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"Latar Belakang: Dalam pemberian pelayanan kesehatan dan non kesehatan dituntut untuk melakukan sebaik mungkin. Proses peningkatan kesehatan dapat dilakukan dengan melakukan penguatan terhadap pelayanan kesehatan, yaitu Rumah Sakit. Tujuan: Tujuan dari penelitian melakukan analisis implementasi indikator SPM IGD pada KMK No. 129 tahun 2008 di IGD Rumah Sakit “Sehat” Depok. Metode Penelitian: Desain pada penelitian menggunakan penelitian kualitatif dengan Jenis Penelitian Rapid Assesment Procedure. Hasil: Pada komponen input, pengambilan kebijakan melalui proses multi pimpinan, SDM masih belum pernah diadakan pelatihan kegawatdaruratan yang tersertifikasi, SOP keperawatan dan medis di IGD berjumlah 116. Sarana dan prasarana IGD masih belum sesuai dengan Permenkes RI No.47 tahun 2018. Pada komponen proses terdiri dari perencanaan dan pengambilan keputusan, pengorganisasian, kepemimpinan, dan pengendalian. Pada komponen output terdapat indikator yang belum sesuai dengan SPM, pada indikator pemberi pelayanan gawat darurat yang bersertifikat yang masih berlaku BLS/PPGD/GELS/ALS hasil capaian 71%, keterserdian tim penanggulangan bencana tersedia satu tim, namun belum ada SK dari pimpinan. Kesimpulan: Belum tercapainya keseluruhan indikator pada SPM mengindikasikan bahwasanya mutu pelayanan dasar pada IGD Rumah Sakit “Sehat” Depok belum maksimal dalam implementasi dan pelaksanaanya. Saran: Melakukan optimalisisi pada SPM dengan mengadakan pelatihan dan penurunan SK untuk tim bencana di IGD.

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Background: In the term of providing both health and non-health services, we are required to do our best. The process of improving public health can be undertaken by strengthening health services in the hospitals. Objectives: The purpose of this research is to analyze the implementation of the indicators of SPM IGD in KMK No. 129 of 2008 in the emergency room of Sehat Hospital in Depok. Research Methods: The design of this study uses a qualitative approach with Rapid Assessment Procedure. Results: Based on the input component, the hospital’s policy-making through a multi-leader process, the hospital’s human resources have never been held a certified emergency training while nursing and medical SOPs in the emergency room is 116. The emergency room facilities are still not following the Minister of Health Regulation No. 47 of 2018. Based on the process component, it consists of planning, decision making, organizing, leadership, and controlling. Based on the output component, the indicators are not following the SPM, the indicators of certified emergency service providers still use BLS/PPGD/GELS/ALS, which results in 71% (standard 100%), the disaster management team is only one team and there is no a decree from the director. Conclusion: The lack of positive results of all indicators in SPM indicates that the quality of basic services in Depok Sehat Hospital’s emergency room has not been maximally implemented. Suggestion: The hospitals’ stakeholder optimizes the SPM through certified training and the director signs the decree for the disaster management team in the emergency room.

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"[Rumah sakit sebagai sarana pelayanan kesehatan yang terpadu harusmempunyai semua ukuran yang dapat menjamin peningkatan mutu.Instalasi Gawat Darurat (IGD) merupakan gerbang awal rumah sakit yangperlu dilakukan penilaian mutu pelayanan kesehatan sehingga dapatmengurangi terjadinya komplain dan meningkatkan derajat kesehatanpasien. Tujuan dari penelitian ini adalah untuk memperoleh gambaranpelaksanaan Standar Pelayanan Minimal (SPM) RS di IGD RS Sentra MedikaCibinong. Jenis penelitian yang digunakan bersifat kuantitatif dan kualitatif(mix method research) untuk memperoleh pemahaman yang baik. Hasilpenelitian menyarankan agar pihak manajemen perlu membuat ataumelengkapi kebijakan/ SPO terutama untuk hal yang berkaitan denganpelayanan di IGD, termasuk dalam pengelolaan SDM untuk mengantisipasijam pelayanan sibuk, membuat rencana diklat/ pelatihan, melengkapisarana dan prasarana, serta membentuk tim penanggulangan bencana diIGD.;Hospital as an integrated health care facilities must have all the sizes that canguarantee its quality improvement. Emergency department as a starting gatehospitals need to do quality assessment of health services to reduce theoccurrence of complaints and improve the health’s degree of the patients. Thepurpose of this research is to obtain the implementation of minimum servicesstandard of the Sentra Medika Cibinong Hospital. Empirically types used arequantitative and qualitative study (mixed method research) to obtain a goodunderstanding. Results of this research suggest to management needs to makethe policy/ Standard Operating Procedures, especially for matters relating tothe emergency services, included in the management of human resources inanticipation of the busy hour of service, create a training plan, completing theinfrastructure, and build a disaster response team, Hospital as an integrated health care facilities must have all the sizes that canguarantee its quality improvement. Emergency department as a starting gatehospitals need to do quality assessment of health services to reduce theoccurrence of complaints and improve the health’s degree of the patients. Thepurpose of this research is to obtain the implementation of minimum servicesstandard of the Sentra Medika Cibinong Hospital. Empirically types used arequantitative and qualitative study (mixed method research) to obtain a goodunderstanding. Results of this research suggest to management needs to makethe policy/ Standard Operating Procedures, especially for matters relating tothe emergency services, included in the management of human resources inanticipation of the busy hour of service, create a training plan, completing theinfrastructure, and build a disaster response team]"

"Pelaksanaan Standar Pelayanan Minimal SPM bidang farmasi di Instalasi Farmasi RS Bhakti Yudha Depok dan RSUD Depok dipengaruhi oleh faktor input yang meliputi SDM jenis pasien jenis resep ketersediaan obat peresepan dokter sarana dan prasarana formularium obat kebijakan atau SOP pelayanan resep serta faktor proses pelayanan resep yang meliputi penerimaan resep dan pemberian harga obat pembayaran pengambilan dan peracikan obat pemberian etiket obat dan penyerahan obat kepada pasien. Hasil penelitian didapatkan rata rata waktu tunggu pelayanan resep jadi tunai RS Bhakti Yudha Depok adalah 29 46 menit resep racikan tunai 49 92 menit tidak adanya kejadian kesalahan pemberian obat 100 penulisan resep sesuai formularium 99 Dan rata rata waktu tunggu pelayanan resep jadi tunai RSUD Depok 46 81 menit resep racikan tunai 80 69 menit tidak adanya kejadian kesalahan pemberian obat 100 penulisan resep sesuai formularium 97 25 Kata Kunci Standar Pelayanan Minimal SPM Rumah Sakit Bidang Farmasi Waktu Tunggu Pelayanan Resep

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The implementation of the minimum service standard in the pharmacy section at Bhakti Yudha Depok hospital and RSUD depok influenced by input factors which includes human resources types of patients kinds of prescription drugs availability of medicines doctor's prescribing facilities medicines the payment the receipt and extraction of medicines the average waiting period needed to change a prescription into cash is 29 46 minutes medicines extraction into cash 49 92 minutes prescription delivery with no mistakes is 100 the accuracy of prescription with medicine formulation 99 In RSUD Depok the average waiting period needed to change a prescription into cash is 46 81 minutes medicines extraction into cash 80 69 minutes prescription delivery with no mistakes is 100 the accuracy of prescription with medicine formulation 97 25 "

"Instalasi Gawat Darurat IGD memberikan pelayanan yang cepat dan tepat untuk mencegah kondisi kesehatan pasien memburuk dan mencegah kematian dan kecacatan. Penelitian ini bertujuan untuk melakukan analisa patient flow dengan menggunakan pendekatan Lean Six Sigma. Desain penelitian ini adalah analisa kualitatif dan kuantitatif dengan kerangka acuan DMAI Define, Measure, Analyze, dan Improve. Observasi dilakukan dengan teknik Time Motion Studies mulai dari pasien datang sampai perawat melakukan serah terima pasien diruang rawat inap yang dibagi menjadi4 cycle respon time dokter, waktu observasi, boarding dan transfer pasien, wawancara mendalam, telaah dokumen. Hasil penelitian dari 30 pasien rata-rata respon time dokter pada pasien level II adalah 35 menit 5 detik, dan pada pasien level III selama 43 menit 4detik. Total Lead time 6 Jam 56 menit 08 detik. Hasil identifikasi value stream mappingdari 4 cycle didapatkan respon time dokter membutuhkan waktu 00:46:38, Waktu Observasi 01:29:47, Waktu Boarding 04:17:02 dan transfer pasien 00:22:42. ProporsiNon value Added secara keseluruhan adalah 84.95 dan Value added sebesar 15,05, dengan total waste selama 05:53:29 detik. Hasil analisis Five Whys menunjukan adanya bottleneck di boarding pada proses kegiatan pencarian dan penempatan kamar 2:45:04 dengan penyebab yaitu ketersediaan kamar, sistem waiting list karena menunggu pasien pulang, pasien asuransi atau rencana pulang, kebijakan beset kamar, sistem pencarian kamar di Front Office dan kebijakan titip kamar. Upaya penerapan Lean Six Sigma diharapkan dapat memperbaiki kinerja di IGD, selain menghilangkan waste dan memaksimalkan nilai valu-added, mengetahui akar masalah, perbaikan kualitas dan peningkatan efisiensi kinerja secara terus menerus.

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Emergency Departement provides fast and precise services to prevent the patient 39s deteriorating health condition and prevent death and disability. This study aimed to analyze patient flow by using Lean Six Sigma approach. The design of this research are qualitative and quantitative analysis with reference framework DMAI Define, Measure, Analyze, and Improve. Observation was conducted with Time Motion Studies technique from patient arriving until nurse performed patient handover in in patient room which was divided into 4 cycles doctor respontime, observation time, boarding and patient transfer, in depth interview, study document.

Research result from 30 patients on average the physician 39s response time at patient level II was 35 minutes 5seconds, and in the patient 39s level III for 43 minutes 4 seconds. Total Lead time 6 Hours56 mins 08 sec. Identification result of value stream mapping from 4 cycle got doctor time response time 00 46 38, Observation Time 01 29 47, Boarding Time 04 17 02 and patient transfer 00 22 42. Proportion of Non value added as a whole is 84.95 and Value added of 15.05, with total waste for 05 53 29 sec.

Five Whys analysis results showed that there are a bottleneck in the process of searching and placing the room 2 45 04 with the cause of room availability, waiting list system waiting for the patientto go home, insurance patient or return plan, room beset policy, in the Front Office androom care policies. We suggest to apply Lean Six Sigma to improve performance in theER, in addition to eliminating waste and maximizing the value valu added, knowingthe root of the problem, quality improvement and continuous improvement inperformance efficiency."

"Pelaksanaan SPM bidang farmasi Di Instalasi Farmasi Rumah Sakit Tugu Ibu dipengaruhi faktor input: SDM, jenis pasien, jenis resep, ketersediaan obat, peresepan dokter, sarana dan prasarana, formularium obat, SOP pelayanan resep serta faktor proses pelayanan resep yang meliputi: penerimaan resep dan pemberian harga obat, pembayaran, pengambilan dan peracikan obat, pemberian etiket obat, dan penyerahan obat kepada pasien. Hasil penelitian didapatkan ratarata waktu tunggu pelayanan resep jadi tunai 13,07 menit, resep jadi jaminan 21,36 menit, resep racikan tunai 26,31 menit, resep jadi jaminan 31,28 menit; tidak adanya kejadian kesalahan pemberian obat 100%; kepuasan pelanggan 90,17 %; penulisan resep sesuai formularium 100 %.

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The implementation of the minimum service standard in the pharmacy section at Tugu Ibu hospital influenced by input factors: human resources, types of patients, kinds of prescription, availability of medicines, doctor's prescribing, facilities, medicine formulation, prescription service operational standard and the process of prescription service, which includes the acceptance of the prescription and priceing medicines, the payment, the receipt and extraction of medicines, the medicine procedure and medicine delivery to patients.

From the research, the average waiting period needed to change a prescription into cash is 13,07 minutes, a prescription into a guaranty 21,36 minutes, medicine extraction into cash 26,31 minutes, a prescription into a guaranty 31,28 minutes; prescription delivery with no mistakes is 100%; customers' satisfaction 90,17%; the accuracy of prescription with medicine formulation 100%."

"Tesis ini merupakan suatu penelitian dengan metode penelitian kualitatif terhadap waktu pelayanan Instalasi Gawat Darurat RS Gading Pluit Jakarta. Tujuan penelitian adalah untuk mengetahui waktu pelayanan IGD serta mencari penyebab lamanya waktu pelayanan IGD. Penelitian dilakukan dengan menghitung waktu pelayanan IGD terhadap pasien yang berobat ke IGD RS Gading Pluit selama bulan Januari 2016. Waktu pelayanan IGD maksimal 90 menit dihitung sejak pasien masuk ke IGD atau setelah dilakukan triase pada pasien. Dilakukan observasi terhadap proses pendaftaran pasien, triase pasien, asuhan keperawatan dan pemeriksaan dokter, pemeriksaan laboratorium, pemeriksaan radiologi serta konsultasi dokter spesialis. Terhadap waktu pelayanan pasien IGD yang melebihi waktu 90 menit dilakukan penelusuran penyebab lamanya pelayanan. Wawancara mendalam dilakukan untuk mendapatkan informasi mengenai penyebab lamanya waktu pelayanan IGD. Dari penelitian didapatkan bahwa waktu pelayanan IGD dipengaruhi faktor-faktor kategori triase pasien dan diagnosis penyakit pasien. Rata-rata waktu pelayanan IGD untuk kategori gawat darurat (Label Merah) adalah 70 menit 40 detik sedangkan rata-rata waktu pelayanan untuk kategori darurat tidak gawat (Label Kuning) adalah 80 menit 40 detik. Saran-saran penelitian : membatasi tindakan konsultasi ke dokter spesialis hanya untuk kasus-kasus gawat darurat, waktu pelayanan IGD sebaiknya berbeda berdasarkan kategori pasien dan menjamin proses triase berjalan dengan prosedur yang berlaku.

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This thesis is a study with qualitative research methods to the service time ER RS Gading Pluit Jakarta. The research objective was to determine the ER service time and find the cause of the length of time emergency services. The study was conducted by calculating the time emergency services to patients who went to the emergency room Gading Pluit Hospital during January 2016. ER maximum service time of 90 minutes is counted since the patient go to the ER or after triage on patients.

Observations on the process of patient registration, triage, nursing care and physician examination, laboratory test, radiological examination and consultation specialist. ER patient care over time that exceeds 90 minutes unpacking the cause of the length of service. Depth interviews were conducted to obtain information about the cause of the length of time the emergency services.

This research's result, the service time ER affected by category of emergency and patient diagnosis. Average services time for emergency category (red label) is 70 minutes while the average time of emergency services for urgent category (yellow label) is 80 minutes 40 seconds. Suggestions research : limiting the action to consult a specialist only for cases of emergency, emergency service time should be different by category triage patients and ensure the process runs with the applicable procedures."

"Tesis ini membahas analisis Pelaksanaan Standar Pelayanan Minimal Rumah Sakit Pada Instalasi Rawat Inap Di RSUD Kabupaten Ciamis Sebelum Dan sesudah Menjadi Badan Layanan Umum Daerah di Tahun 2013. Penelitian ini menggunakan pendekatan kualitatif dengan melakukan wawancara mendalam dari informan terpilih. Hasil penelitian menunjukkan dari aspek SPO, SDM, sarana prasarana pada instalasi rawat inap sesudah menjadi BLUD lebih lengkap dari segi kuantitas maupun kualitas meskipun dari aspek SPO masih ada tindakan yang tidak sesuai dengan SPO, sedangkan dari aspek SDM masih kekurangan dokter spesialis, dan dari aspek sarana dan prasarana masih kurang dalam sistem pemeliharaannya. Kesimpulannya, pelaksanaan Standar Pelayanan Minimal di instalasi rawat inap belum dilaksanakan secara maksimal, karena keadaan rumah sakit yang masih mempunyai kelemahan dan kekurangan. Saran peneliti bagi RSUD Kabupaten Ciamis diharapkan dapat lebih bekerja sama dan melakukan koordinasi yang baik dengan pihak Pemerintah Daerah agar dapat dicarikan solusi yang terbaik, dan diperlukan evaluasi berkala SPM agar pelaksanaannya lebih baik.

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This thesis studied an analysis of the implementation of Hospital Minimum Service Standards of Ciamis District General Hospital at Inpatient Care Unit which was held before and after becoming Local Public Service Institution in 2013. This research used a qualitative approach by conducting detailed interview to selected interviewees.

The result of the research showed that aspects of SPO, Human Resources, infrastructures at Inpatient Care Unit, viewed after the hospital's becoming Local Public Service Institution are more quantitatively and qualitatively complete although if viewed from SPO there are still acts which are not appropriate with SPO, meanwhile viewed from Human Resources, it is still lack of specialists, and from its infrastructures, it’s maintenance system is regarded still inadequate. The Minimum Service Standards implementation at Inpatient Care Unit has not been maximally implemented because of the hospital's weaknesses and lack.

The researcher suggestion for Ciamis District General Hospital is that hopefuly there will be more cooperative good coordination with the local government in order to find the best solution, and the Minimum Service Standards periodic evaluations is required so that the implementation will be better conducted."

"[Skripsi ini membahas faktor risiko ergonomic yang dapat menimbulkanlow back pain pada perawat dengan menilai faktor risiko pada pekerjaan, lingkungan dan alat kerja perawat pada perawat Instalasi Gawat Darurat Rumah Sakit Hermina Depok. Penelitian ini bersifat deskriptif observasional.Pengamatan di lapangan dilakukan untuk mengidentifikasi aktivitas berisiko tinggi LBP, metode BRIEF dan NIOSH digunakan untuk menilai tingkat risiko ergonomi, pengukuran dan analisis untuk menilai faktor alat kerja. Hasil penilaian menunjukkan bahwa aktivitas perawat seperti mendorong branchar, memasang infus, memberikan terapi injeksi dan mengukur tekanan darah memiliki risiko ergonomi sedang untuk menimbulkan low back pain. Adapun faktor lingkungan (tata letak tempat kerja dan ruang kerja IGD) tidak berisiko bagi perawat untukmenimbulkan LBP. Namun pada faktor alat (tinggi, dan adjustability) berisiko bagi perawat untuk menimbulkan LBP. Oleh karena itu, diperlukan pengendalian baik secara engineering maupun administratif sebagai upaya preventif terjadinya Low Back Pain.;Focus of this study is ergonomic risk factor lead to low back pain (LBP) to nurses with assess risk factor on task, environment, and nurses working tolls on the emergency room nurses at Hermina?s Hospital Depok. This is a descriptive observational study. A field research was conducted to identify a high risk ergonomic. Measurement and analysis are to assess the factor working tools were also applied. Research result showed that nurses activity such as pushing the branchar, giving drip therapy, giving injection therapy and blood pressure have anmedium risk of ergonomic that causes low back pain. As for the environmental factors (set of the workplace and workspace emergency room) are not a risk for nurses to cause low back pain. However, the tool factors (height and adjustability) are at risk for nurses to cause low back pain. Therefore, it is needed to take a control of both in engineering and in administrative as preventive efforts occurrence of low back pain., Focus of this study is ergonomic risk factor lead to low back pain (LBP) to nurses with assess risk factor on task, environment, and nurses working tolls on the emergency room nurses at Hermina’s Hospital Depok. This is a descriptive observational study. A field research was conducted to identify a high risk ergonomic. Measurement and analysis are to assess the factor working tools were also applied. Research result showed that nurses activity such as pushing the branchar, giving drip therapy, giving injection therapy and blood pressure have anmedium risk of ergonomic that causes low back pain. As for the environmental factors (set of the workplace and workspace emergency room) are not a risk for nurses to cause low back pain. However, the tool factors (height and adjustability) are at risk for nurses to cause low back pain. Therefore, it is needed to take a control of both in engineering and in administrative as preventive efforts occurrence of low back pain.]"

"Pelayanan kesehatan orang terduga TB merupakan salah satu standar pelayanan minimal (SPM) bidang Kesehatan yang harus dipenuhi oleh pemerintah Kab/Kota. Puskesmas merupakan unit terdepan dalam pencapaian target kinerja SPM bidang Kesehatan. Capaian SPM TB di kota Depok tahun 2021 baru mencapai 36,17 % dan menjadi capaian terendah kedua dari 12 SPM bidang Kesehatan Kota Depok. Tujuan dari penelitian ini adalah untuk menganalisis secara mendalam aspek struktur, aspek proses peningkatan mutu dan kinerja  dengan pendekatan PDSA (Plan-do-study-act) serta output dalam upaya peningkatan capaian pelayanan kesehatan orang terduga TB di Puskesmas Kota Depok Tahun 2022. Penelitian ini menggunakan pendekatan kualitatif dengan menggunakan desain studi kasus melalui wawancara mendalam kepada 31 informan, observasi lapangan dan telusur dokumen. Hasil penelitian, belum semua Puskesmas menetapkan Tim TB Dots, kurangnya tenaga yang terlatih,sarana-prasarana belum semua  sesuai standar, bahan-obat belum memadai, penggunaan teknologi informasi belum optimal, komitmen pimpinan dan staf masih kurang. Pada faktor proses, kegiatan upaya peningkatan capaian SPM TB pada tahapan study belum semua Puskesmas melakukan monitoring dan evaluasi terhadap capaian SPM TB.Pada output; terjadi peningkatan capaian  pelayanan orang terduga TB pada tahun 2022 dibandingkan tahun 2021, namun belum semua Puskesmas dapat mencapai target  SPM TB yang ditetapkan.  Kesimpulan: faktor struktur dan proses peningkatan mutu dan kinerja yang dilakukan berpengaruh terhadap keberhasilan dalam pencapaian SPM TB di Puskesmas.

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The health service for people suspected of having TB is one of the minimum service standards (MSS) in the health sector that must be met by the district/city government. The Public Health Center is the leading unit in achieving the MSS performance targets in the health sector. TB MSS achievement in Depok city in 2021 only reached 36.17% and became the second lowest achievement of the 12 MSS in Depok City Health. The aim of this study was to analyze in depth aspects of the structure, aspects of the quality and performance improvement process using the PDSA (Plan-do-study-act) approach as well as outputs in an effort to increase the achievement of health services for people suspected of having TB at the Depok City Health Center in 2022. This research used a qualitative approach using a case study design through in-depth interviews with 31 informants, field observations and document searches. The results of the study, not all Public Health Centers have established TB Dots Teams, lack of trained personnel, not all facilities are up to standard, medicinal materials are not adequate, use of information technology is not optimal, leadership and staff commitment is still lacking. In terms of process factors, not all Public Health Centers have conducted monitoring and evaluation of TB MSS achievements at the study stage. On output; there has been an increase in the achievement of services for people suspected of having TB in 2022 compared to 2021, but not all Public Health Centers have reached the set TB MSS target. Conclusion: structural factors and quality and performance improvement processes carried out influence success in achieving TB MSS at the Public Health Centers."

"Tesis ini membahas mengenai kinerja Puskesmas dan peningkatan kinerja Puskesmas dalam pencapaian standar pelayanan minimal bidang kesehatan di Kota Depok tahun 2018. Tesis ini menggunakan teori sistem dimana peneliti mendeskripsikan faktor input Puskesmas, factor proses puskesmas berupa penyelenggaraan pelayanan puskesmas dan output Puskesmas yaitu Kinerja Puskesmas berdasarkan 12 indikator SPM. Meode penelitian yang digunakan adalah penelitian mixed methods, yaitu penelitian kuantitatif dari univariate hingga multivariate dengan menggunakan data sekunder. Metode kualitatif menggunakan wawanara mendalam dan diskusi terarah. Hasil penelitian menunjukan bahwa Kinerja Puskesmas terhadap pencapaian SPM sangat rendah, fackor yang berpengaruh terhadap kinerja Puskesmas adalah factor bangunan, alat kesehatan dan BMHP serta factor ketenagaan. Hasil uji regresi logistik menunjukan faktor yang paling berpengaruh adalah faktor ketenagaan.

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This thesis discusses the performance and efforts to improve the performance of Puskesmas in achieving minimum service standards in the health sector in Depok City. This thesis uses a system theory where the researcher describes the input factor, the process factor in the form of puskesmas service delivery and the output factor, namely the Health Center Performance based on 12 SPM indicators. The research method used is mixed methods research, which is quantitative research from univariate to multivariate using secondary data. Qualitative methods use in-depth interviews, focused discussions and document review. The results of the study showed that the performance of the Puskesmas towards achieving SPM was very low, the factors that affected the performance of the Puskesmas were building factors, medical devices and BMHP as well as workforce factors. The results of the logistic regression test show that the most influential factor is the workforce factor."