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"Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also inDistrict General Hospitals. Certainly this condition influences the sustainability of drug access in primary health caresuch as in Community Health Center and District General Hospital, especially in drug financing policy. A crosssectional descriptive study to obtain information on drug management in public healthcare in district had been carriedout between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District HealthOffices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District DrugManagement Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planningin District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals.The minimum health service standards had not been achieved yet. Furthermore, drug procurement, storage andrecording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead timefor drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years."

"Telah dilakukan penelitian mutu pelalyanan Programatic Management Drug Resistance Tuberculosis (PMDT) di RSUP Persahabatan. Tujuan umum: mengetahui mutu pelayanan strategi PMDT di RSUP Persahabatan. Penelitian ini dilakukan dengan disain penelitian dengan metode kualitatif yaitu menggali informan dengan wawancara mendalam dan telaah dokumen. Sampel adalah pasien TB-MDR September 2009 sampai 31 Desember 2011. Hasil penelitian: pasien yang berobat di poli DOTS Plus berjumlah 814 pasien didapatkan 319 (39,2%) pasien TB-MDR, pasien melakukan pengobatan sebanyak 231 (72,4%) pasien dan tidak kembali ke rumah sebanyak 88 (27.6%). Pada penelitian ini dokter dan perawat sudah memenuhi syarat, dana pengobatan masih mendapat bantuan, kebijakan RS sudah dilaksanakan, sarana dan prasarana sesuai PPI TB, laboratorium sudah tersetifikasi WHO hanya masih terjadi kendala hasil pemeriksaan uji resisitensi dengan media padat (Ogawa/LJ), MGIT lebih dari 45 hari pada tahun 2009 sampai dengan tahun 2011, hal ini menyebabkan salah satu keterlambatan pengobatan. Pasien yang telah didiagnosis TB MDR masih didapatkan yang menunda pengobatan (delayed treatment) sebesar 156 pasien (67,5%), dengan lama penundaan 2 minggu - >12 bulan. Penangan pasien mangkir masih belum tercatat dengan baik, Angka keberhasilan pengobatan pasien sembuh/komplit didapatkan 60,2%, putus berobat 15,2%, meninggal 16 %, gagal 1,3% serta on treatment 6,9%. Pasien sembuh/komplit merasakan pengobatan di rumah sakit terjadi kemudahan dalam mengambil obat karena dapat diluar jam kerja dan dapat saling bertukar pengalaman dengan sesama penderita. Pasien penundaan pengobatan karena perlu kesiapan diri dan dukungan keluarga untuk pengobatan selama 2 tahun. Pasien putus berobat merasakan pengobatan menganggu aktivitas, perlu biaya, dan tidak mendapat dukungan dari keluarga. Pelayanan satelit belum maksimal, masih didapatkan memberikan pelayanan pengobatan lanjutan. Edukasi yang masih dirasakan kurang untuk pasien dan keluarga.

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A research about the service quality of Programatic Management Drug Resistance Tuberculosis (PMDT) in Persahabatan General Hospital has been conducted.

Primary objective: To determine the quality of service of the PMDT strategic in Persahabatan General Hospital. This is a qualitative study, by acquiring information with in-depth interview and literature review. The samples were MDR-TB patients from September 2009 until December 2011.

Result: The number of patients seeking treatment in Persahabatan Hospital were 814 patients that consists of 319 patients (39,2%) with positive MDR, treated patients were 231 people (72,4%), and untreated patients were 88 people (27,6%). In this study, the doctor and nurse were qualified, treatment fund still received aid, the policy had been implemented, the laboratory had been certified by WHO, the only constraint was with the result of the resistance test with solid media, MGIT result took more than 45 days from 2009 until 2011, this had caused delay in treatment. There were 156 (67,5%) patients who have already been diagnosed as a MDR TB but was delayed in getting treatment for two weeks until twelve months. The management of default patients was not well-documented. The treatment success rate of cured patients were 60.2%, dropped out treatment were 15.2%, while 16% died, 1.3% failed, and 6.9% were still in on-going treatment. Cured patients felt that during treatment in the hospital, acquiring medicine was easy because it could be done outside working hours and patients were able to exchange experiences with fellow patients. Patients delay treatment because they required time for preparations and needed family support for treatment for 2 years. Treated patients dropped out of treatment felt that the process disrupt their activities, required expenses, and they did not have the support of their family. Satellite service is not maximized, it is found that they provide advanced medical care. Education is still lacking for patients and families."

"Pengelolaan obat adalah salah satu aspek manajemen rumah sakit yang sangat penting dalam usaha pelayanan kesehatan masyarakat. Penelitian ini bertujuan untuk menganalisis pengelolaan obat di instalasi farmasi Rumah Sakit Stroke Nasional Bukitinggi. Metode penelitian yang digunakan dalam penelitian ini adalah studi kasus dengan menggunakan pendekatan kualitatif. Hasil penelitian menunjukkan proses pengelolaan dan pengendalian yang dilakukan selama ini belum berjalan dengan baik terlihat dari masih tingginya angka kekosongan obat pada tahun 2017 yaitu 7,6% dari 421 jenis obat setiap bulannya dan jumlah obat kadaluwarsa yaitu sebesar 10,45% yang seharusnya 0%. Perencanaan dengan memprioritaskan pembelian kelompok VA, EA dan NA perlu dilakukan untuk mencegah terjadinya kekosongan obat. Untuk mencegah tingginya jumlah obat kadaluwarsa adalah dengan penghitungan jumlah obat yang dipesan berdasarkan penghitungan ROP dan Safety Stock. Kelompok VA merupakan kelompok dengan prioritas utama dalam pengadaan terdiri dari 10 macam obat dengan NS 500cc infus sebagai obat terpenting dalam kelompok. NS 500 cc infus membutuhkan Safety Stock 23.400 sebesar dengan nilai ROP 34.860.

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Drug management is one important aspect of hospital management. This study is aiming at analysing drug management in pharmacy unit National Stroke Hospital Bukittinggi. This case study was using qualitative approach.

The study revealed that drug management and monitoring controlling were not well performed. A high percentage of drug stock out in 2017 was found 7,6% out of 421 drugs item each month, while number of expired drugs was high, reaching 10,45% compared to 0% as target. Planning to prioritize purchasing of drugs using VA, EA and NA drug need to implement in order to prevent stock out.

To avoid expired drug, hospital need to purchased based on ROP and Safety Stock. VA group is the highest priority that include 10 drug item where NS 500 cc infusion fluid is the top one in the group. NS 500 cc infusion fluid would need Safety Stock as much as 23.400 number as Safety Stock and ROP 34.860."

"Cancer pain management: is a multidisciplinary effort, where the use of drug is often greatly beneficial for the patient. Pain assessment using the visual analog scale (VAS) is very helpful. Mild pain can be managed using acetaminophen or non-steroid anti-inflammatory drugs (NSAIDs). Moderate pain can be treated using mild opioids, while severe pain is treated using strong opioids such as morphine. Administration of morphine is safe, with a dose that is titrated to reach the optimal dosage, and does not produce serious side-effects. Administration of laxatives to prevent constipation should commence since the. first administration of morphine."

"Biaya obat yang besar memerlukan pengelolaan yang tepat. Proses pengelolaanobat yang paling mengganggu dalam siklus pengelolaan obat di Instalasi FarmasiRSU Sari Mutiara Medan adalah proses pengadaan/pembelian obat. Obat Tingkatpemakaian dan pembelian obat kronis yang tinggi mewakili tingkat pemakaiandan pembelian obat secara keseluruhan. Peningkatan efisiensi pada prosespengadaan/pembelian obat kronis dapat memberikan gambaran peningkatanefisiensi pengelolaan obat secara keseluruhan. Penelitian dengan metode kualitatifini mengobservasi waktu yang digunakan selama proses pembelian obat darimulai pemesanan hingga obat diap didistribusikan, dan bertujuan untukmeningkatkan efisiensi pengelolaan obat di Instalasi Farmasi RSU Sari MutiaraMedan dengan menggunakan metode lean. Hasil penelitian dapat merumuskankegiatan pembelian obat yang beragam menjadi satu alur proses pembelian obat,dalam desain usulan perbaikan tampak pengurangan waktu tunggu, peningkatanpresentasi kegiatan value added dan reduksi presentasi kegiatan non value added.Dengan meningkatnya efisiensi proses pembelian/pengadaan obat diharapkanadanya domino effect pada proses pengelolaan obat lainnya. Dalam penelitian inidicapai kendali biaya dan kendali mutu melalui usulan perbaikan jangka pendekperencanaan kebutuhan obat dengan menggunakan analisis pareto dan VEN, sertametode error proofing dalam evaluasi akhir setiap proses pembelian obat.Penerapan kaizen merupakan usulan jangka panjang yang akan selalu diterapkandalam setiap analisis proses menggunakan metode lean.

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High cost of drugs need a proper management. Procurement purchase of thedrugs is the most disturbing management process in the drug cycle managementin the pharmacy unit of Sari Mutiara Medan Public Hospital. The highconsumption and purchase level of chronic drugs represent the high consumptionand purchase the whole drugs. Efficiency increasing of chronic drugsprocurement purchase is expected to represent the efficiency increasing of drugmanagement in generally. This qualitative research, using the lean method,observed the time spent from when the drug was ordered until the drug was readyto distribute, with the aim to increase the efficiency of drug management in thepharmacy unit of Sari Mutiara Medan Public Hospital.

The results formulatevariation of purchasing flow to be one standard future state mapping, and itshows improvement in waiting time, increasing value added activity and reductionnon value added activity. Efficiency increasing of drugs procurement purchase isexpected to have a domino effect for the continuous drug management process.Cost and quality control in this research are obtained through the proposedshort term fixes using pareto and VEN in drugs demand planning and usingerror proofing method in every end evaluation of drugs procurement purchase.Kaizen is applied for the proposed long term fixes and for every flow analysisusing lean method."

"Instalasi Farmasi Rumah Sakit Umum Daerah Ciracas pada tahun 2020 menunjukkan adanya kejadian kekurangan stok obat, Kekurangan stok obat ini dapat dipengaruhi oleh ketidaktepatan perencanaan, ketidaktepatan pengadaan ataupun kesalahan saat distribusi. Penelitian ini bertujuan untuk mengevaluasi pengelolaan obat di Rumah Sakit Umum Daerah Ciracas tahun 2020 pada tahapan seleksi, pengadaan dan distribusi. Penelitian ini menggunakan metode deskriptif observasional dengan pengumpulan data secara retrospektif dan data pada tahap distribusi tentang ketepatan data jumlah kartu stok obat diambil secara prospektif. Hasil penelitian menunjukkan bahwa pada tahap seleksi tahap seleksi Indikator kesesuaian item obat yang tersedia dengan Formularium Nasional sebesar 85,24%. Pada tahap perencanaan dan pengadaan diketahui bahwa persentase kesesuaian pengadaan dengan kenyataan untuk masing-masing item obat sebesar 100%, frekuensi pengadaan tiap item obat pertahun sebanyak lebih dari 24 kali (43,6%), frekuensi kurang lengkapnya surat pesanan atau faktur sebesar 1,5%, frekuensi tertundanya pembayaran oleh rumah sakit terhadap waktu yang disepakati sebanyak 0 kali. Pada tahap distribusi ketepatan data jumlah obat pada kartu stok sebesar 100%, Turn Over Ratio sebanyak 3,08 kali, tingkat ketersediaan obat sebanyak 16,05 bulan, persentase dan nilai obat yang kadaluwarsa dan rusak sebesar 2,48%, dan persentase stok mati sebesar 3,05%.

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The Pharmacy Installation of the Ciracas Regional General Hospital in 2020 showed that there was a shortage of drug stock. This shortage of drug stock could be influenced by inaccuracies in planning, procurement inaccuracies or errors during distribution. This study aims to develop drug management at the Ciracas Regional General Hospital in 2020 at the stages of selection, procurement and distribution. This study used descriptive observational method with retrospective data collection and data at the distribution stage regarding the accuracy of the data on the number of drug stock cards taken prospectively. The results showed that at the selection stage, the indicator of the suitability of the available drug items with the National Formulary was 85.24%. At the planning and procurement stage it is known that the percentage of procurement conformity with reality for each drug item is 100%, the frequency of procurement of each drug item per year is more than 24 times (43,6%), the frequency of incomplete orders or invoices is 1.5%, the frequency of delayed payments by the hospital against the agreed time 0 times. At the distribution stage, the accuracy of the data on the number of drugs on the stock card is 100%, Turn Over Ratio is 3.08 times, the level of drug availability is 16.05 months, the percentage and value of expired and damaged drugs is 2.48% , and the percentage of dead stock is 3.05%."

"Penelitian ini bertujuan menganalisis penerapan Sistem Manajemen Kinerja dalam kerangka SAKIP serta menganalisis kendala utama yang menghambat penerapan SAKIP pada UPT BPOM dan solusi untuk meminimumkan kendala tersebut. Objek studi yang digunakan adalah Balai Besar/Balai POM, yang merupakan UPT BPOM di daerah yang melaksanakan tugas teknis operasional di bidang pengawasan obat dan makanan. Penelitian ini menggunakan metodologi penelitian kualitatif melalui pendekatan studi kasus (problem solving).  Data yang diperoleh dianalisis menggunakan metode descriptive analysis, dilakukan dengan menggunakan kombinasi data primer (hasil dari wawancara semi terstruktur yang mendalam) dan data sekunder (hasil dari dokumentasi).  Hasil penelitian adalah implementasi SAKIP pada  UPT BPOM menunjukkan hasil yang baik dan menunjukkan penyelenggaraan pemerintahan yang berorientasi pada hasil, namun demikian, terdapat beberapa aspek yang memerlukan perbaikan dan penyempurnaan. Kendala utama yang dihadapi adalah penetapan target kinerja belum semuanya berdasarkan basis data yang memadai, penggunaan berbagai macam aplikasi Monev yang tidak terintegrasi, dan pemanfaatan informasi kinerja yang belum maksimal. Penelitian ini akan membantu UPT BPOM menyempurnakan tata laksana sistem akuntabilitas kinerja, dengan berfokus pada penetapan target kinerja disertai data dukung memadai, pengembangan dan penyempurnaan aplikasi Monitoring dan Evaluasi, dan  pembuatan kertas kerja rekomendasi untuk mengoptimalkan pemanfaatan informasi kinerja.

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This study aims to analyze the implementation of the Performance Management System within the SAKIP framework and the main obstacles that hinder the implementation of SAKIP at UPT BPOM, and solutions to minimize these obstacles. The object of study used is the Balai Besar/Balai POM, which is the UPT BPOM in the regions that carry out operational technical tasks in the drug and food control field. This study uses a qualitative research methodology through a case study approach (problem-solving). The data were analyzed using the descriptive analysis method, combining primary data (results from in-depth semi-structured interviews) and secondary data (results from documentation). The results are that the implementation of SAKIP at  UPT BPOM showed good results and result-oriented governance; however, several aspects needed improvement and refinement.   The main obstacles faced are the setting of performance targets that are not all based on adequate databases, the use of various types of Monev applications that are not integrated, and the utilization of performance information that is not optimal. This research will help UPT BPOM improve the management of the performance accountability system, focusing on setting performance targets with adequate supporting data, developing and perfecting the Monitoring and Evaluation applications, and making recommendation working papers for utilizing maximum performance information."