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Minimum Standard Services (MSS) can be used as an indicator to cover citizen’s rights of essential health service. Furthermore, MSS in women’s labour is expected to be in a certain quality and quantity standards to reduce MMR. Rawamerta Public Health centre reported in 2019, 77.9% and 68.95% achievement in K1 and K4, respectively. These figures are well below the acceptance target of 100%. This study aims to analyze the quality of SPM implementation in Antenatal services at Rawamerta Public Health Center with qualitative methods in concordance with Donabedian’s quality evaluation theory. Research informants were determined by purposive and snowballing sampling. Data collection performed with in-depth interviews, observations, and document reviews. Data analysis was performed descriptively and converted to a narrative. Rawamerta’s structure, process, and outcome to achieve MSS were evaluated. It is found that Rawamerta Public Health Center quality is still below the MSS standards.
This research aimed to obtain an overview of the section services of SectioCaesaria in Muhammadiyah Taman Puring Hospital in 2016 using theDonabedian Quality of Care Framework. The analysis was performed bypresenting the input-process-and-output of the services of Caesarian Section'smeasures compared to the prevailing standards. The research method isqualitative. Based on the result of the research, it can be concluded that theservice of Sectio Caesaria in RS Muhammadiyah Taman Puring is quite goodwith the input which is enough where the human resources owned in accordancewith the standard amount, but still lack in facilities and policy support. Theservice process by referring to existing guidance in the hospital, has not beenconsistently run entirely by hospital staff. The output of this research were LengthOf Stay 3,3 and Wound Infections Surgery hospital rates is 1,3 %.Keywords: Donabedian, Service of Sectio Caesaria.
This study is seeking the impact of structure and process as the qualityaspect according to Donabedian 's theory that affecting to the Net Death Rate/NDR Stroke disease. Selected data source are Stroke patients, consisting ofIntracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso DjatiwibowoBalikpapan Hospital in the year 2014. This study is a qualitative research usingdescriptive analytic retrospective method. Structure and Process Factors that areinfluencing each other. It reveals that Structure Factors in hospitalization that areaffecting sequentially are the condition of the patient, facilities, policies andhuman resource. On the other hand it reveals that Process Factors includeobstacle on running the primary instruction and also Hospital AccociatedInfections/ HAIs occurs due to the nursing process. In Emergency Unit there isobstacle in Process Factor as the CT Scan service is not available sometime. It isrecommend to improve the quality of Stroke patient to overcome the Structure andProcess Factors and to develop the on stop service Stroke Unit.Keywords : Quality, Donabedian , NDR Stroke , Structure Factor, Process Factor.
The patient safety incident reporting system is a critical component in mitigating preventable risks within healthcare services. Dr. Cipto Mangunkusumo National General Hospital (RSCM) has implemented both manual and electronic (e-Report) methods for reporting incidents. However, its implementation remains suboptimal. This study aims to evaluate the implementation of the incident reporting system at RSCM using a qualitative approach, guided by the Donabedian framework (structure–process–outcome) and the Plan–Do–Study–Act (PDSA) improvement cycle. The findings reveal that the current e-Report system does not sufficiently meet user needs due to an unintuitive interface and the absence of key functionalities such as report tracking, automated notifications, and feedback mechanisms. Additionally, fragmented reporting channels, a predominance of manual submissions, and the perception of reporting as a bureaucratic burden have contributed to a weakened safety culture. The follow-up process is also perceived as lacking transparency and is rarely communicated back to reporters, further reducing trust in the system. These challenges form the basis for recommendations to develop a centralized, user-friendly, and integrated reporting system, supported by unit-based training and a single-channel reporting policy. The PDSA cycle is applied as a strategic framework to design a more responsive and sustainable system that enhances both service quality and patient safety at RSCM.
Decomposition Analysis System is operating a system that includes identificationefforts objectives, activities, implementation of activities, the situation faced andinformation needed at each stage of system implementation. This study uses ablend of Systems Theory approach Donabedian-Azwar, the principal stages ofStructural / Input-Process-Output / Outcome to look at heart disease care systemin hospitals Dr.Kanujoso Djatiwibowo Balikpapan 2014. The study wasconducted from April to November 2015, using a design qualitative descriptiveanalytic method. Analysis was performed with the data derived from the study ofmedical documents cardiac patients in hospitals Dr Kanujoso DjatiwibowoBalikpapan in 2014, observation and depth interview with selected informants.The results showed a factor of structure / Inputs that influence mortality incardiovascular disease care system in the Hospital Dr Kanujoso DjatiwibowoBalikpapan is Patient factors, human resources, facilities, and methods. Factorssuch as the process of service delivery, the doctor-nurse coordination andintegration of services. It is recommended that the hospitals Dr KanujososDjatiwibowo Balikpapan perform additional doctors Heart Specialist, create one-stop service for cardiovascular disease / Cardiac Center and increase cooperation /coordination between the hospitals Dr Kanujosos Djatiwibowo with PrimaryHealth Care Facility, City Health Department Balikpapan and house parties otherhospitals in the city of Balikpapan.Keywords :System, Donabedian-Azwar, Input, Process, Output, Heart Disease Mortality.
Mutu layanan Perawatan, Dukungan, dan Pengobatan (PDP) HIV di tingkat pelayanan primer berperan strategis dalam mendukung pencapaian target eliminasi HIV nasional tahun 2030, khususnya dalam kerangka 95-95-95. Puskesmas Perumnas II merupakan puskesmas pertama di Kota Bekasi yang menyelenggarakan layanan PDP HIV dan melayani jumlah ODHIV terbanyak di wilayah tersebut. Penelitian ini bertujuan untuk menganalisis mutu layanan PDP HIV dengan menggunakan pendekatan model Donabedian yang mengevaluasi tiga komponen utama: struktur, proses, dan hasil (outcome). Metode yang digunakan adalah kualitatif deskriptif dengan rancangan studi kasus. Pengumpulan data dilakukan melalui wawancara mendalam terhadap informan kunci dari Dinas Kesehatan Kota Bekasi, petugas pelaksana program PDP HIV di puskesmas, dan pasien ODHIV; disertai observasi layanan serta telaah dokumen seperti SIHA dan catatan kegiatan program.
Hasil penelitian menunjukkan bahwa dari aspek struktur, Puskesmas Perumnas II memiliki dukungan kebijakan nasional dan lokal yang memadai serta sarana dasar layanan seperti ruang pelayanan dan ketersediaan ARV. Namun, keterbatasan masih ditemukan pada jumlah dan kompetensi SDM, serta tidak tersedianya sarana pemeriksaan viral load di tingkat puskesmas. Pada aspek proses, layanan berjalan sesuai pedoman nasional, namun belum konsisten, terutama dalam pelaksanaan konseling berkelanjutan, pendampingan psikososial, dan pelaporan data secara akurat melalui sistem SIHA. Aktivitas monitoring dan evaluasi juga belum terjadwal secara sistematis. Dari sisi outcome, sebagian besar pasien tercatat sebagai on-ARV, tetapi cakupan pemeriksaan viral load dan capaian supresi virus masih rendah akibat keterbatasan akses. Tingkat kepuasan pasien terhadap layanan cukup tinggi, khususnya terhadap sikap petugas dan ketersediaan obat, namun masih terdapat keluhan mengenai waktu tunggu, privasi, dan dukungan emosional.
Penelitian ini merekomendasikan penguatan struktur layanan melalui peningkatan jumlah dan kapasitas SDM, pemenuhan sarana penunjang, optimalisasi proses melalui sistem pencatatan yang akurat dan konseling berkelanjutan, serta pelaksanaan monitoring dan evaluasi rutin. Dengan berbagai praktik baik yang telah berjalan dan pengalaman dalam menjangkau jumlah pasien yang besar, Puskesmas Perumnas II memiliki potensi untuk dijadikan model praktik baik (best practice) bagi puskesmas lain di Kota Bekasi maupun wilayah lainnya dalam penyelenggaraan layanan PDP HIV di tingkat primer.
Hipertensi merupakan penyakit tidak menular dengan prevalensi tinggi di Indonesia dan berisiko menimbulkan komplikasi serius jika tidak tertangani dengan baik. Di Kabupaten Belitung, capaian pelayanan hipertensi belum mencapai target 100% sesuai Standar Pelayanan Minimal (SPM). Penelitian ini bertujuan menganalisis implementasi pelayanan hipertensi berdasarkan SPM tahun 2024 menggunakan pendekatan kualitatif studi kasus dan model Donabedian (struktur, proses, hasil). Informan terdiri dari pengelola program, tenaga kesehatan, kepala Puskesmas, dan pemerintah desa di empat Puskesmas. Data dikumpulkan melalui wawancara, observasi, dan telaah dokumen pada Februari–Mei 2025.
Hasil penelitian menunjukkan keterbatasan SDM, ketidakterpaduan regulasi, serta bervariasinya dukungan desa memengaruhi efektivitas layanan. Proses pelayanan seperti deteksi dini, terapi, edukasi, dan pencatatan di aplikasi ASIK belum berjalan sistematis. Capaian pelayanan tahun 2024 berada di kisaran 44,76–92,66% dengan rata-rata 76,10%. Kepatuhan pasien dalam minum obat rendah dan pengukuran mutu belum konsisten. Kesimpulannya, pelayanan hipertensi belum memenuhi target nasional. Diperlukan penguatan regulasi teknis, distribusi SDM yang merata, peningkatan kapasitas pelaksana, serta kolaborasi lintas sektor dengan dukungan desa dan kader untuk mewujudkan layanan hipertensi yang merata dan bermutu.
