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FACTORS CAUSES OF STOCK OUT AND DRUG STAGNANT AT PHARMACY INSTALLATION OF HOSPITAL X MALANG Tri Utami, Ni Nyoman Ayu; Ratri, Devita Rahmani; Nuthea, Merry
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Hospital pharmacy service is a supporting service as well as a revenue center in the hospital. More than 90% of hospital services use pharmaceutical supplies and 50% of hospital revenues come from managing pharmaceutical supplies. In the Covid-19 pandemic situation, the Pharmacy Installation must calculating the logistics management of the medicine properly. However, based on the hospitalization stock in May-July at X Hospital, there was still an incidence of stock out of 4.06% and stagnation of 2.44% due to poor drug procurement, which caused drug sales to decline. This study aims to analyze the factors that causing drug stock outs and stagnation in the Pharmacy Installation of X Hospital. This study uses a descriptive approach with data collection methods through observation, Focus Group Discussion (FGD), and a Likert scale questionnaire to get the root of the problem. Then the data was analyzed using the Fishbone Diagram and Pareto Diagram. The research subjects based on total sampling were all 11 staff of the Pharmacy Installation. The results obtained through the Fishbone Diagram are 13 root causes covering aspects of Man, Money, Method, Machine, Material, and Environment. The priority of the root cause of drug stock outs and stagnation in the Pharmacy Installation of X Hospital, namely HMIS is not optimal. Solutions that can be given are conducting intensive training for Pharmacy Installation staff in the use of HMIS, developing HMIS related to drug procurement, as well as repairing warehouse and pharmacy installation facilities and infrastructure.

Loss of Linen Stock at Puri Bunda Mother and Child Hospital: What Affects This? Drie, Ivan; Ratri, Devita Rahmani; Nuthea, Merry
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.16s

An insufficient number of linens, lack of linen cleanliness, and untimely linen provision will affect patient satisfaction, service quality, and hospital financing. Data at Puri Bunda Mother and Child Hospital Malang showed 108 linen loss incidents from the initial stock of 792 linens. This study was conducted to identify the factors that influence linen loss at Puri Bunda Mother and Child Hospital Malang. The root of the problems was identified through observations, interviews, and Focus Group Discussion (FGD) with the laundry staff, followed by analysis using a fishbone diagram and creating a Pareto diagram to select the main root of the problems. The study results indicate the absence of hospital policies that regulate the technical management of linen, weak evaluation monitoring, and inadequate linen management planning that contribute to the incidence of linen loss.

Factors Causing Stock-Outs and Drug Stagnation at Pharmacy Installation of Puri Bunda Mother and Child Hospital Malang Tri Utami, Ni Nyoman Ayu; Ratri, Devita Rahmani; Nuthea, Merry
Jurnal Kedokteran Brawijaya Vol. 31 Supplement 2 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.02.14s

Hospital pharmacy service is a supporting service as well as a revenue center in a hospital. More than 90% of hospital services utilize pharmaceutical supplies, and 50% of hospital revenues originate from pharmaceutical supply management. In the Covid-19 pandemic situation, the pharmacy installation must calculate the logistics management of the medicine correctly. However, based on stocktaking in May-July at Puri Bunda Mother and Child Hospital, there were stock-outs (4.06%) and drug stagnation (2.44%) due to poor drug procurement, causing declining drug sales. This study analyzed the factors causing stock-outs and drug stagnation in the Pharmacy Installation of Puri Bunda Mother and Child Hospital. This study uses a descriptive approach with data collection methods using observations, Focus Group Discussion (FGD), and Likert-scale questionnaires to find the roots of the problems. The data were analyzed using the Fishbone Diagram and Pareto Diagram. The research subjects based on total sampling were all 12 staff of the Pharmacy Installation. The results obtained through the Fishbone Diagram were 13 root causes covering the aspects of Man, Money, Method, Machine, Material, and Environment. The priority of the root cause of stock-outs and drug stagnation in the Pharmacy Installation of Puri Bunda Mother and Child Hospital Malang is the suboptimal use of the Hospital Management Information System (HMIS). The possible solutions are conducting intensive training for Pharmacy Installation staff in using HMIS, developing HMIS related to drug procurement, as well as repairing warehouse and pharmacy installation facilities and infrastructure.

Initial Assessment Form of Medical Record Document: Is It Important to Complete? Zhafira Anisah Kesuma; Nuthea, Merry; Hariyanti, Tita
Jurnal Kedokteran Brawijaya Vol. 32 Supplement 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.4s

Medical record document completeness is crucial because it serves as a means of communication, quality evaluation, payment, and legal protection. A preliminary study showed that none of the initial assessment forms in the outpatient unit of Puri Bunda Mother and Child Hospital were filled completely. This study aimed to explore the causes of incomplete initial assessment forms to avoid lawsuits against the hospital. The method used was qualitative research with a case study approach. Data were collected using triangulation, which included in-depth interviews with 15 participants, flow observations, and document studies on 150 medical record files. Data were analyzed using thematic analysis. The document study found none of the medical records with a complete initial assessment form (0%). A total of 141 documents (94%) were not filled at all, and only 9 (6%) of the initial assessment forms were filled in certain fields. The flow observation disclosed that file availability was one of the contributing problems to the completeness of filling. Seven reasons for incomplete initial medical assessment documents were categorized into individual internal and external factors. The internal factors include the lack of awareness of doctors and feeling a high workload, and the external factors include the absence of communication between management and doctors, unavailability of work procedures, the absence of a reward and punishment system, the format and availability of initial assessment forms, and individual culture.

Decreased Motivation as a Reason for Switching Normal Labor from Obstetricians to Midwives in Hospitals Kusuma Wardhana, Eka Chandra; Nuthea, Merry; Hariyanti, Tita
Jurnal Kedokteran Brawijaya Vol. 32 Supplement 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.9s

Based on the regulations, normal delivery with complications referred to a mother and child hospital is not under the right and obligation of the midwife as a maternity leader but must be led by an obstetrician. However, 58% of the normal deliveries were referred to midwives at Puri Bunda Mother and Child Hospital. This study aimed to explore the cause of the transfer of leadership in normal deliveries from obstetricians to midwives as the basis for developing solutions to the problems. This research was qualitative with a case study approach. Data were collected through focus group discussions, unstructured observations, and in-depth interviews. The total number of participants involved in this study was 16 people. Focus group discussions were conducted with midwives in the delivery room. In-depth interviews were conducted with the hospital director, the head of the delivery room, and obstetricians who provide normal delivery services. The results showed no guidelines and policies regarding the transfer of normal deliveries.

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