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All Journal Journal Medical Informatics Technology Journal of Innovative and Creativity Horizon: Indonesian Journal of Multidisciplinary
Balqis Nurmauli Damanik
Universitas Bunda Thamrin
Agriculture, Biological Sciences & Forestry Humanities Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Engineering Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Public Health Social Sciences Other

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An Integrated Approach to Strengthening Public Health System Resilience Against Environmental and Disaster-Related Threats: A Literature Review Hely Hely; Murni Noviani; Balqis Nurmauli Damanik
Journal of Innovative and Creativity Vol. 5 No. 3 (2025)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/joecy.v5i3.6084

Abstract

The purpose of this study is to develop an integrated framework for strengthening public health system resilience in the face of increasing environmental and disaster-related threats. While research on environmental health risks, administrative health governance, and disaster preparedness has progressed independently, public health systems continue to suffer from fragmented strategies. This fragmentation weakens coordinated responses during crises such as climate-driven disasters, pandemics, or infrastructure failures. Therefore, this review aims to synthesize current approaches and propose a unified model for adaptive and sustainable health system resilience. Materials and methods. A structured literature review was conducted using the PRISMA methodology. A total of 36 peer-reviewed articles published between 2018 and 2025 were analyzed. Selected studies were categorized into four thematic areas: environmental health, health governance, disaster preparedness, and integrated resilience models. Quantitative frameworks such as Delphi–AHP and system dynamics were reviewed alongside qualitative governance and policy analyses. Results.The findings reveal significant gaps in current public health resilience strategies. Although predictive modeling and hospital safety protocols are widely discussed, their implementation is often localized and not mainstreamed into national health policies. Governance issues such as fragmented leadership, limited budgets, and lack of inter-agency coordination were consistently cited. Only a few studies presented cross-sectoral resilience models. Conclusions.A unified resilience framework is essential for modern health systems. It must combine environmental forecasting, flexible governance, community engagement, and disaster preparedness. The proposed model provides a foundation for future research and policy innovation aimed at achieving resilient, equitable, and proactive health systems.
Determinants of Hospital Length of Stay Among Pulmonary Tuberculosis Inpatients at A Secondary General Hospital in Indonesia: A Comparative Analysis Balqis Nurmauli Damanik; Hely Hely
Journal Medical Informatics Technology Volume 4 No. 2, June 2026
Publisher : SAFE-Network

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37034/medinftech.v4i2.150

Abstract

Tuberculosis (TB) remains a major public health challenge in Indonesia, which has the second-highest TB burden globally. Hospital length of stay (LOS) is an important indicator of inpatient care efficiency and influences reimbursement under the Indonesia Case-Based Groups (INA-CBGs) payment system. However, evidence regarding determinants of LOS in Indonesian secondary hospitals is still limited. This retrospective comparative study analyzed secondary medical-record data from a secondary general hospital in Medan, North Sumatra, collected between January and August 2025. Among 238 identified records, 215 patients with a primary diagnosis of pulmonary TB (ICD-10: A15.0–A16.9) met the inclusion criteria. LOS was calculated from admission and discharge dates. As LOS was not normally distributed (Shapiro–Wilk, p < 0.001), the Kruskal–Wallis and Mann–Whitney U tests with Dunn post-hoc correction were applied (α = 0.05). The median LOS was 3 days (IQR 2–4; range 0–13). Most patients were younger than 65 years (75.3%), while 51.2% had no documented comorbidity. Comorbidity burden was the only factor significantly associated with LOS (H = 18.74, p < 0.001; η² = 0.082). Patients with two or more comorbidities had significantly longer hospitalization than those without comorbidities (mean 4.18 vs. 2.82 days; p < 0.001) and those with one comorbidity (p = 0.013). No significant differences were found according to age group or insurance status. These findings indicate that comorbidity burden contributes to prolonged hospitalization among pulmonary TB inpatients and support integrating multimorbidity management into TB care. Larger multicenter prospective studies are needed to validate these findings.
Nurses and Service Quality at Regional General Hospitals (RSUD) Across Sumatera Utara Province Nilawati Nilawati; Murni Noviani Nasution; Balqis Nurmauli Damanik
HORIZON: Indonesian Journal of Multidisciplinary Vol. 4 No. 3 (2026): HORIZON: Indonesian Journal of Multidisciplinary
Publisher : Lembaga Intelektual Muda (LIM) Maluku

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54373/hijm.v4i3.5589

Abstract

The delivery of healthcare services in Regional General Hospitals (RSUD) across Sumatera Utara Province faces significant challenges due to dynamic population growth. This study aims to analyze the relationship between nurse workload and service quality within these hospital environments. The methodology employed is a quantitative analysis based on secondary data from the 2025–2026 regional statistical reports and empirical literature reviews of various hospitals in Sumatera Utara. Research findings indicate a significant negative correlation between excessive workload and the quality of nursing care (p = 0.000). The nurse ratio in Sumatera Utara (144.35 per 100,000 population) remains below the national target of 158 per 100,000, triggering physical and mental fatigue (burnout). Decreased concentration due to administrative and temporal burdens increases the risk of Adverse Events (KTD) . The conclusion of this study emphasizes the necessity of accelerating medical record digitalization and workforce redistribution using the WISN method to maintain minimum service standards and patient safety.
Smart Green Hospital: Pengembangan Dashboard Digital untuk Monitoring Risiko Kesehatan Lingkungan dan Pengambilan Keputusan Berbasis Data di RSI Malahayati Medan Tahun 2026 Nurcholisah Fitra; Dedi Ardinata; Balqis Nurmauli Damanik; Ruslan Zuhair Pulungan
Journal of Innovative and Creativity (Joecy) Vol. 6 No. 2 (2026)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/joecy.v6i2.12833

Abstract

Rumah sakit merupakan fasilitas pelayanan kesehatan yang berpotensi menimbulkan risiko kesehatan lingkungan apabila pengelolaannya tidak dipantau secara terintegrasi. Di RSI Malahayati Medan, monitoring risiko kesehatan lingkungan masih dilakukan secara manual, data kualitas lingkungan belum terintegrasi, dan pengambilan keputusan belum berbasis sistem digital sehingga program Green Hospital belum berjalan optimal. Kegiatan pengabdian kepada masyarakat ini bertujuan mengembangkan dashboard digital berbasis web untuk monitoring risiko kesehatan lingkungan sekaligus mendukung pengambilan keputusan berbasis data. Kegiatan menggunakan pendekatan Community-Based Research dan Participatory Action Research melalui enam tahapan: identifikasi kebutuhan, analisis masalah, perancangan dashboard, pelatihan dan implementasi, monitoring dan evaluasi, serta penyusunan rekomendasi. Sasaran kegiatan adalah petugas sanitasi, tim K3RS, komite mutu, dan manajemen rumah sakit. Hasil menunjukkan peningkatan rata-rata pengetahuan peserta dari 58,4 menjadi 84,7 dan keterampilan dari 51,2 menjadi 86,9, percepatan waktu pelaporan data lingkungan, serta tingkat kepuasan pengguna yang tinggi. Dashboard berhasil mengintegrasikan enam indikator kesehatan lingkungan dan indikator Green Hospital. Disimpulkan bahwa implementasi dashboard digital efektif meningkatkan kapasitas mitra dan kualitas pengambilan keputusan kesehatan lingkungan.
Co-Authors Dedi Ardinata Hely Hely Murni Noviani Murni Noviani Nasution Nilawati Nilawati Nurcholisah Fitra Ruslan Zuhair Pulungan