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Manda Hafni Permana; Pembimbing: Syahrizal; Penguji: Dumilah Ayuningtyas, Dian Ayubi, Verry Adrian, Dicky Alsadik
Abstrak:
Provinsi DKI Jakarta memiliki berbagai isu kesehatan, salah satunya yaitu Triple Burden Disease, dimana Penyakit Menular (PM) masih tinggi, kemudian adanya peningkatan Penyakit Tidak Menular (PTM), ditambah dengan adanya Penyakit Infeksi Emerging (PIE)/ Re-Emerging dan/atau New Emerging. Kementerian Kesehatan RI menyatakan bahwa PIE mendapat perhatian khusus karena dampaknya yang cukup serius baik dari sisi kesehatan maupun sosial ekonomi, terlebih di era digital dan globalisasi saat ini. Seiring dengan perkembangan situasi dan kondisi pandemi, maka ditetapkannya Status Tanggap Darurat Bencana Wabah COVID-19 di Provinsi DKI Jakarta Tahun 2020 memerlukan inovasi dalam peningkatan kualitas pelayanan publik dan peningkatan capaian kinerja dari setiap SKPD/UKPD. DKI Jakarta terbukti telah menerima banyak penghargaan salah satunya dinobatkannya sebagai Provinsi Terinovatif pada Tahun 2020, namun inovasi bidang Kesehatan yang masuk dalam Top 99 Inovasi Pelayanan Publik hanya sebesar 2%. Oleh karena itu, diperlukan analisis mendalam terkait implementasi inovasi bidang kesehatan terhadap kualitas layanan di masa pandemi COVID-19. Jenis penelitian ini yaitu mix method dengan menggunakan metode gabungan kuantitatif dan kualitatif secara bersamaan dengan tipe kombinasi Sequential Explenatory. Variabel independent meliputi kepemimpinan, budaya inovasi, pelatihan sumber daya, saluran komunikasi, jaringan dan kemitraan, penghargaan, kompleksitas dan keuntungan relatif, persepsi kegunaan, dan kemudahan penggunaan, serta variabel dependen yang terdiri dari aspek kualitas dengan pendekatan struktur, proses, dan output. Penelitian dilakukan di Puskesmas dalam Naungan Dinas Kesehatan Provinsi DKI Jakarta pada bulan Mei-Juni 2021. Lokasi Penelitian di Puskesmas dalam Wilayah 5 Kota di Provinsi DKI Jakarta. Analisis data yaitu menggunakan analisis univariat, bivariat (Chi Square), dan multivariat dengan regresi logistik. Hasil penelitian didapatkan kualitas layanan kesehatan masa pandemi sudah cukup baik yaitu sebesar 71,8%. Hasil analisis didapatkan adanya hubungan antara faktor implementasi inovasi dan pemanfaatan teknologi informasi bidang kesehatan terhadap kualitas layanan masa pandemi COVID-19 di Puskesmas Provinsi DKI Jakarta Periode Tahun 2020-2021 yaitu pada variabel kepemimpinan, budaya inovasi, jaringan dan kemitraan, serta penghargaan. Adapun variabel yang paling dominan adalah kepemimpinan yang berinteraksi dengan variabel penghargaan yaitu dengan nilai OR=7,64
DKI Jakarta Province has several health challenges, one of which is Triple Burden Disease, in which Communicable Diseases (CD) remind high, then Non Communicable Diseases (NCD) are increasing, besides Emerging Infectious Diseases (EID)/ ReEmerging and/ or New Emerging. According to the Republic of the Indonesia Ministry of Health, PIE got special attention due to its serious impact on health and socioeconomics, particularly in the current digital era and globalization. Along the development of the situation and conditions of the pandemic, the Emergency Response Status for the COVID-19 Outbreak of the DKI Jakarta Province in 2020 requires innovation in improving the quality of public services and health care. DKI Jakarta Province has received many awards, one of which is the most innovative province. However, innovations in the health sector that are include in the top of 99 public service innovations are only 2%. Therefore, an in-depth analysis is needed regarding innovations in the health sector on the quality of services during the COVID-19 Pandemic. This type of research is mix method by using a combination type Sequential Explenatory. The independent variables include leadership, innovation culture, resource training, communication channels, networks and partnerships, rewards, complexity and relative advantage, perceived usefulness, and perceive ease of use, as well as the dependent variable consisting of aspects of quality with a structure, process, and output approach. The research was conducted at Community Health Center and DKI Jakarta Health Office in Mei-June 2021. The research locations in The Community Health Center in 5 Regencies at DKI Jakarta Province. Data analysis used univariate, bivariate (Chi Square) and multivariate with logistic regression. The result showed that the quality of health services during the pandemic was quite good about 71,8%. The results of the analysis found that there was a relationship between the factors of implementating innovation and the utilization of information technology in the health sector on the quality of services during the COVID-19 pandemic at the DKI Jakarta Provincial Health Center for the 2020-2021 Period are leadership, innovation culture, network and partnership, and reward. The most dominant variable is leadership which is interact with reward with OR value 7,64.
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DKI Jakarta Province has several health challenges, one of which is Triple Burden Disease, in which Communicable Diseases (CD) remind high, then Non Communicable Diseases (NCD) are increasing, besides Emerging Infectious Diseases (EID)/ ReEmerging and/ or New Emerging. According to the Republic of the Indonesia Ministry of Health, PIE got special attention due to its serious impact on health and socioeconomics, particularly in the current digital era and globalization. Along the development of the situation and conditions of the pandemic, the Emergency Response Status for the COVID-19 Outbreak of the DKI Jakarta Province in 2020 requires innovation in improving the quality of public services and health care. DKI Jakarta Province has received many awards, one of which is the most innovative province. However, innovations in the health sector that are include in the top of 99 public service innovations are only 2%. Therefore, an in-depth analysis is needed regarding innovations in the health sector on the quality of services during the COVID-19 Pandemic. This type of research is mix method by using a combination type Sequential Explenatory. The independent variables include leadership, innovation culture, resource training, communication channels, networks and partnerships, rewards, complexity and relative advantage, perceived usefulness, and perceive ease of use, as well as the dependent variable consisting of aspects of quality with a structure, process, and output approach. The research was conducted at Community Health Center and DKI Jakarta Health Office in Mei-June 2021. The research locations in The Community Health Center in 5 Regencies at DKI Jakarta Province. Data analysis used univariate, bivariate (Chi Square) and multivariate with logistic regression. The result showed that the quality of health services during the pandemic was quite good about 71,8%. The results of the analysis found that there was a relationship between the factors of implementating innovation and the utilization of information technology in the health sector on the quality of services during the COVID-19 pandemic at the DKI Jakarta Provincial Health Center for the 2020-2021 Period are leadership, innovation culture, network and partnership, and reward. The most dominant variable is leadership which is interact with reward with OR value 7,64.
T-6140
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Haspeni Simanjuntak; Pembimbing: Adang Bachtiar; Penguji: Ede Surya Darmawan, Nana Mulyana, Novrizal Lubis
Abstrak:
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Tesis ini membahas mengenai mutu pelayanan kesehatan gigi dan mulut pada tiga jenis pelayanan kesehatan primer di Kabupaten Serdang Bedagai Provinsi Sumatera Utara. Penelitian ini adalah penelitian mixed method dengan desain sequential dimana penelitian kuantitatif dilakukan terlebih dahulu lalu diperdalam dengan penelitian kualitatif. Hasil penelitian menemukan ada perbedaan mutu pelayanan kesehatan gigi dan mulut pada tigas jenis pelayanan kesehatan primer di Kabupaten Serdang Bedagai dan menyarankan Puskesmas untuk meningkatkan kepuasan pasien (khususnya pada kelengkapan alat, ruangan yang nyaman dan bersih, kemudahan akses, kecepatan dan keramahan dalam memberikan pelayanan), Klinik Pratama untuk meningkatkan kepuasan pasien (khususnya pada ketanggapan petugas dalam memberikan pelayanan dan kesigapan petugas dalam menangani keluhan), Praktik Mandiri Dokter Gigi melengkapi dokumen akreditasi dan meningkatkan kepuasan pasien (khususnya pada ketanggapan petugas dalam memberikan layanan, ketepatan waktu kedatangan dokter gigi dan kejelasan informasi mengenai alur layanan) dan Dinas Kesehatan Kabupaten Serdang Bedagai agar berkomitmen untuk penyetaraan mutu dengan melibatkan ketiga jenis pelayanan kesehatan primer dalam setiap kegiatan peningkatan mutu pelayanan Kesehatan di Kabupaten Serdang Bedagai Provinsi Sumatera Utara.
The focus of this study is the quality of dental and oral healthcare in three types of primary healthcare in Serdang Bedagai Regency, North Sumatra Province. This research is a mixed method research with a sequential design where quantitative research is carried out first and then deepened with qualitative research. The results of the research found that there were differences in the quality of dental and oral health services in three types of primary health services in Serdang Bedagai Regency and suggested that the Public Health Center increase patient satisfaction (especially equipment completeness, comfortable and clean rooms, ease of access, speed and friendliness in providing services), Pratama Clinics to increase patient satisfaction (especially the responsiveness of officers in providing services and the alertness of officers in handling complaints), Private Dentist Practices to complete the practice requirements documents and increase patient satisfaction (especially the responsiveness of officers in providing services, punctuality of the dentist's arrival and clarity of service flow ) and the Serdang Bedagai District Health Service to commit to equalizing quality by involving the three types of primary health services in every activity to improve the quality of Healthcare in Serdang Bedagai District, North Sumatra Province.
T-6975
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Amelia Rahayu; Pembimbing: Ede Surya Darmawan; Penguji: Adang Bachtiar, Amal Chalik Sjaaf
Abstrak:
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Mutu Pelayanan Kesehatan merupakan standar layanan kesehatan untuk individu dan masyarakat yang dapat meningkatkan luaran kesehatan yang optimal. Indikator Nasional Mutu digunakan sebagai tolak ukur dalam mengukur mutu pelayanan kesehatan. Harapan pasien untuk mendapatkan mutu pelayanan yang baik dapat diberikan oleh dokter yang bertugas ketika melayani pasien yang mampu menerapkan kepemimpinan klinis dengan baik. Penelitian ini bertujuan untuk mengetahui hubungan domain-domain kepemimpinan klinis dokter terhadap mutu layanan kesehatan di rumah sakit. Penelitian ini dilakukan dengan metode survei dengan pendekatan kuantitatif. Penelitian dilakukan pada 42 orang dokter umum dan spesialis dengan kuesioner kepemimpinan klinis dokter. Sedangkan mutu layanan kesehatan di Rumah Sakit Izza dilihat pada capaian indikator nasional mutu rumah sakit. Terdapat 5 domain dengan masing-masing 8 dimensi pada kepemimpinan klinis dan 12 indikator nasional mutu yang dianalisis dari 13 total indikator nasional mutu. Pada penelitian ini didapatkan 2 domain kepemimpinan klinis yang berhubungan dengan mutu layanan kesehatan di rumah sakit, yaitu domain kualitas personal dan peningkatan pelayanan. Tiga domain lainnya, yaitu Kerja sama dengan sejawat dan interprofesi, pengelolaan pelayanan, dan penentuan arah pelayanan tidak berhubungan terhadap mutu layanan kesehatan di rumah sakit
Quality of Health Services is a standard of health services for individuals and communities that can improve optimal health outcomes. National quality indicators are used as benchmark in measuring the quality of health services. Patient expectations for good quality of service can be provided by the doctor on duty when serving patients who are able to apply clinical leadership well. This study aims to determine the relationship of physician clinical leadership domains to the quality of health services in hospitals. This study was conducted using a survey method with a quantitative approach. The study was conducted on 42 general practitioners and specialists with a physician clinical leadership questionnaire. While the quality of health services at Izza Hospital is seen in the achievement of national indicators of hospital quality. There are 5 domains with 8 dimensions each in clinical leadership and 12 national quality indicators analyzed from 13 total national quality indicators. In this study, 2 domains of clinical leadership were found to be related to the quality of health services in the hospital, namely the domains of personal quality and service change. The other three domains, namely Collaboration with peers and interprofessionals, managing service, and setting direction are not related to the quality of health services in hospitals.
B-2367
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Bulan Kamillah; Pembimbing: Puput Oktamianti; Penguji: Masyitoh, Situ Fatimah, Ryan Augustian
Abstrak:
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Peningkatan jumlah kunjungan pasien Jaminan Kesehatan Nasional (JKN) di RS Islam Jakarta Pondok Kopi berdampak langsung pada meningkatnya beban kerja Unit Farmasi Rawat Jalan, khususnya dalam pelayanan resep obat. Data rumah sakit menunjukkan bahwa waktu tunggu pelayanan resep pasien JKN masih melebihi standar pelayanan yang ditetapkan, terutama pada pelayanan resep obat jadi/nonracikan. Kondisi ini berpotensi menimbulkan keluhan pasien, menurunkan kepuasan, serta memengaruhi mutu pelayanan farmasi rawat jalan. Penelitian ini bertujuan untuk menganalisis waktu tunggu pelayanan resep obat jadi/nonracikan pasien JKN di Unit Farmasi Rawat Jalan RS Islam Jakarta Pondok Kopi dengan menggunakan pendekatan manajemen lean. Penelitian ini menggunakan desain operational research dengan pendekatan kuantitatif deskriptif dan kualitatif. Pendekatan kuantitatif dilakukan melalui time and motion study untuk mengukur waktu tunggu, lead time, cycle time, value added time, dan non value added time. Pendekatan kualitatif dilakukan melalui wawancara mendalam dan telaah dokumen untuk menggali hambatan pelayanan serta faktor penyebab terjadinya pemborosan. Analisis dilakukan dengan menggunakan Value Stream Mapping untuk memetakan kondisi awal dan kondisi setelah perbaikan, identifikasi aktivitas value added dan non value added, analisis waste, diagram Pareto, diagram fishbone, serta penerapan lean tools secara terbatas seperti 5S, Kanban, dan Spaghetti Diagram. Hasil penelitian menunjukkan bahwa lamanya waktu tunggu pelayanan resep pasien JKN dipengaruhi oleh tingginya volume resep, keterbatasan tenaga kefarmasian, alur kerja yang belum efisien, pergerakan petugas yang belum optimal, serta pemanfaatan sistem informasi yang masih perlu diperkuat. Identifikasi waste menunjukkan bahwa aktivitas waiting, overprocessing, dan defect merupakan pemborosan yang dominan dalam proses pelayanan. Setelah dilakukan uji coba perbaikan terbatas berbasis manajemen lean, terjadi penurunan waktu tunggu pelayanan resep obat jadi/nonracikan. Rata-rata lead time menurun dari 2 jam 15 menit 13 detik pada kondisi current state menjadi 58 menit 34 detik pada kondisi future state. Penurunan ini menunjukkan bahwa perbaikan alur kerja, penataan area kerja, penerapan sistem Kanban, dan penguatan koordinasi antarunit dapat menurunkan aktivitas non value added serta mempercepat proses pelayanan. Kesimpulan penelitian ini menunjukkan bahwa pendekatan manajemen lean dapat digunakan untuk mengidentifikasi sumber inefisiensi dan mengurangi waktu tunggu pelayanan resep obat jadi/nonracikan pasien JKN di Unit Farmasi Rawat Jalan. Rekomendasi penelitian ini meliputi evaluasi waktu tunggu secara berkala, penyesuaian jumlah tenaga kefarmasian dengan beban kerja, penguatan sistem informasi, standardisasi alur kerja, serta keberlanjutan penerapan lean tools untuk mendukung peningkatan mutu pelayanan farmasi rawat jalan.
The increase in the number of National Health Insurance (JKN) patient visits at Jakarta Pondok Kopi Islamic Hospital has had a direct impact on the workload of the Outpatient Pharmacy Unit, particularly in prescription services. Hospital data show that waiting times for JKN patient prescription services still exceed established service standards, especially for ready-to-use/non-compounded medications. This situation has the potential to lead to patient complaints, lower satisfaction, and affect the quality of outpatient pharmacy services. This study aims to analyze the waiting time for ready-to-use/non-compounded medication prescriptions for JKN patients at the Outpatient Pharmacy Unit of Jakarta Pondok Kopi Islamic Hospital using a lean management approach. This study employed an operational research design with both descriptive quantitative and qualitative approaches. The quantitative approach involved a time-and-motion study to measure waiting time, lead time, cycle time, value-added time, and non-value-added time. The qualitative approach utilized in-depth interviews and document reviews to identify service barriers and factors contributing to waste. Analysis was performed using Value Stream Mapping to map the initial conditions and conditions after improvement, identify value-added and non-value-added activities, analyze waste, and utilize Pareto diagrams, fishbone diagrams, and a limited application of lean tools such as 5S, Kanban, and Spaghetti Diagrams. The research findings indicate that the waiting time for prescription services for JKN patients is influenced by high prescription volume, limited pharmacy staff, inefficient workflows, suboptimal staff movement, and the need to strengthen the use of information systems. The identification of waste revealed that waiting, overprocessing, and defects are the dominant forms of waste in the service process. Following a limited pilot improvement project based on lean management, there was a reduction in waiting times for ready-to-use and non-compounded prescription services. The average lead time decreased from 2 hours, 15 minutes, and 13 seconds in the current state to 58 minutes and 34 seconds in the future state. This reduction demonstrates that workflow improvements, workspace reorganization, the implementation of the Kanban system, and strengthened inter-unit coordination can reduce non-value-added activities and accelerate the service process. The conclusion of this study indicates that the lean management approach can be used to identify sources of inefficiency and reduce waiting times for ready-to-dispense and non-compounded prescription services for JKN patients in the Outpatient Pharmacy Unit. The recommendations of this study include periodic evaluation of wait times, adjusting the number of pharmacy staff to match the workload, strengthening the information system, standardizing workflows, and continuing the application of lean tools to support improvements in the quality of outpatient pharmacy services.
T-7699
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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