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This study examines about the satisfaction of medical support affairs of non-civil servants of the remunerations based Competency Based Human Resource Management (CBHRM) in Pasar Rebo Hospital in 2011. This research is a cross sectional research using quantitative methods. The data was collected by filling questionnaires. A total of 134 questionnaires distributed but only 107 complete questionnaires are returned to the researcher. Respondents in this research are 107 medical support affairs of non-civil servants in Pasar Rebo Hospital which is divided into 6 installations. The result showed that there are 53.3 % officers who stated that they are not satisfied with the remuneration received. By this research, known that amount of time working, knowledge about remuneration system, leadership, supervision, remuneration policy, dissemination of remuneration system associated with satisfaction of medical support affairs of non-civil servants of the remunerations based CBHRM. The hospital needs to follow up these findings by evaluating remuneration and improve dissemination of the remuneration system in Pasar Rebo Hospital, involving relevant management and employees of related installation.
Padapenelitian ditemukan 45,8% perawat mengalami stres yang tinggi. Perbedaanproporsi terbesar ditemukan pada faktor individu (kepercayaan diri) dan dukungan(dukungan atasan). Hasil merekomendasikan perbaikan deskripsi kerja yang lebihjelas dan akurat serta pelatihan komunikasi terkait upaya manajemendalammengelola stres kerja.
This study discusses work stress and the factors that affect work stress amongnurses In Emergency Room in RSUD Pasar Rebo 2014. National Institute forOccupational Safety and Health (NIOSH)categorizes the factors that influencework stress, which are as job stressor, non-work, individual, and support factors.This study was conducted among 24 emergency room nurses at RSUD PasarRebo. Descriptive observational cross-sectional method was used in this study.
The results found that 45.8% of nurses experienced high stress. The largestproportionswere found in individual factor (self-esteem) and support (supervisorsupport). This study recommend improvements on clearer job descriptions andaccurate communication and training related to management efforts in managingwork stress.
Pelayanan keperawatan sebagai salah satu subsistim pelayanan kesehatan di rumah sakit merupakan komponen sentral untuk terwujudnya pelayanan kesehatan yang bermutu. Keberhasilan pelayanan kesehatan yang bermutu ditentukan oleh berbagai faktor antara lain kualitas sumber daya manusia, sarana dan fasilitas, kebijakan yang ada serta manajemen rumah sakit. RSU Bina Sehat Kabupaten Bandung, dalam bidang keperawatan masih banyak menghadapi berbagai kendala. Rendahnya kinerja rumah sakit dengan nilai BOR (Bed Occupancy Rate) baru mencapai 4l,05%, tingkat keterlibatan perawat/bidan dalam upaya peningkatan kualitas layanan masih rendah, dan dari sisi manajemen RSU Bina Sehat belum memiliki konsep dan fondasi manajemen yang kuat. Dalam upaya meningkatkan manajemen dan kinerja perawat/bidan, pemerintah melalui Menteri Kesehatan mengeluarkan keputusan tentang Pedoman Pengembangan Manajemen Kinerja (PMK) Perawat dan Bidan yang tercantum dalam Kepmenkes RI Nomor 836/Menkes/SK/VU2005. Tujuan penelitian ini secara umum adalah menganalisis kesiapan RSU Bina Sehat dalam menerapkan PMK perawat/bidan melalui faktor input dan proses. Penelitian menggunakan metode deskriptif analitik dengan pendekatan kualitatif. Fokus penelitian adalah pada lini manajemen dan pelaksana yang berhubungan dengan keperawatan dan kebidanan. Dari hasil telaah dokumen, wawancara mendalam, dan FGD (Focus Group Discusion) menunjukkan bahwa Faktor Input PMK yaitu uraian tugas, SOP, SAK/SAB, pelatihan, sistem penghargaan, kecuali indikator kinerja, sudah dijalankan namun masih bersifat superfisial. Faktor Proses PMK yaitu monitoring, evaluasi, pengelolaan penyimpangan, diskusi refleksi kasus, dokumentasi asuhan keperawatan, dokumentasi asuhan kebidanan belum berjalan optimal sesuai dengan aturan dan standar yang telah ditetapkan oleh pemerintah. Dari hasil penilaian terhadap faktor-faktor tersebut RSU Bina Sehat tidak siap dalam menerapkan Kepmenkes RI No. 836/Menkes/SK/VI/2005 atau kesiapan baru mencapai 30%. Hambatan pelaksanaan PMK adalah kurangnya dukungan terhadap program, kurangnya kualitas dan kuantitas SDM , sarana dan prasarana masih kurang serta rendahnya motivasi kerja. Selain melengkapi kekurangan dari faktor input dan proses, dalam rangka menunjang kinerja dan sistem manajerial, secara umum diusulkan melalui 10 langkah perbaikan yaitu perbaikan struktur organisasi rumah sakit dan instalasi; kebijakan pimpinan rumah sakit; komitmen visi, misi, tujuan rumah sakit dari seluruh komponen rumah sakit; memupuk sifat kepemimpinan; peningkatan ketrampilan klinis dan manajerial; perbaikan deskripsi pekerjaan dan beban kerja; menilai kembali tata letak ruang rawat; melengkapi sarana dan alkes; memperbaharui sistem penghargaan; mengembangkan kerja tim dan pembelajaran.
Nursing service is, as a subsystem of health service in hospital, a central component to achieve quality heath service. The success of quality health service is dependent on the quality human resotuces, facilities and infrastructures, standing policies, and hospital management. Bina Sehat Hospital in Kabupaten Bandung is still facing many problems in nursing services including low perfomiance with 41.05 per cent of BOD (Bed Occupancy Rate) , low involvement of nulseslmidwives in the upgrading of quality service and Bina Sehat Hospital does not have solid concept and foundation of management. In an attempt to improve management and performance of nurses/midwives, the government of Indonesia through the Minister of Health has issued guidance on the development of performance management nurse/midwife in Kepmenkes RI No. 836/Menkes/SK/VI/2005. The objective of this study is to analyze the readiness of Bina Sehat Hospital in Development of Perfomance Management (DPM) nurse/midwife through input and process factor. This study employs descriptive analytic method with qualitative approach. The focus ofthe study is on the line management and execution related to nursing and obstetric. According to the results of document’s review, in-dept interview, and Focus Group Discussion, it is shown that input factors of DPM comprising of job description, Standard Operating Procedure (SOP), nursing/midwifery upbringing standard, training, reward system, except performance indicator, have already been operational yet still superficial. Process factors of DPM consisting of monitoring, evaluation, storage management, case reflection discussion, nursing documentation, obstetric documentation have not been optimal by the govemrnents’ rules and standards. Evaluation results on these factors, Bina Sehat Hospital is considered not ready yet in the implementation of Kepmenkes RI No. 836/Menkes/SK/VI/2005 as its readiness currently achieves only 30 per cent. The problems in implementing DPM nurse/midwife are the lack of support on the program, shortage in the quality and the quantity of human resources, shortage of facilities and infrastructure, and low work motivation. Apart from filling the gap in input and process factors, in supporting performance and managerial system, ten improvement steps are proposed are improve structural organization of hospital and installation; improve hospital management policies, committed vision, mission, objectives of the whole hospital components, nurture leadership, up-grade clinical and managerial skills, improvejob description and work load, review the lay out of nursing, add on facilities and health instrument, renew reward system, develop team work and learning system.
RSUD Pasar Rebo sebagal BLUD, masih menerapkan remunerasl pada tahun 1992. Ini mengindikasikan ketidaksesuaian antara status RSUD Pasar Rebo sebagai BLUD dengan remunerasi yang diterapkan. Salah satu profesi yang menjadi ujung tombak pelayanan kesehatan di rumah sakit dan berperan cukup besar dalam menjaga mutu dan reputasi rumah sakit adalah perawat. Maka manajemen rumah sakit perlu memperhatikan kesejahteraan perawat khususnya dalam bentuk insentif. Pemerintah mengeluarkan Permendagri No. 61 Tahun 2007 yang dapat dijadikan acuan RSUD Pasar Rebo dalam menyempurnakan penentuan insentif untuk perawat. Penelitian ini bertujuan untuk mengetahui penentuan insentif untuk perawat yang berlaku di RSUD Pasar Rebo, serta menganalisis implementasi insentif perawat berdasarkan Permendagri No. 61 Tahun 2007 di RSUD Pasar Rebo. Penelitian operasional dengan pendekatan kualitatif ini menggunakan teknik wawancara mendalam. Informan penelitian adalah beberapa pejabat pengelola terkait serta Wakil Direktur Umum dan Keuangan RSUD Pasar Rebo, pejabat pengelola dan Direksi PT. Rumah Sakit Pasar Rebo sebagai informan triangulasi. Hasil penelitian ini menggambarkan insentif perawat yang berlaku di RSUD Pasar Rebo dinilai variabel tetap dan tidak tetap. Pola penentuan insentif yang berlaku di RSUD Pasar Rebo belum memasukkan indikanor risiko kerja, tingkat kegawatdaruratan dan capaian kinerja. Karena RSUD Pasar Rebo sering berganti status kelembagaan, pergantian dineksi serta komitmen bersama antara direksi dengan pejabat pelaksana yang kurang. Saran penelitian ini adalah penentuan insentif di RSUD Pasar Rebo didasarkan pada prestasi kerja perawat, RSUD Pasar Rebo dapat mengacu pada Permendagri No. 61 Tahun 2007, dalam memasukkan indikator risiko kerja, tingkat kegawatdaruratan dan pengoptimalan indikator capaian kinerja dalam menentukan insentif perawat di RSUD Pasar Rebo; serta peningkatan kornitmen bersama dari unsur pimpinan dan pejabat pelaksana di RSUD Pasar Rebo.
RSUD Pasar Rebo as BLUD, is still uslng the remuneration mechanism ln which used since 1992. This indicate an unappropriatness condition between RSUD Pasar Rebo status as BLUD with implemented remuneration mechanism. Nursing is one of occupation in hospital that become the first line of health services and have a big role in quality improvement and reputation of hospital. So the hospital management should have a big concern of nurse prosperity especially the material incentives. Government announced Permendagri No.61/2007 as a technical guidance for BLUD that can be used by RSUD Pasar Rebo to complete the nurse incentives Formulation. The aim of this research are to know the nurse incentives formulation description in RSUD Pasar Rebo and to analyze the nurse incentives implementation based on Permendagri No.6l/2007 in Pasar Rebo Regional Hospital. The research design is operational research with qualitative approach. The researchers as a research instrument helped by interview guidance to do the indepth interview. The research informant are several stakeholders and Director Representative of Administration and Financial in Pasar Rebo Regional Hospital, several stakeholders and Directors of Rumah Sakit Pasar Rebo Company as triangulation informant. The result of this research are describe that the nurse incentives formulation in RSUD Pasar Rebo is appreciated by fix indicators and variable indicators. The incentives formulation in RSUD Pasar Rebo currently, doesn?t entered Risk Index, Emergency Index, and Performance index yet. Generally, it happen because RSUD Pasar Rebo often face the organizational status transformation, director succession and the lackness of director and performer commitment. The suggestion in this research are the nurse incentives formulation in RSUD Pasar Rebo hopefully really based on performance appraisal like written and arranged in RSUD Pasar Rebo Employee Regulation ; RSUD Pasar Rebo can use the referencies that recommended by Permendagri No.61/2007 to enteres the Risk Index, Emergency Index and Perfomance Index in formulating the nurse incentives; and RSUD Pasar Rebo hopefully could increase the commitment between director as a decision maker in hospital and Performer who manage and do the hospital policy to always give support to the nurse prosperity development along professional and objectives incentives formulation.
Instalasi Farmasi RSUD Pasar Rebo merupakan pusat pendapatan RS, Namun, realisasi anggaran Instalasi Farmasi selalu lebih tinggi dari perencanaannya selama lima tahun terakhir sejak 2007 sampai 2011 yang mungkin dipengaruhi oleh cost awareness, cost management, cost monitoring, dan cost incentive sebagai faktor-faktor dari cost containment. Tujuan penelitian ini untuk menganalisis cost containment di Instalasi Farmasi RSUD Pasar Rebo dengan mengetahui cost awareness, cost management, cost monitoring, dan cost incentive dan juga upaya cost containment yang dilaksanakan secara keseluruhan. Penelitian ini merupakan penelitian kualitatif dengan memanfaatkan dua teknik pengumpulan data yaitu data sekunder dan wawancara mendalam kepada pegawai level manajemen RS yang terkait erat dengan Instalasi Farmasi RSUD Pasar Rebo. Penelitian ini dilaksanakan selama Juli 2011 sampai Juli 2012. Hasil penelitian menunjukkan variabel cost awareness yaitu pelatihan belum mengarah pada efisiensi, serta pengkomunikasian harga melalui spanduk dengan slogan yang memotivasi pegawai ataupun acara khusus untuk pengenalan harga sediaan farmasi bagi pegawai pun belum ada. Variabel cost management yaitu budget dengan realisasi budget lebih tinggi dari perencanaan, pengkonsolidasian dokter melalui forum ?reboan? dihadiri sekitar 30 persen dokter, e-prescribing belum diaplikasikan, penyediaan obat dihitung dengan stok minimum dan maksimum tetapi belum ada pegawai yang ditunjuk untuk bertanggung jawab menghindari obat expired, pengurangan biaya operasional diterapkan dengan mematikan AC dan lampu yang tidak digunakan, pemanfaatan ulang kertas bekas, serta penyiapan obat dengan tepat, sementara dukungan eksekutif masih dipandang sebagai supervisi. Variabel cost monitoring yaitu pemonitoran keuangan berkelanjutan dalam hal ini cash flow masih belum mampu dimanfaatkan sebagai alat untuk memberi peringatan kepada Instalasi Farmasi untuk sejalan dengan perencanaan budget, selain belum kuatnya bargaining position RS walaupun margin obat generik dan obat non generik di atas 30 persen, dan masih terjadi selisih saat stock opname, pelayanan terintegrasi masih birokratis serta belum dapat meraih sense of belonging pegawai karena tidak sampainya informasi yang cukup, pengamanan obat penting dilakukan dengan pembedaan lemari serta adanya kartu stok. Variabel cost incentive yaitu pemberian insentif belum ditentukan oleh output kinerja melainkan kompetensi. Hal tersebut di atas menunjukkan upaya pengendalian biaya yang masih memprihatinkan di RSUD Pasar Rebo khususnya di Instalasi Farmasi. Kesimpulannya bahwa Instalasi Farmasi RSUD Pasar Rebo belum mengimplementasikan cost containment (cost awareness, cost management, cost monitoring, cost incentive) secara tepat.
The Pharmacy Installation of RSUD Pasar Rebo is a revenue centre for the hospital. Therefore, the Realisation of Budget of Pharmacy Installation had been higher than its planning for five years since 2007 until 2011 that might be influenced by cost awareness, cost management, cost monitoring and cost incentive as factors of cost containment. The objective of this research was to analyze the cost containment at The Pharmacy Installation of RSUD Pasar Rebo by knowing cost awareness, cost management, cost monitoring, and cost incentive and also the cost containment efforts for overall. This research was a qualitative research, conducted by utilizing two data collection techniques which were secondary data and in-depth interview on the entire management level of hospital which was related directly to The Pharmacy Installation of RSUD Pasar Rebo. This research conducted throughout the months of July 2011 ? July 2012. The result of the study revealed variables of cost awareness were the training program had not directed to efficiency and there were not the price communication by putting motivation statement on working area nor special event for making pharmacy staff knowing about price of pharmacy things. Variables of cost management were the budget which was realization higher than it plan, the doctor consolidation through "reboan" had admitted around 30 percent, the e-prescribing had not applied, the medicine reservation calculated by minimum and maximum stock but there was not a responsible staff to avoid expired medicine, the reducing operational cost was applied by turning off AC and lamp when unused, reuse paper, and preparation medicine correctly, the executive support was adjusted like a supervision not a support. Variables of cost monitoring were the monitoring financial continuely by cash flow was disable to warn The Pharmacy Installation strict to the budget planning nor had bargaining position in medicine principal even the generic and non generic margins upper 30 percent, moreover stock opname still had dismatch, the integrated service was birocratic and staff`s sense of belonging can?t be reached cause not enough information can be achieved, the security of important medicine through differentiating cupboard and stock card. Variable of cost incentive was the Insentive given had not determined by output of work but competences. It was revealed that cost containment efforts were still poorly implemented at RSUD Pasar Rebo especially at The Pharmacy Installation. The conclution was The Pharmacy Installation of RSUD Pasar Rebo had not yet properly implemented cost containment (cost awareness, cost management, cost monitoring, and cost incentive).