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All Journal Jurnal Kedokteran Brawijaya JAM : Jurnal Aplikasi Manajemen JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Jurnal Ilmiah Kesehatan Rustida Journal of Ageing And Family JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit)
Kurnia Widyaningrum
Hospital Management Masters Degree Program, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia
Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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“ABED TANGI” As a Solution for Time Inaccuracy in Returning Medical Record at X Hospital Susanti, Ika Rahayu; Hamzah, Andriyani; Anggraeni, Siti Asiyah; Widyaningrum, Kurnia
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 7, No 1 (2018): April
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.7152

Abstract

This study aims to determine the root of problem and alternative solutions of inaccuracy return medical record inpatient files. The research was conducted through qualitative descriptive approach in RSUD Blambangan from September until October 2017. Data was collected by  document review, field observation and unstructured interview with Head of Services, Head of Nursing Services, 1 doctor, 2 head of ward, Head of Medical Record Installation, Head of Nutrition Installation and Head of Pharmacy Installation. Root of problem was analyzed with fishbone diagram, focus group discussion (FGD) method and urgency, seriousness, growth (USG) method. Priority determination solution is carried out using filter analysis method with CARL (Capability Accessibility Readiness Leverage). The results show that factor inaccuracy return inpatient medical records file because are incomplete of medical record file, absence of standard operating procedure and unavailability of monitoring and evaluation, and the increasing number of medical record form according to hospital quality standard. The root  problem is not optimally main task and function of professional care giver when filling medical record. Alternative proposed solutions is socialization to professional care giver, revised standard of operational procedure, and monitoring evaluation of the completeness and timeliness of medical record file returns with innovation "ABED TANGI".
Daily Work Load Distribution to Increase Time Quality of Inpatients’ Medical Record Document Procurement In X Hospital Harjanti, Harjanti; Yuliansyah, Navis; Widyaningrum, Kurnia
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 7, No 1 (2018): April
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.7160

Abstract

Procurement of inpatient medical record document is one of some indicators of a hospital’s minimum service standards (SPM). According to the hospital MSS, the ideal procurement of inpatient medical record document is about ≤ 15 minutes, however the procurement on the report of quality committee at the first semester on 2017 in X Hospital reaches 22,89 minutes. The study is aimed at identifying, determining the root of the problems, and trying to devise solutions to the problems. The study employs a qualitative approach by employing document analysis, in-depth interview, and ethnographic observation. The problems are identified by using three steps which are focus group discussion (FGD) by the board of directors, the head of division, and the head of unit X Hospital. The second step is time motion study at the place of inpatient registration, and the last is Urgency, seriousness, and growth (USG) in medical record unit. The study results show that the overload of inpatient admission officers’ work is known to be the root of the problem. Solution to the procurement which is not in accordance with the hospital minimum service standard is to distribute the daily workload of inpatient admission officers to related units.
Evaluating Clinical Pathway Typhoid Fever Monitoring at ABC Hospital Malang Rosalina, Ika Shanti; Mansur, Muhammad; Hidayat, M. Kuntadi Syamsul; Widyaningrum, Kurnia
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 7, No 1 (2018): April
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.7155

Abstract

ABC Hospital has implemented 15 Clinical Pathway, and Typhoid Fever is the most cases that can be served. The inaccuracy of the monitoring report on the implementation of Clinical Pathway has prevented the hospital from taking appropriate actions to improve the implementation of Clinical Pathway Typhoid Fever. This study aims to determine the obstacles of monitoring implementation of Clinical Pathway Typhoid Fever in ABC Hospital. This research is a case study and descriptive-explorative research, using document review, field observation, interview, and questionnaire for data collection. The research was conducted in the in-patient wards and medical records room of ABC Hospital during September 2017. The respondents of the research include room physicians, head of inpatient rooms, pediatric, internist, pharmacist, nutritionist, and medical record staff. The result show that factors which impeded implementation of Clinical Pathway monitoring in ABC Hospital were the absence of Clinical Pathway team, the incompatibility of the Clinical Pathway Guide content, the absence of SOP of Clinical Pathway filling form, and the lack of socialization. Suggestion for improving monitoring of Clinical Pathway Typhoid Fever are establish a Clinical Pathway team, revise the Guidance of Clinical Pathway, compile SOP of Clinical Pathway filling form, and do socialization.
Preparation of financial policy to increase timing of inpatient billing information of hospital “X” Youandi, Abdi Agus; Widyaningrum, Kurnia; Yuliansyah, Navis
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 7, No 1 (2018): April
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.7159

Abstract

Background: One of the main problems encountered in RS X is the timing of inpatient billing information that has not been ≤ 2 hours. The focus of the study was to begin when the DPJP said the patient was allowed to go home until the patient received inpatient billing information. This study aims to explore the root of the problem has not reached the standard speed of inpatient billing information. Method: This research method is qualitative research. The study was conducted at hospital X from September to October 2017. Data were collected using literature study method, document review, unit observation, in-depth interview, focus group discussion (FGD). Result: Delay of billing information due to slow recording and recording differences. Differences in recording arise due to duplicate work of nurses who have other activities. Duties nurses not only provide patient care but have the administrative task. Conclusion: The speed of inpatient billing information information has not been standardized ≤ 2 hours due to duplicate of work of nurse having other activity. The solution to the problem is the need for revised policies and SOPs that regulate the duties, authority and responsibilities of each staff in more detail.
Faktor-faktor yang Mempengaruhi Optimalisasi Unit Rawat Jalan di RS X Widyaningrum, Kurnia; Harijanto, Tatong; Hartojo, Hartojo
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.2015.028.02.4

Abstract

Utilisasi pelayanan rawat jalan merupakan salah satu indikator penting kinerja rumah sakit. Hasil studi pendahuluan di unit rawat jalan RS tempat studi menunjukkan nilai utilitas dan optimalisasi masih belum maksimal dan terjadi penurunan angka kepuasan pasien. Tujuan dari penelitian ini adalah untuk mencari faktor-faktor yang mempengaruhi optimalisasi unit rawat jalan dan solusi untuk meningkatkan optimalisasinya. Metode yang digunakan adalah dengan observasi, telaah dokumen dan wawancara. Hasil penelitian menunjukkan bahwa terdapat gap antara utilitas ruang dan optimalisasi petugas. Utilitas ruang hanya 22,4% sedangkan optimalisasi masing-masing dokter sudah sangat optimal yaitu 141,6%, 172,9% dan 68,75%. Dengan menggunakan diagram fishbone ditemukan faktor–faktor utama kurang optimalnya unit rawat jalan adalah dari sumberdaya manusia yang kurang dan lingkungan yang kurang nyaman. Analisis 5 why's menemukan sistem monitoring dan evaluasi (monev) belum berjalan secara maksimal sebagai akar masalah. Solusi yang disepakati untuk meningkatkan optimalisasi di unit rawat jalan ini adalah dengan mengaktifkan kembali tim monev dengan pemberian pelatihan tentang monev.  Kata Kunci: Evaluasi kinerja rawat jalan, monitoring, optimalisasi, utilisasi
The Effect of Service Quality on the Number of Peristi Patients at Unisma Islamic Hospital Malang Sari, Dwi Ratna; Widyaningrum, Kurnia; Sarwiyata, Tri Wahyu; Rahmawati, Triwahyuning
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

ABSTRACTHospitals, as the spearhead of health services, are required to provide quality services that meet the expectations of the community. Decreasing number of Obstetrics and Gynecology (Peristi) patients at Unisma Islamic Hospital Malang into 119 patients in June 2019 and low BOR value of 15.1%-46.8% that is below the standard (60-85%) indicated that the number of patient visits to the Peristi unit is low. Low patient visits are associated with the satisfaction of quality services. This study aimed to determine the effect of service quality on the increasing number of patients. This study was carried out by using a survey with a cross-sectional study approach among patients in the obstetric unit and inpatients installation for three months. The sample in this study were 139 respondents from the obstetric unit and 18 respondents from Peristi obtained using the accidental sampling method. Data were collected using questionnaires based on the dimensions of service quality and semi-structured interviews. The results showed a number of respondent statements related to the quality of hospital services including dissatisfaction of outpatient flow which was not as promised, long patient waiting time, less responsive officers in responding to complaints or providing information to patients, and waiting room facilities that are not representative and lack complete equipment to support its services. The hospital is expected to provide high-quality services and excellent service to increase patient satisfaction so that it has an impact on increasing the number of patient visits to the Peristi Unit.
Numbers and Potential Causes of Medication Error in Inpatient Service of Rumah Sakit Islam Malang Arundina, Arsy; Widyaningrum, Kurnia
Jurnal Kedokteran Brawijaya Vol 31, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2020.031.02.11

Abstract

Medication errors, ranging from prescription to administration errors, are still problems of patient safety with an average error rate of 8% - 10% and can cause severe morbidity, prolonged length of stay (LOS) in a hospital, unnecessary diagnostic tests and care, and mortality. The objective of this study is to describe the number of medication errors and their potential causes according to the perceptions of health personnel. The study was carried out by questionnaires, interviews, and data exploration on prescriptions made before the observation period and new prescriptions made during the observation period. The priority determination of the solutions was carried out using Capability, Assessibility, Readiness, and Leverage method (CARL) and discussions with related units. The priority root factors that caused medication errors in the inpatient pharmacy at RSI Malang were high workloads and high turnover of inpatient pharmacist, incomplete prescription identity, illegible doctor's writing, and lack of training for the pharmacist. The priority outcome of the alternative solutions to overcome the medication errors in inpatient pharmacist is to regularly conduct training or knowledge refreshing for the inpatient pharmacist at RSI Malang and the implementation of e-prescription.
WHY VISITS OF EMERGENCY DEPARTMENT DECREASED DURING THE COVID-19 PANDEMIC? CASE STUDY IN X HOSPITALS, MALANG REGENCY Kusumawati, Anita Mardiana; widyaningrum, kurnia
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The visits rate to the Emergency DepartmentofX Hospital in the period April to June 2020, on average, decreased by 45.11% compared to the January - March 2020 period. The study aimed to identify the factors causing the decrease in the number of the Emergency Departmentduring the Covid-19 pandemic at X hospital. This study used a qualitative descriptive approach with Focus Group Discussion (FGD) data collection techniques analyzed using Fishbone Diagram combined with 5 WHYs.The subjects were determined based on purposive sampling, namely 8 respondents consisting of Nurses, Doctors and CoordinatorofEmergency Department, Head of Public Relations and Marketing Unit, Coordinator of Security Guard and Coordinator of Patient Registration Office. The results showed that there were several root causes of the decrease in the number of the Emergency Departmentat Xhospital: Emergency departmentstaffs had difficulty in providing education about Covid-19 screening and isolation care to patients and their families, patients refused further treatment, and patients refused to go to the hospital. Thus the decrease in the number of inpatients of the Emergency Department during the Covid-19 pandemic were caused by various factors, especially the difficulty of Emergency Departmentstaffs in providing education on Covid-19 screening and its subsequent care.
WHY INPATIENT VISITS DECREASED DURING THE PANDEMIC? CASE STUDY IN HOSPITAL X, MALANG REGENCY Lukito, Anggun Agatha Cristy; Widyaningrum, Kurnia
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

ABSTRACTCovid-19, designated as a National disaster in Indonesia, has an impact on reducing the number of non-Covid-19 inpatient visits in almost all hospitals. Hospital X also underwent a decrease in inpatient visits, resulting in a decrease in the Bed Occupancy Rate (BOR) by 35,5%. The study aimed to identify the factors causing the decrease in the number of inpatients at Hospital X from April to July. This study used a qualitative descriptive approach with Focus Group Discussion (FGD) data collection techniques analyzed using Fishbone Diagram combined with 5 WHYs. The subjects were determined based on purposive sampling, namely 8 respondents consisting of the head of the inpatient room, the coordinator of the inpatient room, the outpatient coordinator, head of public relations and marketing unit, and the coordinator of the patient registration office. Through the Fishbone Diagram, there found several root cause themes covering 4 aspects, namely the Human aspect, the Method aspect, the Mother Nature or the Environment aspect  and the Market aspect as the cause of the decrease in the number of hospitalized patients at  Hospital X during the Covid-19 pandemic. 
Evaluating Clinical Pathway Typhoid Fever Monitoring at ABC Hospital Malang Rosalina, Ika Shanti; Mansur, Muhammad; Hidayat, M. Kuntadi Syamsul; Widyaningrum, Kurnia
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol 7, No 1 (2018): April
Publisher : Universitas Muhammadiyah Yogyakarta in Clollaboration with ADMMIRASI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.7155

Abstract

ABC Hospital has implemented 15 Clinical Pathway, and Typhoid Fever is the most cases that can be served. The inaccuracy of the monitoring report on the implementation of Clinical Pathway has prevented the hospital from taking appropriate actions to improve the implementation of Clinical Pathway Typhoid Fever. This study aims to determine the obstacles of monitoring implementation of Clinical Pathway Typhoid Fever in ABC Hospital. This research is a case study and descriptive-explorative research, using document review, field observation, interview, and questionnaire for data collection. The research was conducted in the in-patient wards and medical records room of ABC Hospital during September 2017. The respondents of the research include room physicians, head of inpatient rooms, pediatric, internist, pharmacist, nutritionist, and medical record staff. The result show that factors which impeded implementation of Clinical Pathway monitoring in ABC Hospital were the absence of Clinical Pathway team, the incompatibility of the Clinical Pathway Guide content, the absence of SOP of Clinical Pathway filling form, and the lack of socialization. Suggestion for improving monitoring of Clinical Pathway Typhoid Fever are establish a Clinical Pathway team, revise the Guidance of Clinical Pathway, compile SOP of Clinical Pathway filling form, and do socialization.
Co-Authors Ahsan Ahsan Andriyani Hamzah Andriyani Hamzah Anggraeni, Siti Asiyah Arundina, Arsy Dwi Ratna Sari, Dwi Ratna Erich Hudisusanto Hamzah, Andriyani Harjanti Harjanti Harjanti Harjanti Harjanti, Harjanti Hartojo Hartojo, Hartojo Hidayat, M. Kuntadi Syamsul Hidayat, M. Kuntadi Syamsul Ika Rahayu Susanti Ika Rahayu Susanti Ika Shanti Rosalina Insani, Septa Dwi Kusumawati, Anita Mardiana Lukito, Anggun Agatha Cristy Lukman Hakim M. Kuntadi Syamsul Hidayat Mansur, Muhammad MUHAMMAD MANSUR Muhammad Mansur Navis Yuliansyah Navis Yuliansyah Rahmawati, Triwahyuning Ratna Sari, Dwi Rosalina, Ika Shanti Rosalina, Ika Shanti Siti Asiyah Anggraeni Siti Asiyah Anggraeni Susanti, Ika Rahayu Tatong Harijanto, Tatong Tita Hariyanti Tri Wahyu Sarwiyata Wahyu Sarwiyata, Tri Youandi, Abdi Agus Yuliansyah, Navis Yuliansyah, Navis