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"Dokter spesialis merupakan hilir dari sistem rujukan berjenjang dan memiliki peranan penting terhadap keberhasilan pembangunan kesehatan. Namun ketimpangan sebaran dokter spesialis masih terjadi di Indonesia. Terdapat wilayah dengan rasio dokter spesialis yang melebihi standar, namun masih ada juga kabupaten/kota yang tidak memilliki dokter spesialis. Berbagai studi menyebutkan bahwa karakter wilayah berupa indeks pembangunan manusia, kemiskinan, kepadatan penduduk, indikator kesehatan, kondisi ekonomi dan ketersediaan rumah sakit mempengaruhi jumlah dokter spesialis di suatu wilayah. Studi ini bertujuan untuk menganalisis determinan yang berhubungan dengan jumlah dokter spesialis dan berapa besar elastisitas dokter spesialis terhadap pendapatan asli suatu daerah. Rancangan studi ini adalah potong lintang (cross sectional) dengan menggunakan data kurun waktu tahun 2017 yang dikumpulkan dari laporan rutin maupun publikasi resmi lembaga-lembaga BPPSDM, BPS, Kemenkes RI, KARS dan BAN-PT. Analisis multivariat dilakukan dengan negatif binomial untuk mnegatasi masalah overdispersi. Unit penelitian dilakukan pada tingkat kabupaten dan kota.Dari hasil studi ditemukan bahwa 66% dokter spesialis terkonsentrasi di pulau Jawa dan Sumatera. Determinan yang memiliki pengaruh signifikan terhadap sebaran dokter spesialis adalah indeks pembangunan manusia, kepadatan penduduk, rasio kematian bayi, pendapatan asli daerah, jumlah RS kelas C, jumlah RS kelas D dan regional wilayah menurut tarif INACBG. Dimana rasio kematian bayi merupakan prediktor dominan. Variabel rasio kematian ibu, jumlah RS kelas A, jumlah RS kelas B, banyak nya RS yang terakreditasi, ketersediaan perguruan tinggi yang mengelola fakultas kedokteran di suatu wilayah kabupaten/kota memiliki pengaruh yang tidak signifikan terhadap jumlah dokter spesialis. Jumlah dokter spesialis bersifat inelastis terhadap pendapatan asli daerah dengan nilai elastisitas sebesar 0,28. Kebijakan untuk mengatasi masalah ketidakseimbangan sebaran dokter spesialis sebaiknya tidak hanya berfokus pada mengurangi gap jumlah dokter spesialis antar wilayah, akan tetapi harus diikuti dengan strategi jangka panjang terkait penyediaan sarana RS, sarana penunjang lainnya dan kemudahan akses terhadap sarana-sarana tersebut, khusus nya di daerah tertinggal, kepulauan dan perbatasan.

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Specialist doctors are downstream from atiered referral system and have an important role to the success of health development, but unequality in the distribution of specialist doctors still occur in Indonesia. There is a region with a ratio of specialist doctors that exceeds the standard, but also found districts that do not have specialist doctors. Various studies indicate that the character of the region such as human development index, poverty, population density, health indicator, economic conditions and availability of hospitals affect the number of specialists in that region. This study aims to analyze the determinants associated with the number of specialists and how much elasticity a specialist doctors to the original income of a region. The method of this research is cross section by using data of period year 2017 which collected from routine report and official publication of institutions BPPSDM, BPS, Ministry of Health RI, KARS and BAN-PT. Analysis multivariat used negative binomial has done with software stata 13. Unit analysis was conducted at municipality and district level.The study found that 66% of specialist doctors are concentrated in the islands of Java and Sumatra. Determinants that have significant influence on the distribution of specialist doctors are human development index, population density, infant mortality ratio, local originally income, number of class C hospital, number of class D hospital and region. The maternal mortality ratio, percentage of poor population, the number of class A hospital, the number of class B hospital and the number of accredited hospitals, availability of university with medical faculty in a municipality/district region have no significant influence on the number of specialist doctors. The number of specialists doctor is inelastic to the original income of the region with a value of elasticity is 0.28. Policies to address specialist doctors imbalances should not only focus on reducing the gap in the number of inter-regional specialists, but should be followed by long-term strategies related to the provision of hospital facilities, other supporting facilities and ease of access to these facilities, especially in underdeveloped areas, islands and borders."

"Skripsi ini bertujuan untuk mempelajari determinan sosial, ekonomi dan lingkungan terhadap migrasi risen masuk di Indonesia. Determinan variabel yang digunakan ialah PDRB per kapita, kemiskinan, pendidikan, kesehatan, infrastruktur, lingkungan dan kriminalitas. Metode yang digunakan yaitu regresi OLS menggunakan data cross section, yaitu tahun 2012. Hasil penelitian menunjukkan bahwa seluruh variabel independen berpengaruh signifikan terhadap migrasi risen masuk. PDRB per kapita, pendidikan, kesehatan, infrastruktur, dan lingkungan berpengaruh positif terhadap migrasi risen masuk, sementara kemiskinan dan kriminalitas berpengaruh negatif terhadap migrasi risen masuk.

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This study is focusing on the socio-economic and amenities determinants of recent in-migration in Indonesia. The determinants are GDP per capita, poverty, education, health, infrastructure, water facilities, and criminality at the level of district/city. The method used in this research is OLS regression with cross section data in 2012. The results indicate that GDP per capita, education, health, infrastructure, and amenities have positive effect on recent in-migration, while poverty and criminality have negative impact on with recent in-migration."

"Skripsi ini membahas tentang kewenangan dan kompetensi dokter spesialis kedokteran olahraga di Indonesia dengan mengamati apa yang terjadi di klinik Indonesia Sports Medicine Centre. Antusiasme masyarakat akan olahraga sangat besar akan tetapi karena ketidaktahuan akan olahraga memunculkan potensi terjadinya cedera, sehingga muncul dokter spesialis kedokteran olahraga sebagai jawaban. Karena dokter spesialis kedokteran olahraga masih baru mengakibatkan masyarakat termasuk peneliti sebagai mahasiswa hukum mempertanyakan bagaimana kewenangan dan kompetensi dari dokter spesialis kedokteran olahraga. Kesimpulan dari skripsi ini kewenangan dokter spesialis kedokteran olahraga di Indonesia berdasarkan Pasal 35 Undang-Undang Praktik Kedokteran dan kompetensi utamanya adalah mengobati orang yang sakit karena aktifitas olahraga dan mengobati orang yang sakit dengan metodeolahraga. Dokter dan Klinik bertanggung jawab jika terjadi kerugian yang timbul kepada pasien hal ini dapat dilihat pada pasal 58 ayat (1) Undang-Undang Kesehatan bahwa setiap orang berhak menuntut ganti rugi terhadap seseorang, tenaga kesehatan, dan/atau penyelenggara kesehatan yang menimbulkan kerugian akibat kesalahan atau kelalaian dalam pelayanan kesehatan yang diterimanya. Saran dari skripsi ini adalah pihak Konsil KedokteranIndonesia bersama Kolegium Kedokteran Olahraga sesegera mungkin mengesahkan rancangan standar kompetensi dokter spesialis kedokteran olahraga agar dokter spesialis kedokteran olahraga di Indonesia memiliki legalitas yang jelas terhadap Standar Profesi Medik yang dokter spesialis kedokteran olahraga gunakan guna melindungi kepentingan para dokter juga jika sewaktu-waktu ada tuntutan atau gugatan hukum.

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This thesis examines the authority and competence of sports medicine specialists in Indonesia by observing what is happening at the Indonesia Sports Medicine Center.”The enthusiasm of the community for sports is very large, but because of their ignorance of sports, there is potential

for injury, so that sports medicine specialist appears as the answer. Because sports medicine specialists are still new, people, including researchers as law students, question the authority and competence of sports medicine specialists. The conclusion of this thesis is that the

authority of sports medicine specialists in Indonesia is based on Article 35 of the Medical Practice Law and their main competences are to treat people who are sick due to sports activities and treat people who are sick with sports methods. Doctors and Clinics are responsible if there is a loss incurred to patients, this can be seen in article 58 paragraph (1) of the Health Law that everyone has the right to claim compensation for someone, health workers, and / or health providers who cause losses due to errors. or negligence in the health services it receives. The suggestion from this thesis is that the Indonesian Medical Council together with the Sports Medicine College as soon as possible ratify the draft standard of competency for sports medicine specialists so that sports medicine specialists in Indonesia have clear legality

against the Medical Professional Standards that sports medicine specialists use to protect the interests of doctors as well. if at any time there is a lawsuit."

"Kepatuhan Dokter Spesialis Terhadap Implementasi Clinical pathway Pada Lima Area Prioritas di RSUP SanglahPembimbing: Prastuti Soewondo, SE, MPH, PhDTesis ini membahas implementasi clinical pathway pada lima area prioritas yang telah ditetapkan oleh RSUP Sanglah. Rumah sakit ditantang untuk terus meningkatkan pelayanan dengan penekanan pada kendali mutu dan kendali biaya agar dapat tetap menjaga keberlangsungan pelayanan sebagai industri kesehatan di wilayahnya. Dengan perbaikan mutu layanan dan efisiensi, rumah sakit dapat memberi pelayanan terbaik untuk masyarakat sekaligus meningkatkan pendapatan rumah sakit, terutama dalam pelaksanaan skema Sistem Jaminan Sosial Nasional.Penelitian ini menggunakan rancangan potong lintang dengan pendekatan mixed method kuantitatif dan kualitatif . Data dikumpulkan secara concurrent embedded.Hasil penelitian mengungkap adanya kepatuhan dokter spesialis dalam implementasi clinical pathway pada lima area prioritas di RSUP Sanglah yang dipengaruhi oleh faktor komunikasi, sumber daya, disposisi dan SOP. Faktor-faktor tersebut mampu membuat para dokter spesialis merasa memiliki dan menjadi bagian dari kebijakan tersebut. Perlu dilakukan monitoring dan evaluasi serta sosialisasi yang berkelanjutan guna mempertahankan dan memperbaiki hasil terbaik yang telah dicapai.

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Specialist Doctors rsquo Compliancy in the Implementation of the Clinical Pathway in Five Priority Areas at Sanglah HospitalAdvisor Prastuti Soewondo, SE, MPH, PhDThis thesis discusses the implementation of the clinical pathway in five priority areas established by Sanglah General Hospital. Hospitals are challenged to continue improving its services while emphasizing quality and cost control in order to ensure the continuity of the health industry in the region. Improvement in service quality and efficiency will assist hospitals in providing the most effective health services for the community while increasing hospital rsquo s income, especially essential in the era of the national social security system.This research used a cross sectional design with mixed method approach quantitative and qualitative . Data were collected with the concurrent embedded method.

The results suggest the compliance of specialist doctor in the implementation of clinical pathway of five priority areas in Sanglah General Hospital were influenced by factors of communication, resources, disposition and SOP. These factors provided the specialists with a sense of belonging and ownership of the policy. Continuous monitoring and evaluation, as well as ongoing socialization needs to be continued and expanded to maintain and improve the satisfactory results that have been achieved."

"Sesuai dengan peraturan perundang-undangan terbaru tentang kesehatan, maka Rumah Sakit memiliki hak menerima imbalan jasa pelayanan serta menentukan remunerasi, insentif dan penghargaan sesuai dengan ketentuan yang berlaku. Namun indikator pemberian remunerasi bagi Dokter Spesialis saat ini dinilai belum komprehensif karena belum menunjukkan keadilan dan kinerja diluar tugas utama yang dilakukan oleh Dokter Spesialis. Penelitian ini bertujuan untuk melakukan analisis indikator (struktur pembentuk) pemberian remunerasi untuk pegawai khususnya untuk tenaga medis Dokter Spesialis. Pendekatan kualitatif dengan jenis penelitian studi kasus menggunakan wawancara kepada informan dengan penentuan informan dilakukan secara purposive sampling. Hasil studi ditemukan bahwa indikator pemberian remunerasi yang digunakan saat ini sesuai dengan Peraturan Gubernur Nomor 51 Tahun 2021 lebih menitikberatkan pada kinerja berupa koefisien tindakan sesuai ICD-9 namun dirasa belum mencakup pada faktor individu yang juga perlu dipertimbangkan dalam pemberian remunerasi kepada dokter spesialis, seperti masa kerja, kondisi kerja/kegawatdaruratan dan posisi/tanggung jawab. Selain itu penerapannya belum maksimal karena belum terlaksananya penilaian kinerja yang optimal dan belum dilakukan monitoring serta evaluasi secara berkala kepada dokter spesialis melalui komite medik. Namun dengan dilaksanakannya pemberian jasa pelayanan terhadap dokter spesialis dengan menggunakan pola perhitungan remunerasi, memperlihatkan kinerja yang lebih baik dibandingkan saat pemberian jasa pelayanan dengan pola per-kehadiran.

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In accordance with the latest laws and regulations on health, the Hospital has the right to receive service fees and determine remuneration, incentives and awards in accordance with applicable regulations. However, the current indicator of remuneration for Specialist Doctors is considered not comprehensive because it has not shown fairness and performance outside the main duties carried out by Specialist Doctors. This study aims to analyze the indicators (forming structure) of remuneration for employees, especially for medical personnel of Specialist Doctors. A qualitative approach with the type of case study research using interviews with informants with the determination of informants is carried out by purposive sampling. The results of the study found that the remuneration indicators currently used in accordance with Governor's Regulation Number 51 of 2021 focus more on performance in the form of coefficients of action in accordance with ICD-9 but do not include individual factors that also need to be considered in providing remuneration to specialist doctors, such as working period, working conditions/emergencies and positions/responsibilities. In addition, the implementation has not been maximized because performance assessments have not been carried out and periodic monitoring and evaluation have not been carried out to specialist doctors through the medical committee. However, with the implementation of the provision of services to specialist doctors using the remuneration calculation pattern, it shows better performance than when providing services with a per-attendance pattern."

"Studi ini bertujuan untuk menjelaskan mengenai determinan yang mempengaruhi kualitas dokumen perencanaan daerah kabupaten/kota di Indonesia. Motivasi studi ini berasal dari adanya inkonsistensi program, kegiatan dalam dokumen rencana daerah tahunan dimana Pemerintah Daerah setiap tahun menyusun dokumen rencana daerah baik jangka panjang dua puluh tahunan, jangka menengah lima tahunan, maupun jangka pendek tahunan. Namun studi empirik dalam membuktikan faktor yang mempengaruhi kualitas terhadap dokumen perencanaan tahunan sangat terbatas, hal tersebut terjadi karena adanya keterbatasan data. Penelitian bertujuan untuk menganalisis faktor yang mempengaruhi kualitas dokumen perencanaan daerah kabupaten/kota di Indonesia. Penelitian menggunakan regresi data panel dengan temuan tahapan penyusunan dokumen perencanaan tahunan / RKPD, persentase anggaran Bappeda terhadap belanja dalam APBD, nilai LPPD, Incumbent/ Petahana Bupati/Walikota, dan tambahan penghasilan PNS di Bappeda berpengaruh positif dan signifikan terhadap kualitas dokumen RKPD.

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This study aims to explain the determinants that affect the quality of district/city  planning documents in Indonesia. The motivation for this study stems from the inconsistency of programs, activities in the annual regional plan document where the Regional Government annually prepares a regional plan document, either twenty years long term, five year medium term, or annual short term. However, empirical studies in proving the factors that affect the quality of annual planning documents are very limited, this happens because of limited data. This study aims to analyze the factors that affect the quality of district/city planning documents in Indonesia. The study used panel data regression with the findings of the stages of preparing the annual planning / RKPD document, the percentage of Bappeda budget to expenditure in the APBD, the value of LPPD, Incumbent / Regent / Mayor incumbents, and additional income of civil servants in Bappeda had a positive and significant effect on the quality of RKPD documents."

"Ketidakmerataan dokter spesialis masih tinggi di Indonesia. PemberianBantuan Biaya Program Pendidikan Dokter Spesialis (PPDS) merupakan salahsatu cara untuk pemerataan distribusi dokter spesialis. Perlu dikembangkannyasistem pendukung keputusan yang bertujuan untuk menentukan prioritas dalampemberian bantuan biaya pendidikan dokter spesialis dan menyaringpenempatannya pada provinsi, kabupaten/kota dan rumah sakit (RS) yang benarbenarkekurangan. Telah dikembangkan sistem pendukung keputusan denganmenggunakan metode System Development Life Cycle (SDLC). Sistem inimerupakan komplemen dari sistem pendaftaran online PPDS. Penentuan batasanRS dan spesialisasi dalam pemberian biaya pendidikan dokter spesialis telahtersaring dan ditampilkan dalam option form pendaftaran online. Telahtersusunnya basis data kebutuhan dokter spesialis di Indonesia dengan totalkekurangan dokter spesialis pada RS pemerintah tahun 2013 sebanyak 3888dokter spesialis. Provinsi prioritas dalam pemberian biaya PPDS adalah Maluku,Bengkulu, Maluku Utara dan Nusa Tenggara Timur.

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Medical specialists are distributed unequaly in Indonesia . Scholarship

program of medical specialist (PPDS) is one way to equal the distribution. The

need to developed decision support system for medical specialist scholarship and

placement distribution at the provincial, district/city, and hospital where lack of

specialists. The development of decision support system for medical specialist

scholarship and placement distribution is using the System Development Life

Cycle (SDLC) method. This system is a complement of the online registration

system for Scholarship Program of Medical Specialist (PPDS). The determination

of the list of the hospital where lack of specialists and available scholarship

program of medical specialist are displayed in the online registration form option.

The result of this thesis is a database of medical specialist needs in Indonesian

government hospitals in 2013, as many as 3888 specialists. Priority provinces for

Scholarship program of medical specialist (PPDS) are Maluku, Bengkulu, Maluku

Utara, and Nusa Tenggara Timur."

"Kedokteran Militer di Tentara Nasional Indonesia Angkatan Laut (TNI AL) memiliki peran dalam dukungan dan layanan kesehatan pada masa perang dan damai. Ancaman terhadap pertahanan yang tidak hanya berasal dari serangan agresor tetapi juga kondisi bencana alam. Layanan kedokteran forensik dan medikolegal merupakan suatu hal yang baru dalam instansi TNI AL, sehingga penelitian ini akan membahas potensi peranan dokter spesialis forensik dan medikolegal (Sp.FM) di instansi TNI AL dalam mendukung tugas pokok TNI AL, serta memetakan potensi risiko/konflik dalam pemberian layanan kedokteran untuk hukum (yandokkum) serta mitigasi konflik serta membangun imparsialitas dan independensi dalam tugas pelayanan. Sebagai penelitian kualitatif eksploratif dengan pendekatan grounded theory, data diambil dengan metode FGD dan wawancara mendalam terhadap pemangku kebijakan di level menengah dan pemangku kebijakan pusat. Hasilnya, didapatkan bahwa peran Sp.FM yang diharapkan dominan dalam pembuktian kasus perkara pidana, ternyata diutamakan untuk mendukung tata kelola kebencanaan melalui proses identifikasi. Peranan Sp.FM diharapkan dapat berkolaborasi untuk mengatasi konflik baik internal dari kedokteran militer dan antar matra di TNI, maupun eksternal dengan korps lain di TNI dan unsur di luar TNI melalui pendekatan multidisiplin, interdisiplin dan transdisiplin sehingga tujuan yandokkum di instansi TNI AL dapat terwujud.

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Military Medicine in the Indonesian Navy (TNI AL) plays a crucial role in providing healthcare. Defense threats arise not only from aggressor attacks but also from natural disasters. Forensic and medicolegal services is a relatively new field within the Indonesian Navy. This study explores the potential role of forensic and medicolegal specialists (Sp.FM) in supporting the Indonesian Navy's primary duties, mapping potential risks and conflicts in providing forensic medical services, proposing conflict mitigation strategies, and ensuring impartiality and independence in service tasks. This is an exploratory qualitative study with grounded theory approach. Data was collected through FGDs and in-depth interviews with mid-level and top policymakers. The findings revealed that the role of Sp.FM, which was expected to be dominant in criminal case investigations, was primarily directed towards supporting disaster management through identification processes. The role of Sp.FM is anticipated to collaborate in addressing internal conflicts within military medicine, inter-service conflicts within the navy, and external conflicts with other corps and external entities. This can be achieved through comprehensive collaboration with multidisciplinary, interdisciplinary, and transdisciplinary approaches, ensuring that the objectives of medical services for legal purposes are met in the navy."

"[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]"