawang Public Hospital 2013. The main purpose ofthis research is to find out determinant factor of patient loyalty in obstetric out patient unit in Karawang Public Hospital. This study is a cross sectional study using quantitative method by performing survey to patients who came in obstetric out patient unit. This is a descriptive and verificatives tudy. In this research, hypotesis that will be tested is relationship beetwen service quality in obstetric out patient unit with patient loyalty in Karawang Public Hospital. This study performed with survey explanatory method with independent variable that represent healthy service quality consist of five subvariables and dependent variable that represent patient loyalty. This survey performed to 100 respondents who fill the quesioner consists of that variables above withlikert scale. From analysis variable descriptive service quality and loyalty got score rate 3,542 -3,741 that include satisfied/ loyal category. Correlation analysis using Pearson Correlation shows that all variablehas positive correlation (p<0,001). Research analysis with Multiple Linier Regretion method shows that variable X5 (emphaty) has strongest factor relationship with patient loyalty with B coeffisient= 0,426, then X2 factor (responsiveness), X1 factor (tangible), and X3 factor (reliability), where variable X4 (assurance) with multivariable method has no relationship (p=0,121).
B-1567
Depok : FKM-UI, 2013
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Oka Wilsen Joung; Pembimbing: Wachyu Sulistiadi; Penguji: Adang Bachtiar, Kurnia Sari, Eka Ginanjar, Irmina Suyanti
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Rumah sakit secara tidak langsung memiliki tuntutan dalam menerapkan strategi pemasaran. Bauran pemasaran merupakan model strategi terdiri dari 7P, yaitu product, price, place, promotion, people, process, physical evidence. Rumah Sakit Santo Antonio Baturaja mengalami penurunan tingkat keterisian tempat tidur setelah relokasi pada tahun 2019. Informasi pelayanan belum tersampaikan ke masyarakat, salah satunya pelayanan BPJS padahal Universal Health Coverage di Kabupaten Ogan Komering Ulu (OKU) mencapai 87,67% pada November 2023. Penelitian ini bertujuan menciptakan strategi optimalisasi pemilihan RS Santo Antonio sebagai fasilitas kesehatan rujukan tingkat lanjut (FKRTL) di Kabupaten OKU dengan pendekatan bauran pemasaran. Penelitian mixed method, analisis kuantitatif dengan desain potong lintang dari 100 sampel yang mengisi kuesioner di Fasilitas Kesehatan Tingkat Pertama (FKTP), dilanjutkan analisis kualitatif dengan wawancara mendalam beberapa sampel dan manajemen RS Santo Antonio untuk mengkonfirmasi hasil analisis kuantitatif. Hasil analisis kuantitatif didapatkan promosi, harga, sumber daya manusia, proses, dan bukti fisik memiliki hubungan dengan pemilihan FKRTL. Selanjutnya hasil analisis kualitatif didapatkan permasalahan dan rencana strategi. Strategi optimalisasi sesuai prioritas nilai odds ratio (OR) terbesar meliputi pelatihan dan remunerasi untuk mengoptimalkan kinerja SDM, branding tanpa iur biaya, promosi omnichannel yang konsisten, rekam medis elektronik untuk mempersingkat waktu tunggu, dan membangun citra menerima pasien BPJS walaupun gedung RS bagus.
Hospitals indirectly have demands in implementing marketing strategies. The marketing mix is a strategy model consisting of 7Ps, namely product, price, place, promotion, people, process, physical evidence. Santo Antonio Baturaja Hospital experienced a decrease in bed occupancy rates after relocation in 2019. Information about services has not been conveyed to the public, one of which is BPJS services even though Universal Health Coverage in Ogan Komering Ulu (OKU) Regency reached 87.67% in November 2023. Research This aims to create an optimization strategy for selecting Santo Antonio Hospital as an advanced referral health facility (FKRTL) in OKU Regency using a marketing mix approach. Mixed method research, quantitative analysis with a cross-sectional design from 100 samples who filled out questionnaires at First Level Health Facilities (FKTP), followed by qualitative analysis with in-depth interviews with several samples and the management of Santo Antonio Hospital to confirm the results of the quantitative analysis. The results of the quantitative analysis showed that promotion, price, human resources, processes and physical evidence were related to the selection of FKRTL. Furthermore, the results of the qualitative analysis obtained problems and strategic plans. Optimization strategies according to the priority of the largest odds ratio (OR) value include training and remuneration to optimize HR performance, branding without cost fees, consistent omnichannel marketing, electronic medical records to shorten waiting times, and building an image of accepting BPJS patients even though the hospital building is good
B-2440
Depok : FKM-UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Amelia Rahayu; Pembimbing: Ede Surya Darmawan; Penguji: Adang Bachtiar, Amal Chalik Sjaaf
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Mutu Pelayanan Kesehatan merupakan standar layanan kesehatan untuk individu dan masyarakat yang dapat meningkatkan luaran kesehatan yang optimal. Indikator Nasional Mutu digunakan sebagai tolak ukur dalam mengukur mutu pelayanan kesehatan. Harapan pasien untuk mendapatkan mutu pelayanan yang baik dapat diberikan oleh dokter yang bertugas ketika melayani pasien yang mampu menerapkan kepemimpinan klinis dengan baik. Penelitian ini bertujuan untuk mengetahui hubungan domain-domain kepemimpinan klinis dokter terhadap mutu layanan kesehatan di rumah sakit. Penelitian ini dilakukan dengan metode survei dengan pendekatan kuantitatif. Penelitian dilakukan pada 42 orang dokter umum dan spesialis dengan kuesioner kepemimpinan klinis dokter. Sedangkan mutu layanan kesehatan di Rumah Sakit Izza dilihat pada capaian indikator nasional mutu rumah sakit. Terdapat 5 domain dengan masing-masing 8 dimensi pada kepemimpinan klinis dan 12 indikator nasional mutu yang dianalisis dari 13 total indikator nasional mutu. Pada penelitian ini didapatkan 2 domain kepemimpinan klinis yang berhubungan dengan mutu layanan kesehatan di rumah sakit, yaitu domain kualitas personal dan peningkatan pelayanan. Tiga domain lainnya, yaitu Kerja sama dengan sejawat dan interprofesi, pengelolaan pelayanan, dan penentuan arah pelayanan tidak berhubungan terhadap mutu layanan kesehatan di rumah sakit
Quality of Health Services is a standard of health services for individuals and communities that can improve optimal health outcomes. National quality indicators are used as benchmark in measuring the quality of health services. Patient expectations for good quality of service can be provided by the doctor on duty when serving patients who are able to apply clinical leadership well. This study aims to determine the relationship of physician clinical leadership domains to the quality of health services in hospitals. This study was conducted using a survey method with a quantitative approach. The study was conducted on 42 general practitioners and specialists with a physician clinical leadership questionnaire. While the quality of health services at Izza Hospital is seen in the achievement of national indicators of hospital quality. There are 5 domains with 8 dimensions each in clinical leadership and 12 national quality indicators analyzed from 13 total national quality indicators. In this study, 2 domains of clinical leadership were found to be related to the quality of health services in the hospital, namely the domains of personal quality and service change. The other three domains, namely Collaboration with peers and interprofessionals, managing service, and setting direction are not related to the quality of health services in hospitals.
B-2367
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Ulfia Mutiara Supatmanto; Pembimbing: Amal Chalik Sjaaf; Penguji: Helen Andriani, Purnawan Junadi, Wellya Hartati, Endang Adriyani
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Proses bisnis yang penting dalam organisasi rumah sakit salah satunya adalah manajemen pengelolaan perbekalan farmasi. Manajemen pengelolaan perbekalan farmasi di RSPG Cisarua Bogor melibatkan tim dimulai dari tahapan perencanaan, pengadaan, penyimpanan dan distribusi. Hambatan internal dalam proses perencanaan dan pengadaan perbekalan farmasi merupakan hambatan yang bisa dikendalikan dengan intervensi secara internal dalam proses bisnis di dalam rumah sakit. Penelitian ini fokus pada usulan perubahan sistem manajemen pengelolaan perbekalan farmasi khususnya perencanaan dan pengadaan di internal RSPG Cisarua Bogor. Intervensi dalam proses pengadaan menggunakan lean six sigma sebagai alat bantu evaluasi untuk menentukan titik-titik lemah dalam penelitian ini hanya sampai pada tahap improve. Pengumpulan data menggunakan wawancara mendalam dengan informan yang terkait proses perencanaan dan pengadaan perbekalan farmasi, observasi dan penelusuran dokumen kemudian diakhiri dengan diskusi kelompok untuk menentukan kesepakatan bersama. Hasil penelitian menunjukkan bahwa ketiadaan prosedur tetap dalam proses pengadaan perbekalan farmasi membuat lamanya prosedur berjalan dan tidak ada tolak ukur efisiensi dalam sistem. Alat bantu dalam proses pengadaan perbekalan farmasi juga tidak ada sehingga komunikasi internal antar bagian walaupun dalam satu tim yang sama menjadi rendah. Pada tahapan improve dari lean six sigma menghasilkan usulan perubahan standar operasional prosedur untuk proses pengadaan perbekalan farmasi rutin, penggunaan indikator efisiensi pengadaan dan pemanfaatan ABC VEN sebagai alat bantu dalam proses pengadaan perbekalan farmasi. Usulan perbaikan penggunaan ABC VEN dan indikator efisiensi perencanaan untuk mengatasi waste over production yang teridentifikasi selama proses perencanaan perbekalan farmasi. Usulan penetapan standar operasional prosedur baru yang memuat timeline, alat bantu pengelompokan perbekalan farmasi berdasarkan ABC VEN dan indikator efisiensi pengadaan untuk mengatasi waste waiting dalam proses pengadaan perbekalan farmasi.
One of the important business processes in hospital organizations is the management of pharmaceutical supplies. The management of pharmaceutical supplies management at RSPG Cisarua Bogor involves teams starting from the stages of planning, procurement, storage and distribution. Internal obstacles in the process of planning and procuring pharmaceutical supplies are obstacles that can be controlled by internal intervention in business processes within the hospital. This research focuses on proposed changes in the management system of pharmaceutical supply management, especially planning and procurement within RSPG Cisarua Bogor. Intervention in the procurement process using lean six sigma as an evaluation tool to determine weak points in this study only reached the improvement stage. Data collection used in-depth interviews with informants related to the process of planning and procuring pharmaceutical supplies, observation and document tracing then ended with group discussions to determine mutual agreement. The results showed that the absence of fixed procedures in the process of procuring pharmaceutical supplies made the procedure run longer and there was no benchmark of efficiency in the system. Tools in the process of procuring pharmaceutical supplies are also absent so that internal communication between departments even in the same team is low. At the improve stage of lean six sigma produced proposals for changes to standard operating procedures for routine pharmaceutical supply procurement processes, the use of procurement efficiency indicators and the use of ABC VEN as a tool in the pharmaceutical supply procurement process. Proposed improvements in the use of ABC VEN and planning efficiency indicators to address waste over production identified during the pharmaceutical supply planning process. Proposed establishment of new standard operating procedures containing timelines, tools for grouping pharmaceutical supplies based on ABC VEN and procurement efficiency indicators to overcome waste waiting in the pharmaceutical supply procurement process.
One of the important business processes in hospital organizations is the management of pharmaceutical supplies. The management of pharmaceutical supplies management at RSPG Cisarua Bogor involves teams starting from the stages of planning, procurement, storage and distribution. Internal obstacles in the process of planning and procuring pharmaceutical supplies are obstacles that can be controlled by internal intervention in business processes within the hospital. This research focuses on proposed changes in the management system of pharmaceutical supply management, especially planning and procurement within RSPG Cisarua Bogor. Intervention in the procurement process using lean six sigma as an evaluation tool to determine weak points in this study only reached the improvement stage. Data collection used in-depth interviews with informants related to the process of planning and procuring pharmaceutical supplies, observation and document tracing then ended with group discussions to determine mutual agreement. The results showed that the absence of fixed procedures in the process of procuring pharmaceutical supplies made the procedure run longer and there was no benchmark of efficiency in the system. Tools in the process of procuring pharmaceutical supplies are also absent so that internal communication between departments even in the same team is low. At the improve stage of lean six sigma produced proposals for changes to standard operating procedures for routine pharmaceutical supply procurement processes, the use of procurement efficiency indicators and the use of ABC VEN as a tool in the pharmaceutical supply procurement process. Proposed improvements in the use of ABC VEN and planning efficiency indicators to address waste over production identified during the pharmaceutical supply planning process. Proposed establishment of new standard operating procedures containing timelines, tools for grouping pharmaceutical supplies based on ABC VEN and procurement efficiency indicators to overcome waste waiting in the pharmaceutical supply procurement process.
B-2339
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Setyo Wibudi; Pembimbing: Sandi Iljanto; Penguji: Purnawan Junadi, Pujiyanto, Budi Setianto, Amir H. Mauzzy
Abstrak:
Proses pelayanan pasien lama rawat jalan umum di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita berkaitan dengan waktu tunggu pemeriksaan pasien poliklinik, belum mencapai target standar pelayanan minimal rumah sakit kurang dari 60 Menit. Hal ini mengakibatkan pelayanan menjadi tidak efisien. Metode Lean merupakan suatu metode yang diharapkan dapat meningkatkan efisiensi pada proses pelayanan pasien lama rawat jalan umum. Penelitan kualitatif dengan menggunakan prinsip Lean Thinking untuk menggambarkan alur proses pelayanan pasien lama rawat jalan umum, menghitung Cycle Time dan Lead Time dan menganalisai Waste yang terjadi. Hasil penelitian digambarkan dalam current state value stream mapping menunjukkan bahwa 12% total waktu yang dibutuhkan untuk kegiatan value added sedangkan 88% total waktu layanan merupakan waktu yang digunakan untuk kegiatan non value added (Waste). Usulan perbaikan dengan metode Lean dapat menurunkan presentasi non value added activity.
Kata Kunci : Lean; Non Value Added; Proses pelayanan; Value Added; Waste.
The service process of old patient at outpatient poly services in Rumah Sakit Jantung Dan Pembuluh Darah Harapan Kita related to waiting time examination of the patients, it has not reached the target of minimum service standards for hospital less than 60 minutes. This resulted in services being inefficient. Lean method is a method that is expected to improve efficiency in service process on old patients at outpatient general services. Qualitative research by using the principles of Lean Thinking to illustrate the process flow patient service on old patients at outpatient general services, calculated cycle time and lead time and analyzed waste that occurs. The results of the study are described in the current state value stream mapping showed that 12% of the total time required for value added activities, while 88 % of total service time is the time spent on non-value added activities (Waste). Proposed improvements with Lean methods can reduce non-value added activity presentation.
Keywords: Lean; Non Value Added; Process service; Value Added; Waste
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Kata Kunci : Lean; Non Value Added; Proses pelayanan; Value Added; Waste.
The service process of old patient at outpatient poly services in Rumah Sakit Jantung Dan Pembuluh Darah Harapan Kita related to waiting time examination of the patients, it has not reached the target of minimum service standards for hospital less than 60 minutes. This resulted in services being inefficient. Lean method is a method that is expected to improve efficiency in service process on old patients at outpatient general services. Qualitative research by using the principles of Lean Thinking to illustrate the process flow patient service on old patients at outpatient general services, calculated cycle time and lead time and analyzed waste that occurs. The results of the study are described in the current state value stream mapping showed that 12% of the total time required for value added activities, while 88 % of total service time is the time spent on non-value added activities (Waste). Proposed improvements with Lean methods can reduce non-value added activity presentation.
Keywords: Lean; Non Value Added; Process service; Value Added; Waste
B-1830
Depok : FKM UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Marisi Sihaloho; Pembimbing: Mieke Savitri; Penguji: Puput Oktamianti, Astridd Saraswati
Abstrak:
Tujuan penelitian adalah untuk mengetahui pelaksanaan upaya peningkatan mutu pelayananan di poliklinik spesialis RS Citama. Penelitian dilakukan dengan mengumpulkan informasi sebanyak-banyaknya tentang upaya yang dilakukan untuk peningkatan mutu pelayanan di poliklinik spesialis rumah sakit tersebut selama tahun 2015. Upaya peningkatan mutu pelayanan yang baik adalah dengan menerapkan manajemen mutu terpadu. Keberhasilan upaya peningkatan mutu pelayanan di poliklinik spesialis di rumah sakit ditentukan oleh input yang tersedia, yaitu tenaga, sarana dan prasarana, dana dan metoda yang tersedia, serta bagaimana proses peningkatan itu sendiri berlangsung sehingga pada akhirnya akan mempengaruhi pencapaian atau output. Proses perbaikan mutu yang digunakan melalui langkah-langkah identifikasi sikap karyawan, identifikasi kebutuhan pelanggan, identifikasi masalah, analisis masalah, solusi potensial dan implementasi solusi (Gaspersz, 2003). Wawancara mendalam dilakukan untuk mendapatkan informasi mengenai bagaimana upaya peningkatan mutu pelayanan di poliklinik spesialis RS Citama. Dapat disimpulkan dari penelitian ini bahwa tenaga kesehatan di poliklinik RS Citama jumlahnya belum mencukupi untuk kebutuhan pelayanan di rumah sakit tersebut. Sarana dan prasarana dan metode yang tersedia perlu diperbaiki. Sedangkan dana yang disiapkan untuk upaya peningkatan mutu sudah dialokasi dengan cukup baik. Proses pelaksanaan manajemen mutu terpadu sudah ada tetapi tidak berjalan dengan baik. Kata kunci : mutu pelayanan, poliklinik spesialis, manajemen mutu terpadu This thesis is a study with qualitative research methods towards improving the quality of service of a specialist policlinic Citama Hospital in Bogor during 2015. The purpose of research is to investigate the implementation of quality improvement efforts in the specialist policlinic Citama hospital. The study was conducted by gathering as much information about the efforts made for improving quality of service in the hospital specialist policlinic during 2015. Efforts to improve the quality good service is to implement an integrated quality management. The success of quality of service improvement in specialist policlinic in hospitals is determined by the input provided, namely personnel, facilities, funding and methods are available, and how the upgrade process itself takes place that will ultimately affect the achievement or output. Quality improvement process used through measures employee attitudes identification, identification of customer needs, problem identification, problem analysis, potential solutions and implementation of solutions (Gaspersz, 2003). Depth interviews were conducted to obtain information on how efforts to improve the quality of service in a specialist policlinic Citama hospital. It can be concluded from this study that the health worker at the specialist policlinic Citama hospital was not sufficient for the needs of his number of services at the hospital. Facilities and infrastructure and the available methods need to be improved. While funds are prepared for quality improvement efforts also allocated fairly well. The process of implementing integrated quality management already exists but it is not going well. Key word : quality of service, spesialist policlinic, integrated quality management
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B-1824
Depok : FKM-UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Ni Nyoman Diah Redyardani Sutantri; Pembinbing: Dumilah Ayuningtyas; Penguji: Adang Bachtiar, Vetty Yulianty Permanasari
Abstrak:
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Kesehatan merupakan hak setiap individu untuk mau dan mampu hidup sehat, serta memanfaatkan pelayanan kesehatan. Ketersediaan fasilitas pelayanan kesehatan tentu saja menyumbang salah satu faktor keberhasilan dalam pemerataan pelayanan kesehatan di Indonesia. Pelayanan terapi pengganti ginjal (TPG) di Indonesia juga menghadapi tantangan dari segi pemerataan pelayanan. Permintaan pelayanan dialisis meningkat seiring dengan meningkatnya kejadian Penyakit Ginjal Kronis. Pemerintah melalui Peraturan Menteri Kesehatan (PMK) No. 8 tahun 2022 mengatur agar pasien dengan penyakit ginjal kronis stadium akhir mendapat terapi pengganti ginjal yang merata. Upaya pemerataan pelayanan dialisis ini salah satunya adalah dengan mulai memanfaatkan pelayanan CAPD maka RSUD Kota Bogor perlu melakukan persiapan pelayanan CAPD di instalasi hemodialisa. . Tujuan penelitian ini adalah untuk menganalisis kesiapan dan upaya penyelenggaraan pelayanan CAPD di RSUD Kota Bogor. Jenis penelitian ini adalah penelitian kualitatif dengan pendekatan deskriptif analitik yang digunakan untuk mengkaji lebih dalam mengenai persiapan dan kesiapan RSUD Kota Bogor dalam memberikan pelayanan CAPD. Sebagian besar instrumen penilaian kesiapan pelayanan CAPD di RSUD Kota Bogor berdasarkan PMK no.8 tahun 2022 telah terpenuhi, yaitu sebesasr 81%, namun masih perlu penyiapan sarana dan prasarana serta berkas SPO yang belum terpenuhi agar pelayanan CAPD dapat berjalan. Dengan terpenuhinya persyaratan tersebut maka RSUD Kota Bogor siap memberikan pelayanan CAPD.
Health is the right of every individual to want and be able to live healthily, and utilize health services. The availability of health service facilities certainly contributes to one of the success factors in equitable distribution of health services in Indonesia. Kidney replacement therapy (TPG) services in Indonesia also face challenges in terms of equitable distribution of services. The demand for dialysis services is increasing along with the increasing incidence of Chronic Kidney Disease. The government through Minister of Health Regulation (PMK) No. 8 of 2022 stipulates that patients with end-stage chronic kidney disease receive kidney replacement therapy that is evenly distributed. One of the efforts to equalize dialysis services is by starting to utilize CAPD services, so the Bogor City Hospital needs to prepare for CAPD services at the hemodialysis installation. . The purpose of this study was to analyze the readiness and efforts to provide CAPD services at RSUD Kota Bogor. This type of research is a qualitative research with an analytic descriptive approach that is used to examine more deeply the preparation and readiness of Bogor City Hospital in providing CAPD services. Most of the CAPD service readiness assessment instruments at Bogor City Hospital based on PMK no. 8 of 2022 have been fulfilled, which is 81%, but it is still necessary to prepare facilities and infrastructure as well as SPO files that have not been fulfilled so that CAPD services can run. With the fulfillment of these requirements, Bogor City Hospital is ready to provide CAPD services.
B-2378
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Rachmayasti Rachmat; Pembimbing: Mardiati Nadjib; Penguji: Kurnia Sari, Pujiyanto; Chairulsjah Sjahruddin, Hendro Bakti Wibowo
Abstrak:
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Latar Belakang : Rumah sakit sebagai institusi pelayanan kesehatan memiliki keterbatasan fasilitas dan sumber daya manusia menjadi kendala pelayanan pasien di rumah sakit sehingga pasien memerlukan perpindahan fasilitas kesehatan. Perpindahan pasien membutuhkan kesinambungan pelayanan. RS Meilia mengalami kendala dalam merujuk pasien, dari segi sistem maupun sumber daya manusia. Selain itu belum tercapainya evaluasi rujukan dan evakuasi pasien pada penilaian akses dan kesinambungan pelayanan rumah sakit yang dilakukan oleh surveyor KARS pada April 2023. Metode : penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus yang menganalisis elemen penilaian rujukan di dalam akses dan kesinambungan pelayanan di RS. Meilia pada bulan Mei – Juni 2023. Hasil :Pada proses penentuan dasar peraturan mengenai alur rujukan pada akses dan kesinambungan pelayanan, RS Meilia telah menetapkan dasar-dasar mengenai rujukan, namun masih menggunakan literatur yang sudah kurang relevan dengan saat ini. Pada proses perpindahan pasien masih terkendala tenaga SPGDT yang merangkap pelayanan dan belum optimalnya evaluasi sistem rujukan. Pada transportasi pasien tidak tersedianya fasilitas ambulans yang lengkap. Kesimpulan : RS Meilia telah melakukan proses rujukan berdasarkan elemen-elemen penilaian berdasarkan akses dan kesinambungan pelayanan rumah sakit, namun masih perlu perbaikan-perbaikan dalam proses evaluasi dan optimalisasi fungsi dan wewenang struktur organisasi khususnya pada pengelolaan rujukan.
Background: Hospitals as health care institutions have limited facilities and human resources so that patients need to transfer to other health facilities. Transfer of patients requires continuity of care. Meilia Hospital experienced problems in referring patients, in terms of systems and human resources. In addition, the evaluation of patient referral and evacuation has not yet been achieved in April 2023. Methods: this study uses a qualitative approach with a case study design that analyzes referral assessment elements in access and continuity of services at Meilia Hospital in May - June 2023. Results: In the process of determining the basic regulations regarding the flow of referrals on access and continuity of services, Meilia Hospital still uses literature that is less relevant at this time. In the process of transferring patients, the SPGDT staff also serve as services stff and the evaluation of the referral system has not been optimal. There is no complete ambulance facility for patient transportation. Conclusion: Meilia Hospital has carried out a referral process based on assessment elements based on access and continuity of hospital services, but still needs improvements in the evaluation process and optimizing the functions and authority of the organizational structure, especially in managing referrals.
B-2355
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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