Analysis of Organizational Culture Change Processin Badan Rumah Sakit Umum Tabanan-Bali - Sepri Hariyadi; Sudiro Sudiro; Lucia Ratna Kartika (Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro, 2013)
Badan Rumah Sakit Umum Tabanan Bali sejak tahun 2002 telah terjadi perubahan di berbagai aspek organisasi yang kemudian berdampak dan bermakna pada cara pemberian pelayanan selanjutnya meningkatkan jumlah kunjungan pasien dan kesejahteraan karyawan, yang secara keseluruhan mengubah citra rumah sakit. Tujuan penelitian ini menganalisis proses terjadinya perubahan budaya organisasi rumah sakit (asumsi dasar, tata nilai, norma, dan artefak) pada aspek struktur, teknologi, dan orang melalui tahapan-tahapan perubahan (refreezing, freezing, unfreezing). Jenis penelitian observasional, kualitatif. Pengumpulan data dengan wawancara mendalam, pengumpulan dokumen, dan pengamatan langsung. Subjek penelitian terdiri dari informan utama 4 orang manajer (puncak dan menengah), informantriangulasi 3 orang tenaga fungsional (dokter dan perawat). Hasil, pada awalnya organiasi BRSU ada perbedaan pada asumsi dasar, tata nilai, norma, dan artefak. BRSU berstatus UPTD, minim teknologi, terdapat kecurangan pendapatan disetiap bagian, kualitas SDM rendah. Keadaan ini memotivasi direktur (sebagai inisiator) untuk mengubah budaya organisasi rumah sakit. Pelaksanaannya dengan memberikan pemahaman, penyadaran kepada seluruh karyawan yang dituangkan pada Visi, Misi, keyakinan dasar, nilai-nilai dasar, norma, artefak dan motto. Kemudian perubahan yang terjadi pada: 1) struktur pada status RS UPTD menjadi RS LTD oleh bupati dan DPRD, mengikuti standarisasi akreditasi, ISO, Pelayanan piala citra. 2) Teknologi pada SIM RS, system komunikasi, melakukan KSO peralatan. 3) Orang dengan meningkatkan kualitas SDM. Dampak yang terjadi: 1) Peningkatan penghasilan rumah sakit pada tahun 1999 ke 2000 sangat fantastis dari 350-400 juta menjadi 1,6 milyar setahun, 2) Peningkatan penghasilan karyawan secara signifikan. Pengawasan: adanya auditor, kredensial, penyegaran budaya organisasi secara berkala. Dampak perubahan keseluruhan adalah meningkatnya kualitas pelayanan dan tanpa terganggunya kualitas pelayanan setelah terjadi dua kali penggantian pimpinan rumah sakit. Tipe budaya organisasi yang dianut saat ini di BRSU Tabanan adalah tipe budaya organisasi terbuka. Saran, perubahan pasti akan selalu terjadi diharapkan BRSU Tabanan dapat mengendalikan perubahan itu kearah lebih baik tanpa henti baik fisik maupun non fisik. Badan Rumah Sakit Umum (General Hospital Board= BRSU) Tabanan-Bali had changed in many aspects of organization since 2002. These changes had a significant impact on the way to give further services, increasing the number of patients’ visit and staff welfare. These changes, in general, had changed the hospital image. Objective of the study was to analyze the process of hospital organizational culture change (basic assumption, value system, norm, and artifact) on structure, technology, and person aspects through the transformation steps (refreezing, freezing,and unfreezing). This was an observational, qualita tive study. Data were collected through in- depth interview, documentary collection, and direct observation. Studysubjects consisted of four hospital managers (top and middle) as main informants, three functional staffs (physician and nurses) as triangulation informants. Results of the study showed that, at the beginning, there were differences on BRSU organization. The differences included basic assumptions, value system, norm, and artifact. Status of the BRSU was UPTD; and this BRSU had minimal technology, fraudulence revenue in every unit, and low quality of staffs. These situations motivated hospital director (as an initiator) to change hospital organization culture. Implementation of the change was to give understanding and awareness to all hospital staffs through giving vision and mission of the hospital, basic trust,orms,artifacts, and motto. Changes included 1) change of hospital status by District leader and district house of representative, from UPTD to LTD. This change was conducted according to accreditation standard, ISO, and Citra cup service; 2) change on hospital information system (SIM-RS), communication system, and conducting KSO of instruments; 3) change of the quality of hospital human resource. Impact of the changes included 1)increase in 1999-2000 hospital revenue from 350-400 million rupiahs to 1.6 billion rupiahs, 2)significant increase on the staffs’ wages. Supervision was conducted by the presence of an auditors, credential, and periodic refreshment of organizational culture. Impact of the whole changes was improvement of service quality. In addition, no service quality disruption was found after twice changes of hospital directors. The current type of organizational culture in BRSU Tabanan was an open organizational culture type. Suggestion: changes will certainly occur, and BRSU Tabanan is xpected to continuously control the changes towards the better, physically and non-physically