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All Journal Journal Of Vocational Health Studies Jambura Journal of Health Sciences and Research Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
Merita Arini
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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EVALUATING THE IMPLEMENTATION OF PEDIATRIC DHF CLINICAL PATHWAY IN TYPE D HOSPITAL IN YOGYAKARTA Cornel Anggara; Merita Arini; Ikhlas M. Jennie
Jambura Journal of Health Sciences and Research Vol 3, No 2 (2021): JULI: JAMBURA JOURNAL OF HEALTH SCIENCES AND RESEARCH
Publisher : Universitas Negeri Gorontalo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35971/jjhsr.v3i2.10673

Abstract

AbstractBackground: Dengue haemorrhagic fever (DHF) is an endemic disease that has a high incidence and mortality rate in Indonesia. Implementating clinical pathways (CP) in hospitals can be used as the basis for treating patients with DHF so as to improve service quality and minimize complications. Objective: This study aims to evaluate the implementation of CP DHF in the pediatric unit at Type D Private Hospital in Yogyakarta. Methods: This is a mix method research with case study design. Qualitative data was collected through in-depth interviews and observations of pediatricians n=2), nurses (n=3), directors of medical services (n=1) and medical committees (n=1). Quantitative data was collected through document review and interviews with the Integrated Clinical Pathway Appraisal Tools (ICPAT). Results: Documents is true a CP. The role of the organization has been running well. The process of documenting, developing and implementing CP DHF is not optimal. The maintenance process is bad. Compliance completes of CP DHF is 9%. The majority of lenght of stay are above 3.86 days with treatment costs above the BPJS package. The incidence of complications is low. The obstacles found during the implementation of CP DHF were that the patient did not have access to CP, low adherence to CP and human resource management factors. Conclusion: The development and implementation of CP DHF needs to be improved both in terms of content and quality. Strong policies are needed, good organizational support and the active role of clinicians are the keys to the successful implementation of CP.Keywords: Clinical Pathway, Dengue Haemorragic Fever, Integrated Services
User-Centered Feature Requirements in Wearable Digital Health to Support Self-Care Among Stroke Survivors Merita Arini; Moch Zihad Islami; Attar Husna Fathiya; Warih Andan Puspitosari; Nurchayati, Nurchayati; Firman Pribadi; Setyonugroho, Winny
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 8 No. 10 (2025): October 2025
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v8i10.7891

Abstract

Introduction: Stroke is a major cause of death and disability in Indonesia, leaving many survivors with long-term self-care challenges. Wearable technologies using digital health technology offer potential support. However, the adoption of technology is hindered by usability, accessibility, and cultural barriers. This study explores user-driven feature requirements to inform inclusive and effective digital self-care solutions for stroke survivors Methods: This explorative qualitative study with a phenomenological approach involved in-depth interviews with 19 stroke survivors conducted between May and August 2024 in Yogyakarta and Bandung. Participants were selected using purposive and snowball sampling and analyzed using thematic analysis. Ethical approval was obtained from the Universitas Aisyiyah Yogyakarta Ethics Committee (No. 3832/KEP-UNISA/VII/2024), and all participants provided informed consent. Results: A total of 19 stroke survivors (mostly male and aged 45–60) participated in this study, with the majority having lived with stroke for over five years. Two overarching themes emerged. The first, Managing Health and Daily Life, reflected the need for features that assist stroke survivor to navigate their self-care practices. The second, Navigating Technology with Limitations, highlighted emotional and socio-cultural barriers that hinder technology adoption and sustained use among stroke survivors. These findings suggest that effective wearable solutions must integrate practical health management functions with user-centered design, addressing cognitive, emotional, and contextual barriers to long-term use, with implications for inclusive design guidelines and grassroots-based technology policies. Conclusion: This study gives an understanding of user-centered perspectives in digital health technology by highlighting the practical and emotional aspects of technology use. Future research should incorporate caregiver and healthcare provider perspectives and evaluate prototypes in real-world settings to strengthen inclusive innovation and sustainable adoption.
Lean Strategy for Optimizing Response Time in Hospital Code Blue Activation: A Two-Cycle Action Research in Central Java, Indonesia Habib Laksmana Prima; Merita Arini
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 9 No. 1 (2026): January 2026
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v9i1.8571

Abstract

ntroduction: Inefficiencies or delays in Code Blue activation for cardiac arrest patients contribute significantly to increased mortality. Rapid response time is closely associated with better prognosis. However, no previous study has systematically addressed the problem of Code Blue activation delay using a structured approach in hospital settings. This study aimed to formulate and implement improvement strategies to minimize waste and accelerate Code Blue activation. Methods: This research employed an action research design and adopted a two-cycle action research design to validate the application of Lean Management in optimizing Code Blue activation at a private Type D hospital in Banyumas, Central Java, Indonesia. A total of 11 consecutive Code Blue cases were observed in each cycle — 11 cases before (Cycle 1) and 11 cases after intervention (Cycle 2). Each cycle consisted of four stages: diagnosis, planning, action, and evaluation, guided by Value Stream Mapping (VSM) to identify and eliminate waste. Quantitative data (lead time, waiting time, cycle time, and Value-Added Ratio) were analyzed using Mann–Whitney tests, while qualitative insights were obtained from in depth interview and focus group discussions with 20 healthcare professionals. Results: The top three critical wastes identified in the baseline assessment were waiting (20.7%), defects (20.4%), and transportation (17%). Thus, waiting was concluded to be the most critical waste in the Code Blue activation process. Initially, the activation process had four phases: initial assessment by inpatient nurse, assessment by ward doctor, system activation, and arrival of the secondary team. After interventions, it was streamlined to three phases by removing the ward doctor’s assessment. Post-intervention, response time dropped by 92.2 % (from 122.1 to 9.5 minutes, p < 0.001), waiting time decreased by 91.3 % (from 50.7 to 4.4 minutes, p < 0.001), and the Value-Added Ratio (VAR) increased from 7 % to 39 % (p < 0.001). Conclusion: The implementation of Lean Management significantly reduces response time in Code Blue activation. Sustaining these improvements requires ongoing commitment and a multidimensional approach, including training, system evaluation, and strengthening a supportive work culture.
DEVELOPMENT OF E-TIBI+ AS EARLY DETECTION AND SYSTEMATIC MANAGEMENT OF TUBERCULOSIS CASES IN PLHIV Erwin Astha Triyono; Feriawan Tan; Lilis Masyfufah; Sulvy Dwi Anggraini; Maria Lucia Inge Lucida; Soedarsono; Merita Arini; Tri Pudy Asmarawati; Ariani Permatasari; Rosita Dwi Yuliandari
Journal of Vocational Health Studies Vol. 9 No. 3 (2026): March 2026 | JOURNAL OF VOCATIONAL HEALTH STUDIES
Publisher : Faculty of Vocational Studies, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jvhs.V9.I3.2026.199-207

Abstract

Background: HIV and TBC combinations have received global public attention in recent years. Current collaborative tuberculosis and HIV elimination strategy is not enough to eradicate these two infectious diseases. Therefore, an innovative elimination approach leveraging advancements in digital technology is urgently needed. Purpose: To evaluate the tuberculosis elimination by optimizing case finding and monitoring treatment completion through the Early Detection and Management of Tuberculosis Application System + (E-TIBI+) application based on self-assessment in the HIV population. Method: This observational cohort study was conducted in Surabaya city, East Java Province, Indonesia in the period of September - October 2024. The study population consisted of adult PLHIV who completed the E-TIBI+ self-assessment. The E-TIBI+ application is a web-based platform. Data analysis included univariate analysis in the form of frequencies for each variable and crosstab analysis with the Kendall tau-b test in E-TIBI+ application acceptance data. Result: From a total of 386 patients screened, 61 (15.80%) PLHIV were suspected of having TBC. From the 61 patients, there were 17 patients who sought diagnosis at the health facility of their choice. User acceptance of the E-TIBI+ application by PLHIV patients tends to be positive and statistically significant. Conclusion: The E-TIBI+ application demonstrates strong potential to enhance early detection and systematic monitoring of tuberculosis case management among PLHIV through digital technology.
Online Registration Application Quality and User Satisfaction: A WebQual 4.0 and EUCS-Based Study at a Private Hospital in Indonesia Rofiqoh, Khofidhotur; Merita Arini
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 9 No. 3 (2026): March 2026
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v9i3.8818

Abstract

Introduction: The digitalization of hospital services increasingly requires high-quality online registration applications to enhance efficiency and user experience. Ineffective registration processes characterized by long queues, delays, and occasional system bottlenecks remain a major barrier to service efficiency and patient satisfaction in many hospitals. Online registration applications are expected to address these issues, yet limited studies have specifically examined how the quality of such applications influences user satisfaction, particularly in private hospitals in developing regions. This study examines how application quality, measured using the WebQual 4.0 dimensions, influences user satisfaction based on the End-User Computing Satisfaction (EUCS) model. This integration allows a more comprehensive understanding of how system usability, information attributes, and service interaction collectively shape user perceptions in digital health settings. Methods: A quantitative cross-sectional design was employed using validated instruments adapted from the WebQual 4.0 and End-User Computing Satisfaction (EUCS) models. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). To strengthen analytical depth and support theoretical interpretation, qualitative insights obtained from open-ended responses were incorporated to triangulate and enrich the quantitative findings. Results: The Study found that application quality significantly influenced user satisfaction (p < 0.001). All WebQual 4.0 dimensions, Usability, information quality, and service interaction showed positive and substantial contributions to the model. These findings align with core assumptions of the EUCS model, which posits that user satisfaction emerges from perceptions of system usefulness, information relevance, and overall performance quality. Qualitative responses supported the quantitative findings, indicating that users generally perceived the application as easy to use and informative. However, some noted occasional technical issues and suggested improvement to enhance system performance. Conclusion: Usability, information quality, and service interaction play critical roles in shaping user satisfaction with online hospital registration applications. The findings underscore the theoretical relevance of integrating WebQual 4.0 and EUCS, demonstrating that multidimensional system quality is essential for optimizing patient experience in digital hospital services. These results highlight the need for continuous system refinement to improve usability and service responsiveness, ultimately strengthening digital transformation efforts and enhancing patient-centered service delivery in hospital settings.
Co-Authors Ariani Permatasari Arlina Dewi Asmarawati, Tri Pudy Attar Husna Fathiya Cornel Anggara Erwin Astha Triyono Feriawan Tan FIRMAN PRIBADI Habib Laksmana Prima Ikhlas M. Jennie Maria Lucia Inge Lucida Masyfufah, Lilis Moch Zihad Islami Nurchayati Nurchayati Rofiqoh, Khofidhotur Rosita Dwi Yuliandari S. Soedarsono Setyonugroho, Winny Sulvy Dwi Anggraini Warih Andan Puspitosari Yurni Dwi Astuti