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Fitri Dwi Anggraini; Pembimbing: Yaslis Ilyas; Penguji: Puput Oktamianti, Anhari Achadi, Irma Rismayanty, Danyel Suryana
Abstrak:
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Keselamatan adalah isu fundamental bagi rumah sakit, dimana keselamatan pasien merupakan prioritas utama karena berkaitan dengan kualitas dan nama baik rumah sakit. Pelaksanaan keselamatan pasien di rumah sakit dipengaruhi oleh berbagai faktor, antara lain faktor individu, faktor psikologis dan faktor organisasi. Pada tahun 2021, RSIA Bina Medika telah melakukan pengukuran budaya keselamatan pasien dimana diketahui bahwa budaya keselamatan pasien di RSIA Bina Medika masih tergolong rendah. Selain itu, pada tahun 2021 tercatat telah terjadi 37 insiden keselamatan pasien di RSIA Bina Medika, dimana tercatat telah terjadi 1 kejadian sentinel. Oleh sebab itu, penelitian ini dilakukan untuk mengetahui gambaran penerapan keselamatan pasien di RSIA Bina Medika pada tingkat individu dengan melakukan tela?ah dokumen Ongoing Professional Practice Evaluation (OPPE). Penelitian ini juga dilakukan untuk mengetahui gambaran sikap petugas terhadap keselamatan pasien dan hubungannya, serta gambaran pengetahuan petugas terhadap keselamatan pasien dan hubungannya. Selain itu, penelitian ini dilakukan untuk menemukan strategi yang tepat yang harus dilakukan manajemen rumah sakit dalam rangka meningkatkan keselamatan pasien di RSIA Bina Medika. Penelitian ini adalah penelitian mix method dengan pendekatan cross-sectional, dimana dilakukan survei kuesioner terkait sikap (dengan SAQ-INA) dan pengetahuan, serta wawancara mendalam, Focus Group Discussion (FGD) dan tela?ah dokumen terkait termasuk OPPE bagian Keperawatan tahun 2021. Dari hasil penelitian diketahui bahwa 54% petugas menerapkan keselamatan pasien dengan baik. Lalu, diketahui bahwa 56% petugas bersikap negatif terhadap keselamatan pasien dan 78% petugas berpengetahuan baik. Tidak ada hubungan yang signifikan antara sikap petugas dengan keselamatan pasien, begitu pula pengetahuan (p =1 dan p=0,08). Dari wawancara mendalam diketahui terdapat beberapa kendala dalam pelaksanaan keselamatan pasien di RSIA Bina Medika. Dari FGD didapatkan berbagai strategi peningkatan keselamatan pasien di RSIA Bina Medika yang akan diterapkan kedepannya. Dari keseluruhan penelitian ini diketahui bahwa penerapan keselamatan pasien di RSIA Bina Medika masih belum baik karena terdapat beberapa kendala dalam pelaksanaan keselamatan pasien di RSIA Bina Medika. Mayoritas petugas sudah berpengetahuan baik, namun masih banyak petugas yang bersikap negatif terhadap keselamatan pasien. Selain sikap dan pengetahuan, diketahui banyak faktor lainnya yang juga turut berkontribusi dalam pelaksanaan keselamatan pasien di RSIA Bina Medika.
Safety is a fundamental issue for hospitals, where patient safety is a top priority because it relates to hospital?s quality and reputation. The implementation of patient safety in hospitals is influenced by various factors, such as individual factor, psychological factor and organizational factor. In 2021, RSIA Bina Medika had measured patient safety culture where the result showed that patient safety culture at RSIA Bina Medika was still relatively low. In addition, in 2021 there was 37 patient safety incidents at RSIA Bina Medika, where 1 sentinel incident had been recorded. Therefore, this research was conducted to find out the description of the implementation of patient safety at RSIA Bina Medika at individual level by conducting a review of the Ongoing Professional Practice Evaluation (OPPE) document. This study was also conducted to describe staff?s attitude towards patient safety and its relationship, as well as an overview of the staff's knowledge of patient safety and its relationship. In addition, this research was conducted to find the right strategy that hospital management must implement in order to improve patient safety at RSIA Bina Medika. This research was a mixed method research with a cross-sectional approach, in which a questionnaire survey was carried out regarding attitudes (with SAQINA) and knowledge, as well as in-depth interviews, Focus Group Discussion (FGD) and a review of related documents including the 2021 OPPE of Nursing section. The research results showed that 54% of staff implement patient safety well. Then, it was known that 56% of staff had a negative attitude towards patient safety and 78% of staff had good knowledge. There was no significant relationship between staff?s attitudes and patient safety, as well as knowledge (p = 1 and p = 0.08). From in-depth interviews it was known that there were several obstacles in implementing patient safety at RSIA Bina Medika. From the FGD, various strategies were obtained to improve patient safety at RSIA Bina Medika which will be implemented in the future. From all of this research it was known that the implementation of patient safety at RSIA Bina Medika was still not good because there were several obstacles in implementing patient safety at RSIA Bina Medika. The majority of staffs had good knowledge, but there were still many staffs who had negative attitude towards patient safety. Apart from attitude and knowledge, it was known that there were many other factors that also contribute to the implementation of patient safety at RSIA Bina Medika.
B-2304
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Danyel Suryana; Pembimbing: Adang Bachtiar; Penguji: Puput Oktamianti, Amal Chalik Sjaaf, Hinarto Satryana, Andi Heryono
Abstrak:
Salah satu cara untuk melakukan efisiensi, meningkatkan mutu pelayanan dan meningkatkan keselamatan pasien di Amerika dengan menggunakan konsep Lean Thinking yang diterapkan di rumah sakit menjadi Lean Hospital. Di Rumah Sakit Atma Jaya yang merupakan Rumah Sakit Swata Kelas B Pendidikan, penelitian ini menganalisis alur pelayanan resep di Instalasi Farmasi Rawat Jalan sebagai data untuk perbaikan. Dengan menggunakan Root Cause Analysis (RCA), metodologi penelitian operational research, dilakukan observasi dan wawancara mendalam memperlihatkan bahwa kegiatan non value added bisa sampai 85% dan kegiatan value added hanya 15% pada penyiapan obat non racikan. Sedangkan untuk obat racikan kegiatan non value added sekitar 68% dan value added sebesar 32% nilainya. Data tersebut menunjukan bahwa telah terjadi pemborosan (waste). Usulan perbaikan untuk mengurangi pemborosan antara lain penggantian SIM RS yang baru dan menggiatkan fungsi Tim Kendali Mutu di Instalasi Farmasi. Bila perbaikan ini telah di implementasi, diharapakan terjadi peningkatan efisiensi di Instalasi Farmasi Rawat Jalan dan meningkatkan kepuasan pasien. Kata kunci: Konsep Lean, Lean Thinking, Lean Hospital, Resep, waktu tunggu obat, rawat jalan, pemborosan, analisis akar masalah One option to increase efficiency, service quality and patient safety in the United States of America is by using the Lean Thinking concept, which are implemented in Hospitals to become a Lean Hospital. In Atma Jaya Hospital, a class B study private hospital, the research analyses the workflow of prescription sevice in outpatient pharmacy departement to act as data for improvement analysis. Also, by utilizing Root Cause Analysis (RCA), operational research methology, indepth observation and interviews are conducted at compounding and noncompounding medicine storage of Outpatient Patient Departement, the result shows non-value added activities reaches 85%, while value added activities are only 15% on non-compounding medicine storage. While, on compounding medicine storage, non-value added and value added activities are at 68% and 32% respectively. These data clearly shows that great inefficiencies has occurred. Solution is suggested to increase the efficiency in the department, changing Hospital Information System and activate the Quality Control Team function. If these steps are implemented, we can expect the overall efficiency in the Outpatient Pharmacy Departement to improve significantly and resulted in higher patient satisfaction. Keywords: Concepts Lean, Lean Thinking, Lean Hospital, Prescription, drug waiting time, outpatient, waste, Root Cause Analysis
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B-1877
Depok : FKM-UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Mas Aditya Soebangil; Pembimbing: Ascobat Gani; Penguji: Adang Bachtiar, Prastuti Soewondo, Danyel Suryana, Supriyantoro
Abstrak:
Kementerian Kesehatan Republik Indonesia merencanakan percepatan digitalisasi di sektor kesehatan, yang salah satunya adalah penerapan rekam medis elektronik di seluruh fasilitas kesehatan. Namun, seperti yang kita ketahui dengan semakin berkembangnya proses digitalisasi di dunia kesehatan, semakin besar pula ancaman terhadap kebocoran data medis. Hingga saat ini belum ada suatu standar terkait praktik keamanan sistem informasi rumah sakit yang diatur dalam regulasi. Pada penelitian ini, standar ISO 27001:2013 digunakan sebagai alat evaluasi penilaian praktik keamanan sistem informasi rumah sakit RSIA Bina Medika. Didapatkan pada hasil penelitan bahwa dari 6 kontrol ISO 27001:2013 yang dipilih (manajemen aset, kontrol akses, perlindungan fisik dan lingkungan, keamanan operasional, keamanan komunikasi dan keamanan sumber daya manusia), 4 diantaranya sudah sesuai dengan standar dan 2 masih belum lengkap. Belum adanya kebijakan terkait pelabelan informasi serta belum adanya pelatihan rutin terkait praktik keamanan sistem informasi kepada pegawai menjadi poin yang belum dilaksanakan oleh rumah sakit. Hal ini membuka risiko ancaman kebocoran data medis terutama terkait dengan pengelolaan data medis secara internal rumah sakit.
Indonesia’s Ministry of Health is currently enacting a plan to further accelerate the digitalization of the healthcare sector. One of the plans is to ensure the application of Electronic Medical Record (EMR) in all healthcare facilities across Indonesia. Though it is known that the further we accelerate digitalization, the higher the risk of data breaches. The current regulations do not state any standard to adopt as a framework for hospital cybersecurity. Thus, this research aims to implement ISO 27001:2013 standards as one of the means to evaluate the practice of hospital cybersecurity at Bina Medika Maternal and Children Hospital. The results are, according to 6 controls chosen in this research (asset management, access control, physical and environmental security, operational security, communication security, and human resources security), that 4 of the controls are practiced according to the standards. 2 controls that are still not practiced according to the standards, lack the practice and regulation regarding information labeling and routine training of the employees regarding the practice hospital cybersecurity. This opens a risk of medical data breach particularly from inside the organization due to the mishandling of medical information by employees.
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Indonesia’s Ministry of Health is currently enacting a plan to further accelerate the digitalization of the healthcare sector. One of the plans is to ensure the application of Electronic Medical Record (EMR) in all healthcare facilities across Indonesia. Though it is known that the further we accelerate digitalization, the higher the risk of data breaches. The current regulations do not state any standard to adopt as a framework for hospital cybersecurity. Thus, this research aims to implement ISO 27001:2013 standards as one of the means to evaluate the practice of hospital cybersecurity at Bina Medika Maternal and Children Hospital. The results are, according to 6 controls chosen in this research (asset management, access control, physical and environmental security, operational security, communication security, and human resources security), that 4 of the controls are practiced according to the standards. 2 controls that are still not practiced according to the standards, lack the practice and regulation regarding information labeling and routine training of the employees regarding the practice hospital cybersecurity. This opens a risk of medical data breach particularly from inside the organization due to the mishandling of medical information by employees.
B-2360
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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