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All Journal Jurnal Kedokteran Brawijaya JAM : Jurnal Aplikasi Manajemen Kesmas: Jurnal Kesehatan Masyarakat Nasional
Aryo Dewanto
Fakultas Kedokteran Universitas Brawijaya
Decision Sciences, Operations Research & Management Medicine & Pharmacology Public Health

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Pengembangan Instrumen Penilaian Kualitas Layanan Rumah Sakit Kartikasari, Dwi; Dewanto, Aryo; Saleh, Maya Syahria
Jurnal Kedokteran Brawijaya Vol 28, No 1 (2014)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2014.028.01.14

Abstract

Pengukuran kualitas pelayanan secara berkala merupakan titik masuk dalam peningkatan mutu berkelanjutan. Penelitian ini bertujuan untuk mengembangkan instrumen penilaian kualitas layanan. Instrumen dikembangkan berdasarkan kuesioner kualitas layanan yang disusun oleh Padma yang selanjutnya dianalisis untuk melihat faktor pembentuk dimensi kualitas layanan. Data dikumpulkan menggunakan kuesioner delapan dimensi kualitas layanan yang diukur berdasarkan persepsi pasien menggunakan skala Likert 5 poin. Kuesioner diberikan pada 84 pasien di Instalasi Rawat Jalan, Instalasi Rawat Inap dan Instalasi Gawat Darurat (IGD). Analisis data menggunakan Confirmatory Analysis Factor (CFA ) dengan uji kecukupan sampel KMO MSA>0,50 pada semua dimensi dengan signifikasi bartlett test 0,00 (Sign<0,05). Ekstraksi dan rotasi faktor dilakukan hingga terbentuk satu komponen pada satu dimensi. Hasil penelitian ini menunjukkan bahwa dari 8 dimensi kualitas layanan yang terdiri 59 item pernyataaan, setelah dilakukan analisis menggunakan Confirmatory Factor Analysis (CFA) dengan loading factor diatas 0,50, menghasilkan 3-7 item pada masing-masing dimensi sehingga didapatkan 37 item. Dimensi infrastruktur dibentuk oleh 5 item, kualitas personil dibentuk oleh 6 item, proses perawatan klinis dibentuk oleh 4 item, prosedur administrasi dibentuk oleh 4 item, indikator keselamatan pasien dibentuk oleh 3 item, citra rumah sakit dibentuk oleh 5 item, tanggung jawab sosial dibentuk oleh 3 item, dan kepercayaan terhadap rumah sakit dibentuk oleh 7 item.Kata Kunci: Kepuasan pasien, kualitas layanan rumah sakit, kuesioner
Faktor Penghambat Pelaksanaan SPO 7 Benar dalam Pemberian Obat di Ruang Rawat Inap Rumah Sakit Panti Nirmala Sthephani, Pratiwi; Dewanto, Aryo; I, Cecilia Widijati
Jurnal Kedokteran Brawijaya Vol 28, No 2 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (695.47 KB) | DOI: 10.21776/ub.jkb.2015.028.02.19

Abstract

Laporan keselamatan pasien RS Panti Nirmala terdapat 34,1% kejadian yang berhubungan terhadap kesalahan pemberian obat. Hal ini mengindikasikan pelaksanaan pemberian obat berdasarkan 7 benar belum berjalan dengan baik. Tujuan dari penelitian ini adalah untuk mengidentifikasi, menganalisis faktor penghambat pelaksanaan pemberian obat berdasarkan 7 benar sesuai standar prosedur operasional (SPO)di ruang rawat inap RS Panti Nirmala. Penelitian ini dilakukan dengan metode observasi terhadap 39 perawat pelaksana di 7 unit ruang rawat inap pada shift pagi dan sore waktu pemberian obat, baik obat oral dan intravena. Setelah melakukan observasi, peneliti memberikan kuesioner untuk mengukur pengetahuan, sikap dan kemauan perawat. Kuesioner dibagikan kepada 49 orang perawat pelaksana ruang rawat inap. Hasil observasi menunjukkan 64,9% perawat melakukan benar pasien, 86,5% perawat melakukan benar obat, 64,9% perawat melakukan benar waktu, dan 100% perawat melakukan benar dosis, benar cara dan dokumentasi. Hasil kuesioner menunjukkan terdapat 89% perawat rawat inap RSPN memiliki pengetahuan yang baik tentang prinsip 7 benar. Perawat juga memiliki sikap yang baik dalam pelaksanaan pemberian obat berdasarkan tujuh benar dan mau menjalankan prinsip tujuh benar dalam pemberian obat. Hal tersebut disebabkan kurangnya komunikasi yang efektif pada perawat terhadap pasien maupun keluarga. Kata Kunci: 7 benar, pemberian obat, perawat
Penyampaian Informasi oleh Perawat dalam Persetujuan Tindakan Medis di Rumah Sakit: Permasalahan dan Solusi Satiti, Yudha Rose; Susilo, Harsono; Dewanto, Aryo
Jurnal Kedokteran Brawijaya Vol 28, No 2 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2015.028.02.10

Abstract

Tuntutan hukum di bidang kesehatan menjadi perhatian utama rumah sakit di Indonesia karena menghabiskan waktu, biaya dan mencemarkan citra rumah sakit. Banyak kasus dugaan malpraktik terjadi karena kurang baiknya penyampaian informasi yang berisiko terhadap tuntutan hukum dan mutu rumah sakit. Penelitian dilakukan dengan cara observasi di ruang rawat inap dan UGD, untuk mengamati proses penyampaian  tiap tindakan medis yang dilakukan oleh perawat. Observasi dilakukan berdasarkan PERMENKES Nomor 290/MENKES/PER/III/2008 tentang Persetujuan Tindakan Medis. Untuk mencari akar dari penyebab masalah dilakukan brainstorming dengan peserta 6 orang terdiri dari kepala perawat dan tim mutu dilanjutkan dengan pembuatan fishbone dan teknik “5 Whys” untuk mencari akar masalah. Dari hasil penelitian didapatkan hanya 50% tindakan yang ada formulir tindakan dilakukan persetujuan informasi medis sebelum tindakan dan 100% tindakan yang tidak ada formulir, semua persetujuan informasi medis dilakukan sebelum tindakan. Penjelasan tindakan masih sangat rendah berkisar antara 0-30%. Dari hasil brainstorming didapatkan akar permasalahan adalah pemahaman cara menjelaskan informasi medis rendah, belum ada SK pendelegasian pada perawat untuk menyampaikan informasi medis, sistem pengawasan belum berjalan, SOP kurang jelas atau kurang spesifik, belum ada alat bantu untuk menjelaskan dan perawat tidak tahu cara komunikasi atau penyampaian yang benar. Hasil penentuan alternatif solusi dengan metode McNamara menemukan bahwa alternatif solusi terbaik adalah pembuatan leaflet terkait penjelasan informasi medis dan flyer untuk edukasi pasien.Kata Kunci: Flyer edukasi, Informasi medis, persetujuan tindakan medis
Factors Affecting Patient's Length of Stay In The Era Of Covid-19 Pandemic In Emergency Room Persada Hospital Simanungkalit, Sylvia Kitty; Holipah, Holipah; Dewanto, Aryo; David, David
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Length of stay (LOS) of a patient in an Emergency Room (ER) is the interval between the time the patient arrives and the time the patient physically leaves the ER. Prolonged LOS has potential to cause crowding. Meanwhile, from a clinical point of view, the factor of LOS has an impact on service suspension, which can reduce patient safety, even to death. Covid-19 pandemic has made hospitals establish a strict patient screening system and has the potential to increase the LOS of patients in the ER. The purpose of this study was to identify the factors that contribute to the LOS of patients. This study is an observational study of 38 respondents who came to the Emergency. LOS was compared between before and during Covid-19 pandemic condition. Observations were carried out by the Time Motion Study method to determine the patient's average time at each stage of the ER. The results showed the average LOS for emergency room patients with inpatient plans was 2 hours 7 minutes, while the LOS during pandemic was 4 hours 46 minutes 52 seconds. There were 2 hours 39 minutes 52 seconds time extension. The time extension is due to several factors: results of laboratory tests SARS COV-2; approval process for the Covid-19 Screening Team; Emergency Room and Laboratory were located in separate buildings.
The Implementation of the Seven-Rights Procedure in Drug administration in a Hospital Inpatient Room: the Inhibiting Factors and Alternative Solutions Puspitasari, Shinta Dwi; Dewanto, Aryo; Holipah, Holipah Holipah; Muliawan, Arrasyid Indra
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Medication error becomes one of the main concerns in ensuring patient safety worldwide. In the first semester of 2020, Hospital X reported two incidents of medication error. Although the incidents were categorised as “adverse event” and “near miss”, it should have been prevented. One of the methods to prevent medication error is the application of the seven-rights procedures in drug administration. This study aims to identify the inhibiting factors in the implementation of the seven-rights procedure in X Hospital as well as to obtain alternative solutions to those inhibiting factors. This study used a cross-sectional design. The data was gathered from 20 nurses at Hospital X using a questionnaire to measure the knowledge, attitude, and behaviour of nurses on the seven-rights procedure. The data is also supported by observation on the actual implementation of the procedures. At the end of the data gathering process, interviews with nurses in inpatient room were conducted to obtain their opinion about the obstacles in applying the seven-rights procedures. The results show that the main problem of drug administration errors was the lack of standard operating procedures (SOP) and nurses’ non-compliance behaviour on the seven-rights procedure. This study also reveals that there is no relationship between the nurses’ knowledge and their behaviour in applying the seven-rights procedures. To prevent medication error, the hospital manager should revise the SOP, conduct a periodic internal refreshment-workshop about the procedure, and perform scheduled supervision to the nurses.
How Do Hospital Staffs Cope with Covid-19 at Work? A Phenomenological Study Febrianto, Wahyu; Indriani, Wiwin; Dewanto, Aryo; -, Holipah
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The first confirmed Corona Virus Disease 2019 (Covid-19) case in Indonesia was found in March 2020 and rapidly spread out across all provinces. Covid-19 hit unexpectedly that almost all hospitals around the world were unprepared for it. Several studies show that Covid-19 impacts negatively on hospital finance, the mental health of healthcare workers (HCWs), and the death of HCWs. Hasta Brata Hospital (HBH) is one of the hospitals in East Java affected by the pandemic. Therefore, this study aims to investigate the experience of HBH staff face the issues. This study was qualitative research with a phenomenological approach. The data were collected using in-depth interviews with two HBH’s staff. ACovid-19 pandemic causes problems to the hospital, especially the staff. They experienced deep emotional and physical pressure at work, such as fear of infection, repeated conflict with patient's visitor, having different mindsets among staff, and increasing workload. The situation in the community is also frustrating them as the Covid-19 cases keep rising, while people tend to disobey the Covid-19 prevention protocols. Fortunately, they have proper job resource, started from physical support such as the provision of personal protective equipment, nutritional enhancement, and periodic Covid-19 screening; cognitive support such as knowledge update about Covid-19 and its handling methods; to psychological support such as motivational and spiritual support from the HBH leader. Moreover, they also pose strong personal resources that help them to cope with stressful working situations. They could, then, bounce back, feel optimistic that they could fight against Covid-19, with the hope that the pandemic will have an end. Continuous spiritual support gives them another personal resource of tawakkal, an Islamic concept of giving entire resignation and reliance on God only after exerting maximum effort. It seems that job resources and personal resources have succeeded in reducing the highly demanding situation and transform it into positive outcomes. Given a challenging situation, the hospital staffs strive to perform well and bring themselves into their work when providing patient care. Covid-19 pandemic forced the hospital and staff to adapt to the condition quickly. The presence of job resources and the provision of strong personal resources have succeeded in moderating job demands and resulting in positive outcomes. Tawakkal becomes an adding point on staff's personal resources that made them realize that Covid-19 is inevitable, and they have to fight back before finally giving their full resignation to God.
Pengaruh Kepercayaan, Kepuasan Pelanggan dan Komitmen Hubungan terhadap Citra Rumah Sakit di Kota Blitar Muhammad Muchlis; Aryo Dewanto
Jurnal Aplikasi Manajemen Vol 11, No 3 (2013)
Publisher : Jurusan Manajemen Fakultas Ekonomi dan Bisnis Universitas Brawijaya

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Abstract

Abstract: This study aimed to determine the influence of the trust, customer satisfaction, and relationship commitment on the hospital image in Blitar city. The research was a cross-sectional study. The respondent of the study were 122 patients who were hospitalized between April to May 2013 or their families in three hospitals in Blitar city. The samples were taken using purposive sampling technique. In this research, the variables were trust, customer satisfaction, and relationship commitment as the independent variables and hospital image as the dependent variable. Data were collected by questionnaires and measured with a scale of Likert 5 levels. Data were analyzed using the multiple linear regression. The results showed that the trust, customer satisfaction, and relationship commitment influence either partially or simultaneously to the hospital image. Customer satisfaction was a dominant variable compared of trust and relationship commitment.Keywords: trust, customer satisfaction, relationship commitment, hospital image
Pengaruh Kualitas Layanan terhadap Kepuasan dan Kepercayaan di Rumah Sakit Bunda Kandangan Surabaya Dwi Kartikasari; Aryo Dewanto; Fatchur Rochman
Jurnal Aplikasi Manajemen Vol 12, No 3 (2014)
Publisher : Jurusan Manajemen Fakultas Ekonomi dan Bisnis Universitas Brawijaya

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Abstract

Abstract: This study aims to determine the effect of hospital service quality on satisfaction and trust of the patients. Data were collected using questionnaires. Questionnaires were given to patients in the hospitalization unit of RSBK. The sample of this study is 121 people. Data were analyzed by Structural Equation Modeling (SEM) with SPSS AMOS software. The study shows that service quality has a direct and indirect effect on patients’ trust. Service quality has indirect effects on patient’s trust through patient satisfaction as interviening variable. There is a significant direct effect of service quality on patients’ satisfaction, but there is no significant indirect effect of service quality on patients’satisfaction through patients’ trust. Keywords: trust, satisfaction, quality of service
Pengaruh Brand Image terhadap Perceived Service Quality, Kepuasan, dan Loyalitas . David; Aryo Dewanto; Fatchur Rochman
Jurnal Aplikasi Manajemen Vol 12, No 4 (2014)
Publisher : Jurusan Manajemen Fakultas Ekonomi dan Bisnis Universitas Brawijaya

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Abstract

Abstract: This study aims to examine the influence of brand image on patients’ who perceived service quality, satisfaction, and loyalty in outpatient units.This Research conducted on May 2014 was a correlational and quantitative study. The research sample were 109 patients of outpatient units in Ben Mari Hospital Malang. Data were collected by a fivepoint Likert scale questionnaire in which consists of statements about brand image, patients’ perceived service quality, satisfaction, and loyalty. The data were analysed by Structural Equation Modeling using Partial Least Squares. The result of the study shows that brand image has a direct and indirect effect on patients’ perceived service quality, satisfaction, and loyalty . Brand image has the biggest effect directly on patients’ perceived service quality. One of indirect effects of brand image on patient loyalty occurs through patients’ perceived service quality and satisfaction. Brand image influences patients’ perception on service quality, in turn it infuences patients’ satisfaction and loyality. The influence of brand image shows that brand image must be managed by the hospital well and seriously in order to build a positive thought from the patients. Finally, the hospital management image will give the result on patients’ acceptance towards the hospital response to their preferences and needs.Keywords: brand image, perceived service quality, satisfaction, loyalty
Pengaruh Kualitas Pelayanan Terhadap Kepuasan Pasien Rawat Inap di Rumah Sakit Kota Batu Dolly Irbantoro; Aryo Dewanto; Asih Tri Rachmi N
Jurnal Aplikasi Manajemen Vol 13, No 1 (2015)
Publisher : Jurusan Manajemen Fakultas Ekonomi dan Bisnis Universitas Brawijaya

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Abstract

Abstract: The growth of hospitals in Indonesia improve the competition between them. Thus, the hospitals are demanded to improve the services quality of the hospitals. The study aims to determine the influence of the perceived services quality variables into patient satisfaction of inpatient Hospitals in Batu. The design of study is cross sectional study with 110 respondent, as inpatient between April to May 2014 or their families in four hospitals in Batu. The samples were taken using purposive sampling technique. The variables of this research are Infrastructure, Personnel Quality, Clinical Care Process, Administrative Procedure, Patient Safety, Hospital Image, Hospital social responsibility, and Trusthworthiness of the hospital, as Independent variables. Patient satisfaction as dependent variables. The instrument of the research is questionnaires and measured with a scale of Likert 5 levels. The data were analyzed using multiple linear regression. The result showed that the Infrastructure, Personnel Quality, Clinical Care Process, Administrative Procedure, Patient Safety, Hospital Image, Hospital social responsibility, and Trusthworthiness of the hospital influence either partially or simultaneously to patient satisfaction. The dominant of independent variables is hospital image.Keywords: perceived services quality, patient satisfaction
Co-Authors -, Holipah . David . Herjunianto Arrasyid Indra Muliawan Asih Tri Rachmi N Cecilia Widijati I, Cecilia Widijati David David David David Dolly Irbantoro Dwi Kartikasari Fatchur Rochman Fatchur Rochman Febrianto, Wahyu Harsono Susilo, Harsono Holipah Holipah Holipah, Holipah Holipah, Holipah Holipah Indra Wahju Hardjanti Indriani, Wiwin Laksono Trisnantoro Lukman Hakim Lutfi Rachman Maya Syahria Saleh Muhammad Muchlis Muliawan, Arrasyid Indra Noermijati, Noermijati Pratiwi Sthephani, Pratiwi Puspitasari, Shinta Dwi Shinta Dwi Puspitasari Silvia Shinta Devi Simanungkalit, Sylvia Kitty Sylvia Kitty Simanungkalit Yudha Rose Satiti, Yudha Rose