ABSTRAKSalah satu kebijakan Pemerintah selama PIP-II di bidang manajemen rumah sakit adalah pelaksanaan Program Akreditasi terhadap seluruh rumah sakit (RS), baik milik Pemerintah maupun Swasta di Indonesia. Tujuan dan manfaat program ini adalah untuk meningkatkan mutu pelayanan RS, sekaligus untuk memudahkan program pembinaan bagi RS yang membutuhkan. Walau demikian, mengingat kendala dan keterbatasan yang ada, maka strategi pelaksanaan akreditasi RS dilaksanakan secara bertahap, baik jenis pelayanan yang diakreditasi maupun RS yang siap diakreditasi.RSUP Dr. Kariadi, yang merupakan RS kelas Pendidikan juga mampu sebagai pusat percontohan mutu pelayanan RS. Oleh karenanya, di samping melaksanakan self assessment terhadap 5 jenis pelayanan dasar, dalam rangka uji-coba akreditasi tahun 1996, juga terhadap jenis pelayanan lain yang dianggap penting.Salah satu jenis pelayanan RS yang dianggap penting ialah : Pelayanan Gizi Rumah Sakit (PGRS). Alasannya antara lain karena : RSUP Dr. Kariadi ditetapkan sebagai salah satu calon RS-panduan PGRS, sehingga berkinginan menjadi pusat rujukan ringan PGRS diwilayah sekitarnya.Disamping itu hasil survei Tim Depkes (1995) terhadap 10 RS kelas A & B pendidikan belum menggembirakan (termasuk RSUP Dr. Kariadi), menunjukkan adanya kesenjangan antara keadaan sekarang dan gambaran/profil PGRS yang diinginkan.Berangkat dari alasan dan masalah kesenjangan tersebut di atas, maka sangat bermanfaat bila diadakan suatu operational research (penelitian operasional) yang menganalisis faktor-faktor eksternal dan internal pada Instalasi Gizi untuk Perumusan Strategik (Strategy Formulation) Standar optimal PGRS di RSUP Dr. Kariadi Semarang.Metodologi penelitian operasional ini secara diskriptif dengan mempergunakan tehnik analisis strategik yang terdiri atas 3 tahap (David FR, 1995) : (I) Tahap input, dengan analisis faktor eksternal (EFE) dan faktor internal (DE), ( II) Tahap matching, dengan analisis SWOT dan SPACE, ( III) Tahap decision, dengan analisis QSPM (kalau perlu).Penentuan bobot (weight) dan nilai (score) pada tiap-tiap faktor kritis dilaksanakan dengan cara good intuitive judgement dan dimantapkan dengan metode Delphi. Hasil ke tiga tahap analisis merupakan Strategi Terpilih (Strategic Choice) untuk mencapai standar optimal PGRS di RSUP Dr. Kariadi Semarang.Hasil penelitian sebagai berikut :1. Kedudukan strategik Instalasi Gizi dan PGRS di RSUP Dr. Kariadi masih cukup kuat secara finansial, namun tidak dapat tumbuh dan berkembang baik karena tidak mempunyai daya saing kuat. Tempat kedudukan ada di kuadrat kiri atas.Tipe strategi yang paling tepat : Stategi Konservatif.2. Prioritas Strategi Terpilih ialah : I. Tingkatkan citra RSUP Dr. Kariadi, khususnya PGRS, dengan cara konsolidasi dan program pemasaran yang terpadu. II. Tonjolkan produk unggulan PGRS yang bersifat revenue, sementara produk layanan lainnya tetap dimantapkan, III. Tingkatkan manajemen SDM (terutama motivasi kerja dan pemanfaatan SDM mahasiswa/siswa praktek).Disarankan antara lain, agar analisis strategik seperti tersebut di atas dapat dipergunakan oleh pimpinan RS/Intitusi lain di lingkungan Dep. Kes untuk merumuskan strategi mencapai sasaran seseuai dengan visi/misi yang telah ditetapkan.

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ABSTRACT

One of the Government's policy in the hospital management during 2nd-PIP (Longterm National Development) is an implementation of the Hospital Accreditation Program in Indonesia. The goals of this program are to increase the quality of the hospital services, as well as to aid the underquality hospitals. Since there are some constrains in practices, the Hospital Accreditation Program will be implemented stage by stage. At present time, the first stage is being done as a pilot project of self-assessing hospital accreditation towards 5 kinds of primary hospital services : Administration and Management, Medical Care, Nursing Care, Emergency Care, and Medical Records.

Dr. Kariadi hospital, as a largest Teaching Hospital and Medical Referral Hospital in Central Java, should also be able to be a center of the Hospital Nutrition Service (PGRS) networks. For these reasons, during self-assessing hospital accreditation at Dr. Kariadi Hospital in 1996, there will also be completed with other important services i.e. Hospital Nutrition Services (PGRS). Besides, the result of study by Depkes Surveyors Team is disappointed. They highlighted that the highest accreditation score among 10 teaching hospitals (to be centers of PGRS) were only fair score, even there were very low score in 2 teaching hospitals of them. There were some problems in each hospitals especially in the facilitation and human resource.

Because of these problems, it will be very important to perform a Study of the External and Internal factors of Nutrition Department for a Strategy Formulation to achieve the optimal standard of the Hospital Nutrition Services of Dr. Kariadi Hospital.

This is an Operational Research, and a descriptive study with 3 stages of strategic analysis and choice : ( 1 ).The input stage, consists of : Identifications, EFE (External Factor Evaluation) and 1FE (Internal Factor Evaluation), (2 ). The matching stage consists of : a SWOT (Strengths-Weaknesses-Opportunities-Threats) and a SPACE (Strategic Position and Action Evaluation) matrix analysis and (3 ). The decision stage consists of : a QSPM (Quantitive Strategic Planning Matrix) analysis.

Some integrations have to be combined between intuition and scientific analysis in the critical success factor evaluations. In this matter, a "good interactive judgment" in data scoring has to be done by a Delphi method.

The results of this study are as follow : (1 ). The strategic position of Nutrition Department is quite strong in the aspect of Financial Strength, but it is not able to grow up automatically due to the Competitive disadvantage (laid in upper left quadrant of SPACE matrix). (2 ). The appropriate type of strategy : Conservative Strategy. ( 3 ). The strategic choice that can be interpreted as The Grand Strategy are :

a). Market penetration & development, do an integrated marketing to increase a good reputation of Hospital Nutrition services (PGRS) in the community.

b). Product development and concentric diversifications, develop one or two new revenue product and while keeping on maintenance of the current products.

c). Increase the human resources management, especially how to motivate in working.

Even though it is such a recommendation to the hospital administrators to practice the strategic analysis and choice (especially SWOT analysis) for anything to achieve or to make a good strategic decision under conditions of uncertainty.