Pelaksanaan Kebijakan Akreditasi Puskesmas Di Kabupaten Kubu Raya

https://doi.org/10.22146/jkki.25486

Molyadi Molyadi(1*), Laksono Trisnantoro(2)

(1) Dinas Kesehatan Kubu Raya, Kalimantan Barat
(2) Program Studi Ilmu Kesehatan Masyarakat, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: Public health care accreditation is one of Ministry of Health’s strategic plans in 2015-2019 to improve equity of access and service quality in public health center. Although many efforts have been done in order to implement accreditation policy including in 4 PHCs of Kubu Raya District, many constraints and variation are found in the process. The purpose of this study is to identify important factors that influencing the effectiveness of policy implementation in the 4 PHCs and observing its results. Methods: This research is a qualitative research with single embedded case study design. Subjects of the study are 36 respondents including accreditation program manager of District’s Health Office and accreditation team from 4 PHCs interviewed about their experience in preparing for accreditation. Consolidated framework for implementation research (CFIR) used to guide data collection and qualitative analysis process. Construction with greatest effect towards accreditation effectively identified with cross case study and ranked accordingly. Results: Among 25 CFIR constructions, data analysis result shows that accreditation effectiveness in PHC A, B, C, and D are influenced factors such as network and communication, aims and feedback, involvement of leader and resources availability (strongly differentiate), also organization culture and planning (weakly differentiate). While still facing challenges, all respondents report positive acceptance of accreditation policy because of the benefits it give and standard accreditation structure fit to be guidance for work performance especially to develop quality control system and improving quality control in public health center. Conclusion: Public health center accreditation policy in Kubu Raya District generally are well implemented, especially in PHC A and C, on the contrary are still weak in PHC B and D. Therefore, improvement on the performance is needed.

Abstrak

Latar Belakang: Akreditasi Puskesmas merupakan salah satu strategi kebijakan Kementerian Kesehatan pada tahun 2015-2019 yang bertujuan meningkatkan pemerataan akses dan mutu pelayanan kesehatan di Puskesmas. Berbagai upaya untuk menerapkan kebijakan akreditasi telah dilakukan termasuk di empat Puskesmas Kabupaten Kubu Raya, banyak variasi dan hambatan yang dirasakan oleh setiap Puskesmas dalam proses pelaksanaannya. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor penting yang mempengaruhi efektivitas pelaksanaan kebijakan akreditasi di empat Puskesmas Kabupaten Kubu Raya dan mengetahui hasil pelaksanaannya. Metode: Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus tunggal terjalin (embeded). Subyek penelitian sebanyak tiga puluh enam orang terdiri dari pengelola program akreditasi di Dinas Kesehatan Kabupaten dan tim akreditasi di empat Puskesmas diwawancarai tentang pengalaman mereka mempersiapkan akreditasi. Kerangka Konsolidasi Riset Implementasi (CFIR) di gunakan untuk memandu pengumpulan dan analisis data kualitatif. Konstruksi yang paling kuat mempengaruhi efektivitas pelaksanaan akreditasi Puskesmas diidentifikasi melalui perbandingan lintas kasus dan diberi peringkat. Hasil: Dari dua puluh lima konstruksi CFIR yang dinilai, hasil analisis data menunjukkan bahwa tingkat efektivitas pelaksanaan kebijakan akreditasi di Puskesmas A, B, C, dan D di pengaruhi oleh jaringan dan komunikasi, tujuan dan umpan balik, keterlibatan kepemimpinan dan sumberdaya yang tersedia (kuat sangat membedakan) serta budaya organisasi dan perencanaan (lemah membedakan). Meskipun menghadapi beberapa tantangan, seluruh responden melaporkan penerimaan secara positif adanya kebijakan akreditasi karena banyak memberikan manfaat dan keuntungan serta isi struktur standar akreditasi cocok dijadikan pedoman kerja terutama untuk pengembangan sistem manajemen mutu dan upaya perbaikan kinerja pelayanan di Puskesmas. Kesimpulan: Pelaksanaan kebijakan akreditasi Puskesmas di Kabupaten Kubu Raya berjalan cukup baik pada Puskesmas A dan C dan sebaliknya pada Puskesmas B dan D perlu upaya perbaikan kinerja pelaksanaannya di masa mendatang.

 


Keywords


Public health center accreditation; Consolidated Framework for Implementation Research (CFIR); Implementation outcome; Akreditasi Puskesmas; Consolidated Framework for Implementation Research (CFIR); Outcome implementasi

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DOI: https://doi.org/10.22146/jkki.25486

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