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Pada era globalisasi saat ini terdapat kecenderungan peningkatan kejadian tidak diharapkan (adverse event). Berdasarkan dari hal tersebut dikembangkan program untuk lebih memperbaiki proses pelayanan yang kemudian dikenal dengan program keselamatan pasien (patient safety). Namun pada kenyataannya ketika tiba pada pengaplikasian program tersebut di lapangan maka rumah sakit akan kembali menemui berbagai masalah. PSBH merupakan suatu pendekatan yang dapat membantu melaksanakan upaya pemecahan masalah yang terjadi di rumah sakit. Sasaran PSBH ada tiga hal yaitu meningkatkan mutu pelayanan, meningkatkan keselamatan pasien (patient safety) serta meningkatkan efisiensi biaya. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang mendukung keberhasilan pendekatan PSBH dalam meningkatkan keselamatan pasien di rumah sakit kemudian faktor-faktor tersebut akan dikaitkan dengan teori manajemen, teori kepemimpinan serta teori motivasi. Selain itu juga dilakukan penelitian mengenai kesinambungan kegiatan PSBH di rumah sakit. Penelitian dilakukan di Rumah Sakit Pusat Pertamina dan Rumah Sakit Dr.Sardjito dengan 14 informan. Metode penelitian yang digunakan adalah metode kualitatif yaitu wawancara mendalam dan telaah dokumen. Analisis data dilakukan dengan metode analisis isi yaitu membandingkan hasil penelitian dengan teori kepustakaan. Hasil penelitian menunjukkan bahwa PSBH memiliki perencanaan kegiatan yang terstrukur dan terperinci yang disusun dalam bentuk Plan Of Action. Penyusunan POA ini sesuai dengan teori fungsi manajemen. Tipe kepemimpinan yang mendukung keberhasilan PSBH adalah kepemimpinan yang memberikan kebebasan bagi para anggota timnya untuk mengemukakan pendapat dan menitikberatkan pada diskusi kelompok. Tipe kepemimpinan ini sesuai dengan tipe kepemimpinan demokratis. Faktor pendukung motivasi yang mempengaruhi keberhasilan PSBH adalah karena rasa tanggung jawab yang dimiliki terhadap pasien. Sedangkan kegiatan PSBH sebagian besar telah berhasil disinambungkan di kedua rumah sakit dengan cara melegalkan kegiatan tersebut dalam bentuk SOP. Kesimpulan dari penelitian ini adalah pendekatan PSBH tersebut dapat berhasil dikarenakan adanya perencanaan yang jelas dan terstruktur kemudian didukung dengan kepemimpinan yang demokratis dari masing-masing problem solver. Selain itu faktor tanggung jawab terhadap pasien juga mendorong keberhasilan PSBH tersebut. Sedangkan kegiatan PSBH dapat disinambungkan karena kegiatan-kegiatan tersebut dapat dirasakan manfaatnya baik bagi pasien maupun bagai tenaga kesehatan terkait.
In current globalization era theme is tendency of increasing adverse event. Based on that fact a program was developed to fix the services which is known as patient safety program. In reality, when it comes to the application of the program, hospitals will also find some difficulties. PSBH is an approach which can help to resolve a problem in hospitals. There are three aims of PSBH which are increasing the quality of services, increasing patient safety and increasing the cost efficiency in hospitals. The aim of this research is to identify the factors influencing the success of problem solving for better hospitals in increasing patient safety at hospitals. The factors will then be connected to theory of management, theory of leadership and theory of motivation. Beside that a researh is performed toward the continous activities of PSBH at hospitals. Research is performed in Rumah Sakit Pusat Pertamina and Rumah Sakit Dr.Sardjito with 14 informant Research method used is qualitative method that is indepth interview and document study. Data analysis conducted with content analysis method which is comparing the result with bibliography theory. The result of the research shows that PSBH has a structurized and well organized plan which is called Plan of Action. The arrangement of the plan of action is equivalent to the theory of management. The type of leadership influencing the success of PSBH is leadership that gives the freedom to the members of the team to give their opinion and focusing in group discussion. This type of leadership is associated to the democratic type. The motivating factor that influencing the success of PSBH is the responsibility toward patients. The continous activities of PSBH mostly have been sussessfully done by legalisation of the Standard Operating Procedure. The conclusion from this research is the success of PSBH are influenced by the well organized plan of action and supported by the democratic type of leadership from each of problem solver. Beside, the responsibility toward patient also influencing the succes of PSBH. The reason PSBH can be done continously in hospitals is because the advantages of the activities can be feel either by the patient or by the health administrator.
Penelitian ini dilakukan untuk menganalisa alur proses yang adasekaligus memberikan usulan perbaikan agar proses pemulangan pasien rawatinap menjadi lebih cepat. Desain penelitian ini adalah analisis kualitatif denganmetode lean thinking melalui telaah dokumen, wawancara mendalam danobservasi.
Hasil penelitian didapatkan lead time atau waktu yang dibutuhkan untuk pemulangan pasien adalah 252,4 menit (4,2 jam). Total waktu kegiatanyang bersifat value added 168 menit, sedangkan total waktu kegiatan yangbersifat non value added adalah 84,4 menit. Dari identifikasi nilai yang dilakukanterhadap alur proses pemulangan pasien ini ditemukan waste sebesar 63,6 menityang bila bisa dihilangkan akan memotong lead time menjadi 188,3 menit (3,1jam).
Keyword : lean thinking, pemulangan pasien rawat inapUniversitas Indonesia
Process of discharging hospitalized patient is part of service given by the hospital.A Good and satisfying service during hospitalization can turn into unsatisfiedperception if at the end of hospitalization there is obstacle in discharging patientand make the process longer.
This research is to analyze the process and give agood suggestion for discharging inpatient process in order to make it moreefficient. Design of this research is lean thinking method using document analysis, interview, and observation.
Result of the research indicating lead time or timeneeded for discharging patient is 252.4 minutes (4.2 hours). Total activity timewhich is value added is 168 minute, while total activity time which is non valueadded is 84.4 minute. Base on this value identification found waste value time63.6 minute can be diminished and cutting lead time to 188.4 minute (3.1hour).
Keyword : lean thinking, discharging inpatient.
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.
ABSTRAK Nama : Weny Rinawati Program Studi : Kajian Administrasi Rumah Sakit Judul : Analisis biaya perawatan stroke berdasarkan Clinical Pathway di Rumah Sakit Pusat Otak Nasional Jakarta dalam pelayanan pasien Jaminan Kesehatan Nasional Latar belakang. Masalah yang sering dihadapi pada pelayanan pasien Jaminan Kesehatan Nasional adalah kesenjangan biaya perawatan pasien stroke dengan tarif INA-CBGs. Hal ini terkait dengan biaya perawatan dan Clinical Pathway. Tujuan. Mengetahui biaya perawatan pasien stroke di Rumah Sakit Pusat Otak Nasional. Metoda. Penelitian kuantitatif deskriptif mengikutsertakan 277 subjek penyakit stroke yang diperoleh di Rumah Sakit Pusat Otak Nasional Jakarta selama Januari – Juni 2015. Biaya perawatan stroke dihitung berdasarkan biaya satuan (unit cost) dengan menggunakan metode activity based costing dan Clinical Pathway. Hasil. Biaya satuan perawatan stroke iskemik dan stroke hemoragik berdasarkan Clinical Pathway, dengan memperhitungkan biaya investasi dan biaya gaji, tanpa memperhitungkan jasa medis berturut-turut adalah Rp 311,860,860.83 dan Rp 585,083,610.01; dengan memperhitungkan biaya investasi, biaya gaji, dan jasa medis berdasarkan tarif rumah sakit adalah Rp 321,682,940.73 dan Rp598,929,450.01; dengan memperhitungkan biaya investasi, biaya gaji, dan jasa medis berdasarkan tarif IDI adalah Rp 318,360,860.73 dan Rp 594,333,610.01; tanpa memperhitungkan biaya investasi, biaya gaji, dan jasa medis adalah Rp30,361,681.00 dan Rp25,698,199.46; tanpa memperhitungkan biaya investasi dan biaya gaji, tetapi memperhitungkan jasa medis berdasarkan tarif rumah sakit adalah Rp 40,183,761.00 dan Rp 39,544,199.46; tanpa memperhitungkan biaya investasi dan biaya gaji, tetapi memperhitungkan jasa medis berdasarkan IDI adalah Rp 36,861,681.00 dan Rp 34,948,199.46. Simpulan: Dijumpai selisih biaya perawatan berdasarkan biaya satuan dan Clinical Pathway, baik yang memperhitungkan biaya investasi, gaji, dan jasa medis, maupun tanpa memperhitungkan biaya investasi, gaji, dan jasa medis, dengan tarif layanan existing dan tarif INA-CBGs Kata kunci : biaya, Clinical Pathway, INA-CBGs, stroke
ABSTRACT Name : Weny Rinawati Study Program : Hospital Administration Title : Cost of stroke treatment based on Clinical Pathway in National Brain Center Hospital, Jakarta Background. Problem often encountered in patient care National Health Insurance is the gap between the cost of stroke treatment with INA-CBGs tariff. This is related to the cost of treatment and the Clinical Pathway. Aim. Knowing the cost of stroke treatment in the National Brain Center Hospital Jakarta. Methods. Descriptive quantitative study involving 277 subjects stroke obtained at the National Brain Center Hospital Jakarta during January - June 2015. The cost of stroke treatment are calculated based on the unit cost using activity-based costing method and Clinical Pathway. Results. The unit cost of ischemic stroke and hemorrhagic stroke treatment by Clinical Pathway, taking into account investment costs and salary costs, regardless of medical services is IDR 311,860,860.83 and IDR 585,083,610.01; taking into account investment cost, salary cost, and medical services tariff based hospital is IDR 321,682,940.73 and IDR 598,929,450.01; taking into account investment cost, salary cost, and medical services tariff based IDI is IDR 318,360,860.73 and IDR 594,333,610.01; without taking into account investment cost, salary cost, and medical services are IDR 30,361,681.00 and IDR 25,698,199.46; without taking into account the investment cost and salary cost, but taking into account medical services tariff based hospital is IDR 40,183,761.00 and IDR 39,544,199.46; without taking into account the investment cost and salary cost, but taking into account medical services tariff based IDI is IDR 36,861,681.00 and IDR 34,948,199.46. Conclusion. Found difference in the cost of stroke treatment is based on unit cost and Clinical Pathway, both of which take into account the investment, salaries, and medical services cost, and without taking into account investment, salaries, and medical services cost, with existing services and tariff rates INA-CBGs Keywords: Clinical Pathway, cost, INA-CBGs, stroke
Penelitian ini menganalisis faktor-faktor apa saja yang dipertimbangkan bagian kepegawaian perusahaan langganan dalam membeli Layanan Medical Check Up Rumah Sakit Pusat Pertamina Tahun 2012. Penelitian ini juga menentukan faktorfaktor apa saja yang berperan paling besar sebagai pertimbangan bagian kepegawaian perusahaan langganan dalam membeli layanan Medical Check Up RSPP Tahun 2012. Dalam penelitian ini digunakan 31 (tiga puluh satu) variabel dengan populasi penelitian perusahaan pelanggan MCU RSPP yang telah menjalin kerjasama dengan MCU RSPP selama 2 (dua) tahun berturut- turut yaitu tahun 2011- 2012 sebanyak 88 (delapan puluh delapan) perusahaan. Sebanyak 45 (empat puluh lima) perusahaan sebagai responden yang diambil dengan teknik purposive sampling. Metode Principal Component Analysis (PCA), menghasilkan 6 (enam) faktor yang dipertimbangkan bagian kepegawaian perusahaan langganan dalam membeli Layanan Medical Check Up Rumah Sakit Pusat Pertamina Tahun 2012 dan mampu menjelaskan 25 variabel dalam data, yaitu sebesar 79,3 persen. Keenam faktor tersebut adalah Faktor 1 (Alat Promosi yang Menarik dan Informatif), memiliki eigen value sebesar 10,077 dan variansi sebesar 40,3 persen. Faktor 2 (Kecukupan Tersedianya Tempat Parkir) memiliki eigen value sebesar 2,719 dan variansi sebesar 10,8 persen. Faktor 3 (Mutu Produk) memiliki eigen value sebesar 2,062 dan variansi sebesar 8,2. Faktor 4 (Kesesuaian Harga) memiliki eigen value sebesar 1.487 dan variansi sebesar 5,9 persen. Faktor 5 (Ketepatan penerimaan hasil Pemeriksaan) memiliki eigen value sebesar 1,305 variansi sebesar 5,2 persen. Faktor 6 (Transportasi menuju Rumah Sakit) memiliki eigen value sebesar 1,026 dan variansi sebesar 4,1 persen. Ketepatan model yang dihasilkan berdasarkan hasil estimasi matriks faktor adalah sebesar 38 persen atau sebanyak 115 residual dengan nilai absolut di atas 0,05. Hal ini menunjukkan bahwa model memiliki ketepatan sebesar 62 persen pada tingkat penyimpangan 5 persen.
The problems derived from the study - be that as it may, were the factors considered by the clientele of Human Resources Departments In Subscribing to Medical Check-Up Service of Pertamina Central Hospital in 2012. The purpose of this study was to analyze and determine the most affecting factors as far as clients are concerned due to their commitment and preferences in proceeding with the Medical Check-Up of Pertamina Central Hospital in 2012. In order to decide the most dominant variables representing each factor established and in conjunction to assess the other remaining variables included in the fully-formed dominant factors, this study picked out 31 (thirty-one) variables and the population, namely the existing customers of RSPP’s MCU service who have worked closely over the past 2 (two) consecutive years, 2011-2012. The mass of the addressed population comprised of 88 (eighty-eight) companies and the quantity of the respondents taken as study sample were narrowed down to 45 (forty-five) companies altogether and conducted by purposive sampling techniques. The Principal Component Analysis (PCA) method, resulting 6 (six) factors that were taken into consideration by the Human Resources Departments of existing customers in trying out the Medical Check-Up services provided by Pertamina Central Hospital in 2012 and were able to explain 25 (twenty-five) variables in data, which amounted to 79,3 percent. The 6 (six) underlying factors as previously mentioned were Factor 1 (Informative and Attractive Promotional Tools) with 10.077 eigen value and 40,3 percent variance. Factor 2 (The Parking Space Availability) with 2,719 eigen value and 10,8 percent variance. Factor 3 (Product Quality), with 2,062 eigen value and 8,2 percent variance. Factor 4 (Price Reasonability/Affordability), with 1,487 eigen value and 5,9 percent variance. Factor 5 (Punctuality of Examination Results), with 1,026 eigen value and 4.1 percent variance. Last but not least, Factor 6 (Transportation Means to the Hospital), with 1,026 percent of eigen value and a 4,1 percent variance. All the model precision generated were based on the size of residuals, which is the difference from the produced correlations; in accordance to the matrix estimation outcome, the factor was as large as 38 percent or as many as 115 residuals, with absolute significance value above 0,05. These numbers statistically showed that the model had performed accuracy of 62 percent by 0,05 deviation, or 5 percent so to speak/per se.
