Analisis Penggunaan Survei HCAHPS (Hospital Consumers Assessment of Healthcare Providers and System) Mutu Pelayanan Rawat Inap Dari Perspektif Pasien di RSUD Sunan Kalijaga Demak

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2016 ABSTRAK Muhammad Akbar Analisis Penggunaan Survei HCAHPS (Hospital Consumers Assessment of Healthcare Providers and System) Mutu Pelayanan Rawat Inap Dari Perspektif Pasien di RSUD Sunan Kalijaga Demak xxi +81 halaman + tabel 34 + Gambar 4 + Lampiran 5 Penelitian ini menerapkan penggunaan HCAHPS (Hospital Consumers Assessment Healthcare Providers and Systems) untuk mengukur mutu pelayanan instalasi rawat inap dari perspektif pasien di RSUD Sunan Kalijaga Demak. HCAHPS adalah standar nasional pertama di Amerika yang digunakan untuk mengumpulkan informasi dari perspektif pasien tentang pengalaman pelayanan rawat inap. Desain penelitian yang digunakan yaitu observasional analitik dengan pendekatan cross sectional. Pengumpulan data dilakukan secara kuantitatif dengan wawancara kuesioner terstruktur menggunakan kuisoner HCAHPS. Data kuantitatif dianalisis dengan Confirmatory Factor Analysis (CFA) dengan mengunakan SPSS 20.0 Hasil survei HCAHPS menunjukkan komunikasi dengan perawat masih kurang baik (33,53%), komunikasi dengan dokter masih kurang baik (33,33%), daya tanggap rumah sakit sudah cukup baik (41,82%), manajemen nyeri sudah cukup baik (41,49%), komunikasi pengobatan masih kurang baik (40,39%), informasi sebelum pulang masih kurang baik (54,85%), transisi perawatan cukup baik (44,73%), kebersihan lingkungan rumah sakit baik (49,03%), ketenangan lingkungan rumah sakit baik (47,09%), rating rumah sakit 7-8 (59,4%), kesediaan merekomendasikan rumah sakit sepertinya ya (51,61%). Berdasarkan hasil perhitungan dengan SPSS dihasilkan nilai KMO (Kaiser-Meyer-Olkin) 0,511 (> 0,5) yang berarti kecukupan data telah terpenuhi untuk dilakukan analisis faktor. Hasil Bartlett’s test0,000 (α <0,05) yang berarti terdapat korelasi antar variabel multivariat. Hasil CFA menunjukkan bahwa dari 11 variabel yang diuji terdapat 4 variabel yang memiliki nilai MSA (Measure of Sampling Adequacy) < 0,5 sehingga dieliminasi dari pengujian, empat variabel tersebut yaitu variabel manajemen nyeri, informasi sebelum pulang, komunikasi pengobatan dan rating rumah sakit.Hasil uji CFA menunjukkan bahwa ketujuh variabel dapat menjelaskan HCAHPS dengan nilai communalities masing-masing variabel: kebersihan rumah sakit 92,3%, ketenangan rumah sakit 92,1%, komunikasi dengan perawat 66,9%, kesediaan merekomendasikan rumah sakit 66%, transisi perawatan 59,9%, daya tanggap staff rumah sakit 51,6%, komunikasi dengan dokter 50,3%. Berdasarkan hasil penelitan ini HCAHPS dapat diterapkan untuk mengukur mutu pelayanan instalasi rawat inap dari perspektif pasien di RSUD Sunan Kalijaga Demak, namun untuk hasil yang lebih baik diperlukan penyesuaian item-item pertanyaan sesuai dengan karakteristik pasien. Rating 7-8 yang diberikan oleh pasien hendaknya tidak membuat RSUD Sunan Kalijaga Demak merasa puas, masih harus dilakukan peningkatan pelayanan pada aspek komunikasi perawat, komunikasi dokter, komunikasi tentang pengobatan, serta informasi sebelum pulang (discharge planning). Kata kunci :HCAHPS (Hospital Consumers Assessment Providers and Systems), Mutu Pelayanan Rawat Inap, Confirmatory Factor Analysis (CFA). Kepustakaan : 46 (2003-2016) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2016 ABSTRACT Muhammad Akbar Analysis of using Hospital Consumers Assessment of Healthcare Providers and System (HCAHPS) Survey of Inpatient Service Quality from Patients’ Perspective at Sunan Kalijaga Public Hospital in Demak xxi + 81 pages + 34 tables + 4 figures + 5 appendices This study applied Hospital Consumers Assessment Healthcare Providers and Systems (HCAHPS) to measure quality of services at an inpatient unit from patients’ perspective at Sunan Kalijaga Public Hospital in Demak. HCAHPS is a first national standard in The United States that is used to collect information of experience at inpatient unit services from patients’ perspective. This was an observational-analytic study using cross sectional approach. Data were collected using a structured HCAHPS questionnaire and analysed using Confirmatory Factor Analysis (CFA) performed by SPSS v.20.0. The results of this research showed that communication with nurses was bad (33.53%), communication with physicians was bad (33.33%), a response of the hospital was fairly good (41.82%), pain management was fairly good (41.49%), communication of medication was bad (40.39%), information of discharge planning was bad (54.85%), transition of treatment was fairly good (44.73%), environmental hygiene of the hospital was good (49.03%), quietness of the hospital environment was good (47.09%), the hospital rating was 7-8 (59.4%), and willingness to recommend the hospital was yes (51.61%). Based on the calculation of SPSS demonstrated that Kaiser-Meyer-Olkin (KMO) value was 0.511 (>0.5). It means that data sufficiency had met to perform factor analysis. The result of Bartlett’s test was 0.000 (p<0.05). It means that there was any correlation between variables. The result of CFA showed that four of 11 analysed variables had Measurement of Sampling Adequacy (MSA) < 0.5. It means that those four variables were removed from the analysis. Those four variables consisted of pain management, information of discharge planning, communication of medication, and hospital rating. The result of CFA demonstrated that seven variables could explain HCSHPS with communalities value for each variable as follows: environmental hygiene of the hospital was 92.3%, quietness of the hospital was 92.1%, communication with nurse was 66.9%, willingness to recommend the hospital was 66%, transition of treatment was 59.9%, a response of the hospital’s staff was 51.6%, and communication with physician was 50.3%. HCAHPS could be applied to measure service quality of inpatient unit from patients’ perspective at Sunan Kalijaga Hospital in Demak. Notwithstanding, adjustment of questions in accordance with patients’ characteristics needed to be done to obtain better results. The hospital was expected not to feel satisfied even though patients provided rating 7-8. Some aspects like communication of nurse, communication of physician, communication of medication, and discharge planning need to be improved. Keywords: Hospital Consumers Assessment Healthcare Providers and Systems (HCAHPS); quality of inpatient services; Confirmatory Factor Analysis (CFA) Bibliography: 46 (2003-2016