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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.
Kata kunci : Kanker kolorektal, Matched case control, Faktor risiko
Colectal cancer disease is colon cancer and rectum until now is a health problem in the word, including in Indonesia yet. The purpose of this study is to investigate the risk factor and dominant factor of colorectal cancer. The design of study used was matched case control with age matching using the medical record data, the data of case were colorectal cancer patients and control were trauma and fracture patients. The calculate sample is 122 people were 61 pairs of cases and controls. The result of bivariate analysis of mc nemar chi square showed related risk factor was red meat diet with OR=27 (95% CI 4,45-1105,4), high fat intake with OR=2,2 (95% CI 0,967-5,542), and low fiber intake with OR=44 (95% CI 7,49- 1776,9). Multivariate analysis of conditional logistic regression showed the most important factor was low fiber intake with OR=26,8 (95% CI 3,448-209,5). The unrelated risk factors are gender, education level, family history, family income, physical activity, obesity, smoking and alcohol. It is necessary to prevent the prevention of colorectal cancer by increasing fiber intake, reducing fat intake and concumption pattern of read meat.
Keywords : Colorectal cancer, Matched case control, Risk factor