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"Latar Belakang: Tindakan pembedahan atau operasi merupakan tindakan yang sangat berkaitan erat dengan bidang obstetri dan ginekologi. Masing-masing kasus akan bervariasi dan memiliki resiko dan jenis komplikasi tersendiri. Sistem pelayanan di RSCM saat ini telah mengalami perubahan pengaturan menjadi sistem Dokter Penanggung Jawab Pelayanan(DPJP) sejak tahun 2009. Belum ada penelitian di Indonesia yang menyimpulkan bagaimana pengaruh sistem DPJP terhadap angka komplikasi pembedahan. Tujuan: Penelitian ini bertujuan untuk mengetahui insidens kasus komplikasi dalam tindakan pembedahan obstetri dan ginekologi di RSCM pada masa sebelum dan sesudah DPJP. Metode: Penelitian dekriptif observasional ini dilakukan di RS Cipto Mangunkusumo sejak Desember 2017 hingga Februari 2018. Data sebelum sistem DPJP yaitu tahun 2007-2008 dan sistem DPJP yaitu tahun 2010-2011. Data tindakan pembedahan dijabarkan secara deskriptif dan insiden morbiditas diolah dengan analisis bivariat. Hasil: insidens terjadinya komplikasi pembedahan di RSCM pada masa sebelum versus sesudah DPJP adalah sebesar 2,7% versus 1,01%. Perubahan sistem menjadi DPJP di RSCM mempunyai resiko komplikasi yang lebih rendah yaitu sebanyak 22 dan pada sesudah DPJP menjadi 18 kasus bermakna secara statistik dengan nilai (p<0,05) dengan OR 0,41. Pada kasus ginekologi, sistem DPJP bermakna secara statistik (p<0,05) dengan nilai OR 0,23. Untuk onkologi tidak ada perbedaan bermakna, morbiditas pada kelompok pra DPJP sebesar 4,1% dan pada DPJP sebesar 2% dengan nilai p 0,07. Dari jenis pembedahan laparotomi, system DPJP bermakna secara statistik (p<0,05) dengan nilai OR 0,41. Kesimpulan: Perubahan sistem menjadi DPJP di RSCM mempunyai resiko komplikasi yang lebih rendah dibandingkan dengan sistem sebelum DPJP.

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Background: Background:Surgery is an action that is closely related to obstetrics and gynecology. Each case will have various risks and types of complications. The service system at RSCM has changed its settings to become a Service Responsible Doctor (DPJP) system since 2009. There has been no research in Indonesia about the correlation between the DPJP system with rate of surgical complications.

Aims: To determine the incidence of complications in obgyn surgery at the RSCM before and after the DPJP.

Methods: This observational descriptive study was conducted at Cipto Mangunkusumo Hospital from December 2017 to February 2018 before the DPJP (2007-2008) and after DPJP (2010-2011). Surgical action data are described descriptively and the incidence of morbidity is processed by descriptive bivariate analysis.

Result: the incidence of surgical complications at the RSCM before and after the DPJP was 2.7% versus 1.01%. The system change to DPJP at the RSCM has a lower risk of complications compared to the system before DPJP that is as much as 22 and after the DPJP to 18 cases statistically significant with the value (p <0.05) with OR 0.41. In gynecological cases DPJP system reduces the number of complications (p <0.05) with an OR value of 0.23. No significant differences in the oncology case, pre-DPJP group was 4.1% and the DPJP was 2% with a p value of 0.07. in Laparotomy technique the DPJP system was statistically significant (p <0.05) with an OR value of 0.41.

Conclusion: The new DPJP system in RSCM has alower risk of complications compared to the system before DPJP."

"Penelitian ini bertujuan untuk mengetahuikinerjaDokterPenanggung Jawab Pasien (DPJP) sebagai staf pengajar olehpeserta Program Pendidikan Dokter Spesialis (PPDS) diDepartemen Obstetri dan Ginekologi Rumah Sakit CiptoMangunkusumo pada bulan Januari hingga Juni 2013 danfaktor-faktor yang mempengaruhinya.Metode Desain penelitian ini adalah potong lintang menggunakankuesioner yang sudah divalidasi, dengan responden pesertaPPDS di ruang rawat, poliklinik, dan instalasi gawat daruratDepartemen Obstetri dan Ginekologi RSCM pada bulanJanuari - Juni 2013.Hasil Penelitian ini menghasilkan 131 kuesioner yang diisi oleh 40peserta PPDS. Sebanyak 58.78% responden menyatakankinerja DPJP sebagai pembimbing sudah baik, sementara46.56% menyatakan fungsi DPJP sebagai pendidik sudahsangat baik. Terdapat hubungan antara lamanya DPJPmenjadi konsultan dengan kinerja DPJP, bahwa DPJP yangmenjadi konsultan kurang atau sama dengan 10 tahundinilaimemilikikinerja lebih baik. Terdapat hubungan yangbermakna antara cara komunikasi langsungdan sering dengankinerja DPJP yang sangat baik. Faktor lain yang dinilai padapenelitian ini, yaitu tahap PPDS, tempat penugasan DPJP,dan jabatan DPJP tidak menunjukkan hubungan yangbermakna.Kesimpulan Secara keseluruhan, dari ketiga fungsinya, kinerja DPJPdinyatakan baik. Hasil ini dinilai dari 2 sisi yaitu dari faktorDPJP maupun faktor PPDS, dan diketahui bahwa kinerjaDPJP dipengaruhi oleh lamanya menjadi konsultan, dan jugaintensitas dan cara diskusi dengan PPDS.

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Objective To assess the performance of Doctors-In-Charge of Patients

(DICPs) as teaching staffby doctors enrolling in the Specialty

Doctor Education Program (PPDS) in The Department of

Obstetrics and Gynecology of Ciptomangunkusumo Hospital

during the period of January to June 2013 as well as to

explore the factors influencing their performance.

Study design It is a cross-sectional study using a validated-questionnaire.

Respondents of the study are doctors enrolling in the

Specialty Doctor Education Program (PPDS) or generally

referred to as residents in the inpatient rooms, outpatient

clinic and emergency department of the Department of

Obstetrics and Gynecology of Ciptomangunkusumo Hospital

(RSCM) on January - June 2013.

Results The study outcome was 131 questionnaires filled by 40

residents. The result showed that 58.78% of respondents

stated that the performance of DICP as a counselor had been

good, while 46.56% stated that DICP’s function had been

very good. There was a relationship between the duration of

DICP’s role as consultants with their performance, in which

DICPs who had been consultants for 10 years or less were

assessed to have better performances. There was also a

significant relationship between the communication

methodand frequency of DICPs and their performance. Other

factors assessed are resident’s level of PPDS education, point

of DICP’s assignment, and job position of DICPs did not

show significant relationship.

Conclusion Among its three functions, DICPs’ performance was

considered as good. The result was assessed from two sides,

including DICP factors and residents’ factors, and it was

known that the performanceof DICP was influenced by the

duration of their role as consultants; and their intensity of

interaction and way of discussions with their residents."

"Latar belakang: Kesalahan dalam pelayanan medis merupakan ancaman serius karena dapat menyebabkan pasien cedera, meninggal, dan meningkatkan biaya perawatan kesehatan yang tinggi. 1 Berdasar laporan Institute of Medicine (IOM) tahun 2000, terdapat 3-16% Kejadian Tidak Diharapkan (KTD) pada pelayanan pasien rawat inap di Amerika Serikat, Denmark, Inggris, dan Australia. Laporan JOGC tahun 2015 didapatkan 10% KTD terjadi di bidang obstetri. Data tentang KTD di Indonesia masih sulit didapatkan. Tahun 2007, Jakarta menduduki posisi teratas tentang laporan insiden keselamatan pasien yaitu 37,9%. Dari data Komite Mutu, Keselamatan Pasien, dan Kinerja (KMKK) RSUPN dr Cipto Mangunkusumo tahun 2015 dilaporkan 198 kasus KTD. Tujuan: Mengetahui distribusi kasus KTD di Departemen Obstetri dan Ginekologi RSCM tahun 2015 berdasarkan (1) tempat kejadian, (2) penyebab terjadinya, (3) jenis kegagalan, dan (4) penambahan masa rawat. Metode: Penelitian ini merupakan penelitian deskriptif analisis terhadap kasus KTD yang terjadi di Departemen Obstetri dan Gineklogi RSCM dari Januari hingga Desember 2015. Data didapatkan dari Koodinator Pelayanan Masyarakat (Koyanmas) yang telah dilakukan audit klinik dengan metode Root Cause Analysis (RCA). Hasil: Sepanjang tahun 2015 dilaporkan 36 kasus KTD dan dilakukan audit klinik oleh Tim Manajemen Risiko Klinis. Dari 36 kasus, yang memenuhi kriteria inklusi adalah 24 kasus. Berdasar tempat kejadiannya, terdapat 13 kasus (54%) terjadi di IGD, 4 kasus (17%) di ICU, 4 kasus (17%) di Ruang Operasi, dan 3 kasus (12%) di Ruang Rawat Inap. Berdasar penyebab terjadinya, terdapat 18 kasus (75%) disebabkan kurangnya pengetahuan dan kemampuan tenaga medis, 4 kasus (17%) karena penyebab lain, dan 2 kasus (8%) karena kesalahan teknis. Berdasar jenis kegagalannya, didapatkan 8 kasus (33%) terjadi penundaan perawatan atau tindakan medis, 6 kasus (25%) terjadi kegagalan tindakan medis, 5 kasus (21%) terjadi misdiagnosis, 3 kasus (13%) terjadi ketidaktepatan tata laksana, dan 2 kasus (8%) terjadi kegagalan memberikan peringatan untuk mencegah cedera. Berdasar penambahan masa rawat, data menunjukkan distribusi data yang tidak normal dengan nilai Shapiro-Wilk <0,05. Maka digunakan nilai median yaitu 2 hari. (0-34 hari; 95% IK). Kesimpulan: Sebagian besar KTD di Departemen Obstetri dan Ginekologi RSCM tahun 2015 terjadi di IGD (54%), penyebab terbesar adalah kurangnya pengetahuan dan kemampuan tenaga medis (75%), dan sebagian besar kegagalan terjadi penundaan perawatan atau terapi (33%).

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Background: Medical errors are a serious threat because they can cause injury, death and increase the cost of high health care.1 According to Institute of Medicine (IOM) report in 2000, there are 3-16% of adverse events (AEs) in the care of nursing patients stay in the United States, Denmark, United Kingdom and Australia. In 2015, JOGC report 10% of the AEs occurred in obstetrics. Data on AEs in Indonesia is still difficult to obtain. In 2007, Jakarta occupied the top position regarding patient safety incident reports which is 37.9%. In 2015, from Quality, patient Safety and Performance Committee RSUPN dr. Cipto Mangunkusumo reports 198 cases of AEs. Aim: To obtain the distribution of AEs in the Department of Obstetrics and Gynecology RSCM in 2015 based on (1) place where AEs occured, (2) factor contributing to the AEs (3) failure to prevent the occurrence of the AEs, and (4) the additional length of the stay. Method: This research is a descriptive analysis of the AEs case that occurred in the Department of Obstetrics and Gynecology RSCM from January to December 2015. Data were obtained from the Koordinator Pelayanan Masyarakat (Koyanmas) which had been carried out by a clinical audit using the Root Cause Analysis (RCA) method. Result: In 2015, 36 cases of AEs were reported and a clinical audit was carried out by the Clinical Risk Management Team. From 36 cases, which met the inclusion criteria were 24 cases. Based on the place where AEs occurred, there were 13 cases (54%) in the ER, 4 cases (17%) in the ICU, 4 cases (17%) in the OR, and 3 cases (12%) in the Ward. Based on the factor contributing to the AEs, there were 18 cases (75%) due to lack of knowledge and ability of medical personnel, 4 cases (17%) due to other causes, and 2 cases (8%) due to technical errors. Based on the failure to prevent the occurrence of the AEs, there were 8 cases (33%) delayed treatment or medical treatment, 6 cases (25%) malpractice, 5 cases (21%) misdiagnosis, 3 cases (13%) failure to act based on test results, and 2 cases (8%) failure to take precautions in order to avoid injuries. Based on the additional length of stay, the data showed an abnormal distribution of data with a Shapiro-Wilk value <0.05. We use the median value which is 2 days. (0-34 days; 95% CI). Conclusion: Most of the AEs in the Department of Obstetrics and Gynecology RSCM in 2015 occurred in the ER (54%), the biggest cause was the lack of knowledge and ability of medical personnel (75%), and most of failure due to delay in treatment or therapy (33%)."

"Kepuasan pasien adalah indikator penting dalam menilai kualitas pelayanan kesehatan. Pasien cenderung menilai kualitas pelayanan berdasarkan pengalaman mereka, termasuk interaksi dengan tenaga medis, kemudahan akses, dan tingkat kenyamanan yang mereka rasakan. Pasien yang merasa puas dengan pelayanan memiliki kemungkinan lebih besar untuk mematuhi pengobatan yang direkomendasikan dan tindakan medis yang diperlukan. Salah satu upaya yang harus dilakukan dalam perbaikan pelayanan publik adalah melakukan survei kepuasan masyarakat kepada pengguna layanan dengan mengukur kepuasan masyarakat pengguna layanan. Tujuan penelitian ini adalah mengetahui analisis hubungan kualitas pelayanan terhadap kepuasan pasien Poliklinik Obstetri dan Ginekologi di Rumah Sakit Muhammadiyah Taman Puring. Penelitian ini menggunakan studi deskriptif observasional dengan pendekatan kuantitatif dengan cara potong lintang (cross sectional). Subjek penelitian ini merupakan pasien Poliklinik Obstetri dan Ginekologi di Rumah Sakit Muhammadiyah Taman Puring yang berusia ≥ 18 tahun yang merupakan pasien baru maupun pasien lama, namun bukan merupakan pasien rujukan dari poliklinik lain dengan jumlah sampel sebanyak 99 responden yang akan mengisi instrumen penelitian berupa kuisioner. Hasil penelitian menunjukkan bahwa adanya hubungan kualitas pelayanan pada dimensi tangible (p value sebanyak 0,000); dimensi empathy (p value sebesar 0,000); dimensi reliability (p value sebesar 0,000); dimensi responsiveness (p value sebesar 0,000); dimensi assurance (p value sebesar 0,000) terhadap kepuasan pasien.

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Patient satisfaction is an important indicator in assessing the quality of health services. Patients tend to judge the quality of care based on their experiences, including interactions with medical personnel, ease of access, and the level of comfort they feel. Patients who are satisfied with services are more likely to comply with recommended treatment and necessary medical procedures. One of the efforts that must be made to improve public services is to conduct community satisfaction surveys for service users by measuring the satisfaction of service users. The purpose of this study was to analyze the relationship between service quality and patient satisfaction at the Obstetrics and Gynecology Polyclinic at Muhammadiyah Hospital Taman Puring. This research uses a descriptive observational study with a quantitative approach using a cross-sectional method. The subjects of this research were patients from the obstetrics and gynecology clinic at Muhammadiyah Taman Puring Hospital aged ≥ 18 years who were new or existing patients, but were not referred patients from other polyclinics with a sample size of 99 respondents who would fill out the research instrument in the form of a questionnaire. The result shows that there is a relationship between service quality in the dimension of tangible (p value of 0.000); empathy (p value of 0.000); reliability (p value of 0.000); responsiveness (p value of 0.000); assurance (p value of 0.000) on patient satisfaction."

"[ABSTRAK Infeksi daerah operasi merupakan hal yang harus diperhatikan oleh para ahli bedah mengingat tingginya morbiditas dan mortalitas pada pasien yang menderita infeksi daerah operasi Penulis ingin melakukan analisa secara garis besar bagaimana infeksi daerah operasi terutama pada infeksi daerah operasi pada operasi dengan golongan operasi bersih dan bersih tercemar Dilakukan penelitian retrospektif terhadap semua pasien divisi bedah digestif FKUI RSCM dari september 2012 hingga Juli 2014 Pasien dinilai berdasarkan kondisi preoperatif intraoperatif dan pasca operatif Dari data yang terhimpun selama penelitian di dapatkan 57 pasien menderita infeksi daerah operasi Delapan persen dari seluruh total operasi bedah digestif Keganasan kolorektal adenocarcinoma kolorektal menempati urutan pertama 22 39 Didapatkan 2 kasus yang merupakan operasi dengan tipe operasi bersih Didapatkan 17 kasus yang merupakan operasi dengan tipe bersih terkontaminasi Kata kunci Infeksi Daerah Operasi Pembedahan abdominal ABSTRACTSurgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery , Surgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery ]"