Rumah Sakit sebagai sebuah institusi perlu menerapkan good corporate governance dan good clinical governance dalam meningkatkan mutu pelayanannya secara berkesinambungan. Badan Layanan Umum (BLU) adalah instansi di lingkungan Pemerintah yang dibentuk untuk memberikan pelayanan kepada masyarakat berupa penyediaan barang dan/atau jasa yang dijual tanpa mencari keuntungan dan dalam melakukan kegiatannya didasarkan pada prinsip efisiensi dan produktivitas. Pemerintah menyadari perlunya keleluasaan praktik berbisnis yang sehat di berbagai instansinya, sehingga telah mengeluarkan Peraturan Pemerintah No. 23 Tahun 2005 (PP 23/2005) mengenai Pengelolaan Keuangan BLU dan mengijinkan penerapannya dapat dilaksanakan di berbagai instansi pemerintah termasuk Rumah Sakit. Penelitian ini bertujuan mengevaluasi tata kelola pada 4 (empat) Rumah Sakit Vertikal Kelas A di Jawa dan Bali.Terdapat perbedaan implementasi pada ke 4 (empat) RS Vertikal tipe A di Jawa dan Bali yang diteliti. Perbedaan tersebut adalah perbedaan pencapaian kelengkapan persyaratan dokumen tata kelola serta perbedaan pada 4 (empat) unsur tata kelola BLU sesuai PP 23/2005 yang meliputi 12 (dua belas) faktor terkait peningkatan mutu pelayanan menurut skema Donabedian dan Glickman, yaitu budaya korporat, penetapan BLU, hospital by laws, Renstra & RBA, pengembangan layanan, pengadaan barang & jasa, standar pelayanan, penetapan tarif, pejabat pengelola, penetapan remunerasi, kepegawaian, pembinaan & pengawasan.Perlunya peningkatan pemahaman pejabat pengelola satuan kerja, peningkatan kualitas pembinaan dan pengawasan, pembentukan pengelola khusus BLU di Kementerian Kesehatan, pembentukan tim terpadu yang melibatkan seluruh pemangku kepentingan. Diperlukan juga perubahan budaya organisasi, seleksi & evaluasi RS BLU, pemenuhan syarat kelembagaan BLU, reward & punishment, peraturan yang jelas, rencana strategis & rencana bisnis anggaran yang sesuai. Kebijakan publik yang tepat sangat dibutuhkan dan menentukan keberhasilan suatu negara dalam mencapai tujuannya.

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A hospital as an institution needs to implement good corporate governance and good clinical governance to improve service quality continuously. Public Service Agency (BLU) is a government agency established in order to provide services to the community in the form of supply of goods and/or services being sold without profit and doing activities based on the principles of efficiency and productivity. The government realized the needs for flexibility in healthy business practices of various institution, so it has issued Government Regulation No. 23, 2005 (PP 23/2005) of the Financial Management BLU and allow its application to be implemented in a variety of government agencies including the hospitals. The purpose of this research is to evaluate governance at four (4) type A vertical hospitals in Java and Bali.

The result of this study in four (4) type A vertical hospitals in Java and Bali showed that there are differences in the implementation. These include differences in achievement of the completeness document on good corporate governance as well as governance requirements documents as well as differences in the 4 (four) elements of governance from PP 23/2005 that includes 12 (twelve) related factors of Donabedian and Glickman’s scheme which are corporate culture, BLU establishment, hospital by laws, strategic planning & business plan budget, service development, procurement of goods and services, service standards, tariffs, management officer, remuneration, staffing, training and supervision.

This research suggested the need for improved understanding of work force management officer, the quality of guidance and supervision, the establishment of specialized managers in BLU in Ministry of Health, the establishment of an integrated team involving all stakeholders. Improvements needed in change organizational culture, BLU’s hospital selection & evaluation, BLU's institutional requirements, reward & punishment system, clear rules and strategic plan & business plan budget. Appropriate public policy to determine the success of a country in achieving its objectives is needed.