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Luh Komang Enggi Lindayani; Pembimbing: Puput Oktamianti; Penguji: Masyitoh, Fajar Manuaba, I Desak Nyoman Yunita Pratiwi
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Latar Belakang: Unit Gawat Darurat (UGD) merupakan unit pelayanan yang membutuhkan tata kelola mutu yang efektif untuk menjamin keselamatan pasien dan kualitas pelayanan. Meskipun sebagian besar indikator mutu UGD RSU Kertha Usada Singaraja telah mencapai target, masih ditemukan beberapa keluhan pasien yang menunjukkan perlunya evaluasi implementasi tata kelola mutu. Tujuan: Menganalisis implementasi tata kelola mutu dalam pencapaian indikator mutu di UGD RSU Kertha Usada Singaraja Tahun 2025–2026 berdasarkan dimensi struktur, proses, dan outcome Model Donabedian. Metode: Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Data diperoleh melalui wawancara mendalam, observasi, dan telaah dokumen terhadap informan yang terdiri atas direktur, komite mutu, pimpinan UGD, penanggung jawab mutu, dokter, perawat, dan apoteker. Analisis dilakukan secara tematik berdasarkan dimensi struktur, proses, dan outcome. Hasil: Dimensi struktur menunjukkan bahwa UGD didukung oleh sumber daya manusia yang kompeten, sarana prasarana yang memadai, serta komitmen manajemen yang kuat. Namun, masih terdapat kendala berupa beban kerja ganda PIC mutu, keterbatasan dukungan radiologi, dan sistem pelaporan mutu yang belum terintegrasi dengan SIMRS. Pada dimensi proses, pelayanan telah berjalan sesuai standar melalui penerapan triase ATS dan START, pelayanan klinis yang berorientasi pada keselamatan pasien, serta monitoring indikator mutu secara berkala. Pada dimensi outcome, sebagian besar indikator mutu berhasil mencapai target yang ditetapkan, termasuk waktu tanggap pelayanan, kemampuan tindakan lifesaving, pengendalian mortalitas, dan pengelolaan komplain pasien. Kesimpulan: Implementasi tata kelola mutu di UGD RSU Kertha Usada telah berjalan dengan baik dan mendukung pencapaian indikator mutu pelayanan. Penguatan integrasi sistem informasi mutu, optimalisasi beban kerja petugas mutu, dan peningkatan dukungan layanan radiologi diperlukan untuk mendukung perbaikan mutu secara berkelanjutan. Kata kunci: tata kelola mutu, indikator mutu, Unit Gawat Darurat, Donabedian, rumah sakit
Background: The Emergency Department (ED) is a healthcare service unit that requires effective quality governance to ensure patient safety and service quality. Although most quality indicators at the Emergency Department of Kertha Usada General Hospital Singaraja have achieved their targets, several patient complaints were still identified, indicating the need to evaluate the implementation of quality governance. Objective: To analyze the implementation of quality governance in achieving quality indicators at the Emergency Department of Kertha Usada General Hospital Singaraja during 2025–2026 based on the structure, process, and outcome dimensions of the Donabedian Model. Methods: This study employed a qualitative approach with a case study design. Data were collected through in-depth interviews, observations, and document reviews involving informants consisting of the hospital director, quality committee representatives, emergency department managers, quality coordinators, physicians, nurses, and pharmacists. Data were analyzed thematically according to the structure, process, and outcome dimensions. Results: The structure dimension demonstrated that the Emergency Department was supported by competent human resources, adequate facilities and infrastructure, and strong management commitment. However, several challenges were identified, including the dual workload of the quality coordinator, limited radiology support, and a quality reporting system that was not yet integrated with the Hospital Management Information System (HMIS). In the process dimension, services were implemented in accordance with established standards through the application of the Australasian Triage Scale (ATS) and START triage system, patient safety-oriented clinical services, and regular monitoring of quality indicators. In the outcome dimension, most quality indicators successfully achieved the established targets, including response time, lifesaving performance, mortality control, and patient complaint management. Conclusion: The implementation of quality governance in the Emergency Department of Kertha Usada General Hospital has been effectively carried out and has supported the achievement of service quality indicators. Strengthening the integration of quality information systems, optimizing the workload of quality personnel, and enhancing radiology service support are necessary to sustain continuous quality improvement.
T-7596
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Gustiane Adriani Dwisari; Pembimbing: Kurnia Sari; Penguji: Wachyu Sulistiadi, Novita Dwi Istanti
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Pelayanan di Instalasi Gawat Darurat (IGD) memegang peran penting dalam menentukan kualitas pelayanan dan keselamatan pasien di rumah sakit. Indikator kinerja IGD, seperti Length of Stay (LOS), yang mengukur lama pasien d IGD dari kedatangan hingga pemulangan atau pemindahan, dapat memengaruhi tingkat kepadatan di IGD. Penelitian ini bertujuan untuk mengidentifikasi alur pelayanan, hambatan, dan akar penyebab masalah terkait LOS di IGD. Pengumpulan data dilakukan pada bulan April-Mei 2024 dengan pendekatan kualitatif studi kasus, berupa observasi pada 30 pasien, wawancara, dan telaah dokumen. Analisis data menggunakan flowchart untuk mengidentifikasi alur pelayanan, Value Stream Mapping untuk mengenali kegiatan bernilai dan menemukan waste, serta The Five Whys untuk menganalisis akar penyebab hambatan. Metode Lean Thinking digunakan untuk menghasilkan alur dan Model BAS (Baseline, Assess, Suggest Solution) dari Model BASICS. Hasil penelitian menunjukkan bahwa alur pelayanan pasien IGD melibatkan lima tahapan; dengan 65,5% waktu pelayanan adalah kegiatan non-value added, 23,4% kegiatan necessary but non-value added, dan 11,1% kegiatan value added, dengan total Lead Time 7 jam 55 menit 29 detik. Dari sisi pasien, waste yang terjadi meliputi waste of waiting (94,9%) dan transportation (5,1%). Bottleneck terjadi pada aktivitas menunggu terdaftar di rawat inap (25,2%), menunggu advis DPJP (22,9%), menunggu hasil pemeriksaan penunjang (22,3%), dan menunggu kesiapan rawat inap (18,2%), dengan total 88,6%. Perbaikan LOS di IGD dapat menggunakan lean tools seperti standardized work, visual management, heijunka, kaizen, dan just in time agar waste dapat dikurangi.
Emergency Department (ED) services play a crucial role in determining the quality of care and patient safety in hospitals. Performance indicators in the ED, such as Length of Stay (LOS) which measures the duration from a patient's arrival to their discharge or transfer can significantly impact the congestion levels in the ED. This study aims to identify the service flow, obstacles, and root causes of issues related to LOS in the ED. Data collection was conducted from April to May 2024 using a qualitative case study approach, including observations of 30 patients, interviews, and document reviews. Data analysis involved using flowcharts to identify the service flow, Value Stream Mapping to recognize value-added activities and identify waste, and The Five Whys to analyze the root causes of obstacles. Lean Thinking methodology was applied to develop a service flow and the BAS (Baseline, Assess, Suggest Solution) model from the BASICS model. The study results show that the patient service flow in the ED involves five stages, with 65.5% of service time consisting of non-value-added activities, 23.4% of necessary but non-value-added activities, and 11.1% of value-added activities, resulting in a total lead time of 7 hours, 55 minutes, and 29 seconds. From the patient's perspective, the waste observed includes waiting (94.9%) and transportation (5.1%). Bottlenecks were identified in activities such as waiting to be registered for inpatient care (25.2%), waiting for specialist advice (22.9%), waiting for the results of supporting examinations (22.3%), and waiting for inpatient readiness (18.2%), totaling 88.6%. Improving LOS in the ED can utilize lean tools such as standardized work, visual management, heijunka, kaizen, and just-in-time to reduce waste.
S-11692
Depok : FKM UI, 2024
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Via Aulia Effendi; Pembimbing: Septiara Putri; Penguji: Puput Oktamianti, Novita Dwi Istanti
Abstrak:
Tujuan penelitian ini yaitu untuk menganalisis gambaran indikator mutu Unit Rekam Medis RSUI tahun 2020. Penelitian ini merupakan penelitian deskriptif dengan menggunakan metode wawancara, observasi, pengisian matriks (MIV)/C dan telaah dokumen. Penelitian ini menggunakan pendekatan sistem yang meliputi elemen input, process, dan output. Hasil penelitian ini menunjukkan gambaran kesesuaian indikator mutu rekam medis RSUI dengan Standar Pelayanan Minimal (SPM) Rumah Sakit (Keputusan Menteri Kesehatan Nomor 129/Menkes/SK/II/2008) serta memberikan alteranatif penyelesaian masalah (solusi) untuk menjaga dan meningkatkan capaian mutu pelayanan rekam medis di Rumah Sakit Universitas Indonesia.
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S-10792
Depok : FKM UI, 2021
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Malikah Bilqis; Pembimbing: Vetty Yulianty Permanasari; Penguji: Adang Bachtiar, Novita Dwi Istanti
Abstrak:
Pengelolaan limbah padat Bahan Berbahaya dan Beracun (B3) di fasilitas kesehatan sangatlah penting karena berdampak signifikan terhadap kualitas pelayanan dan kesehatan lingkungan. Berdasarkan data statistik lingkungan hidup Indonesia pada tahun 2022 fasilitas pelayanan kesehatan menyumbang 726.817 ton limbah bahan beracun dan berbahaya (B3) dan hanya 48.464 ton limbah yang dikelola. Rumah Sakit Universitas Indonesia (RSUI) memiliki indikator mutu untuk menilai kesesuaian pengelolaan limbah padat B3 dengan peraturan yang berlaku, namun target pencapaian indikator tersebut belum terpenuhi selama tahun 2024. Penelitian ini dilakukan dengan wawancara mendalam, observasi, dan telaah dokumen. Kemudian, informasi yang diperoleh dianalisis menggunakan Root Cause Analysis (RCA) untuk diketahui akar permasalahannya. Indikator mutu pengelolaan limbah padat B3 di RSUI terdiri dari beberapa kriteria berdasarkan proses pengelolaannya, yaitu minimasi, pemilahan dan pewadahan, pengumpulan, penyimpanan, serta pengangkutan limbah padat B3. Berdasarkan hasil penelitian, ditemukan lima akar masalah penyebab tidak tercapainya indikator mutu pengelolaan limbah padat B3 RSUI. Pertama, sosialisasi tidak dilakukan secara rutin, melainkan didasari karena penurunan kesadaran pegawai untuk melakukan pemilahan limbah medis. Kedua, pengadaan tempat sampah ukuran besar bukan merupakan prioritas. Ketiga, anggaran terbatas dalam pemenuhan kebutuhan tenaga CSO. Keempat, proses perbaikan timbangan oleh unit sarana dan prasarana memakan waktu yang lama. Kelima, manajemen gudang farmasi dalam mengelola pemasukan obat kurang optimal.
Management of Hazardous and Toxic Solid Waste in healthcare facilities is crucial as it significantly impacts service quality and environmental health. According to Indonesia’s 2022 environmental statistics, healthcare facilities contributed 726,817 tons of hazardous and toxic waste, but only 48,464 tons were managed. Universitas Indonesia Hospital (RSUI) has established quality indicators to assess the compliance of hazardous solid waste management with applicable regulations. However, the target for achieving these indicators was not met throughout 2024. This study employed in-depth interviews, observations, and document reviews. The information obtained was then analyzed using Root Cause Analysis (RCA) to identify the root causes of the issues. The quality indicators for hazardous and toxic solid waste management at RSUI comprise several criteria based on the management process: minimization, segregation and containment, collection, storage, and transportation of hazardous and toxic solid waste. The study revealed five root causes for the failure to meet the quality indicators for hazardous and toxic solid waste management at RSUI. First, socialization efforts are not conducted regularly but are only triggered by a decline in employee awareness regarding medical waste segregation. Second, the procurement of large trash bins is not prioritized. Third, the budget is limited for meeting the demand for cleaning service officers (CSOs). Fourth, the repair process for weighing scales by the facility unit takes a long time. Lastly, pharmacy warehouse management for incoming medication is not optimized.
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Management of Hazardous and Toxic Solid Waste in healthcare facilities is crucial as it significantly impacts service quality and environmental health. According to Indonesia’s 2022 environmental statistics, healthcare facilities contributed 726,817 tons of hazardous and toxic waste, but only 48,464 tons were managed. Universitas Indonesia Hospital (RSUI) has established quality indicators to assess the compliance of hazardous solid waste management with applicable regulations. However, the target for achieving these indicators was not met throughout 2024. This study employed in-depth interviews, observations, and document reviews. The information obtained was then analyzed using Root Cause Analysis (RCA) to identify the root causes of the issues. The quality indicators for hazardous and toxic solid waste management at RSUI comprise several criteria based on the management process: minimization, segregation and containment, collection, storage, and transportation of hazardous and toxic solid waste. The study revealed five root causes for the failure to meet the quality indicators for hazardous and toxic solid waste management at RSUI. First, socialization efforts are not conducted regularly but are only triggered by a decline in employee awareness regarding medical waste segregation. Second, the procurement of large trash bins is not prioritized. Third, the budget is limited for meeting the demand for cleaning service officers (CSOs). Fourth, the repair process for weighing scales by the facility unit takes a long time. Lastly, pharmacy warehouse management for incoming medication is not optimized.
S-11816
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Devina Nafis Alodia; Pembimbing: Vetty Yulianty Permanasari; Penguji: Wachyu Sulistiadi, Novita Dwi Istanti
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Pelayanan kesehatan berkualitas merupakan komponen esensial dalam mewujudkan masyarakat sehat dan sejahtera, dengan rumah sakit sebagai fasilitas utama dalam menyediakan layanan medis yang efektif dan efisien. Berdasarkan Undang-Undang No. 17 Tahun 2023, rumah sakit diharuskan untuk terus meningkatkan mutu pelayanan baik secara internal maupun eksternal melalui berbagai indikator. Salah satu alat evaluasi penting dalam peningkatan mutu ini adalah Indikator Nasional Mutu (INM), yang digunakan untuk menilai capaian mutu pelayanan di berbagai fasilitas kesehatan. Meskipun INM berperan besar dalam memperbaiki kualitas layanan dan efisiensi biaya, capaian INM di rumah sakit Indonesia masih mengalami kendala, terutama terkait kepatuhan dan infrastruktur yang belum merata. Penelitian ini bertujuan untuk menganalisis capaian INM rumah sakit di Indonesia pada Juni 2024 berdasarkan status kepemilikan, kelas rumah sakit, jenis pelayanan, dan wilayah regional. Metode yang digunakan adalah penelitian potong lintang dengan analisis data sekunder dari basis data Kementerian Kesehatan Indonesia. Hasil penelitian menunjukkan rumah sakit pemerintah dan swasta memiliki perbedaan signifikan dalam beberapa indikator, dengan rumah sakit pemerintah cenderung lebih unggul. Rumah sakit kelas A dan B memiliki capaian lebih baik dibandingkan kelas C dan D, namun tantangan terkait terhadap waktu tanggap operasi sesarea emergensi dan waktu tunggu rawat jalan masih ada, terutama di kelas rendah. Capaian mutu rumah sakit di wilayah Jawa dan Bali lebih baik dibandingkan Indonesia Timur, hal ini dipengaruhi oleh kesenjangan sumber daya dan infrastruktur.
Quality healthcare services are essential for achieving a healthy and prosperous society, with hospitals playing a central role in delivering effective and efficient medical care. According to Law No. 17 of 2023, hospitals are required to continually improve the quality of their services both internally and externally through various indicators. One of the key tools for evaluating quality improvement is the National Health Service Quality Indicators (INM), which assess the performance of healthcare facilities. While INM plays a critical role in enhancing service quality and cost-efficiency, the achievments of INM in Indonesian hospitals faces challenges, particularly related to compliance and uneven infrastructure. This study aims to analyze the achievements of the National Hospital Quality Indicators (INM) in Indonesian hospitals as of June 2024, based on ownership status, hospital class, service type, and regional location. The study uses a cross-sectional design with secondary data analysis sourced from the Ministry of Health of Indonesia’s database. The findings reveal significant differences between government and private hospitals in several indicators, with government hospitals generally performing better. Hospitals in class A and B achieved better quality outcomes compared to those in class C and D, although challenges remain in emergency cesarean section response times and outpatient wait times, particularly in lower-class hospitals. Furthermore, hospitals in the Java and Bali regions demonstrated better quality outcomes compared to those in Eastern Indonesia, with disparities in resources and infrastructure being key influencing factors.
S-11812
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Nur Afiyah; Pembimbing: Dumilah Ayuningtyas; Penguji: Adang Bachtiar, Vetty Yulianty Permanasari, Imam Budi hartono, Ira Irianti
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Tata Kelola Mutu Puskesmas merupakan pengelolaan terhadap tingkat layanan kesehatan untuk individu dan masyarakat yang dapat meningkatkan luaran kesehatan yang optimal. Penjaminan terhadap mutu puskesmas dilakukan akreditasi setiap 5 tahun sekali. Penerapan tata kelola mutu melalui tiga komponen yaitu struktur/input, proses dan output. Input terdiri dari sumber daya manusia, sarana dan prasarana, ketersediaan anggaran, komitmen pimpinan dan staf, serta pengorganisasian. Pada Proses menggunakan USEPDSA (Understanding Quality Improvement Needs, State the quality Problem, Evaluate the root cause, plan the solution, Do or Implement the solution, Study the solution and Action), dan output melihat keberhasilan peningkatan capaian Indikator Nasional Mutu yang ditetapkan oleh Kementerian Kesehatan. Penelitian ini menggunakan pendekatan kualitatif dengan design studi kasus, menggunakan metode wawancara mendalam, observasi dan telaah dokumen. Wawancara mendalam dilakukan pada informan kunci pada Dinas Kesehatan Kota Depok dan kementerian Kesehatan, informan utama pada kepala puskesmas dan penanggung jawab mutu di enam puskesmas kota Depok, dan informan pendukung pada pasien puskesmas tersebut. Enam puskesmas terdiri dari tiga puskesmas yang sudah terakreditasi dan tiga puskesmas yang belum terakreditasi. Hasil penelitian pada faktor input sudah berjalan namun beberapa faktor tidak sesuai standar, faktor SDM secara kuantitas dan kualitas tidak sesuai, kurangnya anggaran, kurangnya komitmen staf dan pengorganisasian tim mutu khususnya bagi tiga puskesmas yang belum terakreditasi. Pada faktor proses USEPDSA belum berjalan yaitu pada proses Do/pelaksanaan pengukuran INM belum sesuai, pada Study/ evaluasi pembelajaran belum dilakukan monitoring evaluasi secara berkala dan kaji banding, Pada proses Act / standarisasi belum dilakukan. Pada faktor Output, capaian prioritas INM tahun 2022 dan 2023 tidak terjadi peningkatan. Kesimpulan tata kelola mutu dalam pencapaian Indikator Nasional Mutu (INM) belum diimplementasikan secara optimal. Pemenuhan faktor input dan optimalisasi proses perlu diupayakan dengan dukungan dari Dinas Kesehatan.
Puskesmas Quality Management is the management of the level of health services for individuals and communities that can improve optimal health outcomes. Assurance of the quality of the puskesmas is accredited every 5 years. Implementation of quality governance through three components, namely structure/input, process and output. Input consists of human resources, facilities and infrastructure, budget availability, leadership and staff commitment, and organization. The process uses USEPDSA (Understanding Quality Improvement Needs, State the quality Problem, Evaluate the root cause, plan the solution, Do or Implement the solution, Study the solution and Action), and the output shows the success in increasing the achievement of the National Quality Indicators which are indicators from the Ministry of Health. This study used a qualitative approach with a case study design, using in-depth interviews, observation and document review. In-depth interviews were conducted with key informants at the Depok City Health Office and the Ministry of Health, key informants at the heads of puskesmas and those in charge of quality at six puskesmas in Depok, and supporting informants at the puskesmas patients. The six puskesmas consist of three accredited puskesmas and three that have not been accredited. The results of research on input factors have been running but not optimal, human resources in quantity and quality are not optimal, lack of budget, lack of staff commitment and quality team organization, especially for three health centers that have not been accredited. The USEPDSA process factor has not been running, namely the Do/Implementation process of INM measurement is not appropriate, the Study/learning evaluation has not been carried out periodic monitoring and comparative studies, and the Act/standardization process has not been carried out. In the Output factor, INM's priority achievements in 2022 and 2023 have not increased. The conclusion of quality governance in achieving National Quality Indicators (INM) has not been implemented optimally. Compliance with input factors and process optimization needs to be pursued with support from the Health Office.
T-6653
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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I Wayan Parna Arianta; Pembimbing: Atik Nurwahyuni;Penguji: Ede Surya Darmawan, R. Sutiawan; Agus Rahmanto; Tutik Kusumawardhani
B-2017
Depok : FKM-UI, 2018
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Clara Josephine Ayal; Pembimbing: Dumilah Ayuningtyas; Penguji: Ugi Sugiri, Mieke Savitri
S-9534
Depok : FKM UI, 2017
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Dwi Susi Andriani; Pembimbing: Mieke Savitri; Penguji: Wachyu Sulistiadi, Aenul Wardah
S-5991
Depok : FKM-UI, 2010
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Winona Maritza Arianty; Pembimbing: Masyitoh; Penguji: Dumilah Ayuningtyas, Adhika Putra Marsaban
Abstrak:
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Latar belakang: Instalasi Gawat Darurat (IGD) berperan penting sebagai garda terdepan dari rumah sakit sehingga harus terus mempertahankan mutu pelayanannya. Tingginya angka kunjungan IGD seringkali didominasi oleh pasien triase hijau. Hal ini menunjukkan bahwa pasien telah menjadi konsumen aktif yang terbentuk dari serangkaian faktor preferensi. Aspek preferensi perlu dianalisis untuk menentukan strategi yang tepat dalam memasarkan serta meningkatkan mutu pelayanan. Tujuan Penelitian: Penelitian ini menganalisis hubungan antara preferensi pasien dengan faktor-faktornya. Metodologi Penelitian: Penelitian ini menggunakan metode kuantitatif dengan desain cross-sectional. Data yang terkumpul merupakan data primer dengan menyebarkan kuesioner. Hasil Penelitian: Pasien memiliki preferensi tinggi terhadap IGD RSPP. Analisis bivariat menunjukkan bahwa faktor lingkungan fisik, lokasi, kualitas pelayanan, SDM, reputasi RS berhubungan signifikan dengan preferensi. Sementara itu, hasil analisis multivariat menunjukkan bahwa faktor lokasi, kualitas pelayanan, dan asuransi kesehatan berhubungan signifikan dengan preferensi. Faktor yang berpengaruh paling kuat adalah kualitas pelayanan. Temuan ini menegaskan pentingnya meningkatkan mutu dengan memerhatikan preferensi pasien agar sesuai dengan kebutuhan dan harapan mereka.
Background: The Emergency Department (ED) plays an important role as the front line of a hospital and must therefore maintain the quality of its services. The high number of ER visits is often dominated by green triage patients. This shows that patients have become active consumers shaped by a series of preference factors. Preference aspects need to be analyzed to determine the right strategy in marketing and improving service quality. Research Objective: This study analyzes the relationship between patient preferences and their factors. Research Methodology: This study uses a quantitative method with a cross-sectional design. The data collected is primary data obtained by distributing questionnaires. Research Results: Patients have a high preference for the RSPP ED. Bivariate analysis shows that physical environment, location, service quality, human resources, and hospital reputation are significantly related to preferences. Meanwhile, multivariate analysis shows that location, service quality, and health insurance are significantly related to preferences. The most influential factor is service quality. These findings emphasize the importance of improving quality by paying attention to patient preferences to meet their needs and expectations.
S-12175
Depok : FKM-UI, 2026
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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