The role of the medical committee in hospital clinical governance in Jambi province

Abstract

Latar Belakang: Tata kelola klinis bertujuan untuk memastikan bahwa layanan kesehatan berjalan sesuai dengan standar keamanan yang tinggi dan kualitas berkelanjutan. Komite Medis bertanggung jawab untuk pelaksanaan tata kelola klinis yang baik di rumah sakit. Penelitian ini bertujuan untuk mengetahui peran Komite Medik dalam tata kelola klinis rumah sakit di era Jaminan Kesehatan Nasional (JKN) pada RS Umum Daerah (RSUD) di Provinsi Jambi. 
 Metode: Desain penelitian bersifat kualitatif. Pengumpulan data dari Agustus hingga Desember 2016 di tiga RSUD kelas C di Provinsi Jambi dan mencakup 23 informan yang diambil melalui wawancara mendalam dan Focus Group Discussion. 
 Hasil: Hasil penelitian menunjukkan bahwa Komite Medik belum berperan optimal dalam proses kredensialing, pemeliharaan mutu profesi dan penjagaan disiplin/etika profesi. Tugas dan fungsi kredensialing di beberapa rumah sakit belum berjalan sebagaimana mestinya (karena digunakan untuk persyaratan penerimaan dokter baru, tetapi tidak untuk menyaring kompetensi dokter), terkesan formalitas, serta sulit dilakukan karena belum memiliki Mitra Bestari. Kebijakan Jaminan Kesehatan Nasional memberi pengaruh baik terhadap peran komite medik dalam tata kelola klinis RS, karena terdapat beberapa regulasi atau peraturan pelaksana tentang JKN yang terintegrasi dengan peran komite medik, khususnya pada aspek kendali mutu kendali biaya. 
 Kesimpulan: Dapat disimpulkan Komite Medik secara umum belum berperan optimal dalam tata kelola klinis pada RSUD Kelas C di Provinsi Jambi. Oleh karena itu, rumah sakit perlu meningkatkan kompetensi, etika dan disiplin profesi medik, serta penyempurnaan regulasi terpadu terkait tata kelola klinis di rumah sakit. 
 Kata kunci: komite medik, tata kelola klinis, RS, Jaminan Kesehatan Nasional.
 Abstract
 Background: Clinical governance aims to ensure that health services run according to high safety standards and ongoing quality. The medical committee is responsible for the implementation of good clinical governance of the hospital. This study aims to analyze the role of the medical committee in the clinical governance of hospitals in the era of National Health Insurance (JKN). 
 Methods: The research design is qualitative. Data collection spans from August to December 2016 in three hospitals in Jambi Province and includes 23 informants who were observed throughout in-depth interviews and focus group discussions. 
 Results: The results show that the medical committee has not played an optimal role in the process of credentialing, maintaining professional quality, and guarding the discipline/professional ethics of the hospital. The duties and functions of credentials in some hospitals are not working properly (because used to apply to new doctor admission requirements, but not as to screen the competence of doctors), seem excessively formal and difficult to implement because they do not have Mitra Bestari yet. JKN policy has a good influence on the role of the medical committee in the clinical governance of the hospital, as there are several regulations that are integrated with the role of the medical committee, especially in the areas of quality control and cost control. 
 Conclusion: It can be concluded that the medical committee in general has not played an optimal role in the clinical governance of hospitals in Jambi Province. Therefore, it is necessary to improve the competence, ethics, and discipline of the medical profession in addition to integrating regulations related to clinical governance in hospitals. 
 Keywords : Medical committee, clinical governance