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Arlina Dewi
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Ruang Jurnal JMMR, Gedung Pascasarjana Universitas Muhammadiyah Yogyakarta, Brawijaya Street, Tamantirto, Kasihan, Bantul, D.I. Yogyakarta, Indonesia
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JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit)
Published by Universitas Muhammadiyah Yogyakarta
ISSN : 20882831     EISSN : 25416715     DOI : https://doi.org/10.18196/jmmr
Core Subject : Economy, Health,
Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Nursing Public Health
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) focuses on the research and research review related to hospital management that is relevant to the development of the theory and practice of hospital management in Indonesia and Southeast Asia. Focus on hospital management (but not limited) to hospital services such as primary health care, laboratory, pharmacy, and radiology. JMMR covered various research approaches, namely: quantitative, qualitative, and mixed-method. JMMR focuses on various themes, topics, and aspects of accounting and investment, including (but not limited) to the following topics: Hospital Management, Hospital Accounting, Health Services Management, Health Insurance, Health Policy, Community Health Center, Medicine, Nursing, Pharmacy, Information Technology Health Services, Health Law and Ethics.
Arjuna Subject : Umum - Umum
Articles 352 Documents
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Feasibility Study of a Competency-Based Performance Assessment Instrument for General Practitioners Samdani, Annisa Fasichatul Laila; Arini, Merita; Basha, Muzaitul Akma Binti Mustapa Kamal
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i1.717

Abstract

An objective and standardized performance evaluation instrument is essential to ensure that general practitioners deliver services in accordance with professional competency standards. This study aims to evaluate the feasibility of a competency-based performance assessment instrument using the Analysis–Design–Develop (ADD) model and multiple regression analysis. The regression model met all classical statistical assumptions. Emphasizing the overall model rather than partial effects, the results demonstrated a significant overall feasibility of the instrument (F = 8.115; p < 0.05) when integrating the six competency domains: patient care, medical/clinical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice were confirmed as feasible components of the instrument. These findings indicate that the instrument is appropriate for use in healthcare facilities and can support a comprehensive and objective evaluation of general practitioner performance.
Service Logistics and Workflow Optimization in the Radiology Department: A CT-Scan Case Study at PKU Muhammadiyah Hospital, Indonesia Ruliyandari, Rochana; Tukiyo, Intan Wahyuni; Andrianty, Athika Ayu; Kuncara, Evrin Isna Nur; Kusumawati, Renita
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i1.708

Abstract

This research examined service logistics and workflow efficiency in the CT-Scan department at PKU Muhammadiyah Hospital, Yogyakarta. As demand for diagnostic imaging increases, this study aimed to describe the distribution of CT examinations by examination type, gender, and age group, and to map workflow patterns within the radiology service process. This study used a retrospective descriptive design to analyze CT scan records of 110 patients in April 2025. Simple Head CT scans represented 75.4% of exams, mostly for neurological disorders. Male patients accounted for 50.9% of the population, and 30% were aged 66–75. These statistics describe the radiology department's patient distribution and CT service use during the research. These findings may provide foundational data for the planning of radiology service capacity and resource distribution. Further research is required to assess operational performance metrics and workflow efficiency in radiology services across various hospital environments.
Exploring the Factors Associated with Discharge Before Noon at Universitas Indonesia Hospital in 2024 Shalawa, Radhica El; Basabih, Masyitoh; Sari, Erna Puspita
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.558

Abstract

Only 20% of inpatients at Universitas Indonesia Hospital (RSUI) were discharged before noon (12:00 PM) in 2024, indicating that the hospital has not yet achieved its early discharge target (70%). While early discharge is recognized as a quality indicator, limited evidence exists on the factors influencing discharge timeliness in teaching hospitals. This study aimed to identify factors associated with inpatient discharge before noon at Universitas Indonesia Hospital. A retrospective design was employed using secondary data from the Hospital Information System for the period January-December 2024. Data were analyzed using univariate analysis, bivariate chi-square tests, and multivariate logistic regression. Six variables were significantly associated with discharge timing: discharge planning, treatment type, patient age, financial coverage, length of stay, and discharge day. These findings underscore the importance of strengthening discharge planning, optimizing clinical and administrative workflows, and enhancing interdepartmental coordination. Managerial contributions were also emphasized, particularly the optimization of the Hospital Information System (HIS), inter-unit coordination, and the implementation of strategies such as early physician orders, morning rounds, standardized discharge checklists, effective communication, and staff training. Further research should examine additional factors, including human resource availability and the involvement of medical students, which are unique to teaching hospitals.
Strategic Roles and Influencing Factors of Hybrid Clinicians: A Scoping Review Afwan, Ofadhani; Sundari, Sri
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.629

Abstract

Clinician involvement in management is crucial to align managerial decision-making with patient-centered care; however, unresolved challenges in hybrid roles often lead to role conflict and ethical dilemmas. Despite governance reforms that support clinical leadership, evidence integrating physicians and nurses in hybrid clinician-manager roles remains limited. This study addressed this gap by applying a three-domain framework to systematically explain the factors shaping the effectiveness of hybrid clinician-manager roles. This scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). Two databases (SCOPUS and PubMed) were systematically searched from 01.01.2015 to 26.02.2025. A total of 21 papers were included. We found that hybrid clinicians perform key strategic roles in improving patient safety, care quality, interprofessional collaboration, and organizational efficiency. Their effectiveness was shaped by three interrelated factors: background and professional identity, influencing legitimacy and authority; motivation, encompassing both aspirational and reluctant engagement; and role enactment, including position and hierarchy. Hybrid managers possess clinical legitimacy and cultural capital that enhance frontline engagement while enabling them to bridge clinical realities and organizational strategy, thereby effectively linking policy with practice and increasing their value to healthcare institutions. Furthermore, lack of formal training and persistent role conflict emerged as common barriers. In conclusion, hybrid roles enhanced hospital performance when clinical expertise, intrinsic motivation, and organizational support were aligned. Strengthening leadership development, clarifying role expectations, and addressing structural hierarchies could improve the sustainability and strategic impact of hybrid clinician leadership.
From Voices to Quality Metrics: Leveraging Patient Conversation Analysis and Speech Recognition for Timely Hospital Service Quality Management in a Hospital Outpatient Setting Sundari, Sri; Purbohadi, Dwijoko; Robani, Anidah
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.694

Abstract

Hospitals today face growing pressure to evaluate service quality in ways that go beyond what conventional surveys can offer. Patient satisfaction questionnaires remain widely used, yet their dependence on retrospective recall means that problems are often identified long after they occur, if at all. This study set out to explore whether patient conversation data, captured via passive audio recording and processed by speech recognition, could serve as a near-real-time source of service quality indicators in a hospital setting. An exploratory observational approach was taken at a private type C hospital in the Special Region of Yogyakarta. Recordings were gathered from public service areas. After processing and cleaning, the dataset contained 47,223 textual units, with 7,368 unique words and 22,329 meaningful phrases. The analysis drew on frequency counting, thematic categorisation, sentiment orientation, and linguistic diversity mapping. Waiting time and queuing issues dominated the data, with 'queue' appearing 317 times and 'waiting' 276 times. BPJS-related topics appeared 155 times, referral problems 114 times. Negative expressions outnumbered positive ones. Conversation volume peaked at 07.00-09.00 (40% of all recorded activity). The findings suggest that routinely recorded patient conversations, when processed systematically, may serve as a practical complement to conventional satisfaction surveys, showing promise for supporting more timely and evidence-grounded decisions in hospital service management.
Transforming Orthopedic Services at a National Referral Hospital: Expertise, Technology, and Policy Sumarwoto, Tito; Sari, Ayi Wagiati; Rizai, Ahmad; Pamela, Dina Sintia; Idulhaq, Mujaddid; Romaniyanto, Romaniyanto
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.702

Abstract

This study describes the strategic transformation of Prof. Dr. R. Soeharso Orthopedic Hospital, Indonesia’s national orthopedic referral center, using a five‑pillar framework: subspecialty development, advanced technologies, infrastructure and rehabilitation, alignment with national health priorities, and structured monitoring. A mixed-methods case study design was employed, integrating qualitative thematic analysis of institutional and policy documents with longitudinal quantitative analysis of performance data spanning 2019–2025. Institutional documents and national policy sources were analyzed thematically and benchmarked against leading international orthopedic hospitals. Service indicators showed substantial growth after the COVID‑19 downturn: total outpatients increased by 54.5% (89,705 to 138,604), surgical procedures by 157.9% (4,661 to 12,024), and hospitalizations by 106.7% (5,014 to 10,365). Bed occupancy recovered to 68.0%, while average length of stay declined from 4.81 to 3.74 days, indicating improved efficiency. Subspecialty outpatient volume rose 358%, with spine and adult reconstruction services showing the fastest growth. Transformation milestones included 100% EMR implementation across 24 clinical units, six dedicated subspecialty operating theatres, SNARS accreditation, and formal designation as a Main Provider Teaching Hospital in 2024. The framework offers a context‑specific, replicable model for orthopedic service transformation in low‑ and middle‑income countries.
Administrative Involvement and Patient Safety in Indonesian Class C Hospitals: Testing Communication, Initiative, and Participation as Mechanisms Nurhasanah, Nurhasanah; Rustam, Junaidy Suparman
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.729

Abstract

Non-clinical contributions to patient safety have received increasing attention in healthcare systems; however, empirical evidence regarding specific administrative mechanisms associated with patient safety remains limited, particularly in Class C hospitals. This study examined how administrative involvement and its mechanisms relate to patient safety in Class C hospitals. A quantitative cross-sectional study was conducted in June–August 2025 in five public and private Class C hospitals in Samarinda, Indonesia. Seventy-six administrative officers were selected using proportional sampling. Data were collected using a structured 74-item questionnaire measuring administrative involvement, communication, initiative, participation, and perceived patient safety outcomes, and were analyzed using PLS-SEM (SmartPLS 4.0). The measurement model showed acceptable reliability and convergent validity (composite reliability: 0.802–0.910; AVE: 0.558–0.659; Cronbach’s alpha: 0.763–0.881). Structural model results indicated significant positive associations with patient safety for administrative involvement (β=0.642; t=10.760; p<0.001), communication (β=0.377; t=7.820; p<0.001), initiative (β=0.221; t=2.720; p=0.007), and participation (β=0.186; t=2.330; p=0.021). The model demonstrated moderate explanatory power, accounting for 41.2% of the variance in patient safety outcomes (R²=0.412), with strong predictive relevance (Q²=0.416). These findings suggest that strengthening administrative involvement, supported by effective communication, proactive initiatives, and participatory practices, is associated with better patient safety in resource-limited hospital settings.
Impact of Tuberculosis Care Pathways on Healthcare Costs and Quality of Nursing Care: A Systematic Review Wibowo, Ahmad Eko; Ardiana, Anisah; Rifai, Ahmad; Hamid, Siti Hazariah Binti Abdul
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.748

Abstract

Tuberculosis (TB) remains a major global public health challenge due to prolonged treatment, substantial healthcare costs, and the need for consistent, high-quality nursing care. Tuberculosis care pathways have been developed to standardize care delivery, improve multidisciplinary coordination, and optimize resource utilization. However, evidence simultaneously evaluating their effects on healthcare costs and nursing care quality remains limited. This systematic review aimed to synthesize evidence on the impact of tuberculosis care pathways on healthcare costs and nursing care quality. A systematic review was conducted in accordance with the PRISMA 2020 Statement. PubMed, ScienceDirect, and Google Scholar were searched for studies published between January 2020 and January 2025. Eligible studies evaluated tuberculosis care pathways and reported healthcare cost, nursing care quality, or both outcomes. Methodological quality was assessed using design-specific appraisal tools, including the Joanna Briggs Institute Critical Appraisal Checklists, Mixed Methods Appraisal Tool, and CHEERS 2022 checklist. Due to methodological heterogeneity, findings were synthesized narratively. Eleven studies met the inclusion criteria. Seven studies (63.6%) assessed healthcare costs, five (45.5%) evaluated nursing care quality, and two (18.2%) examined both. Care pathways were associated with reduced healthcare costs, shorter hospital stays, improved resource utilization, standardized nursing practice, stronger multidisciplinary collaboration, and enhanced continuity of patient-centered care. Overall, all studies demonstrated moderate-to-high methodological quality.
The Effectiveness of An Internet of Things (IoT)-Based Smart Safety Band in Reducing Fall Risk Among Hospitalized Patients Wulandari, Riyani; Nurhayati, Asti; Muhlizardy, Muhlizardy; Suwannaphant, Kritkantorn
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.751

Abstract

This study aims to evaluate the effectiveness of an Internet of Things (IoT)-based Smart Safety Band in reducing fall risk among hospitalized patients, using a validated fall risk assessment tool rather than Early Warning Score (EWS) as the primary outcome measure, as EWS is an indicator of physiological deterioration and not a direct measure of fall risk. A quasi-experimental pretest-posttest control group design was employed over one month. Fifty hospitalized patients with hypertension were assigned to either an intervention group (n=25) that used the Smart Safety Band or a control group (n=25) that received standard care. Fall risk was measured using a validated fall risk scale, while EWS was used solely for routine physiological monitoring. Data were analyzed using Mann-Whitney and Wilcoxon signed-rank tests. The results showed that the Smart Safety Band intervention significantly reduced fall risk scores compared to the control group (p < 0.000), with the intervention group demonstrating a considerably lower mean rank and a 44% reduction in fall rates among high-risk patients. The IoT-based Smart Safety Band is effective at reducing fall risk among hospitalized patients. In contrast, EWS remains an indicator of physiological deterioration and should not be misinterpreted as a direct measure of fall risk. Further research is recommended to validate these findings across broader populations. Ethical approval was granted by the Health Research Ethics Committee of Universitas Aisyiyah Yogyakarta (No. 3786/KEP-UNISA/X/2024).
Forensic Medicine in Domestic Violence: Global Research Trends and Case-Processing Timelines in Surakarta, Indonesia Suwandono, Adji; Azaria, Graseldis Diandra; Wiyono, Nanang; Argaheni, Niken Bayu; Perestroika, Grhasta Dian
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 15 No. 2 (2026): August 2026
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v15i2.755

Abstract

Domestic violence is a criminal offense with important medico-legal implications. Forensic medical documentation supports the evidentiary process, and in Indonesia, Visum et Repertum (VeR) is recognized as documentary evidence under criminal procedure law. However, evidence on case-processing duration in domestic violence cases involving VeR remains limited. This study aimed to map global research trends in forensic medicine related to domestic violence and describe case-processing duration from VeR issuance to the first court hearing at the Surakarta District Court. A multimethod design was employed, comprising bibliometric analysis of Scopus-indexed publications from 1975 to 2025 and descriptive cross-sectional analysis of 21 domestic violence court decisions issued between 2015 and 2025. The bibliometric analysis identified 416 publications, with a historical peak in 1985 and relatively stable output over the last decade. The United States, India, and the United Kingdom were the leading contributors. Keyword co-occurrence analysis identified four thematic clusters: domestic violence, forensic medicine, child and infant injuries, and sexual violence. Case-processing duration ranged from 56 to 354 days, with a mean of 205.81 days (SD = 90.49). Nineteen cases (90.5%) exceeded 90 days, while two cases (9.5%) were processed within 60 days. Prolonged pre-trial case processing was common. Further research should examine procedural and institutional factors and the role of medico-legal evidence in criminal justice processes.

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