Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)

ANALISIS KASUS KEMATIAN RAWAT INAP DI RSAU dr. EFRAM HARSANA MAGETAN

Nunuk Cahyawati — 2025-10-06

Background : Patient mortality is one of the indicators of hospital service quality. Analyzing inpatient mortality is important to determine whether the death was due to a terminal illness and was justified or whether it could have been prevented with better and more advanced treatment so that corrective measures can be taken.

Objective: Conduct a mortality audit at dr. Efram Harsana Air Force Hospital to determine strategies and efforts to improve the quality and management of patient services based on the results of the mortality audit.

Method : The research method used in this research is the clinical audit method. The type of research used is a retrospective audit and this research uses a descriptive approach.

Result and Discussion : The most common immediate cause of death was sepsis/shock sepsis (54.3%) and shock of other conditions (15.2%). The underlying causes of death were DM (21.9%) and stroke (20%). Unreasonable deaths accounted for 46.7% due to untimely diagnosis underlying disease (7.6%), inadequate treatment underlying disease (25.7%), untimely knowing cause of death (27.6%) and inadequate treatment of cause of death (37.1).

Conclusion : Improvement efforts are aimed at timely recognition of sepsis/shock sepsis as a direct cause of death and the provision of adequate sepsis therapy.

ANALISIS FAKTOR YANG MEMPENGARUHI PELAPORAN INSIDEN KESELAMATAN PASIEN DI RS MATA JEC-CANDI, SEMARANG

Uswatunnisa Arfiningtyas — 2025-10-06

Background: The Patient Safety Incident (PSI) reporting system is a recommended method for enhancing patient safety, and it has been implemented by hospitals. However, the reporting rate of PSI remains low.

Objectives: This study aims to analyze the impact of individual, team, and organizational factors on PSI reporting at JEC-Candi, Semarang eye hospital and to develop recommendations to improve PSI reporting.

Methods: A mixed-methods sequential explanatory design was used. Quantitative data were obtained through a cross-sectional questionnaire survey and analytical observations using secondary data. Qualitative data were gathered from focus group discussion (FGD) with four separate groups: daily practitioner doctors, daily practitioner healthcare workers, daily practitioner non-healthcare workers, and managerial staff. Quantitative data were analyzed using chi-square or Fisher's exact tests and multivariate logistic regression, while qualitative data were analyzed using thematic analysis.

Results: The study involved 85 subjects for the quantitative study and 25 subjects for the qualitative study. Individual factors (knowledge and motivation), team factors (teamwork), and organizational factors (feedback) significantly influenced PSI reporting (p<0.005). Motivation emerged as the most dominant factor influencing PSI reporting (p=0.008; OR 47.294; CI 95% 2.678-835.190). The qualitative results provided several recommendations for improving PSI reporting, including regular socialization and training, patient safety awareness campaigns, selecting patient safety champions, establishing reward and incentive systems, organizing team-building and cross-unit collaborative activities, and improving access to PSI reporting feedback information.

Conclusions: Individual, team, and organizational factors significantly influence PSI reporting. Therefore, management should implement the recommended strategies to enhance patient safety and quality in the hospital.

GAYA KEPEMIMPINAN, KEPUASAN KERJA, DAN TURNOVER INTENTION DI RUMAH SAKIT SWASTA KELAS D DI BANTUL

Rosanna Yasmine — 2025-10-06

Latar Belakang: Turnover karyawan merupakan salah satu cara untuk mengekspresikan ketidakpuasan kerja dan mempengaruhi pengelolaan sumber daya manusia sebagai aset penting dalam industri Rumah Sakit. Dampak negatif yang ditimbulkan terkait biaya dan hilangnya karyawan yang memiliki keahlian, di mana faktor kepemimpinan dan kepuasan kerja berperan terhadap turnover intention karyawan. Rumah Sakit Santa Elisabeth yang merupakan Rumah Sakit swasta keagamaan kelas D di Bantul, turut menilai kepuasan dan loyalitas karyawan lewat angka turnover karyawan, akan tetapi hal ini menjadi salah satu indikator yang belum dapat mencapai standar.

Tujuan: Mengevaluasi peran gaya kepemimpinan dan kepuasan kerja terhadap turnover intention karyawan.

Metode: Penelitian ini merupakan penelitian studi kasus eksploratoris dengan desain penelitian kasus tunggal terpancang. Analisis data menggunakan metode statistik regresi linear berganda antar variabel turnover intention, gaya kepemimpinan, dan kepuasan kerja dan dilanjutkan dengan melakukan wawancara mendalam kepada responden yang memiliki hasil survei anomali. Data hasil wawancara mendalam dilakukan koding, identifikasi kategori, dan tema.

Hasil: Hasil uji t pada SPSS didapatkan nilai signifikansi gaya kepemimpinan sebesar 0,362 (> 0,05) dan nilai signifikansi kepuasan kerja sebesar 0,000 (< 0,05). Hasil uji ANOVA didapatkan nilai signifikansi sebesar 0,000 (< 0,05). Berdasarkan wawancara mendalam didapatkan bahwa ketidakpuasan kerja dan faktor keluarga berperan terhadap turnover intention.

Kesimpulan: Secara simultan gaya kepemimpinan dan kepuasan kerja berperan terhadap turnover intention karyawan di Rumah Sakit Santa Elisabeth. Gaya kepemimpinan tidak berperan terhadap turnover intention karyawan di Rumah Sakit Santa Elisabeth, namun kepuasan kerja berperan terhadap turnover intention karyawan di Rumah Sakit Santa Elisabeth.

Kata kunci: gaya kepemimpinan, kepuasan kerja, turnover

ANALISIS FAKTOR YANG BERPENGARUH TERHADAP MORTALITAS PASIEN INTENSIVE CARE UNIT (ICU) DI RSUD Dr. SOEDIRMAN KEBUMEN

Diah Ayu Putriyanti — 2025-10-06

Background: The ICU patient mortality rate is an indicator of hospital service quality. The ICU mortality rate at Dr. Soedirman Kebumen Regional General Hospital over the last five years has been over 40%. This rate is higher compared to the national ICU patient mortality rate in Indonesia, which is 27.6%.

Objective: To identify factors influencing ICU patient mortality and to develop recommendations for an ICU mortality reduction program at Dr. Soedirman Kebumen Regional General Hospital.

Methods: This study employed a mixed-methods research design with a sequential explanatory approach. Quantitative data were obtained from the medical records of ICU patients from July 2024 to December 2024. Qualitative data were gathered through in-depth interviews (management group) and focus group discussions (doctors and nurses). Quantitative data were analyzed using chi-square and Fisher's exact tests, as well as multivariate logistic regression. Qualitative data were analyzed using thematic analysis.

Results: The study included 278 subjects, of whom 126 (45.3%) died in the ICU. Factors identified as significantly influencing ICU patient mortality at Dr. Soedirman Kebumen Regional General Hospital were age (p-value = 0.001), type of diagnosis (p-value = 0.008), Glasgow Coma Scale (GCS) score (p-value <0.001), use of mechanical ventilation (p-value <0.001), and length of stay (p-value = 0.004). The use of mechanical ventilation was the variable with the most significant influence on ICU patient mortality (p = 0.001, OR 43.73, 95% CI 15.84-120.72). Qualitative results suggested several programs to reduce ICU patient mortality, including: re-socialization of ICU admission criteria, activation of palliative care, improvement of human resources competency, multidisciplinary team collaboration, periodic evaluation of Early Warning System (EWS) implementation, evaluation of culture examination procedures, and initiation of High Care Unit (HCU) establishment.

Conclusion: Age, type of diagnosis, Glasgow Coma Scale (GCS) score, use of mechanical ventilation and length of stay are factors influencing ICU patient mortality at Dr. Soedirman Kebumen Regional General Hospital. Given these factors contributing to the high ICU mortality rate, it is crucial for the hospital management to enhance service quality by implementing strategies to reduce ICU patient mortality at Dr. Soedirman Kebumen Regional General Hospital.

Keywords: Intensive Care Unit, ICU, ICU mortality, determinants of ICU mortality, mortality reduction

PERAN PETUGAS PENGENDALI PELAYANAN MEDIS (P3M) TERHADAP LENGTH OF STAY (LOS) PASIEN DI IGD RS AKADEMIK UGM

Febriana Prananingrum — 2025-10-06

Background: Overcrowding in Emergency Departments (ED) poses complex challenges, notably regarding patient waiting times or Length of Stay (LOS). The Emergency Flow Coordinator (EFC) at UGM Academic Hospital plays a critical role in regulating patient flow in the ED, yet their specific impact on reducing LOS remains insufficiently defined.

Objective: The aim of this study is to determine the impact of the role of EFC on the Length of Stay (LOS) in the Emergency Department of UGM Academic Hospital

Methods: A cross-sectional study employing structured questionnaires assessed the EFC's function in the ED, gathering responses from all medical personnel (nurses and physicians) on duty. Analysis of secondary data on patient LOS before (from October 2022 to January 2023) and after (from February 2023 to January 2024) EFC implementation was conducted.

Results: According to the Director's Decree of UGM Academic Hospital, the majority of the respondents 90% (45) who assessed EFC (11) considered that EFC plays a very important role in carrying out their job descriptions. From registration to inpatient admission, the average duration of patients in the ED was recorded at 190 minutes (n=9805), which was a decrease of 17.21% from the duration before EFC, which was 229.5 minutes (n=472). The Wilcoxon sum-rank test was used to analyze the difference in LOS between before and after the EFC policy was implemented. The p-value was 0.001, indicating statistical significance.

Conclusions: The EFC is essential in fulfilling its duties, as evidenced by a significant reduction in ED patient LOS following its implementation, enhancing the efficiency of care delivery.