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Maryam Afifah; Pembimbing: Atik Nurwahyuni; Penguji: Prastuti Soewondo, Wachyu Sulistiadi, Evy Febrina Nurpeni, Martha L. Siahaan
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Rumah sakit memerlukan tata kelola yang baik sebagai instansi mandiri yang bergerak di bidang layanan kesehatan. Tata kelola dalam layanan kesehatan tersebut diturunkan bentuk tata kelola klinis yang dirumuskan dalam Clinical Pathway. Clinical Pathway merupakan alur klinis yang mengatur standar pelayanan kesehatan yang diberikan oleh beragam tenaga ahli kesehatan. Kepatuhan terhadap Clinical Pathway juga menjadi tolak ukur mutu rumah sakit yang menjadi salah satu dari 13 indikator mutu nasional. Kepatuhan terhadap Clinical Pathway di RSIA Kenari Graha Medika masih dibawah standar nasional, untuk itu dilakukan analisis terkait gambaran implementasi dan kepatuhan terhadap Clinical Pathway demam dengue di RSIA Kenari Graha Medika. Penelitian ini merupakan penelitian kualitatif dengan melakukan wawancara terhadap 10 informan dan pengambilan data tagihan pasien rawat inap sebagai data sekunder. Data kemudian dilakukan validasi dengan triangulasi data. Hasil peneltian didapatkan kurangnya diskusi tim, sosialisasi, pelatihan dan pendampingan pada proses implementasi Clinical Pathway membuat pengetahuan terkait Clinical Pathway rendah sehingga variasi penggunaan obat dan jumlah pemeriksaan juga masih sering terjadi. Hal ini menjadi salah satu penyebab selisih tarif rumah sakit dengan tarif inacbg. Penelitian ini diharapkan menjadi bahan pertimbangan untuk dilakukan perbaikan sistem pada implementasi Clinical Pathway di RSIA Kenari Graha Medika.
Hospitals require good clinical governance as independent institutions operating of healthcare services. Clinical Governance is manifested in the form of Clinical Pathways, which regulate the standards of healthcare provided by various healthcare professionals. Compliance with Clinical Pathways is also a benchmark for the quality of hospitals, which is one of the 13 national quality indicators. Compliance with Clinical Pathways at RSIA Kenari Graha Medika is below national standards. Therefore, an analysis was conducted regarding the implementation and compliance with the dengue fever Clinical Pathway at RSIA Kenari Graha Medika. This qualitative study involved interviews with 10 informants and the collection of inpatient billing data as secondary data. The data was then validated through data triangulation. The research found that a lack of discussion, socialization, training, and mentoring in the implementation process of Clinical Pathway results in low knowledge related to Clinical Pathway, leading to frequent variations in drug usage and the number of examinations. This is one of the reasons for the discrepancy in hospital rates compared to inacbg rates. This study is expected to be a consideration for improving the system in the implementation of Clinical Pathway at RSIA Kenari Graha Medika.
B-2476
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Selvie Fitria Pinandita; Pembimbing: Wachyu Sulistiadi; Penguji: Adang Bachtiar, Dumilah Ayuningtyas, Evy Febrina Nurpeni, Cholid Yamani
Abstrak:
Latar belakang : Ketidaktercapaian target kunjungan pasien rawat jalan di RSIA Kenari Graha Medika selama 3 tahun terakhir menunjukkan adanya masalah yang perlu segera diatasi. Tidak tercapainya target pasien lama selama periode tersebut mengindikasikan rendahnya minat pasien untuk kembali (repurchase intention). Komunikasi antara dokter dan pasien di unit rawat jalan RSIA Kenari Graha Medika menjadi perhatian karena beberapa kali mendapatkan komplain pasien. Tujuan : untuk mengetahui hubungan keterampilan komunikasi dokter dengan repurchase intention pasien rawat jalan di RSIA Kenari Graha Medika. Metode : Desain penelitian cross sectional dengan jumlah sampel sebesar 152 sampel. Variabel yang diteliti adalah keterampilan komunikasi dokter dihubungkan dengan repurchase intention yang dimediasi oleh variabel customer satisfaction. Analisis data dilakukan dengan analisis univariat (deskriptif) dan multivariat dengan SEM PLS. Hasil : Dari analisis data didapatkan seluruh konstruk dinyatakan valid dan reliabel berdasarkan hasil perhitungan loading factor, AVE dan corbach alpha. Uji hipotesis menunjukkan semua variabel diterima. Kesimpulan : Keterampilan komunikasi dokter berhubungan positif dan signifikan terhadap repurchase intention melalui kepuasan pasien, semakin tinggi keterampilan komunikasi dokter maka semakin tinggi juga repurchase intention. Berdasarkan temuan bahwa keterampilan komunikasi dokter berhubungan signifikan dengan kepuasan pasien dan repurchase intention, penting untuk terus melatih dokter dalam keterampilan komunikasi yang efektif.
Background: The failure to achieve the target for outpatient visits at RSIA Kenari Graha Medika over the last 3 years indicates a problem that needs to be addressed immediately. Not achieving the old patient target during this period indicates the patient's low interest in returning (repurchase intention). Communication between doctors and patients in the RSIA Kenari Graha Medika outpatient unit has become a concern because several times patient complaints have been received. Objective: to determine the relationship between doctors' communication skills and repurchase intention of outpatients at RSIA Kenari Graha Medika. Method: Cross sectional research design with a sample size of 152 samples. The variable studied is the doctor's communication skills which are associated with repurchase intention which is mediated by the customer satisfaction variable. Data analysis was carried out using univariate (descriptive) and multivariate analysis with SEM PLS. Results: From data analysis, it was found that all constructs were declared valid and reliable based on the results of loading factor, AVE and Corbach alpha calculations. Hypothesis testing shows all variables are accepted. Conclusion: Doctors' communication skills are positively and significantly related to repurchase intention through patient satisfaction. The higher the doctor's communication skills, the higher the repurchase intention. Based on the finding that physician communication skills are significantly related to patient satisfaction and repurchase intention, it is important to continue training physicians in effective communication skills.
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Background: The failure to achieve the target for outpatient visits at RSIA Kenari Graha Medika over the last 3 years indicates a problem that needs to be addressed immediately. Not achieving the old patient target during this period indicates the patient's low interest in returning (repurchase intention). Communication between doctors and patients in the RSIA Kenari Graha Medika outpatient unit has become a concern because several times patient complaints have been received. Objective: to determine the relationship between doctors' communication skills and repurchase intention of outpatients at RSIA Kenari Graha Medika. Method: Cross sectional research design with a sample size of 152 samples. The variable studied is the doctor's communication skills which are associated with repurchase intention which is mediated by the customer satisfaction variable. Data analysis was carried out using univariate (descriptive) and multivariate analysis with SEM PLS. Results: From data analysis, it was found that all constructs were declared valid and reliable based on the results of loading factor, AVE and Corbach alpha calculations. Hypothesis testing shows all variables are accepted. Conclusion: Doctors' communication skills are positively and significantly related to repurchase intention through patient satisfaction. The higher the doctor's communication skills, the higher the repurchase intention. Based on the finding that physician communication skills are significantly related to patient satisfaction and repurchase intention, it is important to continue training physicians in effective communication skills.
B-2487
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Febrini Damayanti; Pembimbing: Purnawan Junadi; Penguji: Anhari, Achadi, Ede Surya Darmawan, Syahrul Muhammad, Dante Saksono Harbuwono
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Latar belakang: Di Indonesia, tingkat kunjungan Antenatal Care (ANC) masih mengalami tantangan serius dengan angka yang terus menunjukkan tingkat partisipasi yang sangat rendah atau kepatuhan pemeriksaan yang rendah. Hal ini dipengaruhi oleh predisposing factors, enablings factors, dan reinforcing factors. Seiring perkembangan teknologi, dalam meningkatkan kepatuhan pemeriksaan ANC tersedia layanan telemedicine. Tujuan penelitian: Untuk mengetahui hubungan karakteristik pada pasien pengguna telemedicine dengan pasien kunjungan langsung terhadap kepatuhan pasien kunjungan antenatal care di RSIA Marissa Palembang Metodologi penelitian: Penelitian ini merupakan jenis penelitian mixmethode dengan desain sequential explanatory dengan maksud untuk mengetahui tentang kepatuhan pasien yang menggunakan telemedicine dan yang tidak menggunakan dalam kunjungan rutin antenatal care. Penelitian ini dilaksanakan pada bulan Maret 2024 hingga Mei 2024. Hasil penelitian: Terdapat hubungan yang signifikan antara karakteristik pengetahuan, sikap,kondisi lingkungan, dan dukungan keluarga terhadap kepatuhan pemeriksaan antenatal care pada pasien pengguna telemedicine maupun bukan pengguna telemedicine. Kesimpulan: Telemedicine tidak membuat pasien malas berkunjung, penggunaan telemedicine sangat membantu pasien dengan akses terbatas ke fasilitias kesehatan sehingga program ini direkomendasikan bagi RSIA Marissa sehingga dapat membantu masyarakat dalam hal akses pelayanan kesehatan. Peningkatan faktor enablings dan reinforcing memainkan peran penting dalam meningkatkan angka kepatuhan pemeriksaan antenatal care pada pasien Kata kunci: Telemedicine; Kepatuhan Pasien; Antenatal Care
Background: In Indonesia, the level of Antenatal Care (ANC) visits still faces serious challenges, with participation rates remaining very low and compliance with examinations being inadequate. This situation is influenced by predisposing factors, enabling factors, and reinforcing factors. With the advancement of technology, telemedicine services are available to enhance compliance with ANC examinations. Objective: To determine the relationship between the characteristics of telemedicine users and in-person patients on compliance with antenatal care visits at RSIA Marissa Palembang. Methode: This study is a mixed-method research with a sequential explanatory design, aimed at understanding the compliance of patients using telemedicine versus those not using it in routine antenatal care visits. The research will be conducted from March 2024 to May 2024. Results: There is a significant relationship between the characteristics of knowledge, attitude, environmental conditions, and family support with compliance to antenatal care examinations among both telemedicine users and non-users. Conclusion: Telemedicine does not make patients reluctant to visit; instead, it greatly assists patients with limited access to healthcare facilities. Therefore, this program is recommended for RSIA Marissa to help the community access healthcare services. Enhancing enabling and reinforcing factors plays a crucial role in improving compliance rates for antenatal care examinations among patients. Key Word: Telemedicine; Patient Compliance; Antenatal Care
B-2475
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Astriana; Pembimbing: Wachyu Sulistiadi; Penguji: Puput Oktamianti, Dumilah Ayuningtyas, Herdiana Eta Prananti, Fitria Saftarina
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Meningkatnya tren jumlah Bed Occupancy Rate (BOR) dari tahun ke tahun di Rumah Sakit Graha Husada menjadi kewaspadaan pada kinerja perawat. Penilaian kinerja yang menurun pada tahun 2023 sangat disayangkan oleh manajemen dan dapat berdampak pada pelayanan kesehatan di Rumah Sakit Graha Husada pada masa yang akan datang. Penilaian kinerja yang dapat diukur melalui teori Gibson melalui variabel individu, organisasi, psikologis serta kebugaran perawat merupakan salah satu langkah untuk menilai kualitas kinerja yang bermutu baik. Tujuan penelitian ini untuk mengetahui hubungan variabel individu, organisasi dan psikologis terhadap kinerja perawat di Rumah Sakit Graha Husada Bandar Lampung. Penelitian ini merupakan jenis penelitian metode penelitian kuantitatif dengan menggunakan desain cross sectional dengan tujuan dapat mengetahui besarnya signifikansi faktor-faktor yang berhubungan dengan kinerja perawat. Penelitian ini dilakukan pada bulan Mei 2024 kepada 82 perawat yang bekerja di Rumah Sakit Graha Husada Bandar Lampung. Hasil penelitian menunjukkan terdapat hubungan yang signifikan antara variabel individu dengan p-value 0,0012 < 0,05, kebugaran dengan p-value 0,090 < 0,05, variabel organisasi dengan p-value 0,000 < 0,05 dan variabel psikologis dengan p-value 0,0002 < 0,05 terhadap kinerja perawat dengan nilai OR secara berurutan (3,93), (20,308), dan (5,438). Hasil penelitian menunjukkan bahwa variabel yang memiliki hubungan kuat terhadap kinerja perawat adalah variabel organisasi dan variabel psikiologis, namun dari kedua variabel tersebut variabel yang memiliki hubungan paling kuat terhadap kinerja perawat adalah variabel organisasi. Artinya dengan meningkatnya variabel organisasi maka dapat meningkatkan kinerja perawat di rumah sakit. Sehingga rumah sakit perlu untuk mengembangkan pengelolaan organisasi dengan berbagai cara seperti meningkatkan akses yang memadai, meningkatkan sumber daya fisik yang diperlukan, memperbaiki struktur organisasi dan hirarki kepemimpinan, memperhatikan desain pekerjaan dengan keberagaman tugas dan tantangan serta memperhatikan kepuasan kerja perawat.
The increasing trend in the Bed Occupancy Rate (BOR) year by year at Graha Husada Hospital has raised concerns about the performance of the nurses. The decline in performance ratings in 2023 is regrettable for management and could impact healthcare services at Graha Husada Hospital in the future. Performance assessment, which can be measured through Gibson's theory via individual, organizational, psychological, and wellness variables of the nurses, is one of the steps to evaluate high-quality performance. The aim of this research is to determine the relationship between individual, organizational, and psychological variables on the performance of nurses at Graha Husada Hospital in Bandar Lampung. This study is a type of quantitative research using a cross-sectional design to determine the significance of factors related to nurse performance. The study was conducted in May 2024 with 82 nurses working at Graha Husada Hospital in Bandar Lampung. The results showed a significant relationship between individual variables with a p-value of 0.0012 < 0.05, wellness with a p-value of 0.090 < 0.05, organizational variables with a p-value of 0.000 < 0.05, and psychological variables with a p-value of 0.0002 < 0.05 on nurse performance, with OR values of (3.93), (20.308), and (5.438) respectively. The results indicate that the variables with a strong relationship to nurse performance are organizational and psychological variables, with organizational variables having the strongest relationship to nurse performance. This means that improving organizational variables can enhance nurse performance in the hospital. Therefore, the hospital needs to develop organizational management in various ways, such as increasing adequate access, improving necessary physical resources, refining organizational structure and leadership hierarchy, paying attention to job design with task variety and challenges, and considering nurse job satisfaction.
B-2488
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Tulus Kurnia Indah; Pembimbing: Ede Surya Darmawan; Penguji: Helen Andriani, Rakhmat Hidayat, Nugraharti, Erwien Sri Ujianto
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Latar Belakang: Proses perawatan di rumah sakit didukung oleh berbagai aktivitas operasional diantaranya pengelolaan logistik dan distribusi perbekalan farmasi. Biaya perbekalan kesehatan merupakan pengeluaran terbesar kedua di rumah sakit setelah belanja pegawai, oleh sebab itu pimpinan rumah sakit perlu mengidentifikasi peluang untuk meningkatkan proses logistik untuk menurunkan biaya dan meningkatkan kualitas pelayanan kesehatan. Untuk meningkatan proses logistik diperlukan pemahaman terkait kinerja rantai pasokan yang saat ini berjalan, sehingga melakukan analisa kinerja rantai pasokan merupakan hal mendasar untuk mengatasi kekurangan dalam aktivitas logistik. Tujuan: Studi ini bertujuan melakukan analisa terkait waste yang ada pada proses perencanaan dan pengadaan obat di RSUPN Dr. Cipto Mangunkusumo, kemudian mencari penyebab dan akar masalah timbulnya pemborosan. Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Lokasi penelitian di RSUPN Dr. Cipto Mangunkumo bulan April-Mei 2024. Data primer diperoleh melalui wawancara dengan key specialist informan yang terkait dengan kegiatan perencanaan dan pengadaan dan observasi lapangan. Data sekunder diperoleh dari telaah data realisasi pemakaian obat tahun 2022, data usulan perencanaan dari unit kerja dan hasil rekapitulasi instalasi farmasi tahun 2023, data daftar barang dalam kontrak tahun 2023, datapenerimaan dan data pemakaian obat tahun 2023. Tahapan penelitian disusun berdasarkan lean six sigma dari mulai define, measure, analyze dan improve. Hasil: Jenis waste yang terjadi diantaranya penyedia tidak mengirimkan obat terhadap item perencanaan yang telah memiliki kontrak, obat yang dipesan dan dikirim tetapi tidak memiliki realisasi penggunaan, penyedia bersedia mengirimkan obat tetapi tidak mau berkontrak dengan rumah sakit, penyedia tidak bersedia mengirimkan obat dan tidak mau berkontrak dengan rumah sakit dan adanya pengadaan lain di luar jalur kontrak utama. Dari seluruh waste yang ada terjadinya pengadaan di luar jalur kontrak utama merupakan jumlah waste yang paling sering terjadi sehingga menjadi area improvement pada penelitian ini. Penyebab dari pemborosan yang masih dapat dikontrol oleh internal rumah sakit adalah keterlambatan penerbitan kontrak. Akar masalahnya karena tiap unit kerja yang terkait dengan kegiatan perencanaan dan pengadaan menyelesaikan proses kerja tanpa mempertimbangkan waktu penyelesaian proses sesudahnya, sehingga tujuan dari perencanaan dan pengadaan yang berupa penerbitan kontrak sebelum tahun anggaran menjadi tidak terlaksana. Kesimpulan: Dalam proses yang berjalan secara berkelanjutan diperlukan proses kerja yang terintegrasi berdasarkan komitmen setiap anggota rantai agar tujuan proses tersebut dapat tercapai.
Introduction: The hospital care process is supported by various operational activities including logistics management and distribution of pharmaceutical supplies. The cost of health supplies is the second largest expenditure in hospitals after personnel expenditure, therefore hospital leaders need to identify opportunities to improve logistics processes to reduce costs and improve the quality of health services. To improve logistics processes, an understanding of current supply chain performance is required, so analyzing supply chain performance is fundamental to overcoming deficiencies in logistics activities. Objective: This study aims to analyze waste in the drug planning and procurement at RSUPN Dr. Cipto Mangunkusumo, then looked for the causes and root causes of waste. Method: This research uses qualitative methods with a case study approach. The research location is at RSUPN Dr. Cipto Mangunkumo on April-May 2024. Primary data was obtained through interviews with key specialist informants related to planning and procurement activities and field observations. Secondary data was obtained from a review of drug use in 2022, drug planning proposals from units and results of drug planning recapitulation by pharmaceutical installations in 2023, list of drugs in contracts 2023, drug receive order and drug use in 2023. The research stages were arranged based on lean six sigma method from define, measure, analyze and improve. Results: Types of waste that occur include supplier not sending drugs from planning items that already have a contract, drugs ordered and sent but not having actual use, suppliers willing to send drugs but refusev to contract with the hospital, suppliers refuse to send drugss and refuse to contracts with hospitals and procurements that come from another its main contracts. The procurements that come from another its main contract occurs most frequently, so it is an area of improvement in this research. The cause of waste that can still be internally controlled by the hospital is delays in issuing contracts. The root of the problem is because each unit related to planning and procurement activities completes the process without considering the completion time of the process afterwards, so that the aim of planning and procurement to complete all the procurement contract before end of the year do not achieved. Conclusion: In a process that runs continuously, an integrated work process is needed based on the commitment of each member of the chain so that the process objectives can be achieved.
B-2469
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Efektivitas Pelayanan Sport Clinic dan Orthopedic Centre di Primaya Hospital Bekasi Timur Tahun 2023
Amelia Kusumawardhani Setiawan; Pembimbing: Purnawan Junadi; Penguji: Eka Ginanjar, Arfan Awaloeddin, Melanie Husna
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Sport Clinic adalah salah satu layanan modern dari rumah sakit yang hadir mengikuti perkembangan zaman. Unit ini tersedia untuk menangani berbagai masalah kesehatan terkait dengan aktivitas fisik, terutama olahraga. Sport clinic adalah bagian dari ilmu kedokteran yang berkaitan dengan preventif, kuratif, rehabilitatif dan upaya performa, baik pelaku olahraga non-profesional maupun profesional. Primaya Hospital Bekasi Timur menyediakan solusi untuk cedera olahraga dengan penanganan yang akurat dan tepat, hingga olahragawan dapat melakukan aktivitas olahraga dengan proses pemulihan yang relatif lebih singkat. Penelitian ini bertujuan untuk mengetahui efektivitas pelayanan Sport Clinic & Orthopedic Centre di Primaya Hospital Bekasi Timur. Upaya untuk mendukung kualitas layanan dalam usaha layanan kesehatan, maka perlu didukung oleh clinical outcome, utilisasi, kepuasan pelanggan, dan keuangan. Metode penelitian yang digunakan adalah pendekatan kuantitatif dengan metode cross-sectional study yang dilakukan pada bulan Oktober 2023 – Januari 2024. Analisis efektivitas pelayanan Sport Clinic & Orthopedic Centre ini dilakukan pada data bulan Januari – Desember 2023. Selama tahun 2023 belum dilakukan pengukuran Clinical Outcomes pasien yang berkunjung ke Primaya Hospital Bekasi Timur. Tingkat utilisasi alat medis di Primaya Hospital Bekasi Timur masih rendah. Angka kunjungan pasien di Sport Clinic & Orthopedic Centre semakin meningkat dengan capaian Indeks Kepuasan Pasien sangat baik.
The Sport Clinic represents one of the most contemporary services offered by the hospital, reflecting the institution's commitment to keeping pace with evolving healthcare needs. This unit is available to treat a range of health issues related to physical activity, with a particular focus on sports. The field of sport medicine is a branch of medical science that encompasses a range of activities, including preventive, curative, rehabilitative, and performance-enhancing interventions, for both non-professional and professional athletes. Primaya Hospital Bekasi Timur offers solutions for sports injuries through the provision of accurate and precise treatment, thereby enabling athletes to resume their sporting activities with a relatively shorter recovery period. The objective of this study is to assess the efficacy of the Sport Clinic & Orthopedic Centre services at Primaya Hospital Bekasi Timur. In order to enhance the quality of service in the healthcare sector, it is essential to consider a range of factors, including clinical outcomes, utilisation, customer satisfaction, and financial aspects. The research method employed is a quantitative approach utilising a cross-sectional study methodology, conducted between October 2023 and January 2024. The analysis of the effectiveness of the Sport Clinic & Orthopedic Centre services was conducted on data collected from January to December 2023. In 2023, no measurement of clinical outcomes of patients visiting Primaya Hospital Bekasi Timur was conducted. Furthermore, the utilisation rate of medical equipment at Primaya Hospital Bekasi Timur remains low. However, services at the Sport Clinic & Orthopedic Centre are considered effective, as evidenced by the increasing number of visits and patients per month, coupled with a high Patient Satisfaction Index.
B-2482
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Danil Anugrah Jaya; Pembimbing: Ede Surya Darmawan; Penguji: Ascobat Gani, Dumilah Ayuningtyas, Dewi Sri Rachmawati, Hariyadi Wibowo
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Latar Belakang: Keselamatan pasien merupakan prioritas utama dalam pelayanan kesehatan. Rendahnya tingkat pelaporan insiden keselamatan pasien di Rumah Sakit Harapan Jayakarta menjadi perhatian serius. Leadership WalkArounds diimplementasikan sebagai upaya untuk meningkatkan pelaporan insiden dan memperkuat budaya keselamatan pasien. Tujuan: Penelitian ini bertujuan untuk mengevaluasi efektivitas implementasi Leadership WalkArounds di Rumah Sakit Harapan Jayakarta terhadap persepsi staf tentang komunikasi terbuka, respon tidak menghukum, frekuensi pelaporan insiden, dan umpan balik terkait kesalahan, serta mengidentifikasi hambatan yang mungkin terjadi. Metode: Penelitian ini menggunakan metode campuran dengan pendekatan sequential explanatory. Tahap pertama melibatkan survei kuantitatif terhadap 47 staf Rumah Sakit Harapan Jayakarta untuk mengukur persepsi mereka. Tahap kedua melibatkan wawancara mendalam dengan 5 informan kunci dan telaah dokumen untuk mendapatkan pemahaman yang lebih mendalam. Hasil: Hasil survei menunjukkan bahwa Leadership WalkArounds efektif dalam meningkatkan persepsi staf tentang komunikasi terbuka, respon tidak menghukum, frekuensi pelaporan insiden, dan umpan balik terkait kesalahan. Wawancara dan telaah dokumen mengungkapkan bahwa rendahnya partisipasi dokter, inkonsistensi jadwal pelaksanaan, ketiadaan daftar pertanyaan terstruktur, sistem pelaporan insiden yang masih manual, dan belum optimalnya komposisi dewan pengawas menjadi hambatan dalam implementasi Leadership WalkArounds. Kesimpulan: Leadership WalkArounds efektif dalam meningkatkan budaya keselamatan pasien di Rumah Sakit Harapan Jayakarta. Namun, beberapa hambatan perlu diatasi untuk mengoptimalkan efektivitasnya.
Background: Patient safety is a top priority in healthcare. The low rate of patient safety incident reporting at Harapan Jayakarta Hospital is a serious concern. Leadership WalkArounds were implemented as an effort to improve incident reporting and strengthen the patient safety culture. Objectives: This study aims to evaluate the effectiveness of Leadership WalkArounds implementation at Harapan Jayakarta Hospital on staff perceptions of open communication, non-punitive response, incident reporting frequency, and feedback related to errors, as well as to identify potential barriers. Methods: This study uses a mixed-methods approach with a sequential explanatory design. The first stage involves a quantitative survey of 47 staff at Harapan Jayakarta Hospital to measure their perceptions. The second stage involves in-depth interviews with 5 key informants and document reviews to gain a deeper understanding Results: The survey results show that Leadership WalkArounds are effective in improving staff perceptions of open communication, non-punitive response, incident reporting frequency, and feedback related to errors. Interviews and document reviews reveal that low physician participation, inconsistent implementation schedules, lack of structured question lists, manual incident reporting systems, and a suboptimal board of supervisors composition are barriers to Leadership WalkArounds implementation. Conclusion: Leadership WalkArounds are effective in improving the patient safety culture at Harapan Jayakarta Hospital. However, several barriers need to be addressed to optimize their effectiveness. Keywords: Leadership WalkArounds, patient safety, safety culture, open communication, non-punitive response, incident reporting.
B-2471
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Ratna Ningsih; Pembimbing: Masyitoh; Penguji: Puput Oktamianti, Iing Ichsan Hanafi, Balgis Alzagladi
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Latar Belakang: Waktu tunggu radioterapi merupakan salah satu indikator mutu penting dalam pelayanan onkologi karena keterlambatan memulai terapi dapat memengaruhi luaran klinis, pengalaman pasien, dan mutu layanan rumah sakit. RS Hermina Bekasi mengalami peningkatan kebutuhan layanan radioterapi yang tidak sepenuhnya diimbangi oleh kapasitas pelayanan sehingga menimbulkan antrean dan waktu tunggu yang panjang. Penelitian ini bertujuan menganalisis penerapan Lean Six Sigma dalam mengurangi waktu tunggu radiasi pertama di RS Hermina Bekasi. Metode: Penelitian menggunakan desain operational research dengan pendekatan mixed methods explanatory sequential. Pengumpulan data kuantitatif dilakukan melalui time-motion study terhadap pasien BPJS dengan seluruh diagnosis kanker yang menjalani pelayanan radioterapi sejak konsultasi dokter onkologi radiasi hingga radiasi pertama. Sampel terdiri atas 55 pasien periode pre-intervensi, 55 pasien periode post-intervensi, dan 50 pasien periode control. Data kualitatif diperoleh melalui observasi, telaah dokumen, wawancara, dan Focus Group Discussion. Analisis dilakukan menggunakan pendekatan Lean Six Sigma melalui tahapan DMAIC (Define, Measure, Analyze, Improve, Control), pemetaan alur proses, Value Stream Mapping, identifikasi aktivitas value added dan non-value added, analisis Pareto, Five Whys, serta Statistical Process Control. Hasil: Sebelum intervensi, total lead time pelayanan radioterapi mencapai 70,05 hari, dengan waktu terpanjang pada tahap konsultasi dokter onkologi radiasi hingga CT Simulator sebesar 61,44 hari. Aktivitas value added sebesar 5,87 hari (8,38%), sedangkan aktivitas non-value added sebesar 64,18 hari (91,62%). Waste dominan adalah waiting, terutama menunggu jadwal CT Simulator akibat keterbatasan kapasitas layanan dan ketersediaan slot LINAC. Intervensi yang dilakukan meliputi penambahan LINAC kedua, penambahan dokter spesialis onkologi radiasi, pengembangan dashboard monitoring antrean radioterapi terintegrasi SIMRS, perbaikan SPO penjadwalan pasca CT Simulator menggunakan kartu kontrol pasien, serta standarisasi pelaksanaan PSQA sebelum radiasi pertama. Setelah intervensi, total lead time menurun menjadi 31,05 hari, sedangkan pada tahap control menurun lebih lanjut menjadi 19,60 hari. Aktivitas value added meningkat menjadi 6,15 hari (19,81%) dan aktivitas non-value added menurun menjadi 24,88 hari (80,13%). Hasil control chart menunjukkan variasi proses yang lebih stabil dibandingkan sebelum intervensi. Kesimpulan: Penerapan Lean Six Sigma mampu mengurangi waktu tunggu radiasi pertama dan meningkatkan efisiensi alur pra-terapi radioterapi di RS Hermina Bekasi. Perbaikan terutama terjadi pada tahapan konsultasi hingga CT Simulator sebagai bottleneck utama pelayanan. Kombinasi peningkatan kapasitas, standarisasi proses, penguatan sistem monitoring, dan pengendalian berkelanjutan terbukti efektif dalam mendukung pencapaian indikator mutu prioritas rumah sakit berupa waktu tunggu radiasi pertama ≤30 hari.
Background: Waiting time for radiotherapy is an important quality indicator in oncology services because delays in treatment initiation may adversely affect clinical outcomes, patient experience, and hospital service quality. Hermina Bekasi Hospital has experienced increasing demand for radiotherapy services that has not been fully matched by service capacity, resulting in long waiting lists and prolonged waiting times. This study aimed to analyze the implementation of Lean Six Sigma in reducing waiting time to first radiation treatment at Hermina Bekasi Hospital. Methods: An operational research design with a mixed-methods explanatory sequential approach was employed. Quantitative data were collected through a time-motion study involving BPJS-insured patients with all cancer diagnoses undergoing radiotherapy services from radiation oncology consultation to first radiation treatment. The study included 55 patients in the pre-intervention phase, 55 patients in the post-intervention phase, and 50 patients in the control phase. Qualitative data were obtained through observation, document review, interviews, and focus group discussions. Data were analyzed using the Lean Six Sigma DMAIC framework, process mapping, Value Stream Mapping, value-added and non-value-added analysis, Pareto analysis, Five Whys analysis, and Statistical Process Control. Results: Before the intervention, total radiotherapy service lead time was 70.05 days, with the longest delay occurring between radiation oncology consultation and CT simulation (61.44 days). Value-added activities accounted for 5.87 days (8.38%), while non-value-added activities accounted for 64.18 days (91.62%). The dominant waste was waiting, particularly for CT simulation scheduling, primarily caused by limited service capacity and LINAC slot availability. Interventions included the addition of a second LINAC, recruitment of an additional radiation oncologist, development of a radiotherapy queue monitoring dashboard integrated with the hospital information system, revision of post-CT simulation scheduling procedures using patient control cards, and standardization of PSQA implementation before first radiation treatment. Following the intervention, total lead time decreased to 31.05 days and further decreased to 19.60 days during the control phase. Value-added activities increased to 6.15 days (19.81%), while non-value-added activities decreased to 24.88 days (80.13%). Control chart analysis demonstrated improved process stability compared with the pre-intervention period. Conclusion: Lean Six Sigma implementation successfully reduced waiting time to first radiation treatment and improved the efficiency of the radiotherapy pre-treatment process at Hermina Bekasi Hospital. The most substantial improvement occurred in the consultation-to-CT simulation stage, which was identified as the primary service bottleneck. A combination of capacity expansion, process standardization, monitoring system enhancement, and continuous control proved effective in supporting the hospital’s priority quality indicator of maintaining waiting time to first radiation treatment within 30 days.
Background: Waiting time for radiotherapy is an important quality indicator in oncology services because delays in treatment initiation may adversely affect clinical outcomes, patient experience, and hospital service quality. Hermina Bekasi Hospital has experienced increasing demand for radiotherapy services that has not been fully matched by service capacity, resulting in long waiting lists and prolonged waiting times. This study aimed to analyze the implementation of Lean Six Sigma in reducing waiting time to first radiation treatment at Hermina Bekasi Hospital. Methods: An operational research design with a mixed-methods explanatory sequential approach was employed. Quantitative data were collected through a time-motion study involving BPJS-insured patients with all cancer diagnoses undergoing radiotherapy services from radiation oncology consultation to first radiation treatment. The study included 55 patients in the pre-intervention phase, 55 patients in the post-intervention phase, and 50 patients in the control phase. Qualitative data were obtained through observation, document review, interviews, and focus group discussions. Data were analyzed using the Lean Six Sigma DMAIC framework, process mapping, Value Stream Mapping, value-added and non-value-added analysis, Pareto analysis, Five Whys analysis, and Statistical Process Control. Results: Before the intervention, total radiotherapy service lead time was 70.05 days, with the longest delay occurring between radiation oncology consultation and CT simulation (61.44 days). Value-added activities accounted for 5.87 days (8.38%), while non-value-added activities accounted for 64.18 days (91.62%). The dominant waste was waiting, particularly for CT simulation scheduling, primarily caused by limited service capacity and LINAC slot availability. Interventions included the addition of a second LINAC, recruitment of an additional radiation oncologist, development of a radiotherapy queue monitoring dashboard integrated with the hospital information system, revision of post-CT simulation scheduling procedures using patient control cards, and standardization of PSQA implementation before first radiation treatment. Following the intervention, total lead time decreased to 31.05 days and further decreased to 19.60 days during the control phase. Value-added activities increased to 6.15 days (19.81%), while non-value-added activities decreased to 24.88 days (80.13%). Control chart analysis demonstrated improved process stability compared with the pre-intervention period. Conclusion: Lean Six Sigma implementation successfully reduced waiting time to first radiation treatment and improved the efficiency of the radiotherapy pre-treatment process at Hermina Bekasi Hospital. The most substantial improvement occurred in the consultation-to-CT simulation stage, which was identified as the primary service bottleneck. A combination of capacity expansion, process standardization, monitoring system enhancement, and continuous control proved effective in supporting the hospital’s priority quality indicator of maintaining waiting time to first radiation treatment within 30 days.
T-7604
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nadia Afiyani; Pembimbing: Amal Chalik Sjaaf; Penguji: Ede Surya Darmawan, Purnawan Junadi, Sidhi Laksono Purwowiyoto, Slamet Agus Waluyo
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Implementasi Rekam Medis Elektronik (RME) di berbagai unit rumah sakit, termasuk Intensive Care Unit (ICU), bertujuan untuk meningkatkan efisiensi dan kualitas pelayanan kesehatan. Di RSPAD sendiri implementasi RME telah diimplementasikan sejak bulan September 2023 dan belum pernah dilakukan evaluasi. Evaluasi dari perspektif pengguna sangat penting untuk memahami sejauh mana sistem ini efektif dan diterima oleh para tenaga kesehatan. Penelitian ini menggunakan metode kombinasi kuantitatif dan kualitatif (mixed methods) dengan desain convergent parallel untuk mengevaluasi implementasi penerapan RME berdasarkan perspektif pengguna. Penelitian kuantitatif dan kualitatif dilakukan untuk mendapatkan analisa lebih mendalam mengenai perspektif pengguna RME. Hasil penelitian menunjukkan bahwa implementasi RME di ICU RSPAD Gatot Soebroto secara umum baik. Faktor pimpinan dan budaya organisasi sangat mendukung implementasi ini. Meskipun begitu, dalam implementasinya, masih banyak yang dapat ditingkatkan agar RME dapat mendukung pelayanan.
The implementation of Electronic Medical Records (EMR) in various hospital units, including the Intensive Care Unit (ICU), aims to enhance the efficiency and quality of healthcare services. At Gatot Soebroto Army Central Hospital (RSPAD), the EMR system has been in place since September 2023 and has not yet been evaluated. Evaluation from the users' perspective is crucial to understanding how effective and well-received the system is among healthcare professionals. This study employs a mixed methods approach with a convergen parallel design to evaluate the implementation of EMR from the users' perspective. The quantitative and qualitative data are collected to gain a deeper understanding of EMR users' perspectives. The results indicate that the EMR implementation in the ICU at RSPAD Gatot Soebroto is generally good. Leadership and organizational culture greatly support this implementation. However, many areas remain for improvement to ensure the EMR system can fully support healthcare services.
B-2465
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Wahyu Hapsari; Pembimbing: Mardiati Nadjib
B-782
Depok : FKM-UI, 2004
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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