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"Sumber Waras Hospital ( RSSW) is a non government hospital which is appointed as a referral hospital in West Jakarta. This hospital also has develop a vision to become a prominently referral hospital in its service area. Lately, RSSW has faced a major problem caused by the decrease of its total number of patients. To achieve its vision of becoming a good referral hospital, The Sumber Waras Hospital is strongly required to have a superior competency on four major types of services , namely are pediatric , obstetric and gynecologic , surgery and internal medicine care. Based on the current data of RSSW's services utilization, the surgery care has the smallest proportion of decrease number of patients. The purpose of this research is to gather various information which affect surgery care in RSSW and conduct an analysis marketing strategic for surgery care. This design of this research is a case study which focuses on problem solving using combination qualitative and survey method quantitative. Data collection instruments includeiv questionnaire and indepth interviews. In addition the Porter's competitive analysis and TOWS analysis are used to asses the existing data.Based on the results of this research, RSSW's surgery care is facing various threats. But on the other hand it this hospital gaining unexplored opportunities. The current management of RSSW need to deal with various weaknesses over its limited strengths. Using TOWS technique, following strategy is suggested to the management :1. RSSW has to cope with ongoing continuous technology aspect of the surgery care and fix the internal weaknesses by applying the double distribution and cost analysis. Hence, RSSW will have more financial resources for dealing with this threat.2. Due to the current economic crisis of the country and the people's ability to pay has substantially reduced, RSSW is recommended to provide a low cost economic package services for surgical patient and increase the third party payer consumer.3. To anticipate competition among similar institutions, the RSSW has to develop an effective marketing program.4. It is further recommended that the RSSW has to strengthen its human resources and also improve the quality or surgical services and initiate to extend r the market to the third party payer."

"Penyakit kardiovaskular menjadi salah satu penyebab kematian tertinggi di tingkat global. Upaya tindakan pencegahan dan tatalaksana terus dikembangkan untuk mengatasi permasalahan ini. Perawat spesialis memiliki peran sebagai pemberi asuhan keperawatan langsung, menerapkan evidence base nursing dan melakukan inovasi keperawatan. Praktik residensi spesialis keperawatan medikal bedah telah dilaksanakan untuk mengaplikasikan peran perawat sebagi pemberi asuhan langsung, peneliti dan inovator. Peran sebagai pemberi asuhan keperawatan langsung dilakukan dengan memberikan asuhan keperawatan pada 30 kasus kelolaan resume dan kasus kelolaan utama Coronary Artery Disease 3VD dengan teori Model Adaptasi Roy. Peran sebagai peneliti dijalankan dengan melakukan pemberian intervensi Nostril Breathing dalam penurunan tekanan darah pada pasien hipertensi. Peran perawat sebagai inovator dilakukan dengan menyusun proyek inovasi tentang penggunaan spiritual Assessment Fica dalam pemenuhan kebutuhan spiritual pasien. Hasil analisis praktik menunjukkan bahwa Model Adaptasi Roy efektif digunakan untuk pasien dengan gangguan sistem kardiovaskular.

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Cardiovascular disease is one of the highest causes of death at the global level. Preventive measures and management efforts continue to be developed to overcome this problem. Specialist nurses have a role as providers of direct care, applying the nursing evidence base and implementing care innovations. Medical surgical care specialist residency practices have been implemented to implement the role of nurses as direct care providers, researchers and innovators. The role as a provider of direct assistance was carried out by providing care in 30 cases of resume management and main management cases of Coronary Artery Disease 3VD using Roy's Adaptation Model theory. The role as a researcher begins by providing Nostril Breathing intervention in reducing blood pressure in hypertensive patients. The role of nurses as innovators is carried out by preparing innovation projects regarding the use of the Fica spiritual assessment in meeting patients' spiritual needs. The results of the practice analysis show that the Roy Adaptation Model is effective for patients with cardiovascular system disorders."