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"A comprehensive guide to effective strategic management of health care organizations. Strategic Management of Health Care Organizations provides essential guidance for leading health care organizations through strategic management. This structured approach to strategic management examines the processes of strategic thinking, consensus building and documentation of that thinking into a strategic plan, and creating and maintaining strategic momentum all essential for coping with the rapidly evolving health care industry. Strategic Management of Health Care Organizations fully explains how strategic managers must become strategic thinkers with the ability to evaluate a changing industry, analyze data, question assumptions, and develop new ideas. The book guides readers through the strategic planning process demonstrating how to incorporate strategic thinking and create and document a clear and coherent plan of action. In addition, the all-important processes of creating and maintaining the strategic momentum of the organization are fully described. Finally, the text demonstrates how strategic managers in carrying out the strategic plan, must evaluate its success, learn more about what works, and incorporate new strategic thinking into operations and subsequent planning. This strategic management approach has become the de facto standard for health care management as leadership and strategic management are more critical than ever in coping with an industry in flux. This book provides heath care management students as well as health care administrators with foundational guidance on strategic management concepts and practices, tailored to the unique needs of the health care industry. Included are a clear discussion of health services external analysis, organizational internal analysis, the development of directional strategies, strategy alternative identification and evaluation, and the development and management of implementation strategies providing an informative and insightful resource for anyone in the field. This new eighth edition has been fully updated to reflect new insights into strategic thinking, new methods to conceptualize and document critical environmental issues, practical steps for carrying out each of the strategic management processes, industry and management essentials for strategic thinkers, and new case studies for applying the strategic management processes. More specifically, readers of this edition will be able to: Create a process for developing a strategic plan for a health care organization. Map and analyze external issues, trends, and events in the general environment, the health care system, and the service area. Conduct a comprehensive service area competitor analysis. Perform an internal analysis and determine the competitive advantages and competitive disadvantages. Develop directional strategies. Identify strategic alternatives and make rational strategic decisions for a health care organization. Develop a comprehensive strategy for a health care organization. Create effective value-adding service delivery and support strategies. Translate service delivery and support plans into specific action plans. The health care industrys revolutionary change remains ongoing and organizational success depends on leadership. Strategic management has become the single clearest manifestation of effective leadership of health care organizations and the strategic management framework strengths are needed now more than ever. The Strategic Management of Health Care Organizations provides comprehensive guidance and up-to-date practices to help leaders keep their organizations on track"

"Penurunan kesehatan klien lanjut usia/lansia yang dirawat di rumah sakit seringkali terlambat diketahuioleh perawat. Mendeteksi adanya masalah kesehatan yang kemudian menentukan klien mengalamikemunduran kondisi kesehatan selama dalam perawatan belum dapat dilakukan dengan cepat. Kondisiini terjadi karena banyaknya instrumen yang harus diisi oleh perawat untuk dapat menentukan masalahkeperawatan klien dan membutuhkan waktu yang cukup lama untuk menyelesaikannya. Penelitian inibertujuan untuk mengembangkan instrumen deteksi kemunduran kesehatan lansia dan pemodelanteoritisnya yang dapat digunakan dalam pengambilan keputusan saat memberikan asuhan keperawatanklien di Rumah Sakit. Penelitian ini diawali dengan studi literatur, identifikasi instrumen yangdigunakan Rumah Sakit untuk menapis masalah kesehatan lansia yang dirawat, me n g konsultasikani n s t r ume n k e p a d a 7 orang pakar akademisi dan praktisi dari berbagai keilmuan terkait,dilanjutkan dengan menggunakan metode cross sectional untuk uji construct validity dengan analisamenggunakan Confirmatory Factor Analysis. Uji model teoritis kemunduran kesehatan lansia dilakukandengan menggunakan Structural Equation Modelling pada 469 klien geriatri dari empat Rumah SakitUmum Daerah (2 Kabupaten dan 2 Kota). Analisa data menggunakan software MPlus dari Muthen andMuthen versi 8.1. Hasil penelitian ini adalah instrumen deteksi kemunduran kesehatan lanjut usiaatau IDeKu Ke Lansia dan pemodelan teoritis kemunduran kesehatan lansia di rumah sakit Indonesiayang komprehensif dan meliputi penilaian aspek fisik, kognitif-mental, sosial dan spiritual. Hasilpenelitian menjelaskan bahwa aspek f isik berdampak langsung terhadap kemundurankesehatan lansia (koefisien RMSEA < 0,05; CI 95%: < 0,05; probability RMSEA > 0,05; CFI 0,846;TLI 0,801) atau memenuhi kriteria unidimensional dan fit. Tanda-tanda vital (frekuensi nadi danpernafasan), hasil pemeriksaan gula darah sewaktu, usia dan riwayat pendidikan merupakan indikatoryang secara langsung mempengaruhi kemunduran fisik. Kemunduran fisik berpengaruh langsungterhadap masalah status gizi, aktifitas sehari-hari, kemunduran aspek kognitif-mental, dan aspek sosial.Jenis Kelamin berdampak tidak langsung untuk terjadinya kemunduran fisik melalui mediatorkemunduran aspek sosial dan riwayat pekerjaan. IDeKu Ke Lansia merupakan instrumen pertama diIndonesia yang secara valid dan reliabel mampu mengukur kemunduran kesehatan lansia secaramenyeluruh yaitu meliputi bio-psiko-sosio dan spiritual. Pengembangan instrumen ini dirancang untukmemudahkan perawat dalam mengambil keputusan klinik secara cepat dalam memberikan asuhankeperawatan. IDeKu Ke Lansia memiliki keunggulan sederhana, dapat dilakukan dengan cepat danmampu menilai kondisi kesehatan lansia secara komprehensif. IDeKu Ke Lansia diharapkan mampumenguraikan kompleksitas masalah keperawatan selama lansia dalam perawatan, terutama dalammendeteksi masalah kesehatan lansia saat klien masuk ruang rawat inap di Rumah Sakit. Instrumen inidapat diubah dalam bentuk digital agar semakin memudahkan perawat untuk mengambil keputusanklinis dalam pemberian asuhan keperawatan klien lansia yang dirawatnyaThe deterioration of elderlys health status is often seen through by nurses. Detecting a health problemto determine if the client goes under a deterioration during the care could not be done quickly yet. Thishappens due to the time taken for many instruments a nurse has to fill out to determine the problem.This research aims to develop the instrument to detect the elderlys health deterioration and itstheoretical model as the means to make the decisions on nurse care in hospitals. This research is donewith literature study, instruments identification on what has already used in the hospitals, consultationwith seven academic and practitioner experts from the related studies, followed by cross sectionalmethod to test out the construct validity with Confirmatory Factor Analysis. The theoretical model teston elderlys health deterioration was conducted with Structural Equation Modelling on 469 geriatricclients from State Hospitals (2 districts and 2 cities). Data analysis was done by MPlus software fromMuthen and Muthen ver.8.1. The result would be an elderly health deterioration detection instrumentor IDeKu KE Lansia and the a comprehensive theoretical model on elderlys health deterioration inhospitals in Indonesia, including the assessments of physical, cognitive-mental, social and spiritualaspects. The result shows that physical aspect is directly affecting on the deterioration (coefficientRMSEA < 0,05; CI 95%; < 0,05; probability RMSEA > 0,05; CFI 0.846; TLI 0,801) or to fulfil the fitand unidimensional criteria. Vital signs (pulse and breathing frequency), blood sugar test result, age,and educational background are the indicators that directly affect the physical deterioration. Thephysical deterioration would directly affect the nutritional status, daily activities, setbacks on cognitivemental,and social aspect. Gender does not directly affect the physical deterioration through themediator of social aspect and educational background. IDeKu Ke Lansia is the first valid and reliableinstrument in Indonesia to measure the overall elderlys health deterioration including bio-psycho-socioand spiritual. The development of this instrument is designed to let the nurse easily make a clinicaldecision during the care. IDeKu Ke Lansia has a simple distinction, it could quickly andcomprehensively determine the elderlys health condition. IDeKu Ke Lansia is expected to disentanglethe complexity of elderlys health status during the care especially in detecting the problem at the timewhen the elderly was admitted to the hospital. This instrument could be altered into digital form so thatit could be easily used by the nurse in taking clinical decisions during the elderly care."

"Untuk menerapkan paradigma baru pelayanan kesehatan dalam era globalisasi yang akan datang, Bidang Kimia Kesehatan Balai Laboratorium Kesehatan Palembang diharapkan memiliki daya saing tinggi dan swadana. Namun, Bidang Kimia Kesehatan masih belum terakreditasi sementara jumlah pemeriksaan laboratorium yang ditargetkan masih rendah. Dalam rangka meningkatkan kinerja Bidang Kimia Kesehatan, telah dirumuskan perencanaan strategis dengan melakukan penelitian operasional.Penelitian opeasional ini dilaksanakan menggunakan model pemecahan masalah yang terbagi menjadi tiga tahap, yaitu tahap masukan (input stage), tahap penyesuaian (matching stage) dan tahap keputusan (decision stage). Dalam tahap pertama, data tentang faktor-faktor internal sebagai kunci sukses dikumpulkan dari 12 orang staf Kimia Kesehatan dengan wawancara mendalam dan CDM, sedangkan data tentang faktor-faktor eksternal dikumpulkan dengan observasi dan wawancara mendalam. Dengan menggunakan matriks SWOT dan IE, dalam tahap kedua semua data yang terkumpul dianalisis untuk menetukan posisi organisasi, tujuan jangka panjang, beberapa strategi yang mungkin untuk mencapai tujuan serta strategi-strategi alternatifnya yang cocok. Akhirnya, matriks QSPM digunakan dalam tahap ketiga untuk menyusun prioritas strategis yang paling cocok dalam mengembangkan Bidang Kimia Kesehatan.Matriks-matriks yang telah dibuat menunjukkan bahwa Bidang Kimia Kesehatan berada dlam posisi tumbuh dan membangun (grow and build). Oleh karena itu, strategi yang cocok untuk posisi ini adalah strategi integratif dan strategi integratif horizontal. Selanjutnya, berdasarkan matriks SWOT dirumuskan 12 strategi integratif dan 3 strategi horizontal Akhirnya, dari semua strategi yang telah dirumuskan pembentukan tim pemasaran merupakan prioritas utama.

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Stragegic Planning for the Develompent of Health Chemistry Unit of the Palembang Health Laboratory 2001-2003To implement new paradigm in health services in the coming globalisation era, Health Chemistry Unit of the Palembang Health Laboratory is expected to be high competitive and self financed. However, the Unit has not been accredited while the achievement of targeted laboratory' tests is still very low. In order to improve the Unit performance, a strategic planning has been formulated by conducting an operational research.

The operational research was carried out using problem solving model which were divided into input stage, matching stage, and decision stage. In the first stage data on internal factors as success keys of the Health Chemistry Unit organisation were collected from 12 staffs of Health Chemistry by in-depth interview and CDM, whereas data on external factors were collected by in-depth interview and observations. Using SWOT and IE matrices, in the second stage all coIIected data were analysed to determine the position of the organisation, its long-term objectives, possible strategies to achieve the objectives as well as appropriate alternative strategies. Finally, QSPM matrix was used in the third stage to prioritise the most appropriate strategies for the development of Health Chemistry laboratory unit.

The constructed matrices show that the Health Chemistry Unit is in grow and build position. Therefore, the suitable strategies for this position are integrative strategy and horizontal integrative strategy. Further, based on the SWOT matrix 12 integrative strategies and 3 horizontal strategies were formulated. Finally, of the formulated strategies forming marketing team is the top priority."

"Pembangunan nasional dilaksanakan dalam rangka pembangunan manusia Indonesia seutuhnya yang mana dalam pelaksanaannya meliputi berbagai pembangunan mencakup program, proyek dan bagian proyek. Pembangunan kesehatan merupakan bagian integral dari pembangunan nasional. Dalam Undang-Undang Nomor 23 Tahun 1992 tentang Kesehatan ditetapkan bahwa kesehatan adalah keadaan sejahtera badan, jiwa dan sosial yang memungkinkan setiap orang hidup produktif secara sosial dan ekonomi. Perubahan-perubahan yang terjadi beberapa tahun belakangan ini berlangsung sangat cepat. Paradigma lama yang menganut sistem sentralisasi sudah tidak dapat dipertahankan lagi. Laporan realisasi anggaran pembangunan secara berkala dan evaluasi namun kurang mendapat perhatian. Di sisi lain pimpinan membutuhkan informasi mengenai perkembangan realisasi anggaran pembangunan untuk menetapkan kebijakan dan umpan balik bagi penyusunan rencana dan program tahun mendatang.Semangat desentralisasi untuk mendorong pembangunan di daerah terns bersambut seiring dengan dikeluarkannya Undang-Undang Nomor 22 Tahun 1999 tentang Pemerintah Daerah dan Undang-Undang Nomor 25 Tahuri 1999 tentang Perimbangan Keuangan antara Pemerintah Pusat dan Daerah, maka kegiatan laporan dan evaluasi sangat diperlukan dan penting peranannya untuk mengontrol pemakaian dana dialokasi di daerah dan dana yang ada di Pusat.Penelitian ini bertujuan untuk mengevaluasi sistem laporan anggaran pembangunan Departemen Kesehatan tahun 1998, 1999, 2000. Data diperoleh dari observasi di Biro Keuangan, Biro Perencanaan dan Kanwil Kesehatan DKI, Jawa Tengah, DI.Yogyakarta, Kalimantan Selatan, Kalimantan Timur, Sumatera Barat, Sulawesi Tengah serta wawancara mendalam untuk menggali penyebab kurang tepat waktu dan akurat laporan. Responden adalah beberapa orang yang terlibat, meliputi para Pemimpin Proyek dan Bendahara, pejabat-pejabat dan staf terkait di Pusat dan Daerah.Hasil penelitian menemukan permasalahan yang salah satu sebabnya mekanisme penyampaian laporan masih secara manual, kebijakan di Pusat yang masih menggunakan pola sentralisasi. Bertitik tolak dari permasalahan tersebut peneliti mencoba untuk memberikan masukan perbaikan mekanisme pengiriman laporan, format laporan, penggunaan teknologi komputasi, kebijakan yang memberikan sangsi dan penghargaan kepada pengelola proyek apabila tidak melapor.

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Evaluation on Reporting System of Development Budget Realization of Department of Health for year 1998, 1999, 2000National development has been held in order to build a better Indonesian people, that consist of development with all its aspects. Health development is part of national development. It's said in UU no. 23, 1992 that health is a state of good body, soul and social, so man can live productively both in social and economics. The changes happened so fast in the past few years. Old thoughts that contain centralization system can not be maintained. The regular development budget realization reports and evaluations are important for managerial chain. But its ignorance sometimes will make a good plan can not achieve well in result. In the other hand, chief needs information about the progress of development budget realization so that policies can be made.

Decentralization spirit to speed up local development keeps continuing, hand in hand with UU no. 22, 1999 about local government and UTJ no. 25, 1999 about The Equality Finance between Local and Central Government. It makes report and evaluations are needed and important in order to control the cash flow at local and central government.

The goals of this examination are to evaluate Health Department's System of Development Budget Report for year 1998, 1999, and 2000. Data was collected and gathered from finance bureau and province head office DKI, Central Java, Yogyakarta, South Kalimantan, East Kalimantan, West Sumatra, and Central Sulawesi and interview in order to know the causes of unpunctual and inaccurate reports. Respondent consist of staffs in local and central government.

The examination found that problems, caused by manual and unintegrated working mechanism and central government's policies that still based on centralization pattern. From those problems, examiner try to make some advises on how to improve report delivery mechanism, report's form, computerization, an policies of rewards and penalties for insub ordinance."

"Visi Indonesia sehat 2010 mengharapkan masyarakat Indonesia dimasa depan melalui pembangunan kesehatan adalah penduduknya hidup dalam lingkungan dan perilaku yang sehat, memiliki kemampuan untuk menjangkau pelayanan kesehatan yang bermutu secara adil dan merata serta memiliki derajat kesehatan yang setinggi-tingginya.Dengan adanya UU Nomor 22 tahun 1999 tentang Pemerintahan Daerah dan UU Nomor 25 tahun 1999 tentang Dana Perimbangan antara Pemerintah Pusat dan Pemerintahan Daerah, diharapkan Pemerintah Daerah Kabupaten lebih aktif melaksanakan pembangunan di bidang kesehatan mulai dari perencanaan, pelaksanaan maupun pengawasan.Puskesmas sebagai ujung tombak pelayanan kesehatan kepada masyarakat lebih meningkatkan perannya sebagai pusat pembangunan kesehatan, pusat pembinaan peran serta masyarakat serta pusat pelayanan kesehatan tingkat pertama dengan cara meningkatkan sistim manajemen sumberdaya, khususnya manajemen peralatan Puskesmas.Penelitian ini bertujuan untuk mendapatkan secara rinci proses manajemen peralatan di Puskesmas Inderalaya, Puskesmas Tanjung Raja dan Puskesmas Tanjung Lubuk Kabupaten Ogan Komering Ilir. Dalam mendeskripsikan proses manajemen peralatan Puskesmas yang digunakan dalam penelitian ini adalah pendekatan evaluasi dimensi kesesuaian (appropriateness) dan dimensi kecukupan (adequateness).Penelitian ini dirancang dengan pendekatan kualitatif dilakukan pada bulan April sampai Mei 2002 dengan subjek penelitian adalah Pimpinan Puskesmas, Bendaharawan barang dan koordinator program, masing-masing 1 (satu) orang untuk tiap Puskesmas.Dari hasil penelitian dapat disimpulkan bahwa kesesuaian dan kecukupan faktor dalam kajian manajemen peralatan di 3 (tiga) Puskesmas telah sesuai dan cukup. Sedangkan faktor pemanfaatan dan pemeliharaan hanya Puskesmas Inderalaya yang sesuai dan cukup.Demikian juga Pimpinan Puskesmas diharapkan membina stafnya terus menerus, meningkatkan keterampilan petugas pengelola peralatan Puskesmas dengan cara mengirim petugas tersebut untuk mengikuti pelatihan baik di kabupaten maupun propinsi, sehingga nantinya diharapkan manajemen peralatan Puskesmas sebagai bagian dari sistim manajemen sumberdaya Puskesmas tujuannya akan betul-betul tercapai.

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Evaluation of Equipment Management System in Community Health Center of Indralaya, Tanjung Raja and Tanjung Lubuk, at the District of Ogan Komering Ilir Year 2001The vision of "Healthy Indonesia Year 2010" expects that the health development of the future Indonesia will construct healthy community and nation which are indicated by people living in healthy environment, applying healthy behavior, and able to access to health services equitably.

The Law No. 22, 1999 about Local Government and the Law No. 25, 1999 about the Fiscal Balance of Central and Local Government outlined that Local Government at the district level to be more active on undertaking health development including planning, implementing, and controlling.

Community Health Center (PUSKESMAS) as the main community health services should play more important role as the center of health development, the community participation and center of primary health services by improving its management system of resources especially the management of PUSKESMAS equipment.

This research aims to get the detail information about management system of equipment in PUSKESMAS of Indralaya, Tanjung Raja, and Tanjung Lubuk at the District of Ogan Komering Ilir. To describe the process of PUSKESMAS equipment management, this research used the appropriateness and adequateness dimension evaluation approaches.

This research was designed with qualitative approach that conducted during April and May 2002. Subject of this research were the head of PUSKESMAS, commodities treasurer, and program coordinator, and respectively one person in each PUSKESMAS.

The result of the research concluded that the appropriateness and adequateness of input factors of equipment management in the three PUSKESMAS has been appropriate and adequate, while the process factor, especially the utilization and maintenance, only PUSKESMAS of Indralaya which is appropriate and adequate.

It is gratefully hoped that the head of PUSKESMAS could guide his staff continuously and increase the skills of the worker who uses and maintains the PUSKESMAS equipment by sending him to get such training either in district or provincial level. Thus, the purpose of PUSKESMAS equipment management as the part of resources management system of PUSKESMAS will be reached."