PENGELOLAAN SUKARELAWAN DI LEMBAGA SWADAYA MASYARAKAT BIDANG KESEHATAN (STUDI KASUS) YAYASAN KANKER INDONESIA CABANG DAERAH ISTIMEWA YOGYAKARTA

INTISARINurhasni Yoisangadji1, Fatwa Sari Tetra Dewi2, Lutfan Lazuardi3Latar Belakang: Di negara berkembang sekitar 25 juta orang mengidap kanker. Apabila dilakukan pengobatan dan terapi secara teratur dapat menekan pertumbuhan penyakit kanker. Untuk itu, dibutuhkan program untuk masyarakat yaitu kegiatan pencegahan seperti: skrining, deteksi dini, pengobatan dan perawatan paliatif secara menyeluruh, serta pemeriksaan lanjutan pasca sembuh. Yayasan Kanker Indonesia (YKI) Cabang Daerah Istimewa Yogyakarta adalah organisasi nirlaba bersifat sosial dan kemanusiaan di bidang kesehatan serta merupakan organisasi yang mengkhususkan diri untuk menanggulangi kanker. YKI bertujuan mengupayakan penanggulangan kanker dengan menyelenggarakan kegiatan di bidang promotif, preventif, dan supportif. Sesuai dengan visi YKI yaitu PEDULI yang merupakan singkatan dari pertama, PErhatian bahwa masalah kanker bukan hanya masalah individu atau keluarga yang terkena kanker saja. Kedua, memberikan DUkungan baik moral dan material sesuai dengan kemampuan dan kapasitasnya. Ketiga, memberikan LIndungan agar mereka yang terkena kanker merasa terayomi sehingga timbul semangat diri untuk mencari solusi terbaik dalam rangka pengobatan maupun peningkatan kualitas hidup penderita kanker.Tujuan Penelitian: untuk menganalisa pengelolaan sukarelawan pada lembaga swadaya masyarakat di YKI Cabang DIY.Metode Penelitian: Penelitian ini merupakan penelitian deskriptif kualitatif dengan menggunakan studi kasus (case study). Penelitian ini menggunakan metode sampling purposif (purposive sampling), yaitu teknik pengambilan sampel sumber data dengan pertimbangan tertentu. Dalam penelitian ini, peneliti menggali informasi dari beberapa informan. Subjek penelitian yaitu, 2 orang pengurus aktif YKI Cabang DIY dan 6 orang relawan aktif yaitu: 3 orang survivor, 3 Orang non survivor.Hasil: Pengorganisasian kegiatan relawan di Yayasan Kanker Indonesia Cabang DIY selama ini sudah diatur dan ditetapkan dalam rapat pleno, yang diselenggarakan setiap tahun dalam 5 tahun masa kepengurusan. Setiap divisi dalam kepengurusan melakukan evaluasi terhadap program kerja yang tidak terlaksana dalam setahun, serta mengajukan perencanaan program kerja dalam satu tahun kedepan. Pengkoordinasian tata kelola kerja relawan di YKI Cabang DIY, terhadap para relawan dikoordinir langsung oleh pengurus yayasan. Relawan dilibatkan secara langsung dalam semua kegiatan, hal ini dilakukan agar dapat terjalin kerjasama dan hubungan baik antara pengurus YKI Cabang DIY dengan relawan. Ketersediaan relawan di YKI Cabang DIY sampai saat ini berdasarkan penelitian sangat kurang. Walaupun demikian semua kegiatan yang melibatkan relawan dapat terlaksana. Hal ini disebabkan oleh motivasi yang tinggi yang dimiliki oleh relawan.Kesimpulan: Relawan yang memiliki latar belakang pengalaman sebagai survivor sangat penting dan efektif dalam melakukan pendampingan.Kata Kunci: Pengelolaan relawan, LSM, Pengorganisasian, Yayasan Kanker Indonesia 1Dinas Kesehatan Kabupaten Kepualauan Sula, Propinsi Maluku Utara.2Kepala Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Gadjah Mada.3Sistem Informasi Manajemen Kesehatan, Program Pascasarjana Fakultas Kedokteran Universitas Gadjah Mada.

UPAYA MANAJEMEN RUMAH SAKIT DALAM MENDUKUNG KOLABORASI ANTARA DOKTER UMUM DAN SPESIALIS DI INSTALASI GAWAT DARURAT

Background: General practitioners play a major role in runningthe service in the emergency department. As members ofthe team, general practitioners often disagree with specialistdoctors. Problems in communication and coordination oftenhave an impact on the poor service. They even have legalconsequences for the hospital.Objective: This study identified problems of collaboration betweengeneral practitioners and specialists in the managementof patients in the emergency unit, factors that impede thecollaborative process and evaluated efforts of hospital managementin supporting the collaborative process.Methods: This descriptive and exploratory study obtaineddata from in-depth interviews, official documents and routing,as well as participant observation and field observations.Results: General practitioners and specialists have a poorworking relationship that can be coined the legal consequencesin the management of patients in the emergency unit. Individualfactors such as a lack of confidence in the competence ofspecialist physicians, social closeness, the arrogance of specialiststo general practitioners, incomplete standards of carein the emergency unit, and physician adherence to hospitalpolicies and regulations are all obstacles in implementing cooperationteamwork in the emergency unit. The hospital management,on the other hand, takes a losing position in thepresence of doctors. Hospital management failed to prioritizethe development and the implementation of hospital bylawsthat control poor professional coordination and communication.The hospital management still has problems in contractsystem with the doctor, the procedures in the recruitment process,debriefing doctor, and the standard of care in the emergencyunit. This situation becomes more complicated with theexistence of blaming culture, no informal meetings betweendoctors, tacit practices in the supervision and guidance of themedical staff, as well as management’s lack of assertivenessoffenses committed by doctors on hospital policies and regulations.Conclusion: This study shows that general practitioners andmedical specialists fail to understand the legal consequencesof poor cooperation in emergency services. If a hospital managerdevelop and enforce the hospital bylaws relevant to situationalproblems in emergency care, reluctance and barrierscollaboration between physicians, personal issues, and professionalbias in medical practice would no longer a source ofpoor team performance. Hospital managers should enforcetheir hospital bylaws to control personal and professional arrogance.Keywords: Collaboration between GP and specialists, hospitalmanagement, emergency unit

BIAYA SATUAN POLIKLINIK IBU DAN ANAK SEBAGAI USULAN PENETAPAN SUBSIDI DI RUMAH SAKIT IBU DAN ANAK

Background: Funding is a very important aspect to improvequality of services and sustainability. The calculation per unitof service at the hospital is required to determine the amountof subsidy from the government.Aim: To calculate of unit cost and operating cost subsidiesand to explore stakeholder opinions toward the calculation inmaternal and child hospital, Government of Aceh.Method: The study used a descriptive case study design.Data processing referred to the calculation of unit cost byusing Activity Based Costing (ABC) through two steps of directtracing and driver tracing.Results: The average cost of direct cost is Rp13.616,00. andthe driver cost is Rp2.421,00 and the unit cost is Rp20.046,00.The highest unit cost is Rp38.343,00 for implant removalservice. The total subsidy required by this hospital in 2012amounted to Rp1.019.946.211,00.Conclusion: Costs produced per unit of service are greaterthan tariff. Stakeholders strongly support the calculation ofunit costs and will use the information for proposing subsidyto the Government of Aceh.Keywords: unit cost, activity based costing, subsidie

LAMA WAKTU YANG DIHABISKAN PASIEN DI UGD RSPAU dr. S. HARDJOLUKITO DAERAH ISTIMEWA YOGYAKARTA

Latar Belakang: Salah satu keluhan pasien yang paling sering muncul adalah lama waktu yang dihabiskan pasien di unit gawat darurat setelah mereka mendapatkan penanganan pertama. Pasien harus menunggu sebelum mereka bisa pulang, atau dipindahkan ke bangsal perawatan, ke ICU atau menjalani operasi. RSPAU Dr Suhardi Hardjolukito adalah RS tipe B dengan kapasitas 215 tempat tidur. Tujuan: untuk mengukur lama waktu yang dihabiskan pasien di UGD dan menganalisis faktor-faktor yang mempengaruhi lama waktu tunggu tersebut. Metode: Ini adalah penelitian observasional dengan rancangan cross-sectional. Penelitian dilakukan di unit gawat darurat RSPAU Dr Suhardi Hardjolukito, yang memiliki kapasitas 15 tempat tidur, pada bulan November 2014. Observasi dilakukan selama 7 hari pada shift pagi, sore, dan malam. Sejumlah 305 pasien menjadi sampel penelitian dan diamati selama pasien berada di UGD. Hasil: Rata-rata waktu perawatan di UGD RSPAU dr.S.Hardjolukito masih sangat bervariasi, berkisar antara 8 s/d 270 menit (4.5 jam). Tahapan pelayanan yang memiliki waktu tunggu paling lama adalah pelayanan di laboratorium dan radiologi. Sementara karakteristik kunjungan yang paling besar pengaruhnya terhadap lama pelayanan di UGD adalah kunjungan pada hari kerja, jenis kelamin pasien perempuan, diagnosis emergency, dan waktu kunjungan pagi hari.  Kesimpulan dan Rekomendasi: Waktu yang dihabiskan pasien di UGD RSPAU dr.S.Hardjolukito sangat bervariasi. Banyak penyebab waktu tunggu tersebut sebenarnya tidak penting dan bisa dicegah. Rumah sakit harus mengurangi kepadatan UGD pada waktu-waktu sibuk dengan meningkatkan efisiensi RS, memperbaiki alur pasien, dan menggunakan metode maajemen operasional dan teknologi informasi

PENGARUH INTERVENSI DISKUSI KELOMPOK KECIL DISERTAI UMPAN BALIK TERHADAP PERENCANAAN KEBUTUHAN OBAT DI RUMAH SAKIT UMUM DAERAH TIDAR KOTA MAGELANG

Background: In order to increase health service to people toobtain healing and restore health, very influencing factor issufficient drug need planning, either for its type and amount.Problem faced in Magelang Tidar Hospital is excessive drugand low appropriate drug requirement plan (<100%). Thisresearch to increase appropriate drug need planning inMagelang Tidar Hospital in 2013.Method: This research used quasi experiment research designwith pretest-posttest design. It used indicator of drug needplanning as output before and after FGD intervention.Results: 1) Average drug suitability with formulary for regularin before and after FGD intervention are 82.2% and 84.1%, forASKES in before and after intervention are 95.1% and 97.5%,and for Jamkesmas in before and after FGD intervention are64.7% and 81.8%. 2) Average drug appropriateness withDOEN 2011 for regular in before and after FGD interventionare 65.6% and 72.8%, for ASKES in before and af terintervention are 66.6% and 69.1% and for Jamkesmas beforeand after FGD intervention are 68.7% and 71.1%. 3) Drug fundallocation has reached 100% of available fund. (4) Percentageof drug item amount in planning and real drug item in usage forregular drug before and after FGD intervention are 124.6%and 241.7%, for ASKES in before and after intervention are185.5% and 265.2%, and for Jamkesmas in before and afterFGD intervention are 220.5% and 399.8%. (5) Percentage ofplanning appropriateness for regular drug before and afterFGD intervention are 40.1% and 10.4%, for ASKES in beforeand after intervention are 13.5% and 4.9%, and for Jamkesmasin before and after FGD intervention are 13.8% and 4.5%.Conclusion: FGD intervention with feedback can increasesome appropriateness indicator of drug need planning inMagelang Tidar Hospital such as drug suitability with formularyindicator and drug suitability to DOEN indicator. Fund allocationindicted that required fund have accorded to available fund.Percentage of drug item amount in planning and in real usageis increase and percentage of planning appropriateness isdecreased due to excessive drug budget.Keywords: FGD intervention, drug need planning, MagelangTidar Hospita

Penilaian Kinerja Dokter Sebagai Dasar Sistem Remunerasi di RSUD dr.Soehadi Prijonegoro Sragen

Penelitian dengan metode Action Research untuk mendapatkan kesepakatan mekanisme penilaian kinerja dokter dalam rangka pembagian jasa pelayanan JKN di RSUD dr.Soehadi Prijonegoro Sragen.Mekanisme Penilaian kinerja ini dapat digunakan sebagai dasar sistem remunerasi dokter

AUDIT OF ELECTRICAL ENERGY IN AIR CONDITIONING AND LIGHTING EFFORTS ON ENERGY EFFICIENCY IN SURAKARTA ISLAMIC HOSPITAL

Background: The hospital has a high level of dependency on energy requirements in carrying out operational activities. The tendency of increasing energy costs and the entry into force of the National Health Insurance Program since January 1st, 2014, bringing the consequences of the need for reforms in terms of efficiency. Implementation of energy efficiency are still many obstacles encountered due to costly and has not performed an energy audit. Energy audit is one way to determine whether the intensity level of energy consumption in the category of wasteful or inefficient. By using energy more efficiently can reduce operating costs so that hospitals become more productive and competitive.In this study, energy conservation is focused on the use of air conditioning and lights because it is still possible to do control the use, not to use energy-saving technologies, not including the category of vital equipment.Objective: To evaluate the use of air conditioning energy and lights in Surakarta Islamic Hospital.Methods: This study used a descriptive case study research design using problem solving. The instrument of this research is in-depth interview guide and observation guide.Results and Discussion: The need for operational electrical energy supplied from PLN as the primary source. There is one panel, the power factor is less than standard. Energy Consumption Intensity values in Surakarta Islamic Hospital is 12.3 kWh/m²/month, Standard Operating Procedures and policies governing energy management is not complete and has not been completely understood, the communication between the parts has not been going well, the pattern of air conditioning treatments is less done well, schedule treatment has been carried out but with limited human resources and incomplete document control card. Logistics division can  work optimally.Conclusions and Recommendations: Energy Consumption Intensity is 12.3 kWh/m²/month, relatively efficient, can be optimized by replacing to Inverter AC and replacing the lamps into LED lights. Energy efficiency targets will be implemented if supported by policies and Standard Operating Procedures, the availability of human resources, trained staff, prevention efforts with preventive maintenance. Keywords: Hospital, Energy Consumption Intensity, Inverter AC, LED, energy efficiency

MINAT PENGGUNAAN PERANGKAT LUNAK PENGHITUNGAN BIAYA STANDAR PELAYANAN MINIMAL KABUPATEN/KOTA

Background: The Indonesian Ministry of Health developed adistrict essential health package (EHP) costing software in2009. However, this has not yet been utilized due to poordissemination. It is necessary to conduct a study evaluatingthe opinion of health professionals towards intention to usethis software and ensure its usefulnessAim: This paper aims to assess user acceptance of districtEHP costing software by integrating Technology AcceptanceModel (TAM) and End User Computing (EUC) satisfaction.Method: A descriptive study was used. A total of 139respondents were involved in this study. They were policymakers and budget analysts of EHP in district health offices,and also primary health care workers and district hospitalworkers in all districts of Yogyakarta. Data were collected toassess the perceived usefulness, ease of use, content, format,accuracy, timeliness, attitude toward use and behavioralintention to use. Path diagram analysis was conducted.Result: The study showed that the respondents have theintention to use the EHP software. Usefulness and satisfactionhad the greatest positive influence on higher intention to useEHP costing software and were found to be statisticallysignificant, (0.29 and 0.22 respectively). Both the usefulnessand ease of use had positive influence on attitudes, (0.45 and0.23 respectively). Ease of use, content, accuracy andtimeliness gave a positive effect to satisfaction.Conclusion: Intention to use the EHP costing software wasmostly driven by perceived usefulness and satisfaction.Adequate human resources and hardware need to be in placefor its implementation.Keywords: essential health package, costing software,intention to us

HUBUNGAN PENERAPAN SISTEM MANAJEMEN KESELAMATAN DAN KESEHATAN KERJA DENGAN MOTIVASI KERJA DAN STRES KERJA PADA PERAWAT DI RSU ANUTAPURA PALU

Latar Belakang : Sistem manajemen keselamatan dan kesehatan kerja harus diterapkan di semua tempat kerja termasuk rumah sakit yang mempunyai resiko besar terjadinya kecelakaan kerja dan penyakit akibat kerja. Kecelakaan kerja yang terjadi pada petugas kesehatan di pengaruhi oleh beberapa faktor, Faktor penyebab sering terjadi karena kurangnya kesadaran pekerja dan kualitas serta keterampilan pekerja yang kurang memadai, serta rendahnya motivasi tenaga kerja yang berbanding lurus dengan tingginya tingkat stres kerja pada petugas kesehatan. Tujuan : untuk menganalisis hubungan antara penerapan SMK3 dengan motivasi kerja dan stres kerja. Metode Penelitian : penelitian ini merupakan penelitian korelatif yang dijalankan dengan metode survei yang menggunakan rancangan cross-sectional. Hasil Penelitian : (1) Hasil korelasi Pearson Product Moment menunjukkan bahwa Terdapat hubungan yang sangat lemah dan tidak signifikan antara penerapan SMK3 dengan motivasi kerja pada perawat di rumah sakit umum Anutapura Palu (P= 0,0412; R=0,092); (2) Hasil korelasi Pearson Product Moment menunjukkan bahwa Terdapat hubungan yang sangat lemah dan signifikan antara penerapan SMK3 dengan stres kerja pada perawat di rumah sakit umum Anutapura Palu (P=0,0919; R=0,011 Kesimpulan : (1) Terdapat hubungan yang sangat lemah dan tidak signifikan antara penerapan SMK3 dengan motivasi kerja pada perawat di rumah sakit umum Anutapura Palu; (2) Terdapat hubungan yang sangat lemah dan signifikan antara penerapan SMK3 dengan stres kerja pada perawat di rumah sakit umum Anutapura PaluKata Kunci : SMK3 , Motivasi Kerja, Stres Kerj

ANALISIS BESARAN BIAYA KAPITASI DAN PREMI BERDASARKAN BIAYA KLAIM DAN UTILISASI JPK PT JAMSOSTEK DIY

Introduction: Debate on the issue of contributory SocialSecurity Agency (BPJS) for health have yielded disappointingresults. The majority of workers wanting health insurancedues BPJS as lowHowever, the premium that is too lowresulting in payments to health care provider also low. Theamount of the payment of low will affect the quality of servicesand satisf action participants over a health care benefitprogram.Methods: This study is a descriptive research design with acase study involving two data sources, primary and secondarydata. Primary data obtained through interviews and secondarydata obtained from reports the DIY branch office PT.Jamsostek.Results: Based on data of claim costs and utilization of service:In 2008, capitation Rp1.876,00 PMPM and premium Rp11.070,00;in 2009, capitation Rp1.973,00 PMPM and premium Rp11.085,00;in 2010, capitation Rp2.398,00 PMPM and premium Rp13.425,00;in 2011, capitation Rp2.403,00 PMPM and premium Rp14.921,00;in 2012, capitation Rp3.416,00 PMPM and premium Rp15.923,00.Perceptions of the family physician capitation date suggeststhat capitation received lower with the services they have toprovided.Conclusion: The capitation and premium is calculated usingdata cost of claims and the utilization of its value lower thanstandard the capitation and premiums set on PT Jamtsostekbranch DIY and PT Askes. The results of calculation of cost acapitation is also lower than the amount of capitation andpremium on the implementation of the National Health Insurance(JKN) in 2014 who sets capitation Rp8.000,00 to Rp10,000,00PMPM. Need of further studies concerning the benefit serviceclinic 24 hours in effect in jamsostek; an absence of adjustmentbetween magnitudes payment the capitation with the openservice and performance the doctors family.Keywords: capitation, premium, family physician perception