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"Dalam pelayanan kesehatan, peranan Fasilitas Kesehatan Primer yang berhadapan langsung dengan masyarakat sangat penting. Kompetensi personal fasilitas pelayanan kesehatan dalam tatakelola pelayanan khususnya di fasilitas pelayanan primer masih terbatas. Hal itu disebabkan pembekalan melalui pendidikan dan pelatihan belum memenuhi kebutuhan kompetensi manajemen akibat kurikulum pendidikan dan pelatihan yang belum dirancang dan dilaksanakan sesuai dengan kebutuhan dan harapan masyarakat.Penelitian ini merupakan penelitian terapan bertujuan mengembangkan model manajemen peningkatan mutu terpadu pelayanan di Fasilitas Kesehatan Primer.Penelitian menggunakan metode  Kombinasi Kuantitatif-Kualitatif (Mixed Methods) dan rancangan  sequential explanatory. Penelitian ini terdiri dari dua tahap yaitu, tahap penelitian kuantitatif bertujuan menilai mutu layanan dari sisi pelanggan dengan rancangan potong lintang. Tahap penelitian kualitatif bertujuan menilai mutu dari sisi penyedia. Responden penelitian kuantitatif adalah akseptor penerima pelayanan KB AKDR Pasca Persalinan di Fasilitas Kesehatan Primer di Jakarta. Responden penelitian kualitatif adalah tim petugas di Fasilitas Pelayanan Primer dan Pakar di bidang Keluarga Berencana. Pengumpulan data penelitian kuanititatif menggunakan kuesioner yang telah divalidasi. Pengumpulan data penelitian kualitatif menggunakan metode wawancara mendalam menggunakan instrumen maturitas organisasi dan penilaian oleh pakar menggunakan metode Delphi.  Model akhir manajemen peningkatan mutu terpadu dikembangkan dari model awal yang disusun berdasarkan tinjauan pustaka.Berdasarkan kepuasan pelanggan sebanyak 141 (81,1%) responden merasa puas, 35 (19,9%) responden merasa tidak puas. Berdasarkan keselamatan pasien 166 (94,3%) responden menyatakan keselamatan baik, 10 (5,7%) responden menyatakan keselamatan kurang. Pada penilaian mutu dari sisi pelanggan variabel yang memengaruhi mutu adalah regulasi dan standarisasi, sarana prasarana, komunikasi efektif dan kepemimpinan klinik. Pada penilaian mutu dari sisi penyedia dengan penilaian maturitas proses dan maturitas organisasi masing-masing pada tingkat pertama dan kedua dari empat tingkat maturitas. Dari model awal berdasarkan tinjauan pustaka dan hasil penelitian disintesis model akhir Manajemen Peningkatan Mutu Terpadu di Fasilitas Kesehatan Primer.Simpulan: Telah berhasil dikembangkan model Manajemen Peningkatan Mutu Terpadu (M-PMT) di fasilitas Kesehatan Primer yang merupakan perangkat manajemen fasilitas Kesehatan Primer dalam proses manajemen mutu pelayanan untuk mencapai kinerja mutu unggul. Model dikembangkan dengan pendekatan terpadu, komprehensif, holistik dan berkelanjutan. Pendekatan terpadu dalam struktur rancangan sistem sebagai komponen input. Komponen proses dengan pendekatan komprehensif dalam siklus perencanaan, pelaksanaan dan pemantauan evaluasi melalui proses pembelajaran mencapai tingkat kematangan proses dan organisasi berkelanjutan.

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In health services, Primary Health Facilities plays an important role in dealing directly with the community. The personal competence of health service facilities in service governance, especially in primary care facilities, is still limited. This is due to the fact that debriefing through education and training has not met the needs of management competencies due to education and training curricula that have not been designed and implemented according to the needs and expectations of the community.This is an applied research aimed at developing an integrated quality improvement management model of service in Primary Health Facilities.The study combined quantitative methods and sequential explanatory design. This study consists of two stages. The quantitative research stage aims to assess the quality of service from the customer side with a cross-sectional design. The qualitative research phase aims to assess the quality of the provider. Quantitative research respondents are acceptors of contraceptive services of postnatal IUD at Primary Health Facilities in Jakarta. respondents from qualitative research team were officers at Primary Service Facilities and experts in the field of Family Planning. Quantitative research data is collected using validated questionnaires. Collecting qualitative research data using in-depth interview methods using organizational maturity instruments and expert assessment using the Delphi method. The final model of integrated quality improvement management was developed from the initial model which was compiled based on literature review.Regarding customer satisfaction, 141 (81.1%) respondents were satisfied and 35 (19.9%) respondents felt dissatisfied. Regarding patient safety, 166 (94.3%) respondents stated safety was good and 10 (5.7%) respondents said that safety was lacking. In the quality assessment from the customer side, the variables that affect quality are regulation and standardization, infrastructure, effective communication and clinical leadership. In the assessment of quality from the provider side by assessing the process maturity and organizational maturity of each at the first and second levels of the four maturity levels. The final model of Integrated Quality Improvement Management in Primary Health Facilities is synthesized from the initial model based on literature review and the results of the study.Conclusion: The Integrated Quality Improvement Management (M-PMT) Management model in Primary Health facilities has been successfully developed. The result is a primary health facility management tool in the service quality management process to achieve superior quality performance. The model is developed with an integrated, comprehensive, holistic and sustainable approach. Integrated approach in the structure of the system design served as as an input component. The process component with a comprehensive approach in the cycle of planning, implementing and monitoring evaluations through the learning process reaches a sustainable level of process and organization maturity."

"Sistem Informasi Manajemen Rumah Sakit (SIMRS) adalah elemen informatika kesehatan yang berfokus terutama pada kebutuhan administrasi rumah sakit. Penggunaan SIMRS dalam operasi rumah sakit harus dapat memberikan kenyamanan, untuk mengatasi layanan dan kendala administrasi, dan untuk meningkatkan produktivitas. Penelitian ini bertujuan untuk menganalisis dampak implementasi sistem informasi terhadap produktivitas pengeluaran kas / unit bank di rumah sakit Subjek dan Metode: Ini adalah penelitian deskriptif kualitatif yang dilakukan di pusat kardiovaskular nasional Harapan Kita, Jakarta. Variabel dependen adalah produktivitas. Variabel independen adalah implementasi Sistem Informasi Manajemen Rumah Sakit (SIMRS). Data dikumpulkan dengan wawancara dan review dokumen. Hasil: Sistem manual pada pengeluaran administratif unit kas / bank menghasilkan beberapa masalah, seperti kesalahan perhitungan, kesalahan penulisan, duplikasi data, dan waktu pemrosesan yang lama. Penerapan aplikasi verifikasi pengeluaran meningkatkan akurasi perhitungan hingga 100%, menghilangkan duplikasi data, dan mempersingkat waktu pemrosesan Kesimpulan: Penerapan aplikasi verifikasi pengeluaran meningkatkan produktivitas di unit kas/bank pengeluaran dengan meningkatkan akurasi perhitungan, menghilangkan duplikasi data, dan mempersingkat waktu pemrosesan.

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Health Management Information Systems (HMIS) is an element of health informatics that focuses mainly on the administrational needs of hospitals. The use of HMIS in a hospital operation must be able to provide convenience, to overcome service and to administrative constraints, and to increase productivity. This study aimed to analyze the impact of information system implementation on the productivity of the expenditure cash/ bank unit in a hospital. Subjects and Method: This was a descriptive qualitative study conducted at national cardiovascular center Harapan Kita, Jakarta. The dependent variable was performance. The independent variable was Health Management Information Systems (HMIS) implementation. The data were collected by interview and document review. Results: The manual system at the administrative expenditure cash/ bank unit yielded several issues, such as calculation error, writing error, data duplication, and long processing time. The implementation of verification aplication improved calculation accuracy up to 100%, eliminated data duplication, and shortened processing time Conclusion: The implementation of verification aplication improves productivity of the expenditure cash/ bank unit in a hospital by increasing calculation accuracy, eliminating data duplication, and shortening processing time."

"ABSTRAKLifeguard memiliki peranan sangat penting dalam menjaga keselamatan para pengujung pada wahana permainan waterpark. Wahana permainan waterpark merupakan salah satu permainan yang banyak digemari masyarakat, tetapi memiliki risiko tinggi terhadap keamanan dan keselamatan pengunjung. Oleh karena itu, dibutuhkan lifeguard yang memiliki kinerja prima, terutama dalam mengidentifikasi kejadian-kejadian kritis agar tidak menimbulkan akibat yang lebih fatal. Dalam mendukung kemampuan lifeguard untuk mengidentifikasi kejadian-kejadian kritis, maka pihak pengelola memiliki peranan penting dalam mewujudkan rasa aman dan nyaman bagi lifeguard, antara lain dengan mengusahakan adanya manajemen kesehatan dan keselamatan kerja yang baik. Selain itu, juga penting memperhatikan stressor dalam lifeguard, terutama akibat suhu yang panas heat stress dan bekerja yang pada umumnya tanpa ada rotasi time on task . Oleh karena itu penelitian ini bertujuan untuk melihat pengaruh manajemen kesehatan dan keselamatan kerja dan stres heat stress dan time on task terhadap kinerja lifeguard dalam mengidentifikasi kejadian-kejadian kritis serta mencari kombinasi optimal dari ketiga faktor tersebut agar dapat dipertimbangkan dalam meningkatkan kinerja lifeguard. Penelitian ini dianalisis dengan menggunakan metode Design of Eksperiment DOE 3 faktor dengan setiap faktor 2 level. Hasil penelitian ini membuktikan bahwa manajemen kesehatan dan keselamatan kerja, heat stress dan time on task berpengaruh signifikan terhadap kinerja lifeguard dalam mengidentifikasi kejadian-kejadian kritis. Kombinasi untuk dapat menghasilkan kinerja lifeguard yang paling optimal dalam mengidentifikasi kejadian-kejadian kritis yaitu pada manajemen K3 tinggi, suhu < 28oC, dan rotasi setiap 30 menit sekali. Hasil penelitian ini selanjutnya diharapkan dapat memberikan masukan yang berarti bagi pengelola wahana permainan waterpark dalam meningkatkan kinerja lifeguard, khususnya dengan cara memperbaiki sistem manajemen K3, merancang pos jaga agar memiliki suhu ideal untuk kenyamanan lifeguard, dan pengaturan rotasi pengawasan untuk meminimalkan kejenuhan lifeguard.

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ABSTRACTLifeguard has a very important role in safeguarding the safety of the visitors on waterpark rides. Waterpark is one of the most popular in the community, but it has a high risk for the security and safety of visitors. Therefore, it takes a lifeguard that has excellent performance, especially in identifying critical events, so that not to cause more fatal consequences. In support of the lifeguard 39 s ability to identify critical events, its important the waterpark rides managers in realizing a sense of secure and confort for the lifeguard, among others, by ensuring good health and safety management. In addition, it is also important to pay attention to the lifeguard stressors, especially due to the temperature of the heat heat stress and work in general without any rotation time on task . Therefore, this study aims to examine the effect of health and safety management and stress on the lifeguard performance in identifying critical events and to find the optimal combination of these three factors to be considered in improving the lifeguard performance. This research was analyzed by using 3 factor Design of Experiment DOE with each 2 level factor. The results of this study prove that health and safety management, heat stress and time on task significantly influence the lifeguard performance in identifying critical events. The combination to produce the most optimum lifeguard performance in identifying critical events is on high health and safety management, temperature "

"[ABSTRAKPemeriksaan kesehatan secara umum merupakan bagian yang umum dari perawatan kesehatan di beberapa negara. Jumlah permintaan layanan kesehatan di Taiwan mengalami peningkatan selama sepuluh tahun terakhir. Kenaikan permintaan tersebut didorong oleh beberapa faktor, termasuk populasi yang semakin menua, dan peningkatan jumlah kasus penyakit kronis. Fluktuasi jumlah kedatangan peserta tes kesehatan yang tidak menentu, membuat rumah sakit sulit untuk memberikan pelayanan yang memuaskan. Rumah sakit perlu membuat strategi perencanaan, seperti manajemen kesehatan untuk menangani masalah tersebut dengan cara memprediksi kedatangan peserta uji kesehatan. Aplikasi data mining dalam perawatan kesehatan adalah pembuktian bahwa data mining dapat memberikan informasi yang sangat berguna untuk semua pihak yang terlibat dalam industri kesehatan, seperti meningkatkan kualitas pelayanan rumah sakit. Penelitian ini menggunakan pengelompokan dan aturan asosiasi untuk mengetahui pola dari data pemeriksaan penyakit cerebrovascular, dengan tujuan memprediksi kedatangan kembali peserta tes kesetahan. Algoritma Apriori pembobotan dapat mengetahui hubungan antar item menggunakan nilai support, confidence, dan bobot masing-masing item sebagai tingkat prioritas dari aturan asosiasi, karakteristik aturan asosiasi dapat diketahui, yang mana hasil tersebut dapat membantu rumah sakit dalam meningkatkan kualitas pelayanan. Pada dasarnya, data memiliki partisi yang berbeda satu sama lain, atas dasar tersebut maka dalam penelitian ini dilakukan pengelompokan sebelum dilakukan penggalian informasi menggunakan aturan asosiasi, dimana proses tersebut merupakan salah satu proses yang penting. Setiap kelompok diharapkan mengandung asosiasi tanpa kontaminasi dari bagian kelompok lain yang memiliki pola hubungan yang berbeda. Penelitian ini menggunakan metode pengelompokan hirarki yang dikenal dengan Ward?s Agglomerative yang relatif sederhana untuk dipahami. Diimplementasikan, dan tidak perlu menentukan banyaknya jumlah kelompok pada awal proses.

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ABSTRACTGeneral health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees? re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward?s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance.;General health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees? re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward?s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance.;General health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees? re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward?s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance., General health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees’ re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward’s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance.]"

"Keberadaan rumah sakit sebagai bagian dari sistem pelayanan kesehatan dengan nilai strategis Millenium Development Goals, standar kualitas optimum dan cost effective telah menjadi alasan utama diterapkannya TQM di rumah sakit melalui model generik TQM seperti ISO 9001 dan Joint Commission International (JCI) (Munechika, Sano, Jin & Kajihara, 2014; Milner, 2007). Namun demikian, masih banyak pasien yang mengeluhkan pelayanan yang tidak sesuai Standard Operating Procedure (SOP), sarana dan prasarana yang tidak memadai dan biaya yang tinggi (Guspianto, 2015). Hal ini telah membuktikan bahwa penerapan model generik TQM belum efektif dengan mutu pelayanan rumah sakit pemerintah lebih rendah dibandingkan dengan rumah sakit swasta (Guspianto, 2015; Arasli & Ahmadeva, 2004). Milakovich, 1991 dalam Milner 2007 menyatakan bahwa akreditasi seperti JCI mewakili model yang tidak efektif dalam meningkatkan mutu lintas rumah sakit dan telah menciptakan resistensi bahkan oposisi dari staf rumah sakit. Untuk itulah, penelitian ini ditujukan untuk mengembangkan model TQM untuk rumah sakit.Metode yang digunakan adalah Partial Least Square Structural Equation Modeling terhadap persepsi karyawan dan statistik deskriptif terhadap persepsi pasien dan manajemen. Penelitian ini dilakukan di RSPAD Gatot Soebroto dan RSUP Fatmawati di 8 unit pelayanan dengan 16 manajemen, 64 karyawan dan 170 pasien. Hasilnya adalah model TQM untuk rumah sakit yang fit dengan variabel dan indikator yang valid dan reliabel serta Customer Satisfaction dan Result yang baik. Dengan model ini, ditemukan beberapa variabel yang berhubungan (p-value <0.05) dan tidak berhubungan (p-value > 0.05).Hasil penelitian ini menyarankan bahwa variabel yang berhubungan adalah Continuous Improvement terhadap Process Management (r=0.394, p-value=0.000), Organization Behavior and Culture terhadap Process Management (r=0.392, p-value=0.014), Top Management Commitment terhadap Process Management (r=0.303, p-value=0.005), Training and Education terhadapContinuous Improvement (r=0.372, p-value=0.017), Teamwork and Participation terhadap Continuous Improvement (r=0.353, p-value=0.002). Sementara itu, untuk variabel yang tidak berhubungan adalah Information Managementterhadap Continuous Improvement (p-value= 0.076), Customer Focus and Satisfaction terhadap Process Management (p-value= 0.684), Supplier Management terhadap Process Management (p-value=0.287), dan Resource Managementterhadap Process Management (p-value=0.869). Dalam penelitian ini, manajemen rumah sakit direkomendasikan agar menggunakan model TQM untuk Rumah Sakit dalam rangka mendapatkan manfaat berupa kinerja rumah sakit dan kepuasan pasien yang meningkat.

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The existence of hospitals as part of health service system with Strategic Millenium Development Goals (MDGs), optimal quality standards and cost effectiveness has been the major rationalization of TQM implementation in hospitals by adopting generic TQM model such as ISO 9001 dan Joint Commission International (JCI) (Munechika, Sano, Jin & Kajihara et. al., 2014; Milner, 2007). However, there are still many complaints from patient`s side regarding hospital`s service that is not comply with standard operating procedure (SOP), inadequacy of hospital`s facility and high cost (Guspianto, 2015). These evidences have proven that the implementation of generic TQM model is ineffective with condition that the quality of service from public hospitals are lower than private hospitals (Guspianto, 2015; Arasli & Ahmadeva, 2004). Milakovich, 1991 in Milner 2007 has revealed that hospital accreditation such as JCI has represented ineffective model in increasing hospital-wide service quality and created resistance among hospital`s personnels. Therefore, this research is intended to develop TQM model for hospital.

The research methods that has been deployed are quantitative research using Partial Least Square Structural Equation Modeling for analyzing insights from employee perspective and descriptive statistics for generating insights from both management and patient perspectives. This research has been taken place at Gatot Soebroto Army Central Hospital and Fatmawati General Central Hospital in 8 working units with 16 management team members, 64 personnels, and 170 patients.

The result has revealed that the TQM model for hospital is fit with valid and reliable variables and indicators with good Customer Satisfaction and Result. Furthermore, this model finds that several constructs are related and some are not related. Those related are Continuous Improvement with Process Management (r=0.394, p-value=0.000), Organization Behavior and Culture with Process Management (r=0.392, p-value=0.014), Top Management Commitment with Process Management (r=0.303, p-value=0.005), Training and Education with Continuous Improvement (r=0.372, p-value=0.017), Teamwork and Participation with Continuous Improvement (r=0.353, p-value=0.002). Those not related are Information Management with Continuous Improvement (p-value= 0.076), Customer Focus and Satisfaction with Process Management (p-value= 0.684), Supplier Management with Process Management (p-value=0.287), and Resource Management with Process Management (p-value=0.869). In this research, hospital management has been suggested to implement this TQM model for hospital in order to increase both hospital performance and customer satisfaction."

"Inekuitas pelayanan kesehatan masih terjadi setelah pelaksanaan Jaminan Kesehatan Nasional (JKN). Pemantauan secara berkala Kinerja Fasilitas Kesehatan Tingkat Pertama (FKTP) merupakan kunci untuk menurunkan inekuitas pelayanan kesehatan sebagai tujuan utama JKN. Penerapan Kapitasi Berbasis Kinerja (KBK) dengan tiga indikator sejak tahun 2016, menunjukkan terjadi perbaikan kinerja FKTP dalam meningkatkan kualitas dan efisiensi di pelayanan tingkat pertama. Penelitian ini bertujuan untuk mengembangkan model indikator kinerja, kapasitas FKTP dan indikator ekuitas agar dapat mengukur ekuitas pelayanan kesehatan. Desain penelitian menggunakan exploratory sequential-mixed method, dalam tiga tahap. Tahap penelitian secara berturut- turut, 1) Systematic Review (SR) untuk mengidentifikasi indikator yang dapat digunakan dalam mengukur kapasitas, kinerja FKTP dan ekuitas pelayanan kesehatan. 2) Consensus Decision Making Group (CDMG) untuk menetapkan indikator yang kapasitas, kinerja FKTP dan ekuitas pelayanan kesehatan dengan para pakar, 3) Membuat pengembangan model indikator kinerja FKTP berdasarkan skema kapitasi yang dapat mengukur ekuitas pelayanan kesehatan, menggunakan analisis Structural Equation Modelling (SEM) data BPJS Kesehatan tahun 2022. Berdasarkan hasil SR, CDMG dan analisis SEM, indikator terpilih untuk mengukur kapasitas FKTP terdiri dari tiga indikator yaitu rasio dokter umum, sumberdaya sarana dan manusia (skor rekredensialing) dan pembiayaan (persen pembayaran KBK yang diterima). Terpilih sembilan indikator kinerja yaitu angka kontak, proporsi penderita DM diperiksa gula darah, proporsi penderita Hipertensi diperiksa tekanan darah, rasio rujukan non spesialistik, proporsi pasien rujuk balik, proporsi skrining penyakit jantung, DM dan Hipertensi, rasio pasien prolanis terkendali. Ekuitas pelayanan kesehatan dilihat dari rate utilisasi peserta FKTP berdasarkan sosiodemografi (jenis kelamin, usia) dan sosial ekonomi (PBI-Non PBI). Analisis SEM menunjukan terdapat hubungan yang positif dan signifikan antara kapasitas dan kinerja FKTP dengan ekuitas pelayanan. Indikator kapasitas, kinerja FKTP dan ekuitas pelayanan disusun dalam Primary Care Performance Indicator (PCPI) JKN Framework. Hasil penelitian ini direkomendasikan digunakan oleh BPJS Kesehatan untuk memantau kinerja FKTP dan ekuitas pelayanan kesehatan serta menyempurnakan kebijakan KBK; Kementerian Kesehatan dapat menyempurnakan kebijakan pelayanan kesehatan primer dan menyusun Indonesia Primary Health Care Performance Indicator (PHCPI) untuk memantau kinerja pelayanan kesehatan primer.

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Healthcare inequities still occur after the implementation of the National Health Insurance (JKN). Regular monitoring of the performance of primary healthcare facilities (FKTP) is key to reducing healthcare inequities as the main goal of JKN. The implementation of Performance-Based Capitation (KBK) with three indicators since 2016 has shown improvements in the performance of primary healthcare facilities in improving the quality and efficiency of first-level services. Their capacity influences the performance of primary care facilities and impacts primary care performance outcomes (health service equity). This study objective was to develop a model of performance indicators, FKTP capacity and equity indicators to measure health service equity. The research design utilized an exploratory sequential-mixed method. The study was divided into three phases. Phase one was a systematic review to identify indicators that can be used in measuring capacity, FKTP performance and health service equity. Phase two was carried out by a qualitative approach with the Consensus Decision Making Group (CDMG) technique to determine indicators that can be used in measuring FKTP capacity and performance as well as measuring health service equity with experts. Phase three was the development of a model for FKTP performance indicators based on a capitation scheme that can measure the equity of health service access. This phase was carried out using Structural Equation Modeling (SEM) analysis. The SR, CDMG and SEM analysis show that there are three selected indicators to measure the capacity of primary health care facilities: general practitioner ratio, facility sufficiency(recredentialing score) and financing (percentage of KBK payments received). Nine performance indicators were selected, namely contact rate, proportion of DM patients checked for blood sugar, proportion of Hypertension patients checked for blood pressure, non-specialistic referrals ratio, proportion of patients referred back to primary care providers, proportion of screening for heart disease, diabetes mellitus, and hypertension; and ratio of controlled Prolanis patients. Health service equity was analyzed from the utilization rate of participants based on gender, age and socioeconomic factors(PBI-Non PBI). SEM analysis showed a positive and significant relationship between the capacity and performance of primary health care facilities and equity."

"Penerapan Sistem Manajemen Mutu, Sistem Manajemen Lingkungan dan Sistem Manajemen Keselamatan dan Kesehatan Kerja pada pengelolaan proyek konstruksi merupakan keniscayaan dan juga harus berorientasi pada peningkatan berkelanjutan. Industri konstruksi menggunakan semua sumber daya ekonomi, sosial, dan lingkungan yang berada pada titik kritis sehingga mereka harus harmonis dan efisiensi. Pengembangan model integrasi proses yang menjadi tujuan penelitian ini diusulkan agar penerapan sistem manajemen yang ada berdampak signifikan pada peningkatan keberlanjutan proyek konstruksi terutama pada aspek penurunan risiko ekonomi, sosial dan lingkungan, penyelenggaraan organisasi yang baik, transparan dan akuntabel, optimalisasi sumber daya, penerapan penghargaan dan hukuman, dan pengembangan inovasi teknologi baru. Penelitian ini menggunakan metode studi kasus pada penerapan sistem manajemen dalam pengelolaan proyek konstruksi di perusahaan milik negara bidang pekerjaan umum. Proses integrasi sistem manajemen dengan klausul dan sub klausul dalam struktur ISO:2015 mempengaruhi sistem untuk mencapai peningkatan berkelanjutan. Hubungan antar klausul integrasi proses saling mempengaruhi dalam pendekatan PDCA yang merupakan struktur utama standar sistem manajemen. Kepemimpinan, kebijakan dan perencanaan merupakan faktor penting keberhasilan penerapan integrasi proses.

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Application of the quality management system, environmental management system and management system of safety and occupational health on the construction project management is a must and should be oriented to the sustainable improvement. Construction industry uses all of economic, social, and environment resource that are at a critical point so that they must be harmonized and efficiency. Development of model integration process into this proposed research objectives in order that the implementation of the management system, there is a significant impact on improving the sustainability of construction project, especially risk reduction of economic, social and environmental, organizing a good organization, transparent and accountable, optimization of resources, application of reward and punishment and development of new innovation technologies.

This research method using case studies on the application of management systems of construction project management in state owned companies in the field of public works. The integration process of management systems with the clauses and sub clauses in the structure of ISO 2015 affects the system to achieve a sustainable improvement. Process integration clause relations interplay in the PDCA approach, which is the main structure of the standard management system. Leadership, policy and planning important factor successes the implementation of the integration process."

"Skripsi ini membahas gambaran stres dan strategi coping pada tenaga kesehatan di Puskesmas Kelurahan Klender 1 selama pandemik COVID-19 tahun 2021. Penelitian ini adalah penelitian kualitatif dengan desain studi kasus. Tujuan penelitian ini adalah mengetahui stressor, persepsi terhadap stressor, strategi coping yang digunakan untuk menghadapi stressor, dan efek langsung yang dirasakan oleh tenaga kesehatan setelah melakukan coping. Pengambilan data dilakukan dengan metode wawancara mendalam terhadap 5 orang tenaga kesehatan dan 1 orang Kasatpel Puskesmas. Hasil penelitian menunjukan bahwa stressor tenaga kesehatan selama pandemik COVID-19 berasal dari eksternal yaitu kekurangan SDM, kesulitan mencapai target SPM, berkaitan dengan pasien, penggunaan APD, pembuatan laporan, ketakutan menularkan COVID-19 ke keluarga, dan angka kematian COVID-19 yang tinggi. Sebagian besar menilai stressor tidak menghambat dan mengancam. Sedangkan sisanya menganggap bahwa stressor sebagai tantangan dan mengancam. Kemudian seluruh tenaga kesehatan merasa bahwa mereka mampu dan memiliki sumber yang cukup untuk mengatasi stressor. Sebagian besar menggunakan Emotion focused coping. Hasil jangka pendek yang dirasakan oleh informan setelah melakukan coping adalah perasaan positif yang menunjukan coping berhasil.

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.The focus of this study is description of stress and coping strategies for health workers at Klender 1 Public Health Center during the COVID-19 pandemic in 2021. The purpose of this study was to determine stressors, perceptions of stressors, coping strategies used to deal with stressors, and the direct effects felt by health workers after coping. This study is a qualitative research with case study design. Data collection was done by using in-depth interviews with 5 health workers and 1 leader of Public Health Center. The results found that the stressors of health workers during the COVID-19 pandemic came from external sources, those are the lack of human resources, difficulty in achieving MSS targets, relating to patients, use of PPE, reporting, fear of transmitting COVID-19 to families, and high COVID-19 mortality rates. Most of health workers assess stressors are not inhibiting and threatening. While the rest consider the stressor as a challenge and threat. Then all health workers felt that they are capable and have sufficient resources to deal with stressors. Most of them used Emotion focused coping as their coping strategies. The short-term results felt by the informants after coping were positive feelings that showed successful coping."

"Tesis ini membahas teori institutional analysis pada manajemen heat stress di perusahaan konstruksi. Kompleksnya teori institutional analysis yang dikembangkan memicu penulis untuk melakukan penelitian karena banyaknya faktor yang teridentifikasi, selain itu terdapat pula beberapa institutional level eksternal perusahaan yang tidak dapat diintervensi langsung oleh perusahaan konstruksi. Penelitian ini bersifat kualitatif menggunakan tinjauan sistematis dengan metode analisis tematik. Didapatkan hasil penelitian berupa gambaran tematik mengenai underlying factors dan tools and tecnhiques pada setiap institutional level dan keseluruhannya sebagai salah satu metode dalam manajemen heat stress. Penelitian ini menyarankan agar perusahaan konstruksi menerapkan teori institutional analysis dan mengaplikasikan gambaran tematik yang dihasilkan penelitian dalam pelaksanaan manajemen heat stress pada institutional level yang dapat diintervensi langsung oleh perusahaan.

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This study mainly discussing about institutional analysis theory for managing heat stress in construction company. The complexity of that theory urge Author to conduct this research because of many identified factors and some institutional levels that have been identified are an external factors that could not be interfeared directly by construction company. Systematic review with thematic analysis are the methods for this research. The results show thematic analysis about underlying factors and tools and techniques of each institutional level and altogether as one method to manage heat stress. This research recommends the application of institutional analysis combined with thematic analysis from this research to manage heat stress in construction company."

"Pendahuluan: Selama pandemi COVID-19, terjadi peningkatan beban kerja, serta kewaspadaan dan kepatuhan yang lebih besar dalam bekerja. Tenaga kesehatan harus menjalankan tugasnya dalam menghadapi ketakutan terhadap infeksi COVID-19 yang dapat memicu dan/atau memperparah stres. Penelitian ini bertujuan untuk mengetahui faktor determinan stres petugas kesehatan pada masa pandemi dengan menekankan pada perubahan situasi psikososial di rumah sakit.Metode penelitian: Studi potong lintang ini dilakukan dari bulan Januari sampai Maret 2021 dengan menggunakan kuesioner online yang terdiri dari kuesioner pribadi dan pekerjaan, serta kuesioner stres dan stres yang divalidasi menggunakan uji validitas dan reliabilitas (Cronbach's alpha 0,8 dan 0,9). Untuk analisis multivariat, digunakan regresi logistik multinomial untuk mengidentifikasi faktor determinan (p<0,05). Data dianalisis menggunakan software SPSS versi 20 (IBM Corp, USA).Hasil: Gambaran perubahan stresor pada responden adalah peningkatan stresor ringan 59,7%, peningkatan stresor sedang 20,6%, peningkatan stresor berat 5,1%, stresor tetap 11.1%, penurunan stresor 3,3%. Dengan gambaran persepsi stres adalah stres sedang 56,1%, stres berat 27,2%, stres ringan sebanyak 16,7%. Faktor determinan pada kejadian stres berat adalah tingkat perubahan stresor sedang berat dibandingkan dengan stresor menetap [aOR 8(95% CI, 2.2–29.7)], stresor tetap dibandingkan dengan stresor yang menurun [aOR 11(95% CI, 0.01–0.9)] dan lokasi kerja zona merah[aOR 3.2(95% CI, 0.1–0.8)], faktor determinan pada kejadin stres sedang adalah stresor menetap dibandingkan dengan yang menurun [aOR 25(95% CI, 0.7–0.9)], lokasi kerja zona merah[aOR 2.6(95% CI, 0.2-0.9)] dan usia kurang dari 3030[aOR 1.8(95% CI, 1.1-3.2)].Kesimpulan: Faktor determinan kejadian stres berat pada tenaga kesehatan adalah perubahan stresor kerja dan zona kerja, untuk kejadian stres sedang adalah perubahan stresor kerja, zona kerja dan usia

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Background: During the COVID-19 pandemic, there has been an increase in workload, as well as greater vigilance and compliance at work. Healthcare workers must perform their duties while facing fear of COVID-19 infection, which can trigger and/or aggravate stress. This study aimed to obtain the determinant factor of stress among the healthcare workers during the pandemic by emphasizing the change in the psychosocial situation at the hospital.

Methods: This cross-sectional study was conducted from January to March 2021 using an online questionnaire consisting of personal and occupational questionnaires, as well as a validated stressor and stress questionnaires using validity and reliability tests (Cronbach's alpha 0.8 and 0.9). For the multivariate analysis, multinomial logistic regression was used to identify the determinants factor (p<0.05). Data were analyzed using SPSS software version 20 (IBM Corp., USA).

Results: More than half of respondents had a moderate stress (56.1%) and then followed by severe and mild stress. Determinant factors in the occurrence of severe stress are the alteration of stressors, moderate-severe stressors compared to constant stressors [aOR 8(95% CI, 2.2–29.7)] constant stressors compared to decreased stressors [aOR 11(95% CI, 0.01–0.9)], and working in the red zone [aOR 3.2(95% CI, 0.1–0.8)].The determinants of moderate stress events were constant stressors compared to decreased stressors [aOR 25(95% CI, 0.7–0.9)], working in the red zone [aOR 2.6(95% CI, 0.2-0.9)] and age less than 30[aOR 1.8(95% CI, 1.1-3.2)].

Conclusions: The determinant factors for the occurrence of severe stress in health workers are changes in work stressors and work zones, for moderate stress events are changes in work stressors, work zones and age."