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Analisis budaya keselamatan pasien menghasilkan 4 dimensi kategori budaya sedang yang memerlukan perbaikan keselamatan pasien serta 7 dimensi kategori budaya baik yang menjadi kekuatan dalam keselamatan pasien. Pengorganisasian ketenagaan, beban kerja dan pola kerja; konseling pasien; keterbukaan komunikasi; dan respons terhadap kesalahan menjadi kelemahan budaya keselamatan pasien yang menjadi prioritas perbaikan. Tingkat pelaporan kejadian masih rendah dan harus mendapat perbaikan.
Kata kunci: budaya keselamatan pasien, instalasi farmasi
This research uses sequential explanatory design started from quantitative analysis using questionnaire The Pharmacy Survey on Patient Safety Culture (PSOPSC) from AHRQ followed by focus group discussion to formulate strategy to build patient safety culture.
Analysis of patient safety culture resulted in 4 dimensions of moderate cultural categories that require improvement and 7 dimensions of good cultural categories that be strength of the patient safety culture. Staffing, Work Pressure and Pace; Patient counseling; Communication openness; and Response to Mistakes is weakness of the patient safety culture that become priority improvement. Level of incident reporting is still low and need improvement.
Keywords: patient safety culture, pharmacy installation
Penelitian ini dilatarbelakangi kenyataan bahwa Instalasi Gawat Darurat merupakan suatu unit pelayanan di rumah sakit yang harus dapat memberikan pelayanan yang cepat dan tepat agar tujuan dari pelayanan gawat darurat dapat tercapai dan sekaligus memberikan kepuasan kepada pasien atau keluarganya.
Tujuan penelitian ini untuk mengetahui gambaran umum waktu tunggu persiapan operasi cito di IGD dan faktor-faktor yang berhubungan dengan waktu pelayanan terhadap pasien yang akan menjalani operasi cito.
Jenis penelitian ini merupakan studi kasus dengan pendekatan kualitatif. Data dan informasi mengenai proses pelayanan diperoleh melalui wawancara mendalam, fokus grup diskusi, observasi partisipatif dan telaah dokumen. Sedangkan data mengenai waktu pelayanan diperoleh melalui pencatatan waktu pelayanan mulai dari tahap penetapan operasi sampai saat dilakukan sayatan pertama di meja operasi.
Hasil penelitian menunjukkan bahwa waktu tunggu persiapan operasi cito di IGD RS Karya Medika I berhubungan dengan lamanya persetujuan operasi dari keluarga atau penanggung jawab biaya, ketidaksiapan SDM kamar operasi termasuk dokter operator dan dokter anestesi, serta keterbatasan peralatan operasi.
Untuk mempersingkat waktu pelayanan terhadap pasien yang akan menjalani operasi cito, RS Karya Medika I perlu menetapkan kebijakan tentang penanganan pasien operasi cito, memperbaiki manajemen SDM kamar operasi dan sistem pengadaan alat kesehatan.
The background of the research was the fact that Emergency Care Unit is a particular service unit in hospital which has to be able to respond quickly and effectively in order to achieve the goals of emergency care service and at the same moment to deliver satisfaction to the patients and their families.
The purpose of this research was to know the general picture about the waiting time of cito operations in the Emergency Departement and the factors associated with the time of service to patients who will undergo cito operations.
This type of research was a case study wih a qualitative approach. Data and information regarding the service process were obtained from indepth interviews, focus group discussion, participant observation and document review, while data regarding the service time was gained from recording and calculating the time taken starting from the moment of surgery decision until the moment of the first incision on the operating table.
The result from the research showed that waiting time for the preparation cito operation in the Emergency Departement at Karya Medika I hospital associated with informed concent from the family or the insurance, human resources, and the equipment of operation.
To minimize the waiting time for preparation cito operation in Emergency Departement, Karya Medika I Hospital need to establish policies regarding the handling of patients cito operations, to improve human resource management and procurement of medical equipment systems.
Dewasa ini keberhasilan rumah saldt diukur dalam memberikan pelayanan yang bermutu. Mum pelayanan pada alchimya dihubungkan dengan kepuasan kepada pasien_ Kepuasan pasien dilihat dari harapan dan kebutuhan terhadap pelayanan yang mereka terima. Penulisan tesis ini bertujuan untuk mendapakan informasi tentang mutu pelayanan, dengan indikator kepuasan pasien dalam hubungannya dengan aspek pelayanan dokter, pelayanan perawat, administrasi keuangan dan kenyamanan. selain itu ditinjau pengaruh karakteristik pasien yaitu usia, jenis kelamin, pendidikan, pekeijaan, pengetahuan, ternpat tinggal (iarak tempuh), penghasilan, pengalaman di RS lain dan penanggung biaya. Adanya berbagai keluhan maupun kritikan terhadap pelayanan yang mendasari penelitian ini, Penclitian ini bcrsifat deskriptifanalitik kuantitatif cross sectional. Data primer didapat dari melalui kuosioner kepada 206 responden melalui wawancara, selama 25 hari kerja pada minggu ke 2 bulan mei sampai minggu kc 2 bulan juni 2008. Dari hasil penelitian didapat responden yang menyatakan puas terhadap selumh aspek pelayanan yang diteliti sebanyak 59.7% Dari aspck pelayanan dan karakteristik pasien temyata aspek kebersihan - kenyamanan, jarak tempuh, penghasilan dan pengalaman di RS lain mempunyai pengaruh terhadap kepuasan pasien.
Nowadays the hospital success is measured in present ate quality service. The quality service is related to the patient satisfaction. The Patient satisfaction is seen on expectation and the need to service that they accept. The put-posed of this thesis to find out the information about the quality service, with patients satisfactory indicator in its relationship with nursing aspect as doctor, nurse service, financial administration and convenience. besides to measure influence on patient characteristic which is age, gender, education, occupation, knowledge, address (distance), welfare, experience at any other hospital and the insurer cost. The research performed basely by various complaint and also criticism to musing service. This research was analytic descriptive and cross sectional quantitative. Primary data collected through by questioner to 206 respondents through interviews, up to 25 working days on the second week on May until the second week on June 2008. The research result found the respondent declares for feeling pleasant to all service aspect which is analyzed as 59.7%. From service aspect and patient characteristic apparently hygiene - convenience aspect, distance, welfare and experience at any other hospital have influence to patient satisfaction. Experience aspect at any other hospital most dominant regard influence patient satisfaction (OR = 4,0l3).
Rumah sakit Pusat Angkatan Darat Gatot Soebroto merupakan rumah sakit rujukan tertinggi bagi Rumah Sakit TNI diseluruh penjuru nusantara, Salah satu pelayanan di Rumah Sakit Gatot Soebroto adalah Instalasi Gawat Darurat yang merupakan pintu gerbang terdepan pelayanan di Gatot Soebroto. Salah satu standart dan prosedur adalah pelaksanaan Triase di Instalasi Gawat Darurat yaitu menyeleksi dan menilai kegawat daruratan dari setiap pasien untuk segera dapat diberikan pertolongan sesuai dengan tingkat kegawatan dan kedaruratan kemudian dicatat hasil pemeriksaan pada lembaran gawat darurat. Dari pengamatan awal membeikan hasil yang tidak sesuai dengan standar dan prosedur Triase yaitu tidak adanya keberadaan petugas Triase yaitu dokter dan perawat di ruangan Triase, ketidaktepatan kehadiran jam pelayanan petugas Triase, ketidak lengkapan pengisian daftar registrasi pasien baru datang ke Instalasi gawat darurat. Dalam penelitian ini dilakukan pengamatan mengenai faktor individu, psikologis dan organisasi terhadap kepatuhan petugas Triase terhadap standar dan prosedur Triase di IGD. Setelah dilakukan uji regresi linier sederhana dan uji t independent maka dapat disimpulkan bahwa umur perawat, pengetahuan dokter dan perawat, pelatihan dokter dan perawat, komitmen pimpinan dokter dan kecukupan sarana dari segi perawat ada hubungan /perbedaan dengan kepatuhan petugas dalam melaksanakan standar dan prosedur Triase. Untuk menjaga dan meningkatkan mutu pelayanan yang ada di Triase perlu diupayakan petugas Triase selalu berada di area Triase karena Triase merupakan pintu utama untuk penanganan pasien di IGD.Studi ini juga menganjurkan agar komitmen pimpinan terhadap petugas Triase lebih ditingkatkan sehinggan dapat meningkatkan motivasi petugad Traise untuk patuh terhadap standard an prosedur Triase dengan harapan pelayanan yang diberian sesuai dengan standar yang ada dan dapat dipertanggung jawabkan.
Central Army Hospital Gatot Subroto is the highest referral hospital, one service at Gatot Subroto Hospital Emergency Room is the gateway leading service in the Gatot Subroto. One is the implementation of standards and procedures in the unit Emergency Department Triage of selecting and assessing kegawat daruratan from each patient for immediate relief may be granted in accordance with the level of severity and emergency then recorded the results of the examination in the emergency sheet. From initial observations results inconsistent with the standards and procedures is not the existence of Triage Triage officers are doctors and nurses in the room Triage, inaccuracies Triage officer attendance at services, lack of charging lengkapan registration list of new patients coming to the emergency installation. In this study observations on individual factors, psychological and organizations for compliance officers to standards and procedures Triage Triage in the emergency room. After a simple linear regression test and independent t tests it can be concluded that the age of nurses, doctors and nurses the knowledge, training doctors and nurses, physician leadership commitment and the adequacy of existing nursing facilities in terms of the relationship / differences with the compliance officer in implementing standards and procedures Triage. To maintain and improve the quality of existing services need to be pursued in the Triage officer is always in the area because of Triage is the main entrance to the handling of patients in this IGD.Studi also recommends that the leadership's commitment to enhanced sehinggan Triage officers may increase the motivation to officerTraige standards and procedures to Triage the hope diberian services in accordance with existing standards, and reliable.
Diabetes mellitus is a chronic disease that cannot be cured and can cause serious complications, including diabetic gangrene. Diabetic gangrene can cause severe infection that requiring debridement. Debridement is considered the fastest and most efficient method of treating diabetic gangrene. This causes the patient to be hospitalized, which requires a lot of money and long-term care. Longer treatment days and expensive medical expenses are problems that need special attention. This research is a retrospective non-experimental descriptive study that aims to analyze factors related to the bill for diabetic gangrene debridement services at Aisyiyah Bojonegoro Hospital in 2021. Of the 151 patients who met the criteria, it was found that most diabetic gangrene patients who underwent debridement were aged under 60 years (66.2%), with the most sex being female (53%), and the most degree being grade 1 (51.7%). The average length of stay was 4.72 days. With a minimum length of stay of 2 days and a maximum length of stay of 13 days. From the results of the study, it was found that the bill was more than ina-cbgs by 37 cases at degree I, 6 cases at degree II, and 24 cases at degree III. So that from a total of 151 patients treated with diabetic gangrene debridement, there were 67 cases where hospital bills were higher (deficit) than ina-cbgs. The deficit results were found in all treatment classes and all levels of severity except in class 2 degrees I and III and in class 1 degree II where a surplus was obtained compared to ina-cbgs. Based on the results of the study, it was found that P-Value <0.05 was at the level of severity, fornas compliance, length of stay and DPJP which means that there was a significant relationship between severity, fornas compliance, length of stay, and DPJP with the total real bills of diabetic gangrene debridement patients. The most dominant variable affecting the patient's total bill is the length of stay which has an Exp (β) value of 13,108 meaning that the longer the patient is treated, the more the total real bill will increase in patients with diabetic gangrene debridement.
Waiting time is one indicator of health services. The increase in waiting time in the Emergency Department (ED) has an impact on longer treatment days, increased mortality and reduced patient satisfaction. The purpose of this study was to determine the length of stay for services at the emergency department of the Tangerang General Hospital using lean method to determine waste at each stage of activity. This research method is operational research with qualitative and quantitative approaches, primary data sources taken from direct observation using time motion study techniques and in-depth interviews. The waiting time at the ER at the Tangerang Regency General Hospital is 852.92 minutes for inpatients and 564.24 minutes for outpatients. The length of time for each service is as follows: triage is 11.83 minutes, waiting time for an emergency room doctor examination is 32.25 minutes, drug administration time and action is 22.33 minutes, waiting time for laboratory examination is 106.07 minutes, waiting time for examination radiology 140.15 minutes, waiting time for specialist doctor consultation 146.54 minutes, waiting time for inpatient registration 164.8 minutes, waiting time for inpatient admission 58.5 minutes, patient administration time going home 89.6 minutes. The largest nonvalued added activity is waiting for specialist consultations. Found 2 types of waste, namely waiting (93.3%) and motion (6.7%). After conducting an analysis using the 5 why method, the root of the problem was found in the number of nurses, not yet maximally carrying out tupoksi, hospital information system applications that are less user friendly, specialist doctors are not standby and consultation SOPs are not optimally run, lack of clinical experience of doctors ER, as well as the unavailability of the ward. The conclusion, t the waiting time in the ER at the Tangerang General Hospital exceeds the standard time (4 hours). The lean approach is appropriate to look for waste in health service activities so that problem solving efforts can be obtained to improve service waiting times in the IGD RSU Tangerang Gneral Hospital
