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Jurnal Manajemen Pelayanan Kesehatan
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EVALUASI KINERJA PERAWAT PELAKSANA RUMAH SAKIT M.H. THAMRIN SALEMBA DENGAN PENDEKATAN PERSONAL BALANCE SCORECARD TAHUN 2010 Kwang, Ridwan
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Background: In the last decade there has been a dramaticshift in the human resource management. Personal BalanceScorecard (PBS) is a new concept with the approach “fromthe inside out” that uses the individual employee as a startingpoint.objectives: To obtain information about the performance ofnurses in M.H. Thamrin Salemba Hospital based approach tothe PBS, also to analyze PBS as performance appraisal instrument.Methods: The study was conducted in November 2010 toJanuary 2011 using an instrument Scorecard Personal Balance(PBS). Analyses were conducted with quantitative andqualitative approaches. Sample of quantitative research is theentire population of nurses in the inpatient adult MH ThamrinSalemba Hospital. Survey instruments used for quantitativeresearch are containing questions about the performance ofnurses from the perspective of PBS. The qualitative research,conducted in-depth interviews of nurses who meet certaincriteria. Performance measurement results with PBS and thencompared with the desired target and then analyzed descriptively.Results: This study found that the performance is good enoughin the financial perspective, but still lack of nurses performanceon the customer perspective, there are some sectorswhich need to be improved in the internal business perspective,also learning and development perspective, and there is aunit of work teams with performance score less well thanother units, that unit is Burns Unit.Conclusion: From the analysis it concluded that PBS in itsrole to measuring the performance of nurses also can translatethe vision, mission and strategic goals of the nurses intoperformance indicator and strategic planning. It also obtainedfrom this study that the result of performance measurementusing PBS was in conformity with the situation on the field andnot deviate with BSC of M.H. Thamrin Salemba Hospital. Itsuggests that the concept of the PBS can be further developedand used mainly on an ongoing basis.Keywords: balanced scorecard, personal balancedscorecard, performance measurement, system management
Strategi Luar Biasa untuk Penurunan Kematian Ibu dan Bayi Trisnantoro, Laksono
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Di berbagai daerah jumlah absolut kematian ibumeningkat tajam. Kematian bayi juga meningkat.Peningkatan ini tentunya sasaran Millenium DevelopmentGoals (MDG)4 dan MDG5 sulit tercapai.Pada konteks ini, kesehatan ibu dan anak (KIA) telahbanyak dilakukan penelitian yang menghasilkandoktor baru, tulisan di jurnal dan berbagai hal lain.Namun dampak untuk penurunan kematian ibu tidaksignifikan, bahkan di berbagai daerah ada peningkatan.Sebagai komplemen berbagai penelitian perludilakukan rencana aksi di daerah dengan pendekatancommon-sense. Pendekatan ini mengacu padasifat luhur manusia yang mampu menggunakan akalsehat dan naluri.Pendekatan sense making menggunakan langkahlangkah sebagai berikut: 1) Menggunakan konsep-konsep universal untuk memahami masalahyang terjadi di KIA; 2) Mengidentifikasi fakta dilapangan dalam level kabupaten; 3) Melakukanpemahaman dan pemaknaan mengenai data denganperspektif konsep-konsep universal (sense making);4) Melakukan usulan respons dalam kebijakan danmanajemen program untuk mengatasi masalah yangterjadi; (5) Usulan respons kebijakan dan manajemenprogram tertuang dalam dokumen yang berisikebijakan dan manual manajemen yang komprehensif;(6) melakukan aksi perubahan berbasis responsdi berbagai tempat secara sukarela dan dimonitorproses dan evaluasi dampaknya; dan (7) melakukanevaluasi terhadap aksi perubahan yang dilakukanuntuk perbaikan kebijakan. Berbagai langkah dapatdiuraikan lebih rinci agar dapat operasional. Langkah1: Konsep-konsep universal yang dipergunakan.Penanganan KIA memerlukan pendekatan sistemkesehatan dengan komponen-komponen yang mencakup:(1) pelayanan kesehatan dan tindakan masyarakatdi hulu dan hilir; (2) fungsi-fungsi dalamsistem kesehatan misal pemberi pelayanan, regulasi,pembiayaan, pembayaran Sumber DayaManusia (SDM), perubahan perilaku masyarakat;dan (3) perlunya reformasi sistem pelayanankesehatan KIA. Prinsip-prinsip universal yangdigunakan mencakup: continuum of care, koordinasiyang baik antar berbagai pihak, membedakan antaradaerah maju banyak fasilitas dan tenaga dengandaerah yang kurang, mutu pelayanan dankeselamatan ibu dan bayi, dan menggunakansemaksimal mungkin pembiayaan negara untukmengurangi angka kematian.Langkah 2: Mengidentifikasi fakta. Data mengenaikematian ibu dan bayi perlu diindentifikasi. Selanjutnyadilakukan langkah 3 dengan dilakukan pemahamandan pemaknaan data dalam perspektifkonsep universal dan situasi lokal. Pemahaman danpemaknaan data ini dilakukan dalam kerangka pertanyaan:Reformasi kebijakan apa yang akan dilakukandi level kabupaten? Penguatan manajemen apa yangakan dilakukan?Langkah 4. Usulan respons lokal mencakupperlunya kebijakan KIA yang mencakup perbaikan dihulu dan di hilir. Usulan kebijakan tersebut antara lain:penggunaan kematian absolut sebagai indikatorkinerja sistem, perbaikan tata kelola sistem pelayananKIA, dan reformasi kebijakan yang tidak terbataspada Jampersal saja. Reformasi kebijakan mencakupperbaikan aspek pembiayaan jaminan bagi ibuyang bersalin, perbaikan mekanisme pembayaranbagi lembaga dan tenaga kesehatan; perbaikan pengorganisasianpelayanan kesehatan KIA yangmencakup hulu, rujukan dan hilir; penguatan kebijakanregulasi; dan peningkatan promosi kesehatanuntuk memperbaiki perilaku masyarakat. Secarakhusus dalam paket kebijakan ini ditekankan mengenai:peningkatan kemampuan pre-emptive strikedalam rujukan terencana sehingga mengurangi rujukanemergency; perbaikan jalur rujukan; pengarahanpembiayaan negara untuk ibu-ibu bermasalah; danperbaikan mutu pelayanan dan keterlibatan aktif paraspesialis dalam pengurangan kematian ibu dan anak.Langkah 5 berupa penulisan draft kebijakan danmanual manajemen. Mengapa menggunakan modelmanual di kabupaten? Jawabannya adalah bahwaprogram KIA sangat rumit yang melibatkan banyaklembaga dan banyak profesi. Melalui cara manualdiharapkan masalah yang kompleks ini dapat dicarisolusinya dan dapat dilakukan pengembangansecara sistematis. Lebih jauh lagi, dengan adanyamanual sistem pelayanan kesehatan ibu dan anak,peranan tenaga pembantu teknis (konsultan) dalamKIA akan lebih mudah dilakukan.176 Jurnal Manajemen Pelayanan Kesehatan, Vol. 14, No. 4 Desember 2011Laksono Trisnantoro: Strategi Luar Biasa untuk Penurunan Kematian Ibu dan BayiDiharapkan usulan ini dapat diuji di beberapadaerah terpilih sebagai langkah 6 yaitu melakukanaction berbasis respons di berbagai tempat dandimonitor proses dan evaluasi dampaknya (Langkah7). Langkah 7 ini sangat penting karena sebagai usulanyang luar biasa tentunya harus dapat diukur hasilperubahannya. Pengukuran ini dilakukan denganindikator jumlah kematian ibu dan bayi absolut disebuah kabupaten.Pertanyaan yang akan terus berkembang dalampenyusunan dan pelaksanaan perubahan kebijakandan manajemen program KIA di kabupaten adalah:Apakah perubahan kebijakan dan manajemen KIAini logis dan masuk akal (making sense)? Apakahmengandung pembaharuan yang luar biasa untukusaha pengurangan kematian ibu dan anak? Apanyayang baru? Apakah usulan ini dapat berjalan ataukahhanya di atas kertas saja? Apa bukti-bukti yang dapatmendukung usulan ini? Sebagai catatan akhir, andaikatausulan ini dianalisis tidak logis dan tidak dapatdiaplikasikan, apakah ada alternatif perubahan kebijakandan manajemen untuk mengurangi kematianibu dan anak di kabupaten? Laksono Trisnantoro(trisnantoro@yahoo.com)
PERAN TENAGA TEKNIS KEFARMASIAN DALAM MENURUNKAN ANGKA KEJADIAN MEDICATION ERROR Simamora, Sarmalina
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Introduction: Medication error in term is the incidence thatcan be harmful to the patient due to human error in handlinghospitalized patient care that actually can be avoided. Medicationerror can be classified as: dispensing errors, prescribingerrors and administration errors. Among of medication errorcaused by less communication, loading work, distribution systemand a role of occupational health care was low enough.Objective: The aim of this research was to evaluate the frequencyand type’s incidence of medication error by a role ofoccupational pharmacy working at hospitalized room care.Based on active participation they act to check the appropriateof Medical notes, Recipe (R/), Nursing drug administration notes;such as identity of patient, Medical record number, productname, quantity, posology, strengthening, doses ,and directionof doses.Methods: This research was pre-experimental, which tookpre-post intervention approach. Data Collection were conductedin three steps; pre-participation, being-participation andpost-partcipation. To indentify the incidence of medication errorof their active participant determined by Chi-Square statisticallyperformance.Result. As the result of 94 samples patient there were theinfluences of occupational pharmacy among inter variability inwhich the odds ratio value was 4,055, p value 0,0001. Amongof medication error the higher performance were administrationphase 81,32%, prescribing phase 15,88 % and transcribingphase 2,8%.Conclusion: Increasing a role of occupational pharmacy inthe hospitalized health care can be lowering the incidence ofmedication error due to their active participation.Keywords: medication error, RK Charitas Hospital, occupationalpharmacy
PERMENKES SUNAT KAUM PEREMPUAN: PRO DAN KONTRA ANTARA TRADISI DAN PERLINDUNGAN KEPENTINGAN PEREMPUAN Oktarina, Oktarina
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Findings on female circumcision in few areas in Indonesia showthat nearly 88.5% of the field by medical personnel, in PadangPariaman 67.5% also carried out by medical staff, while theremaining non-medical personnel, while in Makassar and bonealmost 100% female circumcision is performed by non-powerhealth or dukun beranak if done by non medical personnel,Kemenkes can not regulate. Female circumcision as a traditionthat must be respected, even if they basically do not agree tosuch practices as viewed from the medical side, female circumcisionis an activity that is not known and is not recommended.To protect the health of women and their infants tofurther strengthen the decision then the health minister issuedregulations Permenkes No.1636/Menkes/Per/XI/2010 femalecircumcision which issued November 2010. In the presence offemale circumcision Permenkes aims to protect women fromillegal life-threatening circumcision and reproductive system,Health Minister also gave authority to certain medical workerssuch as doctors, midwives and nurses to perform female circumcisionprocedure.Keywords: ministerial regulation, Female Genital Cutting, tradition
MODUL MENUJU SELAMAT-SEHAT: INOVASI PENYULUHAN KESELAMATAN DAN KESEHATAN KERJA DALAM PENGENDALIAN KELELAHAN KERJA Duma, Krispinus
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Background: Fatigue was allegedly the cause of accidentsin the Perusahaan Tambang Batubara (PTB) and the OHS managementcompany focused on the manpower to cope with recommendsgetting enough sleep, exercise, balanced diet andso forth. But fatigue is caused by various factors including,work environment factors, lifestyle, health conditions and soforth but it is not disclosed to the work force. OccupationalHealth Safety (OHS) extension system with lectures held sofar one way communication from the management of PTB tothe workforce and look at labor as objects rather than as OHSsubjects.Purpose: Towards a Better Health and Safety Module (MMSS)as the OHS method and media effective counseling increasedknowledge, attitude and behavior of OHS and innovative laborforce in controlling fatigue in PTB.Methods: This quasi-experimental type (quasi experimental)with nonequivalent design (pretest and posttest) control groupdesign, consisting of treatment group (experimental) and controlgroups. Treatment groups received MM-SS, while the controlgroup did not get the MMSS.Result: Application Module Towards Good-Health as a methodand medium of OHS for one-year extension effective improvethe OHS knowledge and attitudes heavy equipment operatorsignificantly (p<0.05), but not yet effective increasing behaviorof heavy equipment operator (p> 0,05) in control of workexhaustion in the PTB. Relationships of OHS knowledge andattitude with the level of job burnout WR light, WR sound indicator,and KAUPK2 significant (p <0.05) but not significantOHS behavior (p> 0.05). The correlation coefficient of OHSknowledge, attitude and behavior with the level of job burnoutWR light, WR sound indicator and KAUPK2 is 0.090 to 0.540.Conclusion: Module OHS (MMSS) as extension methods andmedia effective K3 K3 improve knowledge and attitudes, butnot yet effective increase K3 behavior PTB heavy equipmentoperator. Knowledge and attitudes K3 significantly associatedwith fatigue level heavy equipment operator work PTB, but therelationship behavior of K3 with no significant level of jobburnout.Keywords: modules, knowledge, attitude, behavior, fatiguework
PENYUSUNAN INDIKATOR KLINIS Tandrasari, Devi
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Background: Quality health care is one of the requirementsneeded by everyone, including service in the hospital. Clinicalindicators used as a quality tool that enables objective measurementto assess whether it has provided excellent serviceto customers or patients. Sardjito General Hospital has beenset and measure the performance of clinical services usingclinical indicators since 2000, but the indicators are not compiledsystematically by type of key services that can be givenby doctors in the department at the hospital.Objective: To develop a clinical indicator for measuring theperformance of clinical services of a department in the hospital,to trial the implementation of measures of clinical indicators,and to evaluate the clinical indicators that have beenmade.Methods: Qualitative research using an action research studydesign. The subject of this research is Obstetrics and GynecologyDepartment at Sardjito General Hospital, Yogyakartaand specialist doctors and doctors who follow education obstetricsand gynecology specialization final semester. Datacollection is done by analysis of the results of the workshop,the analysis results of questionnaires, analysis of interviewdata availability, analysis of test results of clinical indicators ofmeasurement, and analysis of the results of the finalized workshop.Results: Ten clinical indicators agreed to be measured in theObstetrics and Gynecology Department. Based on the resultsof the questionnaire, the ten clinical indicators are approvedby most doctors. Of the ten clinical indicators, there is oneindicator that did not have the data, the numerator of the clinicalindicators for services normal partus /vaginal partus. Theagreements in the finalized workshop are to make changesthe operational definition, the value of the achievement standardsand the availability of existing data.Conclusion: Obstetrics and Gynecology Department will performthe measurement for the ten indicators that have beenset. Clinical indicators that do not have the availability of datawill still be measured by creating a special form. Changes andimprovements to the operational definitions and standards ofachievement values need further discussion.Keywords: quality of service, clinical indicators, obstetricsand gynecology
SIKAP MENGENAI KESELAMATAN PADA RESIDEN DAN PERAWAT DI RUMAH SAKIT PENDIDIKAN Emilia, Ova
Jurnal Manajemen Pelayanan Kesehatan Vol 14, No 04 (2011)
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Background: Provider attitudes about issues pertinent topatient safety may be related to errors and adverse events.Residents as the main health provider in teaching hospitalsplay an important factors for assuring patient safety.Objective: To assess the attitudes of residents towards patientsafety and compare the attituted to other health providersnurse/midwive) in the Obstetrics Gynaecology Outpatient Clinic.Methods: This was a survey conducted in a teaching hospitalat Yogyakarta. Safety Attitude Questionnare (SAQ)-A questionnairewas adapted into Indonesian setting to assess attitudesamong residents and nurses at Obstetrics Gynaecologyoutpatient clinic. All residents and health providers were invitedto participate in this survey.Results: Total of 71 respondents involved in this survey (consistedof 79% of total residents and 82% of total nurses). TheSAQ-A questionnaire which was used here had comparableinternal consistency with the previous study. In general attitudestowards patient safety were higher among nurses/midwive than residents. Significant differences revealed relatedto perception to management and stress recognition.Perception to management score was the lowest compared toother scales (19,6% residents versus 33,3% nurses withpositive attitudes). There was no differences for other scalesbut still with low attitude scores. Aspects related to “informationtransfer between residents and consultant”, “clinic referralsystem” and “care in test results management” were perceivedas poor by residents and nurses.Conclusion: Residents have lower attitudes towards patientsafety compare to nurses/midwive. This study shows theimportance of providing orientation among residens beforetheir training program to improve patient safety attitude.Key Words: attitude towards patient safety, safety attitudesquestionnaire, teaching hospital

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