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Enhancing the quality of tuberculosis care in a high-prevalence area of West Java, Indonesia: A comparative study between public and private hospitals Dewi, Inaz K.; Hairi, Farizah M.; Andriani, Helen
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2108

Abstract

Despite the World Health Organization’s (WHO) ambitious goal of eradicating tuberculosis (TB) by 2035, the three key indicators of the End TB Strategy remain unmet. Improving the quality of care is essential to achieving better health outcomes in Indonesia, where both public and private hospitals play a pivotal role in strengthening TB services. The aim of this study was to evaluate the quality of TB care in public and private hospitals in Karawang Regency, a district with the fifth highest TB prevalence in West Java, Indonesia. A mixed-methods approach was employed, using an evaluation framework that integrated the High-Quality Health System (HQHS) model and the Quality of Tuberculosis Service Assessment (QTSA) tool. Quantitative data were collected using a modified QTSA questionnaire administered to patients, while qualitative primary data were obtained through in-depth interviews with stakeholders and healthcare providers. Secondary qualitative data were sourced from patient visit records and TB control reports. The findings indicated that low treatment success rates were associated with increased patient loss to follow-up, inadequate evaluation, patient mortality, and dissatisfaction, which were largely driven by deficiencies in foundational elements and suboptimal treatment processes, including budgeting, policy dissemination, and the functioning of internal and external networks. Positive patient experiences and access to follow-up care significantly influenced patient satisfaction. Strengthening the foundational components of the TB health system and adopting a sustainable, integrated treatment approach are critical to improving treatment success rates, clinical outcomes, and patient satisfaction.
Peningkatan Pelaporan Insiden Keselamatan Pasien dengan Digitalisasi di Rumah Sakit Pemerintah di Jakarta Pertiwi, Revita Anisa; Sjaaf, Amal Chalik; Andriani, Helen; Oktamianti, Puput
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i9.16455

Abstract

Terkait keselamatan pasien, rumah sakit sangat rentan karena merupakan organisasi yang rumit dengan sumber daya terbatas di berbagai bidang seperti teknologi, layanan, pemasaran, sistem mutu, dan bahaya. Berikut ini adalah beberapa jenis kejadian yang mungkin terjadi di rumah sakit yang dapat dihindari: Sentinel, Potential Injury Conditions (KPC), Near Injury Events (KNC), Non-Injury Events (KTC), Adverse Events (KTD), dan divisi Farmasi memiliki potensi kecelakaan tertinggi. Satu rumah sakit di Jakarta telah melihat peningkatan laporan masalah keselamatan pasien, dan penelitian ini bertujuan untuk meneliti penyebabnya. Penelitian ini dilakukan antara Januari dan Maret 2024 dan menggunakan metodologi deskriptif kualitatif, mengumpulkan data melalui wawancara dan meninjau dokumen sekunder yang berkaitan dengan insiden keselamatan pasien. Informan terdiri dari kepala bidang penunjang medis, Ketua Keselamatan Pasien Rumah Sakit, kepala instalasi farmasi, dan staf farmasi. Hasil penelitian menunjukan terjadi peningkatan laporan insiden keselamatan pasien sebesar 660% setelah di lakukan perubahan sistem saat 2023. Setelah di lakukan penyuluhan kepada seluruh tenaga kesehatan di tahun 2024 terdapat peningkatan laporan ada 101% di bandingkan tahun 2023. Penyuluhan kepada semua tenaga kesehatan yang bekerja di rumah sakit menyebabkan peningkatan angka pelaporan insiden yang menandakan mutu kesalamatan pasien di rumah sakit tersebut berjalan baik dan pasien mendapatkan pelayanan prima.
Kebijakan dan Peran Antimicrobial Stewardship Program (AMS) dalam Optimalisasi Penggunaan Antibiotik di Rumah Sakit: Sebuah Kajian Sistematis Irmawati, Irmawati; Andriani, Helen
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i7.60407

Abstract

Latar Belakang: Antimicrobial Stewardship Program (AMS) adalah program terstruktur dan terkoordinasi yang bertujuan untuk mengoptimalkan penggunaan antikroba (seperti antibiotik) untuk meningkatkan luaran klinis pasien, mengurangi risiko resistensi antimikroba, dan menurunkan biaya kesehatan. Program AMS merupakan bagian penting dari rencana aksi nasional dalam mengatasi resistensi antimikroba / antimicrobial resistance (AMR) di berbagai negara. Implementasi AMS di rumah sakit telah terbukti efektif dalam mengurangi penggunaan antibiotik yang tidak rasional dan meningkatkan kepatuhan terhadap pedoman penggunaan antibiotik. Tujuan: Mengevaluasi kebijakan dan peran dari AMS dalam mengoptimalisasi penggunaan antibiotik di rumah sakit, dengan fokus pada tantangan dan keberhasilan implementasi di berbagai konteks geografis dan ekonomi. Hasil kajian ini diharapkan dapat memberikan rekomendasi yang relevan untuk memperkuat implementasi AMS di rumah sakit, khususnya di negara-negara berpenghasilan rendah dan menengah. Metode: Pencarian literatur dilakukan secara sistematis melalui database PubMed, Cochrane, dan EBSCO untuk studi yang dipublikasikan antara Januari 2020 hingga Mei 2025. Studi yang diambil adalah studi yang memenuhi kriteria inklusi mengenai implementasi dan dampak AMS di rumah sakit. Studi tersebut mencakup berbagai negara dengan fokus pada kebijakan, hambatan, dan hasil dari penerapan AMS di rumah sakit. Hasil: Dari 1.439 artikel yang diidentifikasi, didapatkan hasil 178 artikel yang disaring berdasarkan duplikasi, kelayakan dan kesesuaian judul. Setelah disaring kembali sesuai kriteria inklusi didapatkan hasil 5 artikel yang memenuhi syarat. Kesimpulan: AMS berperan penting dalam mengoptimalisasi penggunaan antibiotik di rumah sakit dan pengendalian AMR. Dalam mengimplementasikan AMS, terdapat berbagai tantangan yang dapat dihadapi pada masing-masing rumah sakit, namun dengan dukungan kebijakan yang kuat, pelatihan berkelanjutan, dan kolaborasi bersama, efektivitas AMS dapat ditingkatkan. Upaya berkelanjutan juga diperlukan untuk mengatasi hambatan dan memastikan keberlanjutan program AMS terutama dalam hal pelayanan di rumah sakit.
Prevalensi Global Diabetes Mellitus: Tinjauan Sistematis Negara-Negara dengan Beban Tinggi dan Strategi Penanganannya Widya P Sakul; Helen Andriani
Jurnal Ners Vol. 9 No. 3 (2025): JULI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i3.47890

Abstract

Diabetes Mellitus merupakan salah satu masalah kesehatan global dengan prevalensi yang terus meningkat, terutama di negara-negara berkembang. Penelitian ini bertujuan untuk mengidentifikasi negara dengan angka penderita diabetes tertinggi di dunia serta meninjau strategi penanganan dan pencegahan yang telah diterapkan. Metode penelitian menggunakan pendekatan Systematic Literature Review dengan pedoman PRISMA, menganalisis artikel ilmiah yang dipublikasikan antara tahun 2015 hingga 2025 melalui basis data sepert;, PubMed, Google Scholar, Neliti.com, and ProQuest. Dari 567 artikel yang diidentifikasi, 15 artikel memenuhi kriteria inklusi dan dianalisis lebih lanjut. Hasil tinjauan menunjukkan bahwa Tiongkok, India, dan Amerika Serikat memiliki beban Diabetes Mellitus tertinggi, disusul Brasil dan Indonesia yang juga menunjukkan tren peningkatan signifikan. Strategi mitigasi yang ditemukan bervariasi, mulai dari skrining dini di layanan primer, edukasi perilaku, penguatan kebijakan fiskal seperti cukai gula, hingga pemanfaatan teknologi digital. Temuan ini menegaskan pentingnya pendekatan lintas sektor dan adaptasi kebijakan berbasis konteks lokal untuk mengendalikan laju peningkatan diabetes di berbagai negara
Penguatan Pengendalian Persediaan Obat melalui Integrasi ABC-VEN, EOQ, dan ROP di Rumah Sakit Rujukan Nasional Rasendah, Rasendah; Andriani, Helen; Andriyanto, Dendhi Bagus
Jurnal ARSI : Administrasi Rumah Sakit Indonesia Vol. 12, No. 1
Publisher : UI Scholars Hub

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Abstract

Drug inventory control is a critical component of pharmaceutical management in referral hospitals with high service complexity. This study aimed to evaluate pharmaceutical inventory control performance at the Pharmacy Installation of RSUP Persahabatan and to formulate improvement strategies using an Operational Research approach. A mixed-methods design with a sequential explanatory approach was applied. Quantitative analysis was conducted on 2,291 drug items recorded in the inventory system during October 2025 using ABC-VEN classification to identify priority medicines, followed by calculations of Economic Order Quantity (EOQ) and Reorder Point (ROP). Qualitative data were obtained through in-depth interviews with key informants to strengthen the interpretation of quantitative findings. The results showed that 131 Pareto A medicines had an investment value of IDR 6,788,411,815, indicating a high concentration of inventory investment in a small proportion of items. In addition, stagnant stock was identified in 211 drug items with a total investment value of IDR 444,994,656, while stock out events accounted for 11.25% of total drug items. EOQ and ROP calculations revealed substantial variation across drug items, reflecting differences in demand characteristics, investment value, and procurement lead times, indicating that uniform ordering policies are not appropriate. Scenario-based simulations demonstrated that integrating ABC-VEN, EOQ, and ROP has the potential to improve inventory management efficiency, reduce the risks of stock outs and stagnant stock, and support the continuity of hospital pharmaceutical services.
Projecting the impact of a national strategy to accelerate stunting prevention in East Nusa Tenggara, Indonesia, using the Lives Saved Tool Helen Andriani; Miftahul Arsyi; Alphyyanto E. Sutrisno; Alexander Waits; Nurul D. Rahmawati
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1462

Abstract

Stunting remains a critical public health issue in East Nusa Tenggara (ENT), Indonesia, with prevalence rates among the highest in the country, despite national efforts to reduce its occurrence. The aim of this study was to project the impact of the 2018–2024 National Strategy to Accelerate Stunting Prevention on children under five years old in ENT, using the Lives Saved Tool. A cross-sectional approach was employed, integrating data from various sources, including the 2020 Census of Indonesia, the Global Data Lab-Area Database, the Central Bureau of Statistics Republic Indonesia, the National Socioeconomic Survey, the 2017 Indonesia Demographic and Health Survey, the 2018 Basic Health Research, and the 2021 Indonesia Nutrition Status Survey. The analysis considered three scenarios: (1) a baseline scenario reflecting ENT’s 2017 coverage, maintained through 2028; (2) a scenario assuming Indonesia achieves the Health Plan Action Stunting targets; and (3) a projection of stunting rates based on ENT-specific coverage. Under scenarios 1 and 2, the prevalence of stunting was projected to decrease from 40.04% in 2018 to 39.82% and 39.78%, respectively, by 2028, with scenario 3 reflecting a similar trend.  The findings revealed a sharp increase in the number of stunting cases averted among children under five years old between 2017 and 2021, followed by a more gradual decline, culminating in the 2028 projections: 2,249 children (scenario 2), 2,130 children (scenario 3), and 1,966 children (scenario 1). Breastfeeding promotion emerged as the most impactful intervention, accounting for over half of the total stunting cases averted under both Indonesia-wide and ENT-specific coverage scenarios. This was followed by interventions such as multiple micronutrient supplementation and vitamin A supplementation. The study highlights that reducing the prevalence of stunting among children requires a comprehensive prioritization of intervention strategies. The implementation of breastfeeding promotion, combined with appropriate complementary feeding practices, is expected to contribute significantly to achieving the sustainable development goal targets.
Prophylactic Antibiotic Analysis in Obs-Gyn, Orthopedics, Gastrointestinal Surgery at a South Tangerang Hospital, January-March 2024 Nurjaman, Evelina Endang; Andriani, Helen
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality was assessed based on four criteria: indication, agent type, timing, and duration. Univariate analysis was used to examine the relationship between physician characteristics and compliance. The qualitative findings were analyzed using the Capability, Opportunity, Motivation – Behavior (COM-B) behavioral model. Overall compliance with all four PA criteria was poor, at only 9% (18 of 208 surgeries). Low adherence was particularly noted in agent selection (33%) and administration timing (42%). Orthopedic surgery showed the lowest compliance in terms of indication and duration. Univariate analysis indicated that only surgical procedure type significantly influenced compliance (p = 0.039). Qualitative analysis revealed that non-adherence was primarily driven by the fear of surgical site infection (SSI) and the belief that broad-spectrum agents are more effective. Notably, despite poor compliance, no incidence of SSI (0%) was reported during the 30–90-day post-procedure follow-up. Consistently poor compliance highlights significant gaps in procedural implementation and physician motivation regarding reasonable PA use. Targeted interventions focusing on standardized procedures, evidence-based education, and systemic monitoring are essential to improve prescription practices and mitigate the risk of AMR development.
ANALISIS HUBUNGAN KEPATUHAN DOKUMENTASI DISCHARGE PLANNING DENGAN LAMA RAWAT INAP DAN READMISI PADA PASIEN STROKE DAN CEDERA KEPALA DI RUMAH SAKIT AWAL BROS PEKANBARU Ruth Hutagalung; Helen Andriani
Journal of Hospital Administration and Management (JHAM) Vol 7 No 1 (2026): Journal of Hospital Administration and Management (JHAM)
Publisher : LPPM Universitas Awal Bros

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54973/jham.v7i1.936

Abstract

Stroke and traumatic brain injury are commonly associated with prolonged hospital stay and readmission. Effective discharge planning is essential to ensure continuity of care; however, documentation compliance remains suboptimal. The objective of this research is to examine the association between discharge planning documentation compliance based on the METHOD and IDEAL models and length of hospital stay and 30-day readmission among stroke and traumatic brain injury patients. A quantitative analytical observational study with a retrospective cross-sectional design was conducted using medical records of 111 stroke and traumatic brain injury patients admitted to Awal Bros Hospital Pekanbaru between October and December 2025. Data were analyzed using Spearman's correlation, Mann–Whitney U, Kruskal–Wallis, multiple linear regression, and logistic regression. Source triangulation through confirmatory interviews with healthcare professionals was performed to validate discharge planning implementation. Poor discharge planning documentation was identified in 51.4% of the METHOD model and 44.1% of the IDEAL model. The IDEAL score showed a weak positive association with length of hospital stay (r=0.194; p=0.042), whereas the METHOD score was not significant. Neither model was associated with 30-day readmission (p>0.05). Comorbidity and complete functional dependence were significant predictors of prolonged hospitalization. Source triangulation confirmed that discharge planning was routinely implemented, although documentation remained incomplete, particularly in patient education, medication management, and dietary counseling. Discharge planning documentation showed a weak association with length of hospital stay but not with 30-day readmission. Strengthening documentation quality and multidisciplinary coordination is essential to improve continuity of care.
PENGELOLAAN FARMASI DAN WAKTU TUNGGU OBAT DI RUMAH SAKIT: SYSTEMATIC LITERATURE REVIEW Prima Aprianti; Helen Andriani
Journal of Hospital Administration and Management (JHAM) Vol 7 No 1 (2026): Journal of Hospital Administration and Management (JHAM)
Publisher : LPPM Universitas Awal Bros

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54973/jham.v7i1.928

Abstract

Pharmacy waiting time is a key indicator in evaluating hospital service quality. The waiting time is influenced by various pharmacy management factors, such as stock systems, distribution flow, and information systems. This study aims to identify the relationship between pharmacy management and pharmacy waiting time in hospitals based on a systematic literature review. A systematic review was conducted using ProQuest database within the last ten years, screened through duplication removal, title, abstract, and full-text assessment. A total of 772 articles were identified, and after strict selection, 8 articles met the inclusion criteria for analysis. Key factors affecting waiting time include prescription input delay, drug availability, doctor confirmation, prescription copy making, and stock management. Management interventions such as Six Sigma, Lean Thinking, Root Cause Analysis (RCA), automated queue technology, and integrated information systems were proven effective in reducing waiting time and improving patient satisfaction. Effective pharmacy management significantly reduces waiting time and increases patient satisfaction. Strengthening information systems, stock management, workflow improvement, and continuous application of quality management methods are required.  
Enhancing the quality of tuberculosis care in a high-prevalence area of West Java, Indonesia: A comparative study between public and private hospitals Inaz K. Dewi; Farizah M. Hairi; Helen Andriani
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2108

Abstract

Despite the World Health Organization’s (WHO) ambitious goal of eradicating tuberculosis (TB) by 2035, the three key indicators of the End TB Strategy remain unmet. Improving the quality of care is essential to achieving better health outcomes in Indonesia, where both public and private hospitals play a pivotal role in strengthening TB services. The aim of this study was to evaluate the quality of TB care in public and private hospitals in Karawang Regency, a district with the fifth highest TB prevalence in West Java, Indonesia. A mixed-methods approach was employed, using an evaluation framework that integrated the High-Quality Health System (HQHS) model and the Quality of Tuberculosis Service Assessment (QTSA) tool. Quantitative data were collected using a modified QTSA questionnaire administered to patients, while qualitative primary data were obtained through in-depth interviews with stakeholders and healthcare providers. Secondary qualitative data were sourced from patient visit records and TB control reports. The findings indicated that low treatment success rates were associated with increased patient loss to follow-up, inadequate evaluation, patient mortality, and dissatisfaction, which were largely driven by deficiencies in foundational elements and suboptimal treatment processes, including budgeting, policy dissemination, and the functioning of internal and external networks. Positive patient experiences and access to follow-up care significantly influenced patient satisfaction. Strengthening the foundational components of the TB health system and adopting a sustainable, integrated treatment approach are critical to improving treatment success rates, clinical outcomes, and patient satisfaction.
Co-Authors Acintya Wika Sitakusuma Afiyani, Nadia Ahmat Yurdiansyah Alexander Waits Alphyyanto E. Sutrisno Andriyanto, Dendhi Bagus Arofah, Sari Nur Arsyi, Miftahul Ayudewi Komala Indriastuti Balgis Alzagladi Basabih, Masyitoh Dewi Laksmi Dewi, Inaz K. Dharmaningsih, Dwi Dhima Paramitha Oktacynara Dhima Paramitha Oktacynara Dwi Dharmaningsih Erlin Friska Evarista Theofika Fajarwati, Sinta Fandianto, Yusron Farizah M. Hairi Febrianti, Icha Tiara Devi Friska, Erlin Grara Vema Tuzauna Grara Vema Tuzauna Hairi, Farizah M. Helvira Helvira Ika Oktaviani Ilyas, Jaslis Inaz K. Dewi Inaz Kemala Dewi Indah Prihatin Irmawati Irmawati Kartika Malahayati Katon, Hilda Sri Khairunnisa, Dhiennada Putri Kiranti, Mutiara Larasati, Clara Niken Maharani Sylvia Rindawati Maya Masita Melia Roza Miftahul Arsyi Mirah Wijaya Munthe, Sarah Narumi Nabila, Nasrin Nasrin Nabila Naufal Hilmi Marzuq Nisa, Sefria Nora Fitria Tu Novi Handoko Nurjaman, Evelina Endang Nurul D. Rahmawati Oktaviani, Ulfa Pattyranie, Hermansyah Pertiwi, Khairunnisa Cahya Pertiwi, Revita Anisa Pita Aprilia Pratiwi Ananta A Prima Aprianti Pujiyanto - Puput Oktamianti Putri, Cahya Adriani Raafiana, Mirna Rahmawati, Nurul D. Rasendah, Rasendah Rendra Fariadi Rini, Tia Aditya Roza Falinda Rusmawati, Sisca Ruth Hutagalung Ruth Hutagalung Saly Salim Saleh Alatas Sandry Tri Sumarni Septian Ekawati Silalahi, Ronauli Margaretha Siti Mardhatillah Musa Siti Nurhaliza Sjaaf, Amal Chalik Suprihati - Suryana, Icha Sutrisno, Alphyyanto E. Suwandi, Indah Pratiwi Tahir, Hadijah Ulfa Oktaviani Vetty Yulianty Permanasari Wahyu Chrestanto Waits, Alexander Widya P Sakul Yohana Septiani Merrynda yongky tamigoes Yoseva, Veronica