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"ABSTRAKNama : Patiyus Agustiansyah/NPM 1506706023Program Studi : Kajian Administrasi Rumah SakitJudul : Analisis dan Implementasi Lean pada Persiapan OperasiKanker Ginekologi di RSUP dr. Mohammad HoesinPalembangIndonesia saat ini memiliki beban kanker ginekologi besar yaitu insidensi,morbiditas dan mortalitasnya. Salah satu penanganan kanker ginekologi adalahpembedahan yang akan membantu kesintasan pasien. Waktu tunggu penjadwalanoperasi kanker ginekologi hendaklah memperhatikan progresifitas kankersehingga waktu tunggu operasinya tidak melebihi 2 minggu. Waktu tungguoperasi menggambarkan mutu pelayanan rumah sakit.Tujuan penelitian ini adalah,untuk menganalisis waktu tunggu penjadwalan operasi kanker ginekologi diRSUP dr. Moehammad Hoesin Palembang dengan menggunakan prinsip Lean.Hasil penelitian menunjukan penegakan diagnosis selama 43.844 menit dan waktutunggu operasi selama 66.700 menit, dengan menerapkan prinsip lean makapenegakan diagnosis 10.328,5 menit dan waktu tunggu operasi 10.325 menit.Kesimpulan penelitian, pada current state terdapat 26 aktifitas; 12 aktifitas VA value added ratio / VAR waktu 0,46 ; VAR jarak 89,6 dan 14 aktifitas NVA waste pasien dan 4 waste aktifitas petugas. Aliran proses yang menghambat bottle neck terdapat di pendaftaran, di poliklinik, di pemeriksaan penunjang dandi bagian praoperatif waktu tunggu paling lama . Future State memiliki 15aktifitas VA VAR waktu 33 ; VAR jarak 95,8 dengan 8 aktifitas NVA waste aktifitas pasien dan 0 waste aktifitas petugas, dengan waktu tunggudiagnosis 10.328,5 menit sedangkan waktu tunggu penjadwalan operasi 10.325menit. Hasil perbandingan current state dengan future state didapatkanpeningkatan aktifitas value added sebanyak 7,7 dengan penurunan waktutunggu 81,3 dan penurunan jarak tempuh 0,42 . Analisis akar masalahpenyebab waktu tunggu lama penjadwalan operasi kanker ginekologi di RSMHdikarenakan kekurangan SDM registrasi, rekam medis, DPJP dan keterbatasaninfrastruktur CT scan, kamar operasi dan instrumen dan kelemahan mengelolaproses penjadwalan operasi tersebut. Saran peneliti adalah peningkatan kinerjadan penambahan SDM, membuat regulasi untuk memprioritaskan pelayananpasien kanker ginekologi, serta integrasi Sistem Informasi Manajemen RumahSakit di setiap unit pelayanan.Kata Kunci : prinsip lean, value added VA , non value added NVA , waste,waktu tunggu penegakan diagnosis, waktu tunggu operasi, kanker ginekologi

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ABSTRACTName Patiyus Agustiansyah NPM 1506706023Program Studi Hospital Administration StudyTitle Lean Analysis and Implementation of Gynecology CancerOperative Scheduling in General Hospital dr. MohammadHoesin RSMH PalembangIndonesia currently has gynecologic cancer burden in the incidence, morbidityand mortality. One of gynecological cancer treatment is surgery which will helpthe survival rate of patients. The waiting time of gynecological cancer surgeryscheduling should bu focused to cancer progression so the waiting time should notexceed 2 weeks. The waiting time operation illustrates the quality of hospitalservices.The purpose of this study was to analyze the waiting time of gynecologiccancer surgery scheduling in RSMH by using the principles of Lean. The resultsshowed that establishing diagnosed need 43,844 minutes and the waiting timeoperation was 66,700 minutes. By applying Lean then the diagnosis establishing10,328.5 minutes, and operations waiting times 10,325 minutes. The studyconclusion showing for 26 activities of current state with 12 VA activities VARtime 0.46 VAR range for 89.6 and 14 NVA activities with 14 patient rsquo swastes activities and 4 employee wastes activities. The process flow whichinhibits bottle neck were lies in the stage of registration, at the outpatient clinic,at the laboratory examination and at the preoperative division the longest waitingtime . The waiting time for diagnosis process were 43.844 minutes, while thewaiting time scheduling of operation process were 66.700 minutes. Future Statehas 15 VA VAR time of 33 VAR range of 95.8 with 8 NVA activities and 8patients waste activity and 0 employee waste activities. The waiting time for adiagnosis process were 10328.5 minutes, while the waiting time for operationscheduling process were 10.325 minutes. The comparison between the currentstate to the future state resulted increasement of the VA activity for 7.7 with areduction in waiting time for 81.3 and mileage decrease of 0.42 . Analysis ofroot problems revealed that the long waiting times for scheduling process ofgynecologic cancer surgery in RSMH were due to lack of human resourcesquantity registration, medical records, doctor in charge and the lack ofinfrastructure CT scan, operating rooms and instruments and managerialweaknesses in managing the process of scheduling the surgery. Researcherssuggest to improve the performance of existing recruitment human resources,make regulations of a priority of gynecologic cancer patients, as well as theintegration of Hospital Management Information System in each unit.Keywords lean principles, values added VA , non value added NVA , waste,value added ratio, waiting time for establishing diagnosis, surgery waiting times,gynecological cancer"

"[Instalasi gawat darurat (IGD) rumah sakit adalah bagian dari rumah sakit yang memberikan layanan terdepan. Di Rumah Sakit dr. Mohammad Hoesin (RSMH) Palembang sudah terdapat IGD berdasarkan SK Direktur Utama Rumah Sakit yang menetapkan struktur organisasi, tugas dan tanggung jawab, visi dan misi, dan prosedur tetap pelayanan gawat darurat. IGD RSMH Palembang dikepalai oleh seorang dokter spesialis bedah urologi dibantu oleh dua orang kepala ruangan.Standar pelayanan di IGD sudah menerapkan standar layanan sesuai dengan standar akreditasi KARS 2012. IGD keberadaannya di rumah sakit diatur oleh Kepmenkes RI No. 856/Menkes/SK/IX/2009 tentang Standar IGD. Kepemenkes ini mengatur tentang standarisasi pelayanan gawat darurat di rumah sakit, dalam Kepmenkes tersebutdiatur standar organisasi, sumber daya manusia, pelayanan, kelengkapan sarana prasarana di IGD. Di RSMH Palembang telah dilaksanakan dokter spesialis jaga on site di IGD sejak 30 Januari 2014 sebagai tindak lanjut Kepmenkes RI tersebut. Sejak dilaksanakan kebijakan dokter spesialis jaga on site di IGD masih dijumpai kepatuhan para dokter masih belum optimal dan walaupun mutu layananan semakin membaik sejalan dengan telah terakreditasi paripurna rumah sakit versi KARS 2012. Penelitian ini bertujuan untuk mengetahui bagaimana implementasi kebijakan dokter spesialis jaga on site di IGD sudah dilaksanakan sesuai dengan tujuan yang diharapkan sesuai dengan Kepmenkes. Penelitian dilakukan dengan metode kualitatif melalui wawancara mendalam pada informan. Informan yang diwawancarai adalah jajaran Direktur RSMH Palembang, Ketua Komite Medik, Kabag. Keuangan, Kepala ruangan IGD dan para dokter spesialis. Penilaian hasil wawancara menggunakan kerangka fikir model implementasi kebijakan George Edward III dengan variabelsumber daya, komunikasi, disposisi dan struktur organisasi.Dari hasil penelitian ini didapatkan implementasi kebijakan dokter spesialis jaga on site belum berjalan dengan baik, disebabkan karena faktor komunikasi, disposisi dan struktur organisasi belum berjalan baik dan masih banyak perlu dukungan sumber daya. Usulan yang diberikan adalah penambahan dan kompetensi tenaga sesuai standar, revisi SOP, penyediaan media komunikasi, perbaikan fasilitas,meningkatkan koordinasi dan fungsi pengawasan secara berkala, advokasi ke Kemenkes RI.;Emergency department (ED) is a part of hospital which giving advanced services. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own an emergency department based on SK director of the hospital whom establishes the organizational structure, duties and responsibilities, vision and mission, and standard operating procedures emergency services. ED RSMH Palembang is lead by a specialist urology and assisted by two heads of the room. Standard service of ED has implementing service standards according to accreditation standards KARS 2012. ED in the hospital arranged Indonesian health minister No. 865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulates the standardization of emergency services at the hospital, which managing standard organizations, human resources, services, completeness infrastructure in ED. RSMH Palembang has been implemented specialist doctors duty on site in the ER since January, 30th 2014 as a follow-up of the head of the Indonesian health minister. Ever since implemented a policy specialist on duty in the ER site still found the compliance of the doctors are still not optimal and although the quality of service has improved in line with acreditation hospital KARS version 2012. This research aims to determine how the implementation of policy specialists doctors on site in the ER has been implemented in accordance with the expected goals in accordance with the head of health minister. Research done with qualitative method by performing in-depth interviews on informants. Informants interviewed are RSMH Palembang board of directors, chairman of the medical committee, chief financial officer, head of the ED room and specialist doctors. Assessment interview results are using logical framework policy implementation model George Edward III with variable resources, communications, disposition and organizational structure. From the results of this study, the implementation of policy specialist doctorson site guard has not run well, due to the communication factor, disposition and organizational structure has not been going well and much needed resource support. The given proposal is the addition of appropriate power and competence standards, the revised SOP, provision of communication media, improvement of facilities,improving the coordination and monitoring functions regularly, advocacy to the head of the Indonesian health minister, Emergency department (ED) is a part of hospital which giving advancedservices. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own anemergency department based on SK director of the hospital whom establishes theorganizational structure, duties and responsibilities, vision and mission, and standardoperating procedures emergency services. ED RSMH Palembang is lead by aspecialist urology and assisted by two heads of the room. Standard service of ED hasimplementing service standards according to accreditation standards KARS 2012.ED in the hospital arranged Indonesian health minister No.865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulatesthe standardization of emergency services at the hospital, which managing standardorganizations, human resources, services, completeness infrastructure in ED. RSMHPalembang has been implemented specialist doctors duty on site in the ER sinceJanuary, 30th 2014 as a follow-up of the head of the Indonesian health minister. Eversince implemented a policy specialist on duty in the ER site still found thecompliance of the doctors are still not optimal and although the quality of service hasimproved in line with acreditation hospital KARS version 2012.This research aims to determine how the implementation of policy specialistsdoctors on site in the ER has been implemented in accordance with the expectedgoals in accordance with the head of health minister. Research done with qualitativemethod by performing in-depth interviews on informants. Informants interviewed areRSMH Palembang board of directors, chairman of the medical committee, chieffinancial officer, head of the ED room and specialist doctors. Assessment interviewresults are using logical framework policy implementation model George Edward IIIwith variable resources, communications, disposition and organizational structure.From the results of this study, the implementation of policy specialist doctorson site guard has not run well, due to the communication factor, disposition andorganizational structure has not been going well and much needed resource support.The given proposal is the addition of appropriate power and competence standards,the revised SOP, provision of communication media, improvement of facilities,improving the coordination and monitoring functions regularly, advocacy to the headof the Indonesian health minister]"

"ABSTRAKNama : Selly MarisdinaProgram Studi : Kajian Administrasi Rumah SakitJudul : Manajemen lean terhadap proses pelaksanaan CT Scan kepalapasien stroke iskemik di Instalasi Gawat Darurat RSUP Dr. Moh.Hoesin PalembangWaktu tunggu proses pelaksanaan CT Scan kepala pasien stroke iskemik diIntalasi Gawat Darurat RSUP Dr. Moh Hoesin belum standar. Tujuan penelitianadalah menerapkan manajemen lean terhadap proses pelaksanaan CT Scan kepalapasien stroke iskemik di IGD. Penelitian ini menggunakan metode operationalresearch. Hasil penelitian didapatkan lead time Current Visual Stream Map VSM adalah 175,41 menit. Pada Simulated VSM didapatkan penurunan lead timeyang signifikan menjadi 30,09 menit, peningkatan persentase Value AddedActivities dan penurunan Non Value Added activites. Disimpulkan bahwapenerapan manajemen lean telah berhasil memperbaiki waktu tunggu prosespelaksanaan CT Scan kepala pasien stroke iskemik di IGD.Kata kunci: lean, value added, non value added but neccessary, non value added,current, lead time value streaming map, simulated value streaming map

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ABSTRACTName Selly MarisdinaStudy Progam Hospital Adiministration ProgramJudul Lean management in Head CT Scan Proses of Ischemic StrokePatients inMohammad Hoesin Hospital PalembangThe waiting time of head CT Scan prosess of ischemic stroke patient inEmergency Departement of Mohammad Hoesin Hospital Palembang has not beenstandard yet. The objectives was to apply lean management in this process byoperational research. We found that lead time of Current Visual Stream Map is175,41 minutes and in Simulated VSM, there were a significant decrease of leadtime to 30,09 minutes, increase of Value added Activites percentage and decreaseof Non Value Added Activites. Lean management has been successfully improvedthe waiting time of head CT Scan proses of ischemic stroke patient in ED.Key word lean, value added, non value added but neccessary, non value added,current, lead time value streaming map, simulated value streaming map"

"ABSTRAKNama : Dini Andriani PramitasariProgram Studi : Kajian Administrasi Rumah SakitJudul : Analisis Waktu Tunggu Pada Pasien yang Menjalani Radioterapidi Rumah Sakit Dr. Mohammad Hoesin PalembangLatar Belakang: Peningkatan jumlah kanker menyebabkan peningkatan akankebutuhan pelayanan kanker. Tatalaksana pada waktu yang tepat akanmemberikan hasil pengobatan yang optimal. Waktu tunggu radioterapi dapatmenggambarkan kualitas pelayanan rumah sakit.Tujuan: Mengetahui waktu tunggu radioterapi pada pasien kanker serviks, kankerpayudara, dan kanker nasofaring serta faktor pasien dan manajemen yang dapatmempengaruhi.Metode: Studi kohort retrospektif dengan mengumpulkan data melalui rekammedik pasien kanker serviks, kanker payudara, dan kanker nasofaring yangdirujuk ke Sub Radioterapi RSMH sejak Januari 2015. Waktu tunggu dihitungsejak ada hasil patologi anatomi hingga mulai radioterapi. Studi dilanjutkandengan analisis kualitatif pada faktor manajerial yaitu sarana prasarana, sumberdaya manusia, rencana perbaikan, regulasi/ kebijakan, dan anggaran terhadapadanya waktu tunggu radioterapi.Hasil: Terdapat 180 pasien kanker yang dimasukan dalam penelitian, denganmasing-masing kanker berjumlah 60 pasien. Median waktu tunggu radioterapikanker serviks adalah 131 hari. Median waktu tunggu radioterapi kanker payudaraadalah 144,5 hari. Median waktu tunggu radioterapi kanker nasofaring adalah 224hari. Analisis bivariat dilakukan terhadap variabel-variabel pasien dan didapatkantidak ada hubungan yang bermakna secara statistik terhadap waktu tunggu p>0,05 . Hasil observasi, wawancara mendalam dan telaah dokumen/ teorididapatkan bahwa keterbatasan sarana prasarana, kurangnya jumlah sumber dayamanusia, ketiadaan regulasi, dan keterbatasan anggaran mempengaruhi adanyawaktu tunggu radioterapi.Kesimpulan: Waktu tunggu radioterapi masih panjang dan belum memilikistandar, baik untuk kanker serviks, kanker payudara, dan kanker nasofaring.Diperlukan koordinasi dari berbagai profesi terkait onkologi untuk mendiskusikandan memutuskan waktu optimal pelayanan kanker, khususnya dalam bentuk timmultidisiplin kanker. Pemenuhan kesenjangan antara kebutuhan dan ketersediaanalat radiasi dan sumber daya manusia dapat menjadi solusi untuk mengurangiwaktu tunggu radioterapi.Kata kunci:Faktor Demografi, Kanker Nasofaring, Kanker Payudara, Kanker Serviks,Radioterapi, Waktu Tunggu

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ABSTRACTName Dini AndrianiStudy Program Healthcare AdministrationTitle Analysis of Waiting Time in Patients UndergoingRadiotherapy at Dr. Mohammad Hoesin PalembangGeneral HospitalBackground Increasing number of cancers caused an increase in the need forcancer services. Treatment in the appropriate time will give an optimal result.Radiotherapy waiting time can describe the quality of hospital services.Aim to describe radiotherapy waiting time in cervical cancer, breast cancer, andnasopharyngeal cancer and to examine patient factors and managerial factorsassociated with waiting time.Methods restrospective cohort study conducted by collecting data from medicalrecord for cervical cancer, breast cancer, and nasophryngeal cancer which arereferred to Radiotherapy unit since January 2015. Wait time is define as sinceanatomical pathology confirmed of cancer until start of the first radiotherapy. Thisstudy then continued using qualititative analysis in managerial factors, such asinfrastructure, human resources, plan of improvement, regulation, and funding.Result there was 180 cancer patients, with each cancer is 60. The medianRadiotherapy waiting time for cervical cancer, breast cancer, and nasopharyngealcancer is 131 days, 144,5 days, and 224 days consecutively. There is noassociation between patients demographic characteristics age, education, workingstatus, stage of cancer, domicile, and comorbidities with wait time. From indepthinterviews, observation, and literature review, it is known that shortage ofinfrastructure and medical equipment, human resources, no regulation, andlimitation of budgeting influenced the wait time.Conclusion radiotherapy wait time is still too long and have no standard forcervical cancer, breast cancer, and nasopharyngeal cancer. Coordination betweenall oncologists is needed to discuss the optimal time for cancer services. One ofthe solutions to decrease wait time is by fulfillment between needs and demand ofradiotherapy tools and human resources.Key words Breast Cancer, Cervical Cancer, Demographic Factor, Nasopharyngeal Cancer,Radiotherapy, Waiting time"

"Tesis ini membahas mengenai sejauh mana budaya keselamatan pasien pada residen. Desain penelitian cross sectional dengan analisis mixed method. Subjek penelitian seluruh residen dengan instrumen kuisioner HSOPS. Hasil penelitian menyimpulkan dimensi budaya keselamatan pasien yang paling rendah adalah dimensi respon tidak menghukum terhadap kesalahan (18%). 12 dimensi keselamatan pasien tidak dipengaruhi oleh jenis kelamin dan tingkat kelas residen (p> 0,05), tetapi sebagian besar dipengaruhi oleh asal departemen.

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The tesis focus about the patient safety culture among the resident. This is a cross sectional design research with mix method analysis where all the residen of Medical Faculty of Sriwijaya University as the research subject with HSOPS quesionaire as an instrument. The lowest culture dimension is nonpunitive response to errors (18%). The twelve dimension of patient safety did not influenced by the gender and class level of resident (p>0.05), but majority influenced by the departement catagory"

"Depkes RI (1997) memperkirakan terdapat 1.000.000 ibu yang mengalami komplikasi obstetri setiap tahunnya, dan menyebahkan sekitar 20.000 terjadinya kematian ibu.Komplikasi obstetri dapat terjadi pada masa hamil, persalinan dan nifas. Masa nifas merupakan masa kritis, baik bagi ibu maupun bayi. Penyebab terjadinya komplikasi obstetri pada masa nifas ini antara lain karena perdarahan, infeksi dan eklampsia. Banyak faktor yang menyebabkan terjadinya perdarahan masa nifas, salah satunya adalah retensio plasenta.Retensio plasenta adalah tertahan atau belum lahirya plasenta dalam waktu 30 menit setelah kelahiran bayi (Manuaba, 1998). Penyebab dan faktor predisposisi terjadinya retensio plasenta antara lain karena atonia uteri, adanya bekas jaringan parut pada dinding rahim dan penanganan yang salah pada kala III. Hal ini berkaitan erat dengan anemia, paritas dan penolong persalinan. Terdapat kecenderungan peningkatan jumlah kasus perdarahan masa nifas setiap tahunnya di RSUP dr. Mohammad Hoesin Palembang, dari 15 kasus pada tahun 1999 sampai 76 kasus pada tahun 2001 dengan penyebab terbanyak adalah retensio plasenta (70 kasus) dan belum diketahuinya atau belum ada penelitian tentang retensio plasenta di RS ini . Oleh karena itu diadakannya penelitian tentang hubungan antara anemia, paritas dan penolong persalinan dengan kejadian retensio plasenta di rumah sakit ini.Penelitian ini bertujuan untuk mengetahui hubungan antara anemia, paritas dan penolong persalinan dengan retensio plasenta di RSUP Dr. Mohammad Hoesin Palembang Tahun 1999-2001.Desain penelitian yang digunakan adalah desain penelitian deskriptif cross-sectional, dengan metode pengumpulan data secara kuantitatif yang menggunakan data sekunder (catatan medik). Sampel penelitian ini berjumlah 150 ibu dengan kasus rujukan yang mengalami komplikasi masa nifas (perdarahan, infeksi dan eklampsia).Hasil penelitian menunjukkan estimasi proporsi kejadian retensio plasenta adalah 46,7% dari keseluruhan besar sampel. Ada hubungan antara anemia (OR = 6,88; 95% CI : 5,00 - 8,75), paritas (OR = 0,49; 95% CI : 0,17 - 1,15) dan penolong persalinan (OR = 2,84; 95% CI = 2,24 - 2,90) dengan kejadian retensio plasenta.Disarankan agar wanita hamil mengkonsumsi tablet besi, diadakannya penyebarluasan KIE kepada masyarakat oleh tenaga pemberi pelayanan kesehatan tentang manfaat tablet besi dan bahaya dari anemia, pemilihan tempat dan jenis penolong persalinan, diadakannya pelatihan dan pendidikan berkelanjutan bagi bidan/perawat bidan serta pembinaan/supervisi kepada tenaga penolong persalinan.Daftar bacaan : 55 (1977-2001)

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The Relationship Between Anemia, Parity and Birth Attendant with to Evidence Placenta Retention in dr. Mohammad Hoesin Palembang General Hospital Year 1999-2001Indonesia Health Department (1997) estimate 1.000.000 mothers who had obstetric complication every year, and caused about 20.000 death mother.Obstetric complication could happen on pregnancy, labor and post partum. Post partum is the critical phase for mother and the baby. The etiology of obstetrics complication on post partum are follows : bleeding, infection, and eclampsia. There are many factors which caused post partum bleeding, one of this factors is placenta retention.Placenta retention is stand or not already horn of placenta in 30 minutes after baby born (Manuaba, 1998). Causes and predisposing factor of placenta retention are uterine atony and the wrong management of the third stage of delivery .That are related with anemia, parity and birth attendants. Bleeding cases trend to be increases every year in dr. Mohammad Hoesin Palembang General Hospital, from 15 cases in 1999 up to 76 cases in 2001 which the mostly caused is placenta retention (70 cases) and unknown. Research about placenta retention in this hospital has never been studied. The study must be done about relationship between anemia, parity and birth attendant with to evidence placenta retention in this hospital.The aim of this study is to get information about relationship between anemia, parity and birth attendant with to evidence placenta retention in dr. Mohammad Hoesin Palembang General Hospital Year 1999-2001.This study was descriptive study with cross sectional design. Data collection method quantitatively which used secondary data (medical record). Total sample was 150 mothers who had post partum complication (bleeding, infection, and eclampsia).The result of study show that mother proportion with retention placenta 46,7% from all sample size. There are relationship between anemia (OR= 6,88; 95% CI : 5,00 - 8,75), parity (OR = 0,49; 95% CI : 0,17 -1,15) and birth attendant (OR = 2,84; 95% CI : 2,24 -2,90).It is recommended for pregnancy women to consumed iron, disseminated KIE to the community, by the health provider, iron purpose and iron deficiency, how to choice of place and delivery provider. It's also necessary the training and to be continued of education development for the midwifery/nurse and establishment/supervision to the delivery provider.Reference : 55 (1977-2001)"

"Supervisi adalah suatu bentuk pengawasan yang bertujuan untuk meningkatkan kinerja petugas melalui proses yang sistematis meliputi pemberian motivasi, komunikasi dan bimbingan. Penelitian ini menggunakan desain observasional dengan pendekatan cross sectional dengan menggunakan stratified simple random sampling. Tujuan penelitian ini adalah untuk mengetahui hubungan antara fungsi supervisi kepala ruangan dengan kepatuhan perawat pelaksana dalam melakukan SOP identifikasi pasien Hasil penelitian mempergunakan uji Chi Square membuktikan ada hubungan yang bermakna antara motivasi, komunikasi dan bimbingan dengan kepatuhan perawat pelaksana menjalankan SOP identifikasi pasien. (p value < α). Kesimpulan dari penelitian ini, adalah fungsi supervisi kepala ruangan mempunyai peran yang sangat penting dalam meningkatkan kepatuhan perawat dalam melakukan identifikasi pasien sesuai dengan SOP.

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Supervision is a form supervisory that aim to improve the staf performance through a systematic process in the provision of motivation, communication and guidance. This study used an observational design with cross sectional approach using stratified random sampling. The purpose of this study was to determine the relationship between the function of head room supervision with the compliance of nurses in performing SOP patient identification. The result of this research using Chi Square test to prove there is a significant correlation between motivation, communication and guidance to compliance of nurses in implementating SOP of patient identification (p value < α). The conclusion of this study is that the functions of the supervision of head room have a very important role to improve the nurses complaince in conducting the patient identification based on the SOP."

"Latar Belakang: Inisiasi Menyusui Dini IMD adalah proses alami yang memberi kesempatan bayiuntuk mencari dan mengisap air susu ibu sendiri, dalam satu jam pertama pada awal kehidupannya.Pelaksanaan program IMD merupakan tanggung jawab semua praktisi kesehatan, mulai dari lingkuppelaksana dan manajerial rumah sakit. Tujuan: Mengevaluasi pelaksanaan IMD di RSMH dan faktor-faktor yang mem, pengaruhinya. Metode: Penelitian berdesain cross sectional dengan subjek penelitian ibu bersalin dan tenagakesehatan di Bagian Kebidanan RSMH. Subjek dipilih secara purposive sampling. Data sekunderdiperoleh dari kuesioner yang telah diuji validitas dan reliabilitasnya. Hasil: Selama periode November-Desember 2016, terdapat 19 51,3 pasien pascamelahirkan yangmelakukan IMD dan 18 48,6 pasien tidak melakukan IMD. Terdapat perbedaan bermakna padametode persalinan, dimana persalinan perabdominam mayoritas didapat pada kelompok yang tidakmelakukan IMD p = 0,003 . Penelitian ini melibatkan 43 responden pelaksana bidan dan dokter ,serta 12 responden manajerial. Kondisi medis pasien yang tidak memungkinkan IMD, tidakterlaksananya IMD pada pasien pascaseksio sesaria, dukungan dan sosialisasi rumah sakit kurangmengenai IMD, serta pengetahuan ibu rendah merupakan keluhan responden pelaksana. Penelitian inimenemukan adanya disintegrasi antara pihak manajerial dan pelaksana sehingga menimbulkanketidakjelasan pada pelaksanaan IMD. Simpulan: Peluang terlaksana atau tidaknya IMD dipengaruhi oleh kondisi medis ibu dan janin,metode persalinan, pengenalan dan dukungan rumah sakit terhadap IMD, sosialisasi kebijakan IMD,tingkat pengetahuan ibu. Tantangan melakukan IMD adalah belum ada kebijakan melakukan IMD diruang operasi, kondisi medis ibu sering tidak memungkinkan IMD, ketidakseragaman pengetahuanmanajer terkait IMD, rendahnya sosialisasi peraturan pelaksanaan IMD, ada disintegrasi antara pihakmanajerial dan pelaksana, dan tidak adanya pengawasan IMD di lapangan.

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Background: Early Initiation of Breastfeeding EIB is a natural process of breastfeeding, byallowing the baby to find and suck the breast milk itself, within the first hour of the beginning of life.EIB programme implementation is the responsibility of all health care practitioners, ranging fromexecutive staff and manager.

Objective: To evaluate the implementation of EIB and influences factors in RSMH Palembang.

Method: This is a cross sectional study. All of birth mothers and health professionals doctor andmidwives were include in this study. Samples were selected by purposive sampling. Secondary datawere obtained from the questionnaire respondents which have been tested for validity and reliability.

Results: During the period November to December 2016, there were 19 51.3 patientsswith postspontaneous delivery or abdominal delivery did EIB and 18 48.6 patients did not do EIB. Therewas no significant differences in demographic characteristics between the two groups. There wassignificant differences in the variable method of delivery. Most of patients in no EIB group hadabdominal delivery p 0,003. This study also included 43 doctors and midwives as EIB implementers also 12 managerial staffs. Most of implementer respondents stated that EIB alreadydone well. The patient 39 s medical condition that does not allow the EIB, no EIB in post cesareanpatient, less support and socialization about EIB from hospital, as well as low maternal knowledgewere the executive respondents complaints. This study found the disintegration between the managerial and executive staff, causing ambiguity in the implementation of the EIB.

Conclusion: The opportunitiy of EIB implementation is affected by medical condition of mother andfetus, method of delivery, hospital support, EIB policy socialization, and patient rsquo s level of knowledge.There are so many challenges for our hospital to implement EIB, such as no policy of EIB in operatingroom, the majority of patients are obstetric referral case with complication so that the mother 39 scondition is often not possible to run EIB, knowledge of the managerial about EIB differ greatly, lowsocialization regulations and other elements of the EIB implementation. There is also disintegration between the manager and executive staff causing ambiguity in the implementation of the EIB and thelack of supervision of EIB implementation in the field."

"Selain menyelenggarakan pelayanan kesehatan secara medis rumah sakit juga sebagai sumber informasi kesehatan. Salah satu sistem informasi kesehatan yang ada di rumah sakit adalah sistem pelaporan penderita Demam Berdarah Dengue (DBD), sistem ini mempunyai peranan membantu pihak manajemen dalam mengatasi masalah penyakit DBD. Untuk menjamin ketersediaan sistem informasi yang baik, maka sistem pelaporan penderita DBD sebagai saran penghasil laporan perlu dikembangkan.Penelitian ini bertujuan untuk memperoleh gambaran tentang bagaimana pengembangan sistem pelaporan penderita DBD, berdasarkan data dan sistem yang sedang berjalan dengan menggunakan kaidah pengembangan sistem informasi yang memenuhi syarat, sehingga akan dihasilkan sistem pelaporan yang akurat, relevan dan tepat waktu.Metodologi yang digunakan adalah operational research dengan pendekatan kualitatif. Penelitian dilakukan pada saat sistem masih beroperasi, yang akan mengidentifikasi masalah operasional, mengevaluasi beroperasinya sistem lama dan memberikan alternatif pemecahan masalah.Dengan menerapkan metode ini dalam penelitian di RSMH Palembang, diperoleh data untuk menentukan identifikasi masalah, peluang pengembangan dan penetapan kebutuhan informasi.Dari hasil penelitian diketahui permasalahan yang terjadi pada sistem pelaporan penderita DBD, yang salah satu penyebabnya adalah mekanisme penyampaian laporan masih dilakukan secara manual (konvensional). Dengan pertimbangan mekanisme laporan tersebut maka dibuatlah suatu rancangan sistem dengan menggunakan pendekatan metode SDLC (system development life cycle). Dengan menerapkan metode ini diperoleh keunggulan dari sistem yang dikembangkan yaitu, mempercepat proses pembuatan laporan dan ketepatan informasi.

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Development of Dengue Hemorrhagic Fever (DHF) Reporting System in Dr. Mohamad Hoesin Hospital (RSMH) Palembang Year 2003Besides implementing medical health care, hospital also serves as source of health information. One type of health information system in hospital is DHF reporting system. This system helps management to overcome DHF cases. To ensure the availability of good information system, there is a need to develop DHF reporting system as base for report.

This study aims to obtain description on the development of DHF reporting system based on data and existing system using the principles of good development of information system, thus it will produce an accurate, relevant, and timely reporting system.

Method used in this study was operational research through qualitative approach. Study was conducted at the time when the system was still operating, to identify operational problems, to evaluate the operation of old system, and to provide problem solution alternatives.

By implementing this method in the study at RSMH Palembang, data was obtained to further identify the problem, opportunity for development, and to determine information needs.

The study results shows that there were problems identified in DGF reporting system, one of the causes was manual report mechanism (conventional). Considering the problem, a system design was developed through SDLC (system development life cycle) method. By applying this method the making of report several benefits could be obtained, such as process and information accuracy were improved."

"Penelitian bertujuan melihat perbedaan cost recovery rate (CRR) tarif INA CBG’s dan tarif rumah sakit kasus CAD dengan PCI di RSUP Dr. Mohammad Hoesin Palembang. Hasil penelitian menunjukkan berdasarkan cost of treatment berbasis clinical pathways pada severity level I nilai CRR RS berada diatas CRR tarif INA CBGs, pada severity level II dan III nilai CRR RS lebih rendah dari CRR tarif INA CBGs pada utilisasi stent 1 dan 2. Tarif INA CBGs tidak memperhitungkan jumlah stent dalam setiap tindakan PCI. Perlu evaluasi metode penghitungan tarif INA CBGs dari hospital base rate ke metode perhitungan cost of treatment berdasarkan clinical pathway, sehingga biaya operasional RS dapat dipenuhi dan tetap mampu berikan pelayanan yang bermutu.

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This study aims to see how the difference between the cost recovery rate (CRR) hospital rates and INA CBG's rates in case of CAD with PCI at Hospital Dr. Mohammad Hoesin Palembang.The results showed the cost of treatment based on clinical pathways are at the severity level I value of CRR Hospital rates above the CRR CBGs INA rates, whereas the severity level II and III of CRR Hospital rate more lower than CRR INA CBGs rates for the utility stent is less than 2. This is due to CBGs INA rate do not take into account the magnitude of the stent in every act of PCI performed in patients with CAD. Based on the research necessary to evaluate teh methode of calculating INA CBGs ratesfrom hospital base rate methode to Cost of treatment based on clinical pathway in order to create a balance so that the operational cost of service rates hospitals can be met and still be able to provide good quality services."