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Penyelenggaraan kesehatan pada sarana kesehatan harus memperhatikan mutu dari pelayanan yang diberikan, demikian juga rumah sakit. Rumah sakit harus selalu berusaha untuk meningkatkan mutu pelayanannya kepada pasien, untuk menjadi yang terbaik di era globalisasi saat ini. Untuk memperoleh hasil yang baik, diperlukan sistem keuangan yang baik, kepuasan pelanggan, melaksanakan bisnis dengan profesional dan meningkatkan sumber daya manusia. Pendekatan yang dapat digunakan untuk meningkatkan kinerja keempat aspek tersebut adalah dengan menggunakan balanced scorecard. Penelitian ini dilakukan di Unit Gawat Darurat Pelayanan Kesehatan St. Carolus untuk mengetahui gambaran kinerja Unit Gawat Darurat Pelayanan Kesehatan St. Carolus dengan menggunakan pendekatan balanced scorecard. Penelitian ini merupakan penelitian deskriptif analitik, dimana data primer diperoleh dari responden dan data sekunder diperoleh dari laporan Unit Gawat Darurat Pelayanan Kesehatan St. Carolus. Dari hasil penelitian diperoleh : 1) Kinerja keuangan sudah cukup baik, hal ini dapat dilihat dari tingkat pertumbuhan penerimaan yang meningkat dari tahun 2008 sampai tahun 2010, Cost Recovery Rate (CRR) diatas 100% yaitu tahun 2008 sebesar 131,04%, tahun 2009 sebesar 124,26%, tahun 2010 sebesar 112,31%. 2) Kinerja pelanggan secara umum baik dengan tingkat kepuasan pelanggan sebesar 83,09. 3) Kinerja proses bisnis internal secara umum cukup, tetapi masih perlu perbaikan, hal ini dilihat dari AKPGD dan persentase jumlah pasien yang meninggal di UGD yang masih belum memenuhi Standar Pelayanan Minimal menurut Depkes RI. 4) Kinerja pembelajaran dan pertumbuhan secara umum cukup, dilihat dari tingkat kepuasan kerja pegawai adalah sebesar 52,8% merasa tidak puas dan 47,2% merasa puas, tingkat turn over pegawai yang meningkat di tahun 2010, tingkat absensi pegawai yang menurun dari tahun 2008-2010, tingkat pendapatan per pegawai yang menurun pada tahun 2010 dan akses terhadap pelatihan dan pendidikan yang berkurang di tahun 2010. Dari hasil penelitian keempat aspek dengan pendekatan balanced scorecard dapat dikatakan bahwa kinerja Unit Gawat Darurat Pelayanan Kesehatan St. Carolus sudah cukup baik. Untuk itu diharapkan agar adanya komitmen dari tenaga di UGD dalam memberikan pelayanan yang bermutu terhadap pasien dengan menjalankan standar pelayanan minimal yang telah ditetapkan oleh Depkes RI dan menggunakan hasil penelitian yang didapat sebagai dasar untuk melakukan evaluasi kinerja selanjutnya di Unit Gawat Darurat demi tercapainya visi dan misi Pelayanan Kesehatan St. Carolus.
Health implementation of medical equipments should concerns about the service quality provided, and the hospital as well. Hospital should keep on improving service quality to the patient in achieving the excellence in this currently global era. In order to achieve better input, good financial system is necessary, customer satisfaction,professionally business implementation and human resource improvement. The available approach to improve the performance of those four aspects applies balanced scorecard. This resource executed in Emergency Unit of St. Carolus Medical Service to describe the performance of Emergency Unit St. Carolus Medical Service applying balanced scorecard approach. This research is analytically descriptive research, in which the primary data obtained from the respondents and the secondary data from the Emergency Unit report of St. Carolus medical service. From the research acquired : 1) Sufficiently financial performance, this can be seen by the level of the increasing revenue growth from 2008 to 2010, Cost Recovery Rate (CRR) over 100% in 2008 as of 131,04%, in 2009 of 124,26%, and in 2010 of 112,31%. 2) Customer performance is generally good with the level of customer satisfaction is 83,09. 3) The performance of internal business processes generally is sufficient, however some corrections required, this can be seen from AKPGD and total percentage of dead patients in UGD that has not qualified to the Minimum Service Standard of Department of Health of Republic Indonesia. 4) The performance of Study and Growth in general is sufficient, as seen by the level of staff working performance 52,8% is unsatisfied and 47,2% is satisfied, turn over level of the staff increased in 2010, the level of staff attendance decreased during 2008-2010, the level of the income per staff decreased in 2010 and the access to the training and education decreased in 2010. Based on the research of these four aspects with balanced scorecard approach might be said that the performance of Emergency Unit of St. Carolus medical service is relatively good. Therefore, it is expected for the medical staff of UGD a commitment to provide a good quality of medical service to the patient by conducting a minimum service standard stipulated by Depkes RI and applying the research input as the basis to evaluate further performance of Emergency unit in order to achieve the vision and mission of St. Carolus medical service.
Rumah Sakit Bhineka Bakti Husada memiliki lokasi yang cukup strategis yaitu dipersimpangan perbatasan Jakarta, Bogor, Tangerang dan Depok dengan jumlah kunjungan pasien unit gawat darurat dan poli umum dari tahun ke tahun meningkat. Untuk mengetahui kualitas pelayanan unit gawat darurat maka perIu dilakukan survei analis mutu pelayanan kesehatan unit gawat darurat rumah sakit. Hal ini disebabkan karena masih bergabungnya unit gawat darurat dan poli umum. Jenis penelitian yang digunakan dalam penelitian adalah metode survei dan penelitian kuantitatif. Metode survei bertujuan untuk mengetahui faktor internal (kuantitas SDM, kompetensi SDM. kelengkapan sarana dan prasarana, keterSediaan sarana dan prasarana, kematian di UGD, rata-rata pasien UGD perhari, rata-rata pasien UGD yang dirujuk keluar perhari) yang mempengaruhi mutu pelayanan kesehatan UGD RS Bhineka Bakti Husada. Sedangkan penelitian kuantitatif yang bertujuan untuk mengetahui hubungan antara faktor eksternal (jenis kelamin, pendidikan, pekerjaan) dengan mutu pelayanan kesehatan UGD Rumah Sakit Bakti Husada. Data yang diperlukan adalah data primer dan data sekunder. Data primer diperoleh dari kuesioner yang telah diisi oleh pasien unit gawat darurat dan wawancara mendalam kepada informan. Sedangkan data sekunder diperoleh dari Rumah Sakit Bhineka Bakti Husada Tangerang. Data primer berupa kuesioner berasal dari 150 pasien unit gawat darurat, dan di analisa menggunakan univariat, bivariat, dan diagram kartesius. Untuk analisis bivariat digunakan uji chi square parametrik. Dilakukan pada bulan April dan Mei 2008. Hasil penelitian menunjukkan bahwa : Jumlah SDM yang tersedia di UGD R8 BBH sudah memenuhi standar, kompetensi SDM yang tersedia di UGD RS BBH sudah memiliki sertifikat UGD (ACLS, EKG dan PPGD). Ketersediaan sarana dan prasarana masih belum memadai dimana unit radiologi belum beroperasi selama 24 jam, kapasitas tempat tidur rnasih belum memenuhi standar nasional yaitu 12 tempat tidur, jumlah kunjungan pasien UGD mengalami peningkatan selama 4 tahun terakhir. Jumlah pasien UGD yang dirujuk ke tempat lain mengalami peningkatan khususnya pada bulan Desember 2007, angka kematian pasien di UGD tergolong tinggi, ada hubungan yang signifikan antara pendidikan dengan kepuasan pasien, tidak ada hubungan yang signifikan antara jenis kelamin kepuasan pasien tidak ada hubungan yang signifikan antara pekerjaan dengan kepuasan pasien. Variabel yang menurut pasien paling memberikan rasa puas dalam pelayanan yaitu dimensi kehandalan (penguasaan keterampilan dokter pada tugasnya) pasien menyatakan puas sebesar 97.3 %, kurang puas sebesar 2,7%, dirnensi ketanggapan (kernampuan dokter daIam berkomunikasi dengan pasien) yang menyatakan puas sebesar 90,0 %, kurang puas 10,0 %, dimensi kehandalan (kesediaan dokter ketika dibutuhkan) yang menyatakan puas sebesar 86,7 %, kurang puas sebesar 13,3 %, dimensi jaminan (perhatian dan keramahan dokter kepada pasien) yang menyatakan puas 84,7%, kurang puas 15,3 %, dimensi empati (kemampuan petugas UGD dalam mengatasi masalah tanpa membedakan pasien) yang menyatakan puas 78,7 %, kurang puas 21,3 %. Pada diagram kartesius yang termasuk di dalam kuadran 1 artinya variabel yang memiliki performance di bawah rata-rata tetapi tingkat kepentingannya cukup tinggi. Variabel yang masuk dalam kuadran 1 yaitu kemampuan petugas melayani pasien, kecepatan petugas dalam menangani pasien, pendaftaran dilaksanakan dengnn cepat, perhatian dan keramahan dokter kepada pasien. Disarankan kepada rumah sakit terutama manajemen untuk memperbaiki faktor-faktor yang berada pada kuadran 1. Selain itu mutu pelayanan unit gawat darurat RS Bhineka Bakti Husada perlu diperbaiki dengan cara melihat berbagai aspek, seperti ketersediaan sarana dan prasarana antara lain seperti pemisahan UGD dengan poli umum. unit radiologi agar beroperasi selama 24 jam, penambahan kapasitas tempat tidur minima! menjadi yaitu 12 tempat tidur sehingga rnemenuhi standar nasional.
Rumah Sakit Bhineka Bakti Husada is a hospital which has strategic location enough that is around Jakarta, Bogor, Tangerang and Depok which has significant of member patient of emergency department and general poly each year. In order to determine the quality of service of this hospital, survey of health service quality of emergency department needs to be applied to this hospital. It is because still united between emergency department and general poly The research divided into two group, there are survey method and quantitative research. The aim of survey method is to known internal factor (human resOurces quantity, human resources competence, completion tool and infrastructure, availability of tool and infrastructure, death at emergency department, amount average emergency department patient each day,amount average patient emergency department that referred out each day) which has influenced health service quality of emergency department of Bhineka Bakti Husada Hospital. While the aim of quantitative research is to known relationship between external factor (sex, education, job) with health service quality of emergency department of Bhineka Bakti Husada Hospital. The research used two kinds Qf data, there are primary data and secondary data. Primary data which collected from kuesioner that loaded by emergency department patient and interview deepens to informant. While secondary data is collected from Bhineka Bakti Husada Hospital in Tangerang. Primary data was collected from kuesioner that comes from 150 patients of emergency departmen4 and has been analised using univariat, bivariat and cartesius diagram. Bivariat analysis has used test chi square parametrik. This research was conducted in April - May 2008. The result shows that: human resources quantity that available at emergency department of Bhineka Bakti Husada Hospital is fulfil standard, human resources competence that available at emergency department of Bhineka Bakti Husada Hospital has certificate emergency department (ACLS, EKG and PPGD), completion tool and infrastructure stills not yet. give good service which the radiology unit does not operate during 24 clocks, bed capacity does not fulfil standard national that is 12 bed, totals of patient visit in emergency department have been enhanced during 4 the last year, totals patient of emergency department that referred to other place have been enhanced especially in december 2007, the rate of patient mortality at emergency department is stiil high. Relationship between education with patient satisfaction is significant. Relationship between sex of patient with patient satisfaction, relationship between job with patient satisfaction are no significant. Based on patient, we can conclude the variables which give satisfaction in service are: reliability dimension satisfaction (doctor know-how mastery in the task) patient declare satisfied as big as 97,3 %) less satisfied as big as 2,7%, dimension responsiveness (the ability of doctor in communicate with respondent) that declare satisfied as big as 90,0 %, less satisfied 10,0 %, reliability dimension (doctor always already when needed) that declare satisfied as big as 86,7 %, less satisfied as big as 13,3 %, guarantee dimension (attention and affability of doctor to respondent) that declare satisfied 84,7%, less satisfied 15,3 %. empathy dimension (operator emergency unit ability in overcome problem without distinguish patient) that declare satisfied 78,7 %, less satisfied 21,3 %. The cartesius diagram that belong in first quadrant mean variable with under average but have high importance level. Variables that enter in first quadrant are the ability operator in serves patient, operator speed in handle patient, enrollment is carried out swiftly, attention and affability of doctor to patient. Regarding t0 the result the Bhineka Bakti Husada Hospital management shall improve all factors tbat stay in first quadrant. Besides of that, service quality of emergency department of Bhineka Bakti Husada Hospital necessary repaired by see various aspect, like tool availability and infrastructure among others like separation between emergency department with general poly, radiology unit can operate during 24 clocks, increase bed capacity to become 12 beds so that fulfil standard nationa1.
The Emergency Department (ED) has already known as the gateway and the reflection of services given by the hospital which is suppose to be fast accurate and qualified without neglecting the pntient's safety. As the problem is more and more complicated regarding to services at the ED, therefore, a study is needed in order to explore how the quality of the service management is, as well as the input and process factors influenced at the ED of RK Charitas Hospital of Palembang. The research is a qualitative study with the Problem Solving Approach as the strategy of the study. The study is carried out at the ED of RK Charitas Hospital from March to April 2008 with an in-depth interview, direct observation and documents assessment (secondary data exploration), as the method of infonnation eolleetion. The study is using the Problem Priority Matrix in order to find the problem solving prioritizing base on the magnitude of benefit yielded from effort required. There are five problems in the three first order, namely ; time for picking-up inpatient care at the ED still too long, inadequate quality of doctor and nurse at the ED, in adequate amount of nurses, and inadequancy on triase implementation at the ED of RK Charitas Hospital of Palembang. It was suggested the existence of coordination between medical directorates and nursing to minimize time of patient?s transfer from ED to inpatient care unit, giving education and training for doctor and nurse at ED, adding nurse worker at ED, assuring triase implementation and opening an incidental unit near ED at the time of outpatient unit is closed.