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Kata kunci : Budaya keselamatan pasien rumah sakit, keselamatan pasien, budaya keselamatan
This study aims to analys the hospital of patient safety culture of Awal Bros Hospital Batam in 2016. The concept used was the concept of patient safety culture from AHRQ (2004) which is adopted from Puspitasari M. research (2009), then for improvement used the concept of system reliability form Marx D. (2010). The research design was sequential explanatory, used questionnaire from AHRQ which has been translated to Indonesia language, followed by FGD to formulate the weak dimension improvement effort. Patient safety culture status categorized into medium culture, average of positive perception 70,82%. The greatest strengths are in organizational learning and continuous improvement, feedback and communication about patient safety, communication openness. Weaknesses are primarily in staffing, non-punitive responses to errors, handover and transitions must be fixed immediately. Improvement suggestions by reducing non core job assignments, employee retention programs, hotline service internal, leader lead tracer, investigator training.
Keywords: Hospital of patient safety culture, patient safety, safety culture
Increasing the number of patients the period 2014-2015 due to theimplementation of the National Health Insurance policy, followed by an increasedincidence of wound infection Operations (ILO) in RS. Awal Bros Pekanbaru.Data from the Committee on Hospital Infection Control Committee showedincreased rates of ILO in 2012-2013 from 0 to 8 events in 2014 and 2015. Of thenine events at the ILO cases, the highest number is the case of post-apendiktomiseven events, then a row followed by four incident cases of kidney stones andthree events in the case of a cesarean section.The study aims to determine the factors associated with the occurrence ofILO apendiktomi in the period, carried out with a qualitative approach utilizing aretrospective data analysis of case studies. The data collection is done byanalyzing secondary data from medical records include in-depth interviewsreferring to the interview guidelines.The results of the analysis get prophylactic antibiotics compliance factorscontribute to the incidence of surgical site infection five. Factors related to theaccuracy of antiseptic aseptic techniques contained in all occurrences of surgicalwound infections, as well as to the suitability of the operating time factor obtainedin five events wound infections. From the search root of the problem can besummed up, the issue of scheduling of operations and standard operatingprocedure is the main problem. Settling on the scheduling of operations andimprovements in the standard operating procedures can be a solution to reduce theincidence of surgical site infection apendiktomi.Keywords: ILO, appendectomy, prophylactic antibiotics, surgery time
Latar Belakang : Waktu tunggu sering kali dijadikan indikator untuk menilai kualitas pelayanan rumah sakit oleh pasien. Salah satu aspek yang menjadi perhatian adalah waktu tunggu untuk pemulangan pasien. Data RS Mitra Keluarga Bintaro tahun 2023 menunjukkan rata-rata waktu tunggu pasien adalah 87 menit dengan perbedaan yang cukup signifikan antara pasien dengan penjaminan pribadi (66 menit) dan penjaminan asuransi (121 menit). Data rata-rata waktu tunggu tersebut terhitung sejak dokter memberikan instruksi pulang hingga pasien melakukan billing akhir. Data tersebut belum terhitung hingga pasien meninggalkan ruang rawat inap. Standar pelayanan minimal waktu tunggu pemulangan pasien rawat inap yang ditetapkan oleh Kemenkes yaitu kurang dari 120 menit. Pencapaian waktu tunggu pasien yang keluar dalam waktu ≤ 2 jam tercatat sebesar 88%, meskipun masih belum memenuhi target korporat yang ditetapkan sebesar 100%.
Metode : Penelitian ini mengadopsi desain operational research yang mengintegrasikan metode kuantitatif dan kualitatif. Teknik pengambilan sampel yang digunakan adalah simple random sampling, dengan total sampel sebanyak 38 pasien yang pulang setelah menjalani rawat inap. Pemilihan sampel didasarkan pada distribusi hari, jam kepulangan, dan jenis metode penjaminan yang telah ditetapkan.
Hasil : Hasil penelitian dengan pendekatan lean six sigma berhasil mengidentifikasi lead time pemulangan pasien rawat inap di RS Mitra Keluarga Bintaro sebesar 5 jam 10 menit 54 detik dimana 69% merupakan kegiatan non value added yang didominasi oleh waste tipe waiting sebesar 3 jam 14 menit 23 detik. Akar masalah dari memanjangnya waktu tunggu pemulangan pasien rawat inap berada di fase III pada kegiatan menunggu pasien meninggalkan ruang rawat inap. Penerapan lean six sigma dalam proses pemulangan pasien rawat inap di RS Mitra Keluarga Bintaro berhasil mengurangi lead time sebesar 16%, dari 5 jam 10 menit 54 detik menjadi 4 jam 21 menit 25 detik. Pengurangan lead time ini diikuti dengan penurunan waste di seluruh tahapan pemulangan pasien, dengan penurunan waste terbesar terjadi pada fase I, yaitu sebesar 44%, dari 1 jam 3 menit 27 detik menjadi 35 menit 46 detik.
Kesimpulan : Terdapat penurunan waktu tunggu pemulangan pasien rawat inap di RS Mitra Keluarga Bintaro setelah penerapan lean six sigma. Penurunan waktu tunggu pemulangan pasien rawat inap masih diatas target standar pelayanan minimal yang ditetapkan oleh Kemenkes.
Background : Waiting time is often used as an indicator to assess the quality of hospital services by patients. One aspect of concern is the waiting time for patient discharge. Data from Mitra Keluarga Bintaro Hospital in 2023 showed that the average patient waiting time was 87 minutes with a significant difference between patients with personal guarantees (66 minutes) and insurance guarantees (121 minutes). The average waiting time data is calculated from when the doctor gives instructions to go home until the patient makes the final billing. The data does not include until the patient leaves the inpatient room. The minimum service standard for inpatient discharge waiting time set by the Ministry of Health is less than 120 minutes. The achievement of waiting time for patients who leave within ≤ 2 hours was recorded at 88%, although it still does not meet the corporate target set at 100%. Method : This study adopted an operational research design that integrates quantitative and qualitative methods. The sampling technique used was simple random sampling, with a total sample of 38 patients who returned home after undergoing inpatient care. Sample selection was based on the distribution of days, hours of discharge, and types of guarantee methods that had been determined. Hasil : The results of the study using the lean six sigma approach successfully identified the lead time for inpatient discharge at Mitra Keluarga Bintaro Hospital of 5 hours 10 minutes 54 seconds, where 69% were non-value added activities dominated by waiting type waste of 3 hours 14 minutes 23 seconds. The root of the problem of the long waiting time for inpatient discharge is in phase III in the activity of waiting for the patient to leave the inpatient room. The application of lean six sigma in the inpatient discharge process at Mitra Keluarga Bintaro Hospital successfully reduced the lead time by 16%, from 5 hours 10 minutes 54 seconds to 4 hours 21 minutes 25 seconds. This reduction in lead time was followed by a decrease in waste in all stages of patient discharge, with the largest decrease in waste occurring in phase I, which was 44%, from 1 hour 3 minutes 27 seconds to 35 minutes 46 seconds. Kesimpulan : There is a decrease in the waiting time for discharge of inpatients at Mitra Keluarga Bintaro Hospital after the implementation of lean six sigma. The decrease in the waiting time for discharge of inpatients is still above the minimum service standard target set by the Ministry of Health.
Analisis budaya keselamatan pasien menghasilkan 4 dimensi kategori budaya sedang yang memerlukan perbaikan keselamatan pasien serta 7 dimensi kategori budaya baik yang menjadi kekuatan dalam keselamatan pasien. Pengorganisasian ketenagaan, beban kerja dan pola kerja; konseling pasien; keterbukaan komunikasi; dan respons terhadap kesalahan menjadi kelemahan budaya keselamatan pasien yang menjadi prioritas perbaikan. Tingkat pelaporan kejadian masih rendah dan harus mendapat perbaikan.
Kata kunci: budaya keselamatan pasien, instalasi farmasi
This research uses sequential explanatory design started from quantitative analysis using questionnaire The Pharmacy Survey on Patient Safety Culture (PSOPSC) from AHRQ followed by focus group discussion to formulate strategy to build patient safety culture.
Analysis of patient safety culture resulted in 4 dimensions of moderate cultural categories that require improvement and 7 dimensions of good cultural categories that be strength of the patient safety culture. Staffing, Work Pressure and Pace; Patient counseling; Communication openness; and Response to Mistakes is weakness of the patient safety culture that become priority improvement. Level of incident reporting is still low and need improvement.
Keywords: patient safety culture, pharmacy installation
. Patient falls prevention program in Awal Bros Hospital Group has been madesince 2013 but the incidence of patient falls still occur and have not beenevaluated. The purpose of this study is to evaluate the program uses crosssectional method. Data collected through documents review and in-depthinterviews.The results of the study concluded that the average fall rate incident ininpatient units is 0,18 per 1.000 days of hospitalization, ratio of nurses to patientsis 0,22, fall risk assessment compliance is 0,95, compliance for risk fall educationis 0,94, the use of fall risk bracelet 0,97. From the four variables studied only theprovision of education that significantly affects the incidence of patient falls.Recommendations for improvement of patient falls prevention programs wereproposed referring to the theory of Malcolm Baldrige, compiled by seven aspectsleadership, strategic planning, customer, management of measurement, analysisand knowledge (quality improvement), labor (human resources), informationsystems / processes work and result.Key Words : Patient Safety; Fall Incident; Malcolm Baldrige Framework
ABSTRAK Nama : Roswin Rosnim Djaafar Program Studi : Kajian Administrasi Rumah Sakit Judul : Analisis Pengaruh Fokus Pasar Dan Pelanggan Serta Pengelolaan Proses Layanan Terhadap Kinerja Rumah Sakit Omni Pulomas Tahun 2016 Penelitian ini bertujuan untuk menegtahui besarnya pengaruh fokus pasar dan pelanggan (pengetahuan pasar, pengetahuan pelanggan, hubungan pelanggan, kepuasan pelanggan) dan pengelolaan proses layanan terhadap kinerja operasional RS Omni Pulomas tahun 2016. Secara teoritis penelitian ini mengacu kepada konsep dari Malcolm Baldrige Criteria for Performance Excellence 2015. Penelitian ini merupakan penelitian survey dengan pendekatan kuantitatif, dimana data yang digunakan adalah data primer dengan memakai alat bantu kuesioner. Metode penelitian menggunakan metode analisis jalur atau disebut juga Path Analysis. Sampel penelitian diambil dari karyawan RS Omni Pulomas tahun 2016 dengan menggunakan stratified random sampling berdasarkan kelompok unit kerjanya. Hasil penelitian di temukan bahwa pengelolaan proses layanan di pengaruhi oleh pengaruh pengetahuan pelanggan, hubungan pelanggan dan kepuasan pelanggan. Pengetahuan pasar pada penelitian ini tidak berpengaruh terhadap pengelolaan proses layanan. Pengaruh langsung yang paling kuat korelasinya adalah kepuasan pelanggan dengan nilai koefisien korelasi 0,321 dan nilai p-value 0,000. Untuk pengaruh pengetahuan pelanggan, hubungan pelanggan, kepuasan pelanggan dan terhadap kinerja operasional RS Omni Pulomas ditemukan bahwa yang mempunyai pengaruh langsung paling kuat adalah pengelolaan proses layanan dengan nilai koefisien korelasi 0,397 dan nilai p-value 0,000. Berdasarkan penelitian ini disarankan pada manajemen untuk melibatkan karyawan lebih banyak untuk pengenalan dan pemahaman karakteristik dari pasar dan pelanggan. Pihak manajemen perlu melakukan upaya terus menerus untuk melakukan evaluasi dan perbaikan pada proses kerja. Sistem informasi yang terintegrasi sebaiknya segera di implementasikan. Daftar Kepustakaan : 30 ( 2005-2015 )
ABSTRACT Name : Roswin Rosnim Djaafar Study Program: Kajian Administrasi Rumah Sakit Title : The Analysis of Market Focus Influences and Customer Focus and also Service Management Process To Operational Work In Omni Hospital Pulomas in 2016 This study has a purpose to know how much the influence of market focus and customer focus (market knowledge, customer knowledge, customer relationship, customer satisfaction) and also service management process to operational performance in Omni Hospital Pulomas in 2016. In Theory, this study is based on Malcolm Baldrige Croteria for Performance Excellence (MBCfPE), in Health Care Criteria for Performance Excellence 2015. This study is a survey study with quantitative approach, where the data that is used is a primary data by means of a questionaire help device. The methods that had been used by this study is Path Analysis. The Sample was taken from Omni Hospital Pulomas employee in 2016 using Stratified Random Sampling according to its work unit. The results show that service management process is affected by customer knowledege , customer relation and customer satisfaction. In this study it was found that market knowledge does not have an influence on the service management process. The biggest influence comes from customer satisfaction with a correlation coefficient value at 0,321 and p-value at 0,000. For the effect of customer knowledge, customer relation, customer satisfaction and service management process to Omni Pulomas Hospital operational performance, from this study it was found that the most influencing factor came from the service management process with a correlation value at 0,397 and p-value 0,000. In regards to this study it reccomends that the management in the hospital to involve more employee interaction with the market knowledge and customer related interaction to recognize more of market and customer characteristics. Management need to evaluate and make continous improvement for the service process and an integrated hospital information system needs to be implemented as soon as possible. Reference : 30 (2005-2015)
