Layanan radioterapi sebagai modalitas penanganan kasus kanker secara komprehensif menjadi permasalahan global atas sebaran yang belum merata dan pengembangan layanan yang memerlukan investasi sumberdaya manusia serta sarana dan prasarana berbiaya tinggi. Pemanfaatan layanan radioterapi yang optimal diharapkan dapat menjadikan layanan tersebut sustainable dan mandiri dalam pembiayaannya. Penelitian ini bertujuan untuk mengetahui strategi optimalisasi pemanfaatan layanan radioterapi yang dikembangkan dalam suatu rencana aksi. Dengan pendekatan kualitatif dilakukan pengolahan data primer dan sekunder melalui tahap input stage dengan matriks IFE dan EFE, matching stage dengan matriks SWOT dan IE Matriks, serta decission stage dengan matriks QSPM. Hasil penelitian didapatkan strategi terpilih meliputi product development, market penetration dan market development. Strategi product development meliputi pengembangan layanan okologi terpadu dalam kemampuan diagnostik, layanan kanker sistemik (kemoterapi) pengembangan cakupan layanan pembedahan dan penyinaran (radiasi), serta penyusunan layanan radioterapi eksekutif. Strategi market penetration meliputi penyusunan jejaring rujukan kanker dan penyusunan kesepakatan kerja sama rujukan radioterapi pada RSUD di Jakarta dan rumah sakit jejaring rujukan. Strategi market development yang dipilih adalah pengembangan pemasaran radioterapi dengan digital marketing, pengukuran capaian pemasaran radioterapi serta promosi layanan rasioterapi dengan menggunakan sistem informasi estimasi waktu tunggu layanan. Rekomendasi hasil penelitian menitik beratkan pada perlunya pengkajian pemanfaatan SDM unit radioterapi dalam penelitian selanjutnya.

Radiotherapy services as a comprehensive cancer case treatment modality are a global problem due to uneven distribution and service development that requires investment in human resources and high-cost facilities and infrastructure. Optimal utilization of radiotherapy services is expected to make these services sustainable and independent in their financing. This study aims to determine the strategy for optimizing the utilization of radiotherapy services developed in an action plan. With a qualitative approach, primary and secondary data processing was carried out through the input stage with the IFE and EFE matrices, the matching stage with the SWOT and IE matrices, and the decision stage with the QSPM matrix. The results of the study obtained selected strategies including product development, namely market penetration and market development. The product development strategy includes the development of integrated oncology services in diagnostic capabilities, systemic cancer services (chemotherapy), development of surgical and radiation (radiation) service coverage, and the preparation of executive radiotherapy services. The market penetration strategy includes the preparation of a cancer referral network and the preparation of a radiotherapy referral cooperation agreement at regional hospitals in Jakarta and referral network hospitals. The chosen market development strategy is the development of radiotherapy marketing with digital marketing, measurement of radiotherapy marketing achievements and promotion of ratiotherapy services using a service waiting time estimation information system. The recommendations of the research results emphasize the need for an assessment of the utilization of radiotherapy unit human resources in further research.

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.

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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.

This study used a quantitative, non-experimental, observational design to assess international student patient satisfaction with healthcare services at Universitas Indonesia Hospital (RSUI), a major academic hospital committed to high-quality, patient-centred care. With a growing international student population relying on RSUI, understanding their service experiences is critical to enhancing care delivery and aligning with international standards. A structured questionnaire was used, combining the SERVQUAL (tangibles, reliability, responsiveness, assurance, empathy) and HEALTHQUAL (safety, efficiency, care improvement) models, along with communication and cultural sensitivity dimensions. A total of 100 international student patients participated between April and May 2025. Data were analysed using descriptive statistics, crosstabulation, and logistic regression. The results showed high satisfaction in the dimensions of tangibility, assurance, and safety. However, empathy and communication were found to have a negative influence on overall satisfaction, indicating key areas that require improvement. A significant relationship was observed between service quality, communication, and patient satisfaction (p < 0.05). These findings underscore the need for strengthening interpreter services, implementing staff training in cultural and communication competence, and improving service workflows. This study contributes new insights to the limited literature on foreign patient satisfaction in Indonesia and offers strategic recommendations to support RSUI in achieving service excellence for international patients.

Latar belakang: Perkembangan teknologi informasi di bidang kesehatan telah mendorong rumah sakit untuk menyelenggarakan Rekam Medis Elektronik (RME) guna meningkatkan mutu pelayanan, efisiensi kerja, dan keselamatan pasien. Kerangka PIECES merupakan kerangka kerja yang mengklasifikasikan masalah, peluang, dan arahan menjadi 6 kategori yang dapat memberikan panduan yang komprehensif dan seluruh faktor penting diperhatikan dalam melakukan evaluasi sehingga dapat diidentifikasi area-area yang membutuhkan perbaikan dan dapat mengukur dampak terhadap organisasi secara menyeluruh dalam evaluasi sistem RME. Penerapan RME di RS Andhika berjalan sejak 2022 namun sampai saat ini belum berjalan maksimal dan masih ditemukan kendala dalam pelaksanaannya seperti formulir yang tidak lengkap, hak akses staf tidak aktif masih ada, adanya dobel rekam medis dan capaian pengisian rekam medis di RS Andhika baru mencapai 93% dengan standar 100%. Tujuan: Penelitian ini bertujuan untuk menganalisis penerapan RME di RSU Andhika Jakarta Selatan menggunakan metode PIECES yang mencakup enam aspek terdiri dari Performance, Information and Data, Economics, Control and Security, Efficiency, dan Service. Metode: Penelitian ini merupakan penelitian kualitatif dengan teknik pengumpulan data dilakukan melalui observasi, wawancara mendalam serta telaah dokumen. Hasil: Hasil menunjukkan bahwa pada aspek Performance, sistem RME telah memberikan informasi yang cukup tetapi masih ditemukan kendala teknis dan kelengkapan data. Information and Data dinilai cukup informatif namun fleksibilitas dan kesesuaian data dengan kebutuhan masih perlu ditingkatkan. Pada aspek Economics, ditemukan tantangan terkait keterbatasan integrasi dan tingginya biaya operasional. Control and Security sudah mengatur hak akses, namun masih ditemukan kelemahan dalam autentikasi pengguna. Efficiency menunjukkan sistem cukup mudah dipelajari namun tidak memberi notifikasi kesalahan. Aspek Service menunjukkan akurasi cukup baik, namun masih terdapat ketidakkonsistenan data di beberapa jenis data. Kesimpulan: Penerapan RME di RS Andhika saat ini belum optimal yang masih diperlukan perbaikan dalam setiap aspek yang mempengaruhi dilihat dari segi Performance, Information and Data, Economic, Control and Security, Efficiency, dan Service dengan melakukan perencanaan, evaluasi, dan monitoring dalam penerapan rekam medis elektronik serta berupaya untuk selalu melakukan perbaikan.

Background: The development of information technology in the health sector has encouraged hospitals to organize Electronic Medical Records (EMR) to improve reciprocal services, work efficiency, and patient safety. The PIECES framework is a framework that classifies problems, opportunities, and directions into 6 categories that can provide comprehensive guidance and all important factors are considered in conducting evaluations so that areas that need improvement can be identified and the impact on the organization as a whole can be measured in the EMR evaluation system. The implementation of EMR at Andhika Hospital has been running since 2022, but until now it has not been running optimally and there are still obstacles in its implementation such as incomplete forms, inactive staff access rights still exist, there are double medical records and the achievement of filling in medical records at Andhika Hospital has only reached 93% with a standard of 100%. Purpose: This study aims to analyze the implementation of EMR at Andhika Hospital, South Jakarta using the PIECES method which includes six aspects consisting of Performance, Information and Data, Economics, Control and Security, Efficiency, and Service. Method: This study is a qualitative study with data collection techniques carried out through observation, in-depth interviews and document review. Results: The results show that in the Performance aspect, the RME system has provided sufficient information but there are still technical constraints and data completeness. Information and Data are considered quite informative but anxiety and alignment of data with needs still need to be improved. In the Economic aspect, challenges were found related to limited integration and high operational costs. Control and Security have regulated access rights, but there are still weaknesses in user authentication. Efficiency shows that the system is quite easy to learn but does not provide error notifications. The Service aspect shows fairly good accuracy, but there is still data inconsistency in several types of data. Conclusion: The implementation of RME at Andhika Hospital is currently not optimal and still needs improvement in every aspect that affects it in terms of Performance, Information and Data, Economic, Control and Security, Efficiency, and Service by planning, evaluating, and monitoring in the implementation of electronic medical records and trying to always make improvements.

Rumah Sakit Pusat Pertamina (RSPP) menghadapi tantangan operasional dalam sistem penyediaan darahnya, yang ditandai dengan tingginya angka pembatalan darah, waktu tunggu layanan yang lama, dan biaya pengadaan eksternal yang signifikan, yang berpotensi menghambat pengembangan layanan unggulan. Penelitian ini bertujuan untuk melakukan analisis pra-kelayakan yang komprehensif terhadap rencana pendirian Unit Pengelola Darah (UPD) di RSPP guna memberikan rekomendasi strategis berbasis bukti. Penelitian ini menggunakan metode studi kasus kualitatif dengan dukungan data kuantitatif. Pengumpulan data dilakukan melalui analisis dokumen, wawancara mendalam dengan pemangku kepentingan utama, dan observasi langsung. Hasil analisis menunjukkan bahwa pendirian UPD dengan klasifikasi Madya sangat layak untuk dilaksanakan. Terdapat potensi permintaan yang sangat besar, dengan proyeksi volume gabungan untuk RSPP dan RS PELNI mencapai 28.093 kantong pada tahun 2025. Proyek ini memerlukan estimasi biaya investasi (CAPEX) sebesar Rp 10,65 miliar dan biaya operasional (OPEX) tahunan sekitar Rp 6,46 miliar. Meskipun memerlukan investasi besar, analisis finansial awal menunjukkan kelayakan yang sangat kuat dengan periode pengembalian (Payback Period) 3,22 tahun, Net Present Value (NPV) positif sebesar Rp 30,05 miliar, dan Internal Rate of Return (IRR) mencapai 34,22%. Disimpulkan bahwa proyek ini layak untuk dilanjutkan ke tahap studi kelayakan (FS) penuh, dengan fokus pada penyusunan desain teknis rinci, analisis finansial mendalam, rencana induk SDM, dan mitigasi risiko utama terkait pendanaan, teknis, sumber daya manusia, dan keberlanjutan pasokan donor.

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Pertamina Central Hospital (RSPP) faces operational challenges in its blood supply system, characterized by high blood cancellation rates, long service turnaround times, and significant external procurement costs, which potentially hinder the development of its centers of excellence. This study aims to conduct a comprehensive pre-feasibility analysis of the plan to establish a Blood Management Unit (UPD) at RSPP to provide evidence-based strategic recommendations. This research employed a qualitative case study method supported by quantitative data. Data was collected through document analysis, in-depth interviews with key stakeholders, and direct observation. The results indicate that the establishment of an Intermediate (Madya) classification UPD is highly feasible. There is significant potential demand, with a projected combined volume for RSPP and PELNI Hospital reaching 28,093 bags in 2025. The project requires an estimated investment cost (CAPEX) of IDR 10.65 billion and annual operational costs (OPEX) of approximately IDR 6.46 billion. Despite the large investment, the preliminary financial analysis shows very strong viability with a Payback Period of 3.22 years, a positive Net Present Value (NPV) of IDR 30.05 billion, and an Internal Rate of Return (IRR) of 34.22%. It is concluded that the project is feasible to proceed to a full Feasibility Study (FS) stage, with a focus on detailed engineering design, in-depth financial analysis, a human resources master plan, and mitigation of key risks related to funding, technical aspects, human resources, and the sustainability of donor supply.