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The Impact of Obstetrician/Gynecologist Hospitalists on Neonatal Quality of Care in Sardjito General Hospital Yogyakarta, Indonesia: A Retrospective Cohort Study Phyowai Ganap, Eugenius; Hakimi, Mohammad; Hadijono, Soerjo; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 3, No 2 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

ABSTRACT Background : The hospitalist model in obstetric care which was introduced over the last decades now has an important role in care delivery management with the potential positive impact on neonatal outcomes.Methods : This research design was retrospective cohort. Participants included is the patient in the time before and after implementation of obstetrician/gynecologist full-hospitalist policy during October 2013 until September 2014. The outcome measured were mean response time, APGAR score at 5 minutes, , NICU admission. Univariate and multivariable analyses was conducted to evaluate and determine the factor which significantly contribute to neonatal outcomes.Results and Discussion: We included total 71 patients (37 on-call obstetrician group andÂ 34 full-time hospitalist group).Â Univariate analysis indicatedÂ mean response time was significantly differ in full-time hospitalist group when compared to the on-call obstetrician group (65,3 + 25,89 vs. 84 + 22,29 mins; p = 0,002). Implementation of full-time hospitalist did not impact theÂ NICU admission and APGAR score at 5 minutes. Conclusion : Implementation of full-time hospitalist model is Â not affecting neonatal outcomes.Keywords : Â Infant and Maternal Mortality, Obtericians / Gynecologist Hospitalist, Labor and Delivery, Maternal and Neonatal Care, ICU Response Time.Â

The Impact of Obstetrician/Gynecologist Hospitalists on Maternal Quality of Care in Yogyakarta Indonsia: A Cohort Study Ganap, Eugenius Phyowai; Hakimi, Mohammad; Hadijono, Soerjo; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: The hospitalist is defined by 24-hour a day/7 day a week physician who assists or is employed by the hospital to manage patients, triage and emergencies.Â The hospitalist model in obstetric care that was introduced over the last decades now has an important role in care delivery management with the potential positive impact on maternal outcomes. Unfortunately, in Indonesia there were limited data available related to the implementation of hospitalist model and the impact on maternal quality of care.Objective: To determine the impact of obstetrician/gynecologist hospitalist on maternal quality care. Method: This research design was a retrospective cohort. Participants included were the patients in the time before and after implementation of obstetrician/gynecologist hospitalist policy during October 2013 until September 2014. Univariate and multivariate analysis were conducted to evaluate and determine the factors, which significantly contribute to maternal outcomes.Result and Discussion: We included a total of 71 patients (30 in the on-call group and 41 in the full time hospitalist group). Univariate analysis indicated mean response time was significantly different in the hospitalist group compared to the on-call group (65.3 Â± 25.89 vs 84 Â± 22.29 mins; p = 0.002). Implementation of full-time hospitalists did not impact the ICU admission and transfusion incidence.Conclusions: Implementation of the full-time hospitalist model was associated with a significant improvement of response time in emergency obstetric care without affecting maternal outcomes.Keywords: Maternal mortality, obstetrician/gynecologist hospitalist, labor and delivery, maternal care, ICU response time

Pengaruh Konseling saat Persalinan terhadap Kepesertaan Keluarga Berencana Pasca Salin di Kabupaten Kolaka Abbas, Marwan; Hadijono, Soerjo; Emilia, Ova; Hartono, Eddy
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Death among repro ductive age women about 25-50% is caused by pregnancy related condition. Family Planning program is known as one pillar to control pregnancy. Counseling plays important roles to increase contraceptive prevalent rate.Objective: To assess the effectiveness of family planning counseling during latent phase of labor in increasing postpartum contraception.Method: The study was an experimental design which involved all primary health centre, Maternity Hospital and General hospital in Kolaka district in the period of 1 January 2016 to March 2016. Sampling included 108 subjects divided into intervention and control group. Selection of health facility into two groups was done through simple coin toss. Intervention was family planning counseling conducted during latent phase of labor using flipchart standardised by BKKBN in 2014.Result and Discussion: From all subjects, 70 (64.8%) decided to participate in post partum contraception. Participation for contraception was significantly higher in counseling group (92%) compare to control (37%) (p<0.001, RR 2.5; CI 1.75 â€“ 3.57). Age and companion during labor did not influence contraception participation (p>0,05). There was a trend that contraception participation higher in older age. Other factors such as education, income, parity and previous conseling significantly influence contraception participation (p<0,05).Conclusion: Family planning counseling during latent phase increase the participation in postpartum contraception. Education, income, parity and previous counseling influence the participation in postpartum contraception.Keyword: Family Planning, Post partum contraception, Factors on contraception participation

Impact of Obstetrician/Gynecologist Hospitalists on Response Time of Obstetric Emergency Operation in Sardjito Hospital Yogyakarta Indonesia: A Retrospective Cohort Study Ganap, Eugenius Phyowai; Hakimi, Mohammad; Hadijono, Soerjo; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: The hospitalist model in obstetric care which was introduced over the last decades now has an important role in care delivery management with the potential positive impact on maternal and neonatal outcomes.Objective: The aim of this study was to evaluate the effect of hospitalist model towards surgical emergency response time.Method: This research design was cohort a retrospective study. Participants included wereÂ the patient in the time before and after implementation of obstetrician/gynecologist full-hospitalist policy during October 2013 until September 2014. The outcome measured were mean response time and possible hospital factors which contribute to response time.Result and Discussion: We included a total of 71 patients (30 on-call obstetrician group andÂ 41 full-time hospitalist group).Â Univariate analysis indicatedÂ mean response time was significantly differ in full-time hospitalist group when compared to the on-call obstetrician group (65.3 + 25.89 vs. 84 + 22.29 mins; p = 0.002). Multivariable analysis determined that hospital factors which contribute to response time are readiness of operating theatre.Conclusion: Implementation of full-time hospitalist model is associated with a significant improvement of response time in emergency obstetric care.Keywords: Maternal mortality, Obstetrician/Gynecology Hospitalist, C-section, Response Time

Hubungan antara Program Ekspanding Maternal and Neonatal Survival (EMAS) dengan Peningkatan Pengetahuan, Sikap dan Perilaku Bidan dalam Pengelolaan Kasus Kegawatdaruratan Obstetrik Pra Rujukan Widyaningsih, Wiwik; Siswosudarmo, Risanto; Hadijono, Soerjo
JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Latar Belakang:Â Angka kematian ibu di Kabupaten Kebumen tahun 2014 adalah 12 yang sebagian besar disebabkan oleh perdarahan pascasalin dan preeklampsia berat (PEB). Dalam program EMAS salah satu kegiatan adalah peningkatan pengetahuan dan ketrampilan untuk penatalaksanaan perdarahan pascasalin dan preeklampsia berat (PEB).Tujuan:Â Untuk mengetahui hubungan paparan program EMAS dalam hal pengetahuan, sikap dan perilaku bidan saat mengelola kasus kegawatdaruratan obstetrik pra rujukan.Metode:Â Penelitian ini menggunakan desain cross sectional, dilaksanakan terhadap bidan yang merujuk kasus perdarahan postpartum dan pre eklampsia berat di IGD RSU PKU Muhammadiyah Gombong dari tahun 2014-2015. Kuesioner yang digunakan dinilai dengan skala Likert, menilai pengetahuan dengan kuesioner benar salah, sedangkan ketrampilan dengan daftar tilik keterampilan nilai dari 10 sampai 100 kalau menjalankan prosedur sesuai harapan.Hasil dan Pembahasan:Â Sebanyak 104 responden (bidan), yang terdiri dari 52 bidan yang terpapar program EKSPANDING MATERNAl AND NEONATAL SURVIVAL (EMAS) dan 52 lainnya adalah responden tang tidak terkena program EMAS (kontrol). Mereka sebanding dalam usia, tahun pelayanan (pengalaman kerja), dan nilai pelatihan PPGDON. Analisis bivariat menunjukkan bahwa paparan program EMAS berhubungan secara signifikan dengan peningkatan pengetahuan, sikap dan perilaku bidan di bidang kegawatdaruratan kebidanan. Hasil analisis regresi logistik menunjukkan bahwa program EMAS berhubungan dengan hasil peningkatan pengetahuan managemen aktif kala III (OR: 6,41; 95% CI 2,32-17,72); pengetahuan PEB (OR: 11,72; 95% CI 4,19-32,78); sikap managemen aktif kala III (OR: 2,97; 95%CI 1,11-7,91); sikap PEB (OR 25,87; 95% CI 8,17-81,90). Hubungan dengan keterampilan managemen aktif kala III (OR: 7,37; 95% CI 2,10-25,85) dan keterampilan PEB (OR: 26,64; 95% CI 7,98-88,96).Kesimpulan:Â Terdapat hubungan antara Program Expanding Maternal and Neonatal Survival dengan peningkatan kemampuan, sikap dan perilaku bidan di bidang pengelolaan prarujukan kasus kegawatdaruratan obstetrik.Kata kunci: Expanding Maternal and Neonatal Survival (EMAS);Â pengetahunan; sikap; perilaku; penanganan prarujukan kegawatdaruratan obstetrik;

Development of Clinical Training Models for Comprehensive Emergency Obstetrics and Neonatal Care (Ceonc/Ponek) and Facilitative Supervision for Improving Hospital Performance Hadijono, Soerjo; Samsudi, Samsudi; Florentinus, Totok Sumaryanto; Noorpramono, Noorpramono
The Journal of Educational Development Vol 7 No 1 (2019): February 2019
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jed.v7i1.29334

Training investments and provision of facilities can only mobilize a part of healthcare production machines, and will be successfully drive it if they are fully supported by the local institutions / government and clinical training quality assurance system. In medical education and clinical training, the behaviours and attitudes modeled by professional practitioners are a special mechanisms in which participants will implicitly "learn" various aspects of their professional positions in the future. This study aim is to assess the educational management of a competency-based clinic training of Comprehensive Emergency Obstetric and Neonatal Care (CEONC/PONEK) followed by model simulation and the influence of facilitative supervision as an effort to improve hospital performance. Improving the quality of health services are expected to have significant leverage to reduce morbidity and mortality rates of mothers and neonates in Indonesia. The research was conducted in Dr Kariadi Central Hospital Semarang and Umbu Rara Meha Waingapu General Hospital at East Sumba Regency (East Nusa Tenggara Province) from 2012 to 2016. The research and evaluation conducted only in the process of educational management, so change towards a better state are expected after the intervention. The research was conducted through observational single cohort of pre-posttest design using performance assessment appraisal forms, direct and retrospective assessment which have been prepared for this research, and using primary data taken from the Hospital Management and Information System (SIMRS) database. CEONC skills training with simulation followed by facilitative supervision significantly improves the input and process in both maternal and neonatal hospital service (p < 0.05). Training also has a significant impact on improved team performance (p < 0.05), as well as compliance of health personnel to maternal care standards, although it has not had a significant impact on neonatal health services in both hospitals.

Analisis Hubungan Clinical Autonomy Terhadap Kepuasan Kerja Dokter Spesialis Obstetri dan Ginekologi Dalam Tindakan Seksio Sesarea Pada Sistem Jaminan Kesehatan Nasional Mappaware, Nasrudin Andi; Emilia, Ova; Hadijono, Soerjo; Malinta, Umar; Hakimi, Mohammad; Soetrisno, Soetrisno; Tiro, Eddy
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: In Indonesia, the National Health Insurance System (NHIS) is an implementation of law No. 40 of 2004 on the National Social Insurance System in health sector with universal health coverage (UHC) concept. Therefore, the satisfaction of specialistâ€™s work will be very influence towards hospital works. The previous research (Nasruddin, 2017) about factor analysis related to job satisfaction of doctor specialist for obstetrics and gynecology (SpOG) toward Sectio Caesarea (SC) on NHI showed that medical service (transparency and remuneration) and working condition have significant correlation towards work satisfaction of doctor SpOG in SC on NHI. Â Â Â Objective: to analyze the correlation of clinical autonomy on job satisfaction of doctor SpOG on Sectio Caesarea on National Health Insurance system.Method: A quantitative research by applying analytic observational study with cross sectional design.Materials and Research: This research was conducted in Makassar. A number of sample was 73 doctors SpOG. Data was obtained by clinical autonomy questionnaire having been tested its validity and reliability. The result of the research was analyzed by using chi-square test.Â Â Result: Based on the correlation of characteristics towards work satisfaction of doctor SpOG in SC on National Health Insurance system found that age category between 36 â€“ 45 years old is satisfied, female is satisfied, working duration more than 5 years is dissatisfied and public hospital status is dissatisfied. There is no correlation between clinical autonomy in this case is control overwork (p = 0.170) and prerogative obtain need service (p = 0.240) on job satisfaction of doctor SpOG in Sectio Caesarea on National Health Insurance System.Conclusion: There is no relation between clinical autonomy on job satisfaction of doctor SpOG in Sectio Caesarea on National Health Insurance System. Even though the doctors SpOG are not satisfied with NHI (medical service and working condition) but the doctors are able to work professionally with clinical autonomy.Â Keywords: clinical autonomy, doctor SpOG, National Health Insurance SystemÂ

Development of Clinical Training Models for Comprehensive Emergency Obstetrics and Neonatal Care (Ceonc/Ponek) and Facilitative Supervision for Improving Hospital Performance Hadijono, Soerjo; Samsudi, Samsudi; Florentinus, Totok Sumaryanto; Noorpramono, Noorpramono
The Journal of Educational Development Vol 7 No 1 (2019): February 2019
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jed.v7i1.29334

Training investments and provision of facilities can only mobilize a part of healthcare production machines, and will be successfully drive it if they are fully supported by the local institutions / government and clinical training quality assurance system. In medical education and clinical training, the behaviours and attitudes modeled by professional practitioners are a special mechanisms in which participants will implicitly "learn" various aspects of their professional positions in the future. This study aim is to assess the educational management of a competency-based clinic training of Comprehensive Emergency Obstetric and Neonatal Care (CEONC/PONEK) followed by model simulation and the influence of facilitative supervision as an effort to improve hospital performance. Improving the quality of health services are expected to have significant leverage to reduce morbidity and mortality rates of mothers and neonates in Indonesia. The research was conducted in Dr Kariadi Central Hospital Semarang and Umbu Rara Meha Waingapu General Hospital at East Sumba Regency (East Nusa Tenggara Province) from 2012 to 2016. The research and evaluation conducted only in the process of educational management, so change towards a better state are expected after the intervention. The research was conducted through observational single cohort of pre-posttest design using performance assessment appraisal forms, direct and retrospective assessment which have been prepared for this research, and using primary data taken from the Hospital Management and Information System (SIMRS) database. CEONC skills training with simulation followed by facilitative supervision significantly improves the input and process in both maternal and neonatal hospital service (p < 0.05). Training also has a significant impact on improved team performance (p < 0.05), as well as compliance of health personnel to maternal care standards, although it has not had a significant impact on neonatal health services in both hospitals.

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