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Fakultas Kedokteran Universitas Brawijaya Gedung Graha Medika Lt. 1, Ruang 104
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INDONESIA
Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
Medicine & Pharmacology
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 23 Documents
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Search results for , issue "Article in Press" : 23 Documents clear
Are Segmenting, Targeting, and Positioning Necessary for Strategic Marketing? Amira, Hisan; Fitriasari, Nikma
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Changes in the hospital environment have led to an increasingly competitive market. Marketing strategies are vital ingredients to offer more creative, innovative, and valuable products to customers to compete with other hospitals. Hyperbaric Oxygen Teraphy (HBOT) installation is one of the superrior service at  Paru Hospital Jember which have a low number of visit for the last three years. Segmenting, targeting, and positioning (STP) strategies will help to identify the most profitable market, which can be used to create the right connection to customers. This research aimed to arrange STP strategies as a base for the hospital strategic marketing plan at Hyperbaric Oxygen Therapy (HBOT) installation of Paru Hospital Jember. This research was a descriptive study. The root of the problems was identified using the urgency, seriousness and growth (USG) method and followed by identifying the problem solutions with the capability, accessible, readiness and leverage (CARL) method before finding the solutions. The results of this study show that the five geographic segmentation areas of the target market are Jember, Probolinggo, Lumajang, Bondowoso, and Banyuwangi. The targets are patients older than five years old, middle-high economic class people, patients with diabetic foot, Buerger's disease, and sudden deafness. The new tagline “Tabik” stands for “Instalasi Hiperbarik,” and the new motto “Jadikan hidup lebih baik bersama Tabik” is a positioning made for STP strategies. Ten-year projection showed a gap visit number as many as 1.958 patients with STP as a strategic marketing plan in HBOT Installation Paru Hospital Jember. The implementation of the marketing mix is one tool to reach the gap. Implementation of the promotion is the first element of the marketing mix to complete to reach number of visits gap. 
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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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.
Increased Response Time and Triage Accuracy with Resetting of Systems and Spatial in a Hospital Emergency Room Hapsari, Riandiani Dwi
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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The triage system in the emergency room is crucial for categorizing patients based on the level of emergency and finding out further medical services for the patients. An accurate triage system will accelerate the IGD response time and result in better ER quality. The purpose of this study was to determine the factors influencing the accuracy of the triage location in the Emergency Room of a type C hospital as well as the relationship between the activation of the triage area and the emergency response time. The sample consisted of 30 patients before and 30 patients after the activation of the triage area. According to the priority level, the sample was then divided into ten patients each. This research used field experimental design with a Participatory Action Research approach. The results showed that the accuracy of the triage implementation in the Emergency Room of this hospital was influenced by the facilities and infrastructure, human resources, and the flow of patients in the emergency room. Based on the Wilcoxon test, there is an increase in P1 and P3 patient response time before and after triage activation but not significant. The increase in response time in P2 patients before and after the activation of the triage area is significant with p-value <0.046. This study concludes that the right triage system can increase emergency response time.
Professional Care Providers Instruction: Does It Reduce Postoperative Fever Rate? Pramudya, Indradi; Youandi, Abdi Agus; Indriani, Wiwin
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Postoperative fever is a fever that occurs after surgery and might develop among children, adults, and the elderly indirectly related to the type of surgery. Surgical site infection (SSI) is the most common cause of postoperative fever. However, it is common that the specific causes of fever are not found or without any signs of infection. This study aimed to determine the cause of postoperative fever and its intervention plan. This research was a case study at X Hospital in September to October 2019 initiated by identifying the root of the problem, identifying the priority of the root problem, and planning the intervention. The results of the identification of the root of the problems found that fever occurred less than 24 hours postoperatively. The results of the root problem identification revealed no SOP that regulates the Professional Care Providers (PCP) to give instructions to patients if there is a delay in the operating schedule. The proposed intervention plan is to make regulations regarding service delay instructions. Postoperative fever less that is than 24 hours causes patient discomfort due to the absence of instructions from the PCP if there is a delay in the operating schedule. The establishment of the regulations is a solution to reduce the incidence of postoperative fever.Keywords: postoperative fever, operation delay, regulation
Supervision as a Solution to Improve Hand Hygiene Compliance Ayu, Jennyla Puspitaning
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Hand hygiene is an act to prevent and control infections, one of which is nosocomial phlebitis infection. The results of a preliminary study conducted at Syuhada Haji Hospital Blitar showed the number of phlebitis cases had not reached the target of ≤1.5% (1.63% in December 2018). One of the reasons was hand hygiene non-compliance. This study intended to analyze the factors causing non-compliance with hand hygiene in Syuhada Haji Hospital Blitar and find alternative solutions. This study was a case study conducted with observations on implementing nurses in five inpatient rooms and Focus Group Discussion (FGD) on five implementing nurses and eight management staff at Syuhada Haji Hospital Blitar. The main factor influencing compliance with hand hygiene at Syuhada Haji Hospital is that no supervision policy supports hand hygiene implementation, and the solution is supervision for monitoring hand hygiene compliance. Supervision is expected to increase compliance and awareness of the importance of hand hygiene; thus, in turn, affect the service quality.
Exploring the Factors explaining Length of Stay at Emergency Department: Study in a C Class Private Hospital Amalia, Eta Riska
Jurnal Kedokteran Brawijaya Article in Press
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ABSTRACTThe process of admitting patients to the inpatient wardfrom the emergency room is of the factors that influence the access block time in services in the emergency room and hospitals. This study aimed to identify the cause of transition time to inpatient services from the emergency room at a private C class hospital in Malang. This research is a descriptive exploratory study using interviews withfour general practitioners, two emergency nurses, two general inpatient nurses, two children inpatient nurses, and one administrative staff, and also observation of the stages and duration of emergency services and inpatient care. The process from arrival, registration, and inspection takes 0-15 minutes. Overall, the stages of registration until the inpatient ward transfer require 1-3.5 hours, which exceeds the hospital quality standards. Factors that influence the transfer time are the condition of the patient, the absence of a transition room, the availability of inpatient wards, and the patient discharge process. To manage ER LOS, especially block access to inpatient services, hospitals need to apply Bed Management properly.  
Re-engineering Prescription Services as an Alternative Solution Indriastutik, Nunung; Fitriasari, Nikma; Rusdiana, Dina
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Medication errors could occur at any stage, including prescribing, transcribing, dispensing, and administration stages. Errors in the prescribing stage accounted for the most significant percentage, ranging from 70% to 99%. The most mistake at the prescribing stage is the illegible prescription. This situation causes high morbidity and mortality in hospitals. This study aimed to analyze the root of the problems of the incidence of illegible prescriptions and find anticipating strategies. This research is a descriptive study initiated by finding the root of the problems, followed by identifying alternative solutions and preparing priority solutions. From the analysis of the root of the problems, the illegible prescription included incomplete identity, drug name and the preparation, unclear usage, the error in assuming the writing in the prescription, and ineffective design of the prescription. The solution chosen was the improvement of prescription service flow (re-engineering) that added an identity labeling procedure to correct the error on patient's identity due to the repetition of manual writing and the addition of an authorization procedure by double-checking. The second solution was creating patient identity labels, creating appropriate prescription designs, and developing prescription service guidelines to support the implementation of prescription services re-engineering. This research concludes that the root of the problems on the illegible prescription is the absence of prescription service procedures that aim to anticipate medication errors. Hence, a re-engineering of prescription service needs to be prepared as an alternative solution
Frontliner: Does it play a role in reducing the waiting time of outpatient registration? Hapsari, Riva Redianita; Fitriasari, Nikma; Pratama, Bramantya Surya
Jurnal Kedokteran Brawijaya Article in Press
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Outpatient services often become the first gateway for patient access to hospital services. One of the minimum service standards for improving the quality of hospital services is collecting the medical record files in less than 10 minutes. This study aimed to prove whether the frontliners can help cut the process in the outpatient registration by revising the SOP and describing the outline of the outpatient service flow involving the frontliners at Ananda Srengat Hospital. The study applied quantitative analysis methods with a descriptive analysis technique to patients, medical records unit employees, outpatients, and related units. A total population of 10 people was taken within one week. The methods of collecting data were using a questionnaire instrument and a stopwatch. The results of this study are the changes in the SOP and the description of frontliner tasks in assisting the process of sorting files that can reduce the process of registration waiting time.
Re-Layout of Service Room to Overcome Waiting Time of Finished Drug Services in Outpatient Pharmacy of dr. Iskak General Hospital Tulungagung Yulianto, Wahyu; Sujianto, Sujianto; Hariyanti, Tita
Jurnal Kedokteran Brawijaya Article in Press
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ABSTRACT Background: The minimum standard waiting time for finished drug services in an outpatient pharmacy depot is less than 30 minutes. However, the implementation of standard waiting time for finished drug services at dr. Iskak General Hospital Tulungagung is still above the standard that is 69.83 minutes. This study aimed to analyze the factors causing the long waiting time for finished drug services in outpatient pharmacy and to find solutions to overcome the long waiting time.Methods:  This research used a qualitative method, and the data collection was carried out by observation, interviews, and focus group discussions (FGD).Results:  The observation results show that the actual time required to complete one prescription was 11 minutes and 50 seconds. The roots of the problem identified were the accumulation of prescriptions in the administration of the outpatient pharmacy depot, inefficient service layout, and low utilization of information technology. The results of the FGD illustrated the alternative solutions to the regulation of prescription arrival by setting the doctor schedule, the application of electronic prescriptions, and spatial arrangements for outpatient pharmacy depots.Conclution: This study concluded that ineffective service layout is a very influential factor in the waiting time for finished drug services in the pharmacy. Arrangement of the outpatient pharmacy service layout can reduce the waiting time for drug services into less than 30 minutes.Keywords: waiting time, focus group discussion, re-layout, pharmacy
Development of Caesarean Section Clinical Pathway : a lesson learnt Sastrawan, I Gede
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Clinical pathway is a crucial clinical management strategy aimed to ensure quality and cost. However, the development of clinical pathway at the hospital was mainly for administrative purpose as it is required by accreditation standards leading to high variation. Study aims to develop clinical pathway for caesarean section and explore the problem during development and initial implementation (simulation). The selection of caesarean section is based on its high volume, risk, and cost. Using participatory action research, the researcher started the program by performing literature review and regulation to proposed the first revised version draft. A group of relevant expert in the hospitals than discuss and proposed review, considering the available resources, current practice and behavior. The main differences of the new clinical pathway are: 1) it was developed based on literature and current practice, 2) adding notification, explanation, inclusion and exclusion criteria, and references.  Before initial implementation (simulation), the hospital also develop a procedure operational standards for the implementation, resources, and monitoring.  The first simulation on two cases found differences in type of medication and documentation method, which than further discussed with all care providers involved to define the agreed solution. Professional engagement and openness culture that embrace along the process are the main important key lesson learnt in addition to the understanding that clinical pathway development and implementation is a continuous learning process. Therefore continuous monitoring and evaluation is of paramount important to reach quality and efficiency, the ultimate goals of clinical pathway.

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