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"Keselamatan pasien (patient safety) adalah suatu sistem di mana rumah sakit membuat asuhan pasien lebih aman, mencegah terjadinya cidera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil. Tata kelola Patient Safety pada penyakit Stroke adalah penyusunan Standar Patient Safety untuk diterapkan pada pasien Stroke yang dirawat inap di RSKD.Sepuluh Standar Patient Safety yang diteliti adalah Identifikasi Pasien, Komunikasi Efektif, Obat High Alert, Ketepatan Pasien, Prosedur dan Lokasi Operasi, Hand Hygiene, Risiko Pasien Jatuh, Nama Obat Rupa Mirip, Akurasi Pemakaian Obat, Pemasangan Kateter/ Selang, Spuit Sekali Pakai merupakan kombinasi dari Solusi Keselamatan Pasien WHO dan Sasaran Keselamatan Pasien Internasional. Dalam penelitian ini berhasil disusun Tatakelola Patient Safety (Patient Safety Pathway) penyakit Stroke di RSKD dan dianalisis kepatuhan penerapannya.Patient Safety is a system in which hospitals make patient care safer and to prevent injuries caused by medical error due to an action or not taking action that should be taken. The Management of Patient Safety is the Pathway set up as the Patient Safety Standard to be implemented for Stroke disease at Kanujoso Djatiwibowo Hospital.

Ten Patient Safety standard being studied are Patient Identification, Effective Communication, High Alert Medications, Accuracy of Patient, Procedure and Location of Operation, Hand Hygiene, Fall Risk Patient, Look alike Sound alike Drugs, Accuracy of Drug use, Catheter / Hoses Installation and Disposable syringes, this standard is the combination from The Solution of Patient Safety WHO and The International Patient Safety Goals This study has successfully formed a Patient Safety Pathway for Stroke disease and analyse the implementation the standard as well."

"ABSTRAKPada penelitian ini dicari pengaruh dari Faktor Struktur dan Proses sebagai unsur mutu sesuai teori Donabedian terhadap Net Death Rate/ NDR dari penyakit Stroke. Sumber data yang terpilih berasal dari pasien Sroke berupa kasus Intracerebral haemorrhage dan Cerebral infarction di RSUD Dr Kanujoso Djatiwibowo Balikpapan pada tahun 2014. Penelitian bersifat kualitatif dengan metode deskriptif analitik menggunakan studi retrospektif. Didapatkan faktor struktur secara berurutan yang mempengaruhi adalah kondisi pasien, fasilitas, kebijakan dan sumber daya manusia. Sedangkan faktor proses terbanyak di Rawat Inap yang mempengaruhi adalah kendala dalam menjalankan instruksi serta adanya Infeksi Rumah Sakit/ IRS yang terjadi dalam proses perawatan. Di IRD faktor proses yang menjadi kendala adalah pelayanan pemeriksaan penunjang khusus nya CT Scan tidak selalu dapat dilakukan. Disarankan untuk melakukan peningkatan mutu pelayanan dengan memperbaiki kendala faktor struktur dan proses serta mengembangkan pelayanan satu atap Unit Stroke.

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ABSTRACTThis study is seeking the impact of structure and process as the quality aspect according to Donabedian 's theory that affecting to the Net Death Rate/ NDR Stroke disease. Selected data source are Stroke patients, consisting of Intracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso Djatiwibowo Balikpapan Hospital in the year 2014. This study is a qualitative research using descriptive analytic retrospective method. Structure and Process Factors that are influencing each other. It reveals that Structure Factors in hospitalization that are affecting sequentially are the condition of the patient, facilities, policies and human resource. On the other hand it reveals that Process Factors include obstacle on running the primary instruction and also Hospital Accociated Infections/ HAIs occurs due to the nursing process. In Emergency Unit there is obstacle in Process Factor as the CT Scan service is not available sometime. It is recommend to improve the quality of Stroke patient to overcome the Structure and Process Factors and to develop the on stop service Stroke Unit."

"ABSTRAKAnalisis Sistem merupakan penguraian operasional suatu sistem yang meliputiupaya pengidentifikasian tujuan, kegiatan, pelaksanaan kegiatan, situasi yangdihadapi serta informasi yang dibutuhkan sistem disetiap tahap pelaksanaannya.Penelitian ini menggunakan pendekatan perpaduan Teori Sistem Donabedian-Azwar, dengan pokok tahapan Struktur/Input-Proses-Output/Outcome untukmelihat sistem pelayanan penyakit jantung di RSUD Dr.Kanujoso DjatiwibowoBalikpapan Tahun 2014. Penelitian dilakukan pada bulan April hingga Nopember2015, menggunakan rancangan kualitatif dengan metode deskriptif analitik.Analisis dilakukan dengan data bersumber dari telaah dokumen medik pasienpenyakit jantung di RSUD Dr Kanujoso Djatiwibowo Balikpapan tahun 2014,observasi dan wawancara mendalam terhadap informan terpilih. Hasil penelitianmenunjukan faktor dari Struktur/Input yang berpengaruh terhadap mortalitadalam sistem pelayanan penyakit jantung di RSUD Dr Kanujoso DjatiwibowoBalikpapan adalah faktor Pasien, SDM, Fasilitas, dan Metode. Faktor Prosesberupa proses pemberian pelayanan, koordinasi dokter-perawat dan keterpaduanlayanan. Disarankan agar pihak RSUD Dr Kanujosos Djatiwibowo Balikpapanmelakukan penambahan tenaga dokter Spesialis Jantung, membuat pelayanan satuatap pasien penyakit jantung/Cardiac Center dan meningkatkankerjasama/koordinasi yang baik antara pihak RSUD Dr Kanujosos Djatiwibowodengan Faskes Pelayanan Primer, Dinas Kesehatan Kota Balikpapan dan pihakrumah sakit lainnya yang ada di Kota Balikpapan.

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ABSTRACTDecomposition Analysis System is operating a system that includes identificationefforts objectives, activities, implementation of activities, the situation faced andinformation needed at each stage of system implementation. This study uses ablend of Systems Theory approach Donabedian-Azwar, the principal stages ofStructural / Input-Process-Output / Outcome to look at heart disease care systemin hospitals Dr.Kanujoso Djatiwibowo Balikpapan 2014. The study wasconducted from April to November 2015, using a design qualitative descriptiveanalytic method. Analysis was performed with the data derived from the study ofmedical documents cardiac patients in hospitals Dr Kanujoso DjatiwibowoBalikpapan in 2014, observation and depth interview with selected informants.The results showed a factor of structure / Inputs that influence mortality incardiovascular disease care system in the Hospital Dr Kanujoso DjatiwibowoBalikpapan is Patient factors, human resources, facilities, and methods. Factorssuch as the process of service delivery, the doctor-nurse coordination andintegration of services. It is recommended that the hospitals Dr KanujososDjatiwibowo Balikpapan perform additional doctors Heart Specialist, create onestopservice for cardiovascular disease / Cardiac Center and increase cooperation /coordination between the hospitals Dr Kanujosos Djatiwibowo with PrimaryHealth Care Facility, City Health Department Balikpapan and house parties otherhospitals in the city of Balikpapan."

"ABSTRAKNama : Achmad Zuhro Ma rsquo;rufProgram Studi : Kajian Administrasi Rumah SakitJudul Tesis :Analisis Pelaksanaan Fungsi Komite Medik di RSUD dr. Kanujoso Djatiwibowo,Balikpapan Periode 2014-2016Penelitian ini bertujuan untuk menggali faktor-faktor yang mempengaruhipelaksanaan fungsi Komite Medik di RSUD dr. Kanujoso Djatiwibowo, Balikpapansesuai dengan PMK No 755 tahun 2011. Desain penelitian adalah kualitatif studikasus. Responden penelitian Komite Medik periode 2014-2018 dan stake holderrumah sakit.Hasil penelitian menunjukkan pelaksanaan fungsi Komite Medik belum maksimal.Faktor-faktor yang mempengaruhi pada tingkat individu usia, spesialisasi,pengalaman, tugas rangkap, pelatihan , kelompok iklim kerja, kepemimpinan,sarana prasarana, pengambilan keputusan, penghargaan, komunikasi, targetkinerja dan organisasi hospital bylaws dan stake holder .Rekomendasi perbaikan dengan penyempurnaan hospital bylaws corporate danmedical staff dan memperbaiki sistem di Komite Medik.Kata kunci :Komite Medik, PMK No.755 tahun 2011, Hospital Bylaws, Medical Staff Bylaws

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ABSTRACTName Achmad Zuhro Ma rsquo rufStudy Program Kajian Administrasi Rumah SakitTitle Analysis of The Implementation of Medical Committee Functions in RSUD dr.Kanujoso Djatiwibowo, Balikpapan Period 2014 2016The aim of this study is to explore the factors that affect the implementation of thefunctions of the Hospital Medical Committee in dr. Kanujoso Djatiwibowo GeneralHospital, Balikpapan, accordance with Minister of Health Regulation Number 755of 2011.The design of this study is a qualitative case study. The respondents are TheCommittee rsquo s members for the period 2014 2018 and the stake holder of thehospital.The result shows that the implementation of Hopital Medical Committee rsquo sfunctions are not maximal yet. The influencing factors are at the individual level age, specialization, experience, double task, training , group level work climate,leadership, infrastructure, decision making, awards, communication, performance and organization level hospital bylaws and stakeholders .Recommendations are improving hospital bylaws corporate and medical staff andimproving systems in the Medical Committee.Kata kunci Medical Committee, PMK No.755 tahun 2011, medical staf bylaws"

"[Dalam konteks pengobatan modern, kompleksitas sistem perumahsakitan dianggap sebagai faktor utama penyebab insiden kesalahan medis. Dengan paradigma ”pelayanan berfokus pasien”, hak pasien mendapatkan pelayanan kesehatan yang aman adalah indikator utama dalam Standar Akreditasi Rumah Sakit versi 2012 (SARS 2012) di Indonesia, melalui penerapan 6 Sasaran Keselamatan Pasien (SKP).Adapun salah-satu jenis penyakit dengan mortalitas dan morbiditas yang tinggi adalah Sepsis. Pengunaan modifikasi klinis Internasional Classification of Desease (ICD) berbasis revisi ke-9, telah menimbulkan kerancuan terminologi dan meningkatkan mortalitas sepsis. Secara global, mortalitas sepsis mencapai 8 juta/tahun, dengan pertumbuhan di negara berkembang berkisar 8 – 13% per-tahun. Untuk memastikan efektifitas Keselamatan Pasien pada alur pelayanan penyakit sepsis, dilakukan penelitian terhadap imlementasi Tatakelola 6 Sasaran Keselatanan Pasien. Melalui kerangka studi kasus, dengan pendekatan kualitatif diskriptik analitik, dilaksanakan penelitian di Rumah Sakit Tebet Jakarta, pada bulan April-Mei 2015. Hasil penelitian menunjukkan, efektifitas Tatakelola 6 SKP mencapai 96,283%,dengan tingkat kesalahan 5%. Penelitian ini berhasil membuktikan implementasi Tatakelola 6 SKP pada alur pelayanan penyakit sepsis. Disimpulkan bahwa Tatakelola 6 Sasaran Keselamatan Pasien sangat efektif mengurangi resiko KP.;In the context of modern medicine, complexity hospital’s management is regarded as the primary cause of medical error (ME). The new healthcare paradigm of “Patient-Focused Care”, patient’s right to receive safe healthcare treatment is considered as main indicator in Standar Akreditasi Rumah Sakit of 2012 (SARS2012) in Indonesia, through the implementation of the 6 Targets of Patient Safety (KP). In the category of emergency medical treatment, Sepsis is considered as a disease with high mortality and morbidity rate. The use of The International Classification of Diseases, based on Ninth Revision, have caused terminological confusion and contribute to the increase of sepsis mortality rate. Globally, sepsis’ mortality ratereaches 8 million/year or 24.000/day, with growth rate of 8-13% per-year. To ensure the effectiveness of KP standard implementation in sepsis medical treatment, a research on the implementation of 6 Targets of KP in RS Tebet is conducted. Using case study, qualitative and descriptive analysis, this research is performed in the course of April-May 2015. The research shows that effectiveness 6 Targets of KP implementation reaches 96,283%, with 5% margin of error. This research proves that implementation of 6 Targets of KP in healthcare treatment procedure for sepsis cases can reduce the risk of ME., In the context of modern medicine, complexity hospital’s management is regardedas the primary cause of medical error (ME). The new healthcare paradigm of“Patient-Focused Care”, patient’s right to receive safe healthcare treatment isconsidered as main indicator in Standar Akreditasi Rumah Sakit of 2012 (SARS2012) in Indonesia, through the implementation of the 6 Targets of Patient Safety(KP).In the category of emergency medical treatment, Sepsis is considered as a diseasewith high mortality and morbidity rate. The use of The International Classificationof Diseases, based on Ninth Revision, have caused terminological confusion andcontribute to the increase of sepsis mortality rate. Globally, sepsis’ mortality ratereaches 8 million/year or 24.000/day, with growth rate of 8-13% per-year.To ensure the effectiveness of KP standard implementation in sepsis medicaltreatment, a research on the implementation of 6 Targets of KP in RS Tebet isconducted. Using case study, qualitative and descriptive analysis, this research isperformed in the course of April-May 2015. The research shows that effectiveness 6Targets of KP implementation reaches 96,283%, with 5% margin of error. Thisresearch proves that implementation of 6 Targets of KP in healthcare treatmentprocedure for sepsis cases can reduce the risk of ME.]"

"ABSTRAKTerdapat sekitar 10-15% klaim yang tertunda pembayarannya di Rumah SakitUmum Daerah dr Kanujoso Djatiwibowo. Tujuan penelitian ini adalahmengetahui faktor-faktor yang berpengaruh pada tertundanya klaim BadanPenyelenggara Kesehatan Sosial Kesehatan sesuai panduan klaim dan perjanjiankerjasama. Sumber data yang diambil berasal dari jumlah klaim yang tertunda diRumah Sakit Umum Daerah dr. Kanujoso Djatiwibowo periode Januari - Maret2016 dan menggali penyebab terjadinya permasalahan tersebut melalui informan.Penelitian bersifat kuantitatif dan kualitatif dengan metode deskriptif analitikmenggunakan studi retrospektif dari data sekunder resume medis yang tidaklengkap dan wawancara serta diskusi. Hasil penelitian menunjukkan faktor yangmempengaruhi klaim tertunda adalah ketidaklengkapan resume medis yangdidominasi ketiadaan tanda tangan Dokter Penganggungjawab Pasien ( DPJP)disebabkan didapatkan adanya tugas ganda pada case manager sehinggaterjadinya keterlambatan dalam penyelesaian resume medis elektronik. Saran yangdiajukan adalah penggunaan rekam medis elektronik, pemisahan tugas antaracase manager dengan dokter ruangan, peningkatan kepatuhan case manageruntuk menulis sejak awal data resume medis pasien antara lain dengan penilaiankinerja dan remunerasi terintegrasi

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ABSTRACTThere was 10-15% pending of claim because uncomplete medic in dr. KanujosoDjatiwiwo Hospital. The purpose of this study is to find factors affecting pending ofclaims of Badan Penyelenggara Jaminan Sosial Kesehatan as claims guidance andcontract paper. Data sources has taken from pending of claims of dr KanujosoDjatiwibowo hospital periode January ? March 2016 and see the deeper problembehind this problems through informans. This study is quantitative qualitativeresearch with analitic describtion method with retrospective study from pending ofclaims, interview and discussion. The result from this study shows factor affectingpending of claims is the absence of specialist doctor who responsible for the patienbecause there is double function from case manager that effect delaying completingelectronic medical resume. Suggest to use immediately electronic medical record,splitting job for case manager and doctor on ward, increasing obedience to writepatien data from beginning such as performance evaluation and integratedremuneration."

"Penerapan keselamatan pasien di Rumah Sakit Setia Mitra belum berjalan dengan optimal maka perlu pengukuran budaya keselamatan pasien tertutama di kalangan perawat. Penelitian ini bertujuan untuk mengetahui gambaran persepsi perawat tentang budaya keselamatan pasien dan bagaimana penerapan sasaran keselamatan pasien di Rumah Sakit Setia Mitra. Penelitian deskriptif ini dilakukan dengan pendekatan kuantitatif dan kualitatif. Populasi adalah seluruh perawat yang ada di Rumah Sakit Setia Mitra yaitu 77 perawat dengan sampel 68 perawat. Hasil penelitian menunjukkan persepsi perawat tentang budaya keselamatan pasien di Rumah Sakit Setia Mitra yaitu 72.1% baik. Dimensi paling banyak dipersepsikan baik yaitu dimensi operan sebesar 75% dan paling sedikit dipersepsikan baik adalah dimensi dukungan manajemen sebesar 1.5%. Secara statistik usia (p value = 0.048), masa kerja (p value = 0.016) dan jabatan perawat (p value = 0.049) memiliki hubungan dengan persepsi perawat terhadap budaya keselamatan pasien (p<0.05). Pada penerapan sasaran keselamatan pasien yaitu 55.15% memahami dengan baik bagaimana penerapan sasaran keselamatan pasien di Rumah Sakit Setia Mitra. Disarankan agar tim keselamatan pasien yang ada lebih dioptimalkan tugas dan fungsinya sehingga budaya keselamatan pasien di rumah sakit dapat terus ditingkatkan.

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It is necessary to measure patient safety culture especially among nurses. This study aims to describe the nurses perception about patient safety culture and how the implementation of patient safety goals at Setia Mitra Hospital. This descriptive research conducted with quantitative and qualitative approaches. Population in this study is all nurses in Setia Mitra hospital that consist of 77 nurses with sample 68 nurses.

The result of study shows the nurse's perception about patient safety in Setia Mitra hospitals is 72.1% good. Dimension with the most good nurse perception is hospital handoffs and transitions dimension by 75% and at least perceived good is management support dimension of 1.5%. Statistically, age (p value = 0.048), work period (p value = 0.016) and the level of nurses (p value = 0.049) have a relationship with the nurses perception on patient safety culture (p <0.05).

In the implementation of patient safety goals in Setia Mitra Hospital, namely 55.15% with a good understanding. It is recommended that patient safety team in the Setia Mitra Hospital further optimized its duties and functions so that the patient safety culture in hospitals can be improved."

"Kepatuhan perawat dalam pelaksanan Surgical Safety Checklist Patient SSCP yang dinilai masih rendah. Penelitian ini bertujuan untuk mengetahui hubungan sikap dengan kepatuhan perawat terhadap pelaksanaan SSCP di kamar bedah RS dr. Suyoto Pusrehab Kemhan Republik Indonesia. Desain penelitian yang digunakan adalah pendekatan deskriptif analitik. Teknik pengambilan sampel, total sampling. Hasil penelitian menunjukan tidak adanya perbedaan yang bermakna antara sikap dengan kepatuhan perawat dalam pelaksanaan SSCP dengan uji T Independent dan didapatkan nilai p=0,078 atau >p-value p-value sebesar 0,05 . Nilai rata-rata kepatuhan perawat dengan sikap kurang baik adalah 8,38 dengan standard deviasi 5,805, sedangkan perawat yang memiliki sikap baik nilai rata-rata kepatuhannya adalah 12,86 dengan standard deviasi 2,268. Instrumen penelitian yang digunakan diadopsi dari Safety Attitudes Questionnaire ndash;Operating Room version SAQ ndash;OR , dan lembar observasi pelaksanaan SSCP dari WHO. Penelitian ini merekomendasikan perlunya upaya peningkatan pengetahuan perawat terkait SSCP di kamar bedah.

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The compliance of nurses in conducted of SSCP was still considered low. This study aimed to determine the relationship with adherence nurse attitude towards the implementation of the SSCP in the operating room dr. Suyoto Rehabilitation Center of the Ministry of Defence of the Republic of Indonesia. The study design used is descriptive approach analitic, the sampling technique is total sampling. The data obtained were analyzed by univariate and bivariate. The results showed no significant difference between the attitude of the compliance of nurses in the implementation of the SSCP with Independent T test and p value 0.078 or p value p value of 0.05. With an average value of compliance nurse who has a poor attitude toward patient safety culture is 8.38 with a standard deviation of 5.805, while the nurses who have a good attitude average value of compliance is 12.86 with a standard deviation of 2.268. The research instrument used was a questionnaire that was adopted from the Safety Attitudes Questionnaire Operating Room version SAQ OR, and the observation sheet SSCP implementation of WHO. This study is recommended that importance to increase nursing knowledge about SSCP in operating teather."

"Patient safety is one of the five crucial hospital safety issues. This study aimed to determine factors related with nurses’ compliance in the implementation of indicators of patient safety goals (IPSG 1, IPSG 2, IPSG 5, and IPSG 6). This study was a descriptive correlative with a cross-sectional approach. Samples were recruited using a purposive sampling technique (n = 102). Data were analyzed using chi-square and Mann–Whitney tests. The results of this study indicate that the leadership style of the head nurse, rewards, attitudes, and motivation had a significant relationship with the level of adherence in the implementation of IPSG 1 and IPSG 2. The level of nurses’ compliance in the implementation of IPSG 5 was only influenced by the leadership style of the room head and the nurses’ positive attitude. None of the factors had significant relationships with the level of nurses’ compliance in the implementation of IPSG 6. The consultative leadership style of the room head can change the level of nurses’ compliance in the implementation of IPSG 1 by 5.6 times, with 5.06 times toward IPSG 2 and 4.71 times toward IPSG 5. This research recommends the need for consultative leadership style from the room head to carry out the roles and functions as a supervisor to improve associate nurses’ compliance in the implementation of IPSG 1, IPSG 2, IPSG 5, and IPSG 6."

"Insiden Keselamatan Pasien ( IKP ) di RSKBP berkisar antara 0,31% sampai dengan 3,01% dengan angka kematian 2,22%.IKP di RSKBP dinilai masih under reporting karena kebanyakan IKP tidak dilaporkan.Membangun budaya keselamatan pasien merupakan elemen penting untuk meningkatkan keselamatan pasien dan kualitas pelayanan.Penelitian ini bertujuan untuk mengetahui budaya keselamatan pasien dan faktor-faktor yang berhubungan dengan budaya keselamatan pasien di RSKBP tahun 2015. Penelitian dilakukan bulan Maret sd April 2015, dengan sampel 115 responden. Desain penelitian explanatory sequential. Analisa data dilakukan dengan regresi logistic.Penelitian menunjukan budaya keselamatan pasien di RSKBP masih kurang. Faktor-faktor yang berhubungan dengan budaya keselamatan pasien di RSKBP adalah umpan balik laporan insiden ( p=0,021 α=0,05, OR= 15,516 ) budaya tidak menyalahkan ( p=0,019 α=0,05, OR= 14,396 ) dan budaya belajar ( p=0,006 α=0,05, OR= 0,096 ).Disarankan agar RSKBP dapat memperbaiki budaya keselamatan pasien dengan upaya yang komprehensif dan terstruktur.

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Adverse even ( AE ) in RSKBP ranged from 0.31% to 3.01% with a mortality rate of 2.22%.AE in RSKBP still considered under-reporting because most AE not reported. Building a culture of patient safety is an important element to improve patient safety and quality. This research aims to know the culture of patient safety and the factors related to the patient safety culture in RSKBP 2015. The study was conducted in March to April 2015, with a sample of 115 respondents It is Sequential explanatory research design.

The data analysis with regression logistic. Patient safety culture in RSKBP still lacking. Factors related to the patient safety culture in RSKBP feedback is incident report (p = 0.021 α = 0.05, OR = 15.516) culture is not to blame (p = 0.019 α = 0.05, OR = 14.396) and a learning culture (p = 0.006 α = 0.05, OR = 0.096) .RSKBP sugest to improve patient safety culture with a comprehensive and structured efforts."