Performance Measurement of Comprehensive Emergency Neonatal Obstetric Servant (PONEK) in Dr. Moh. Hoesin Palembang with a Balanced Scorecard to Improve the Quality of Midwifery Services

Abstract

A B S T R A C TIntroduction Maternal Mortality Rate (MMR) and Neonatal Mortality Rate (IMR)in Indonesia are the highest among ASEAN countries, namely 307 / 100.000 livebirths for MMR and 20/1000 live births for IMR. This situation can actually beprevented through early detection approaches and appropriate management ofmothers and babies through the Comprehensive Obstetric Neonatal EmergencyServices (PONEK) program as one of the important elements of good hospitalservice performance. The performance of a hospital is of course determined by theperformance of each unit and team which requires relevant multi-dimensionalmeasurement standards. Basic Score Card (BSC) is a method developed byKaplan and Norton (1996) to measure performance comprehensively, so it ishoped that this method can help improve the quality of obstetric emergencyservices, especially in Palembang. Methods: This descriptive analytic study wasconducted at Dr. Mohammad Hoesin (RSMH) Palembang by looking for factorsthat affect the quality of emergency obstetric care and analyzing the performanceof the PONEK team in providing PONEK services. Primary data is obtainedthrough questionnaires with direct interviews with respondents or by directobservation in the field to see the real obstacles that occur during service. Thedata were analyzed qualitatively and quantitatively. Results: During the periodOctober 2014 - March 2015 there were 1219 total hospitalized patients. Based onthe Financial Perspective, the effectiveness ratio for achieving the performance ofthe RSMH PONEK team still meets the target of 1.3 for vaginal and has not metthe target of 0.5 for SC with a financial perspective score of +2. Based on theCustomer Perspective, the total score is +2 with the patient satisfaction index is5957 (satisfied) and the Gross Death Rate (GDR) figure for PONEK RSMH servicesis 14 (meets GDS MOH standards). Based on the Internal Business Perspectivethe total score is +1, with the level of compliance with the clinical pathwaystandard = 92%, the level of compliance for the National Fornas PONEK = 100%,while the response time is > 1 hour. Based on the perspective of learning andgrowth, the total score = +1, with the number of PONEK trained personnel <50%,neonatal resuscitation and lactation management <10%, employee workmotivation is very high, and facilities and infrastructure are classified as good.Based on these four perspectives, the BSC score for RSMH PONEK performanceis +0.6 with an interval scale of -1 to +1. Conclusion: Based on the BSCmeasurement results of the PONEK team at RSMH Palembang, it can beconcluded that the PONEK team's performance is good.