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Abstrak :
ABSTRAK
Tindak lanjut Laporan Hasil Pemeriksaan (LHP) yang dilakukan oleh Satuan Pemeriksaan Intern (SPI) wajib dilakukan dan merupakan tanggung jawab manajemen rumah sakit. Di RSUP Sanglah tahun 2012 rata-rata rekomendasi yang ditindaklanjuti 55,9% dengan rata-rata waktu penyelesaian 55 hari, melebihi ketentuan yang ada. Tujuan penelitian ini untuk mengetahui faktor penentu rendahnya jumlah dan keterlambatan waktu penyelesaian tindak lanjut LHP SPI serta diketahuinya cara pemecahan masalahnya. Penelitian ini merupakan penelitian deskriptif kualitatif, dengan melakukan wawancara mendalam, telaah dokumen, dan focus group discussion. Analisa data dengan content analysis. Hasil penelitian menunjukkan belum maksimalnya dukungan dalam hal komitmen, kepemimpinan, motivasi , dan pengkomunikasian manajer di semua lini, kurangnya dukungan kompensasi non finansial, kurangnya fasilitas , serta belum adanya pedoman bagi unit untuk melakukan tindak lanjut menyebabkan pelaksanaan tindak lanjut LHP SPI belum sesuai ketentuan. Oleh karena itu diperlukan dukungan dari pimpinan tertinggi dalam bentuk kebijakan tertulis dan semua manajer perlu berkoordinasi dalam upaya pelaksanaan tindak lanjut, serta pentingnya dilakukan evaluasi dan monitoring pelaksanaan tindak lanjut LHP oleh SPI

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ABSTRACT
The Follow-up Audit Reports which is conducted by The Internal Audit Unit in the hospital is mandatory and also is the responsibility of the hospital management. In Sanglah hospital in 2012, the average of 55,9% recommendations was followed-up with an average of 55 days completion time which exceeded the allowed time of completion. The purpose of this study is to determine factors influencing the small number of completion and the delayed completion time of the follow-up audit reports by the Internal Audit Unit and to find resolutions to solve the problems. This is a qualitative descriptive study which uses deep interviews, document reviews and focus group discussions. Data was analyzed with Content Analysis. This study suggests that there was no sufficient support with regard to: commitment, leadership, motivation, and communication system among managers in all levels of management. There were also lack of non financial compensations, lack of facilities and also the absent of guidelines in all units to conduct follow-up which resulted in inadequate Follow –Up Audit Report by the Internal Audit Unit. Therefore, a Legal Document (Policies) from the Top Manager and coordination among managers are needed to ensure that the follow-up of the audit report is conducted. In addition, it is important for the Internal Audit Unit to implement monitoring and evaluation of the followup of audit reports.

Abstrak :
ABSTRAK
Teknik anesthesia regional blok subarachnoid (RA BSA) adalah yang paling banyak dilakukan setelah teknik anesthesia umum inhalasi pipa endotrakea (GA PET) di RSUP Sanglah. Teknik anesthesia regional blok subarachnoid dapat menggantikan teknik anesthesia umum pipa endotrakea pada pasien mini laparatomi (appendisectomy dan laparatomi kehamilan ektopik). Belum pernah dilakukan studi tentang cost effectiveness analysis (CEA) pada teknik anesthesia regional blok subarachnoid di RSUP Sanglah. Cost diambil dari catatan medis penggunaan obat di ruang operasi dan ruang pemulihan. Outcome (efektifitas) dilihat dari kejadian efek samping pasca operasi (nyeri akut pasca operasi, mual muntah pasca operasi / PONV dan menggigil (shivering) . Hasil penelitian menunjukkan bahwa teknik anesthesia regional blok subarachnoid lebih cost effective daripada teknik anesthesia umum pipa endotrakea pada pasien mini laparatomi (appendisectomi dan laparatomi kehamilan ektopik) di RSUP Sanglah Bali.

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ABSTRACT
Regional anesthesia blok subarachnoid is the most common anesthesia technique after general anesthesia endotracheal tube at RSUP Sanglah. Regional anesthesia blok subarachnoid can replaced the general anesthesia endotracheal tube for minilaparatomy (appendisectomy & laparotomy ectopic pregnancy) patient. None of report on cost effectiveness analysis for regional anesthesia blok subarachnoid at RSUP Sanglah. Cost were calculated from anesthesia record paper at the operating room and recovery room. Outcome were taken from side effect after operation (acute pain, post operative nausea vomiting and shivering). The result, anesthesia regional blok subarachnoid were more cost effective than general anesthesia endotracheal tube for mini laparotomy (appendisectomy and laparotomy ectopic pregnancy) at RSUP Sanglah Bali.

Abstrak :
Review rekam medis merupakan suatu proses yang penting dalam rangka peningkatan mutu layanan Rumah Sakit sesuai akreditasi Internasional. Review rekam medis yang dilakukan belum mencapai 100%. Penelitian ini merupakan penelitian deskriptif kualitatif. Pengumpulan data dengan wawancara dan penelusuran dokumen. Analisa data dengan content analysis. Hasil penelitian menunjukkan standar pelaksanaan review rekam medis sudah dibuat sesuai rekomendasi tim akreditasi Internasional. Sosialisasi standar belum optimal, pemahaman tentang review rekam medis oleh dokter dan petugas gizi masih kurang, keterlibatan sumber daya manusia belum sesuai, belum adanya format laporan dan jadwal pelaporan dari instalasi rekam medis ke direksi dan belum berjalannya sistem evaluasi tindak lanjut sesuai PDCA (Plan Do Check Action). Kesimpulan: review rekam medis belum berjalan sesuai standar yang dibuat. Saran: pelaksanaan review rekam medis dimasukkan sebagai salah satu tugas pokok pejabat yang berwenang, supervisi dilakukan secara berkesinambungan, tingkatkan sosialisasi standar review rekam medis, review rekam dapat dilakukan secara rutin untuk semua rumah sakit sebagai siklus perbaikan kualitas rekam medis.

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Review of medical records is an important process in order to improve the quality of service correspond Hospital International accreditation. Review of medical records that do not reach 100%. This research is a qualitative descriptive study. Data collection with interviews and document searches. Data analysis with content analysis. The results showed a standard implementation review of medical records has been made according to the International accreditation team's recommendations. Socialization of standards is not optimal, an understanding of the medical record review by physicians and nutrition workers are still lacking, the involvement of human resources is not appropriate, the lack of reporting formats and reporting schedules of the medical record installation to the directors and the evaluation system of follow-up not accordance to PDCA (Plan Do Check Action). Conclusion: a review of medical records have not been going according to the standards set. Suggestion: the implementation of medical record review included as one of the main tasks the competent authority, supervision is done on an ongoing basis, increase socialization standard medical record review, and medical record review can be performed routinely for all hospitals as medical record quality improvement cycle.

Abstrak :
[ABSTRAK
Tindak lanjut Laporan Hasil Pemeriksaan (LHP) yang dilakukan oleh Satuan Pemeriksaan Intern (SPI) wajib dilakukan dan merupakan tanggung jawab manajemen rumah sakit. Di RSUP Sanglah tahun 2012 rata-rata rekomendasi yang ditindaklanjuti 55,9% dengan rata-rata waktu penyelesaian 55 hari, melebihi ketentuan yang ada. Tujuan penelitian ini untuk mengetahui faktor penentu rendahnya jumlah dan keterlambatan waktu penyelesaian tindak lanjut LHP SPI serta diketahuinya cara pemecahan masalahnya. Penelitian ini merupakan penelitian deskriptif kualitatif, dengan melakukan wawancara mendalam, telaah dokumen, dan focus group discussion. Analisa data dengan content analysis. Hasil penelitian menunjukkan belum maksimalnya dukungan dalam hal komitmen, kepemimpinan, motivasi , dan pengkomunikasian manajer di semua lini, kurangnya dukungan kompensasi non finansial, kurangnya fasilitas , serta belum adanya pedoman bagi unit untuk melakukan tindak lanjut menyebabkan pelaksanaan tindak lanjut LHP SPI belum sesuai ketentuan. Oleh karena itu diperlukan dukungan dari pimpinan tertinggi dalam bentuk kebijakan tertulis dan semua manajer perlu berkoordinasi dalam upaya pelaksanaan tindak lanjut, serta pentingnya dilakukan evaluasi dan monitoring pelaksanaan tindak lanjut LHP oleh SPI.

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ABSTRACT
The Follow-up Audit Reports which is conducted by The Internal Audit Unit in the hospital is mandatory and also is the responsibility of the hospital management. In Sanglah hospital in 2012, the average of 55,9% recommendations was followed-up with an average of 55 days completion time which exceeded the allowed time of completion. The purpose of this study is to determine factors influencing the small number of completion and the delayed completion time of the follow-up audit reports by the Internal Audit Unit and to find resolutions to solve the problems. This is a qualitative descriptive study which uses deep interviews, document reviews and focus group discussions. Data was analyzed with Content Analysis. This study suggests that there was no sufficient support with regard to: commitment, leadership, motivation, and communication system among managers in all levels of management. There were also lack of non financial compensations, lack of facilities and also the absent of guidelines in all units to conduct follow-up which resulted in inadequate Follow ?Up Audit Report by the Internal Audit Unit. Therefore, a Legal Document (Policies) from the Top Manager and coordination among managers are needed to ensure that the follow-up of the audit report is conducted. In addition, it is important for the Internal Audit Unit to implement monitoring and evaluation of the followup of audit reports.;The Follow-up Audit Reports which is conducted by The Internal Audit Unit in the hospital is mandatory and also is the responsibility of the hospital management. In Sanglah hospital in 2012, the average of 55,9% recommendations was followed-up with an average of 55 days completion time which exceeded the allowed time of completion. The purpose of this study is to determine factors influencing the small number of completion and the delayed completion time of the follow-up audit reports by the Internal Audit Unit and to find resolutions to solve the problems. This is a qualitative descriptive study which uses deep interviews, document reviews and focus group discussions. Data was analyzed with Content Analysis. This study suggests that there was no sufficient support with regard to: commitment, leadership, motivation, and communication system among managers in all levels of management. There were also lack of non financial compensations, lack of facilities and also the absent of guidelines in all units to conduct follow-up which resulted in inadequate Follow –Up Audit Report by the Internal Audit Unit. Therefore, a Legal Document (Policies) from the Top Manager and coordination among managers are needed to ensure that the follow-up of the audit report is conducted. In addition, it is important for the Internal Audit Unit to implement monitoring and evaluation of the followup of audit reports., The Follow-up Audit Reports which is conducted by The Internal Audit Unit in the hospital is mandatory and also is the responsibility of the hospital management. In Sanglah hospital in 2012, the average of 55,9% recommendations was followed-up with an average of 55 days completion time which exceeded the allowed time of completion. The purpose of this study is to determine factors influencing the small number of completion and the delayed completion time of the follow-up audit reports by the Internal Audit Unit and to find resolutions to solve the problems. This is a qualitative descriptive study which uses deep interviews, document reviews and focus group discussions. Data was analyzed with Content Analysis. This study suggests that there was no sufficient support with regard to: commitment, leadership, motivation, and communication system among managers in all levels of management. There were also lack of non financial compensations, lack of facilities and also the absent of guidelines in all units to conduct follow-up which resulted in inadequate Follow –Up Audit Report by the Internal Audit Unit. Therefore, a Legal Document (Policies) from the Top Manager and coordination among managers are needed to ensure that the follow-up of the audit report is conducted. In addition, it is important for the Internal Audit Unit to implement monitoring and evaluation of the followup of audit reports.]