Service Agencies Research Articles

EFFECTIVENESS OF THE ROLE OF THE HOSPITAL BLU SUPERVISORY BOARD DURING THE COVID-19 PANDEMIC

<p>The Covid-19 pandemic has significantly impacted the performance of Public Service Agencies (BLU), particularly hospital BLUs, contributing to the global economic crisis. This study examines the effectiveness of Hospital BLU Supervisory Board roles during the Covid-19 pandemic and their impact on hospital performance. Using a mixed-method approach, this research analyzed data from 208 respondents (134 supervisory board members and 74 BLU managers) through Likert-scale questionnaires and conducted in-depth interviews with 8 supervisory board members. Results indicate that the role of the Supervisory Board during the Covid-19 pandemic experienced increased intensity and a shift in focus. However, uneven understanding of existing governance necessitates routine activities for improving the Supervisory Board's role, including redesigning the appointment process. The study found that board effectiveness was influenced by member competency, governance understanding, communication quality, and collaborative leadership development.</p>

Design and Framework of a Technology-Based Closed-Loop Referral Project for Care Coordination of Social Determinants of Health.

Screening for social determinants of health (SDOH) has been mandated by health systems nationwide. However, a gap exists in closed-loop referral for care coordination between health care and social services. This article presents the framework of a technology-based project to facilitate closed-loop referral between health care and social service agencies in Greater Houston by leveraging and connecting the existing care coordination technology infrastructure. Ten health care and social service organizations in Greater Houston participated in the demonstration project initiated in January 2023. The authors leveraged and linked regional health information exchange (HIE) technology with a master patient index of >18 million, and sector-specific care coordination platforms to build closed-loop referral capacity between HIE-participating health care organizations and social service organizations to meet patient SDOH needs. Evaluation efforts will assess the reach, adoption, implementation, and the effectiveness of the closed-loop framework in improving social and health outcomes. The framework comprised the following 4 components: (1) establishment of collaborative governance for shared decision-making processes, fostering trust, alignment, and transparency among organizations; (2) development of technology linkages between existing platforms to facilitate seamless referrals between organizations and ensure visibility of referral outcomes; (3) integration of regional resource directories into technology infrastructure to ensure resource accessibility/quality; and (4) evaluation of the system's impact on health equity, efficiency, and cost reduction. This project aimed to close the loop for care coordination between health care and social service agencies, enable data evaluation to determine care coordination effectiveness, and lay the foundation for SDOH-related research/practice equitably.

Prehospital Trauma Compendium: Fluid Resuscitation in Trauma– a position statement and resource document of NAEMSP

ABSTRACT Fluid resuscitation choices in prehospital trauma care are limited, with most Emergency Medical Services (EMS) agencies only having access to crystalloids. Which solution to use, how much to administer, and judging the individual risks and benefits of giving or withholding fluids remains an area of uncertainty. To address the role of crystalloid fluids in prehospital trauma care, we reviewed the available relevant literature and developed recommendations to guide clinical care. The topic of prehospital blood product administration is covered elsewhere. NAEMSP recommends: Isotonic crystalloid solutions should be the preferred fluids for use in prehospital trauma management. Specific choice of isotonic crystalloid solutions may be driven by medication compatibility and other operational issues. Permissive hypotension is reasonable in patients without traumatic brain injury (TBI). Avoiding or correcting hypotension in polytrauma patients with TBI may be a higher priority than restricting fluid use. Large volume crystalloid resuscitation should be generally avoided. Developing processes to administer warmed intravenous (IV) fluids is reasonable. • Risks of IV fluid use, or restriction, in trauma resuscitation should be weighed against possible benefits. • Strategies to reduce the need for IV fluids should be considered. • A standard trauma resuscitation curriculum for prehospital providers should be developed to improve evidence-based delivery of IV fluids in trauma.

Enhancing Prehospital Decision-Making: Exploring User Needs and Design Considerations for Clinical Decision Support Systems.

In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have found to cause workflow disruptions and usability issues. Therefore, it is critical to investigate how to design CDSS that meet the needs of prehospital providers while accounting for the unique characteristics of prehospital workflows. We conducted semi-structured interviews with 20 prehospital providers recruited from four emergency medical services (EMS) agencies in an urban area in the northeastern U.S. The interviews focused on the decision-making challenges faced by prehospital providers, their technological needs for decision support, and key considerations for the design and implementation of a CDSS that can seamlessly integrate into prehospital care workflows. The data were analyzed using content analysis to identify common themes. Our qualitative study identified several challenges in prehospital decision-making, including limited access to diagnostic tools, insufficient experience with certain critical patient conditions, and a lack of cognitive support. Participants highlighted several desired features to make CDSS more effective in the dynamic, hands-busy, and cognitively demanding prehospital context, such as automatic prompts for possible patient conditions and treatment options, alerts for critical patient safety events, AI-powered medication identification, and easy retrieval of protocols and guidelines using voice commands. Key considerations for successful CDSS adoption included prioritizing alerts to reduce alert fatigue and workflow disruptions, facilitating real-time data collection and documentation to enable decision generation, and ensuring trust and accountability while preventing over-reliance when using CDSS. This study provides empirical insights into the challenges prehospital providers face and offers design recommendations for developing CDSS solutions that align with prehospital workflows.

Internet Devices and Internet Access Among Migrant and Seasonal Farmworkers, North Carolina, 2023.

Migrant and seasonal farmworkers work in rural areas where internet access may be limited. We assessed internet access, cost of access, and devices available to farmworkers through a statewide survey in North Carolina. During the 2023 agricultural season, we surveyed 1034 migrant and seasonal farmworkers during routine outreach visits in partnership with community health workers employed by 8 community health centers or by nonprofit health service agencies serving farmworkers in North Carolina. We surveyed participants aged ≥18 years by using time-venue sampling and surveyed up to 5 farmworkers at migrant housing locations. We weighted participants to the total population of farmworkers living in surveyed housing and calculated frequencies and percentages of internet access, internet speed, internet cost, available internet devices, and awareness and use of the Affordable Connectivity Program-a program that was run from 2021 through May 31, 2024, by the Federal Communications Commission to make internet access more affordable in the United States. We assessed predictors of internet access and ability to use online videos by using regression models. Participants were predominantly Spanish-speaking men who lived in housing provided by farm owners. Among participants, 9.8% had internet connections with a cable or digital subscriber line, and 23.5% did not have consistent internet access. Most participants used cellular network internet (84.9%) and mobile phone devices (93.9%). Even among farmworkers who lived in their housing year-round, few had heard of (34.4%), applied to (4.8%), or used (2.0%) the Affordable Connectivity Program. Interventions are needed to increase internet access and digital inclusion for migrant and seasonal farmworkers in North Carolina. Development of state and county broadband infrastructure should consider farmworker housing.

Interaction of customs and law enforcement agencies in the issues of combating smuggling

The article deals with the search for ways to combine the efforts of customs and law enforcement agencies in the fight against illegal attempts to move goods, objects or substances across the customs border of a country. The concept and basic principles of law enforcement activities are studied, as well as the criteria for inclusion in such a system. By analyzing the powers of a number ofstate bodies, the author has compiled a list of law enforcement agencies involved in the fight against smuggling. It is emphasized that customs authorities today can be fully attributed to law enforcement agencies. Approaches to understanding the interaction of law enforcement agencies, its principles and directions of implementation are considered in detail. The author critically assesses the absence of a legal act regulating the procedure for interaction of bodies in in the fight against crime. While there is definitely a need for this, although the issues of interaction are locally outlined in special laws on individual state (law enforcement) agencies. It is recognized that modern regulation of issues of interaction between law enforcement agencies, and their list should be updated in the light of the reforms of such bodies, and must necessarily include customs authorities. It is emphasized that the problem of duplication of tasks and functions, chasing indicators and creating the illusion of an active fight against crime, has been relevant for more than two decades. Despite changes in legislation, liquidation or reorganization of previous bodies and the creation of new ones, renewal of personnel and units, the lack of clear delineation of powers of law enforcement agencies, and sometimes of law enforcement agencies, and sometimes dual competence or departmental ambitions, lead to a distortion of the actual picture of the organization of countering smuggling. The author outlines certain risks of interference with the organization and implementation of customs control that arise from a destructive perception of interaction. The institutional capacity of customs authorities as a lever is considered for improving the mechanism of interaction between the State Customs Service and law enforcement agencies. The author substantiates the expediency of including operational units to the list of subjects of operational and investigative activities. The author additionally argues that the prospect of granting customs authorities to conduct pre-trial investigations, and it is proposed to to delimit the powers of the authorities conducting it, for which purpose to determine the jurisdiction of the crime of “Smuggling of goods” for the bodies of the State Customs Service of Ukraine.

A Transaction Cost Approach to Policy-Mandated Collaborations: Evidence from North Carolina

ABSTRACT In human services domains, policymakers mandate formal collaborations and alliances between public service agencies as part of policy implementation. We examine mandated child welfare collaborations in a stratified random sample of North Carolina counties, finding that agencies experienced frictions associated with collaboration fatigue and unclear goals. Access to private information, the ability to combine collaborations, and even serving lunch were conduits for successful collaboration. Agencies that did not engage faced high costs and saw little marginal benefit. We argue that policymakers looking to improve collaboration should communicate the value propositions to the agencies involved. They should also fund lunch.

Self-Sufficiency of Survivors of Intimate Partner Violence: Evaluating the Effectiveness of a Legal Service Agency Primarily Serving Latino Immigrants

This quantitative study examined the effectiveness of the services provided by a legal advocacy agency for survivors of intimate partner violence (IPV), with a primary focus on Latino immigrants. Data was collected from 335 clients at multiple service points. Mixed Linear Models were used to model the growth of self-sufficiency in 13 life domains measured by the Arizona Self-Sufficiency Matrix. Findings revealed that clients improved the most in the areas of housing, family/social relation, and childcare. Clients struggled most with job readiness, employment, income, and food. Primary language and age were significant predictors for self-sufficiency. Older non-English-speaking clients were significantly less self-sufficient than younger English-speaking clients. The study underscores the effectiveness of an interdisciplinary approach to assisting IPV survivors that combines legal and social services for ethnic minority and undocumented immigrants. Further research should employ an experimental design to better understand the unique contributions of legal services in fostering self-sufficiency among IPV survivors.

The Effect of Compensation on Job Satisfaction of Regional Public Service Agency (BLUD) Nurses and Organizational Citizenship Behavior (OCB) at RSUD Bayu Asih Purwakarta

Introduction: Organizational Citizenship Behavior (OCB) is the behavior of employees that goes beyond their formal obligations, is very important in supporting organizational performance. Good job satisfaction is often associated with increased OCB, while compensation is a key factor in influencing employee job satisfaction. This study was conducted at RSUD Bayu Asih Purwakarta, especially for BLUD nurses, to determine the effect of compensation on job satisfaction and its impact on OCB. Objective: This study aims to analyze the effect of compensation on job satisfaction and Organizational Citizenship Behavior (OCB) in BLUD nurses at RSUD Bayu Asih Purwakarta. Methods: This study used quantitative methods with a cross-sectional approach. The study was conducted from March-September 2024. Data were collected from 76 BLUD nurses at RSUD Bayu Asih Purwakarta through questionnaires. Analysis of research data using univariate analysis explains the characteristics of variables, while bivariate analysis examines the influence between variables using chi-square. This study uses path analysis to test the causal relationship between variables that have been determined bivariate. Data processing was carried out with the SPSS version 25 statistical program. Results: The results showed that there was a significant influence between compensation and nurses' job satisfaction, indicated by a p-value of 0.001 (<0.05). In addition, compensation also has a significant influence on the application of OCB with a p-value of 0.005 (<0.05). The effect of job satisfaction on OCB is also significant with a p-value of 0.000 (<0.05). The contribution of the effect of compensation on job satisfaction and its impact on OCB is 43.9%, indicating the important role of job satisfaction as a mediator in this relationship. Conclusion: Adequate compensation can increase nurses' job satisfaction and Organizational Citizenship Behavior (OCB). Hospital management needs to increase compensation and improve supervisor-subordinate relationships to foster job satisfaction, so that voluntary behaviors such as OCB can develop, improving overall organizational performance.

Abstract 4137878: Trends in Survival After Out-of-Hospital Cardiac Arrest Across Community Demographics Since the COVID-19 Pandemic

Background: The COVID-19 pandemic in 2020 was marked by a sharp decrease in out-of-hospital cardiac arrest (OHCA) survival. Whether OHCA survival has recovered to pre-pandemic levels, and whether changes in OHCA survival are similar across communities of different racial and ethnic composition, is unknown. Methods: We included adult patients with non-traumatic OHCA from 2015-2022 in the Cardiac Arrest Registry to Enhance Survival registry. Using hierarchical multivariable regression, we calculated risk-adjusted rates of survival to hospital discharge during 2015-2019 (reference period) and compared this to survival rates during 2020, 2021, and 2022. We also examined whether the trajectory of survival over this period differed based on the racial/ethnic composition of the community served by the emergency medical service (EMS) agency, defined as predominantly White (>80% White residents), majority Black or Hispanic (>50% Black or Hispanic residents), or integrated (neither). Results: Of 485,079 patients with OHCA, mean age was 61.9 years; 64% were male, and 22% were of Black race with 7% of Hispanic ethnicity. Overall, risk-adjusted survival rates to hospital discharge for OHCA decreased from 10.1% in 2015-2019 to 8.4% in 2020 (P<0.0001). The relative decrease was similar at EMS agencies serving predominantly Black and Hispanic communities (-17.2%) as compared to predominantly White (-17.5%) or integrated communities (-16.8%). Risk-adjusted survival rates recovered partially in 2021 (8.7%) and 2022 (8.9%) but remained below the pre-pandemic period. As of 2022, OHCA survival in majority Black and Hispanic communities was still 9.7% lower, as compared to pre-pandemic years, whereas it was 10.9% lower in integrated communities and 13.6% lower in predominately White communities. Moreover, the survival disparity for OHCAs in Black/Hispanic vs. White communities narrowed to 0.4% (8.4% vs. 8.8%) in 2022, as compared to 1.0% (9.3% vs. 10.3%) prior to the pandemic. Conclusions: OHCA survival has improved in the U.S. since the initial pandemic year of 2020, but remains lower than the pre-pandemic years. The survival disparity for OHCAs occurring in majority Black and Hispanic relative to predominately White communities decreased since 2020, although absolute survival remained lower in majority Black and Hispanic communities throughout the study period.

Flood Risk Assessment and Its Implications on Critical Infrastructure Resilience in Nigeria

Flooding is one of the recurrent natural disasters in Nigeria that poses huge threats to not just people but also critical infrastructures. In 2024, the Federal Ministry of Water Resources and Sanitation and the Nigeria Hydrological Services Agency (NIHSA) identified 31 states including the FCT as high-risk areas for significant flood impacts. The impact of floods generally has caused devastating damage to critical infrastructures resulting from high rain intensities for a long duration. It becomes pertinent to evaluate the impact of floods on critical infrastructures like roads, bridges, residential buildings, water supply systems, and electricity facilities. Thus, this research seeks to explore the vulnerabilities and impacts of floods on critical infrastructure which is fundamental to economic growth, development, and coping mechanisms. A structured questionnaire was distributed among a sample of 90 including government department, construction industry, and community members to seek their views on the vulnerability risk of infrastructure and flood sources. Results indicate that most of the damages reported 42% were due to the destruction of roads and bridges, followed by residential houses at 31%. The main cause of flooding identified by 54% of respondents was poor drainage systems, while 31% cited poor waste management as a contributing issue. Hence, restoration of the drainage systems, implementation of prohibitions on encroachment of flood-prone areas and improvement of early warning systems are critical and pressing. The uniqueness of the study lies in its effort to address the gaps and challenges that exist in infrastructure resilience by identifying the most critical elements that are prone to risks and proposing mitigation measures against floods in the urban centers of Nigeria which are experiencing rapid growth.

Using the five-factor questionnaire to study the personality of a specialist-cynologist of the security agencies of the Russian Federation

The article presents the results of using the Russian-language version of the “Big Five” personality questionnaire, in which personality is considered as a structure consisting of 5 factors, including many secondary factors. The subject of the study are psychological characteristics of the personality of dog handlers of law enforcement agencies of the Russian Federation (hereinafter referred to as RF) at various stages of professionalisation. The author emphasises the relevance of studying and further psychological support of the professional development of dog handlers, with consideration to the fact that specifics of their service and professional activities in order to ensure the security of the country have no analogues and are unique. The results of a focused interview with experienced dog handlers with extensive experience in service cynology have formed the basis for constructing a psychograph for a specialist in the profile in question. Using the “Big Five” methodology, it is possible to identify the characteristic features of cadets studying in the field of training “Animal Science”, profile “Cynology”, and employees of canine services of the law enforcement agencies of the RF. The author correlates the results obtained and notes the correspondence of the psychological qualities of both groups of respondents to the professionally oriented qualities presented in the psychograph of a specialist dog handler of the law enforcement agencies of the RF. The five-factor questionnaire adapted by A.B. Khromov adequately describes the psychological characteristics of an individual and can be used in the study of various aspects of its professional development.

Enhancing Public Service Delivery through Digital Transformation: A Study on the Role of E-Government in Modern Public Administration

Digital transformation has become a crucial element in improving the quality of public service delivery, particularly through the implementation of e-government. This study aims to analyze the role of e-government in enhancing the effectiveness and efficiency of modern public administration. Using a qualitative research method through literature analysis and in-depth interviews with government employees across several public service agencies in Indonesia, this study explores the benefits and challenges faced in the implementation of e-government. The findings indicate that e-government significantly contributes to expediting public service processes, increasing transparency, and minimizing potential corruption and abuse of power. Furthermore, e-government enables more effective interagency collaboration through integrated information systems, positively impacting operational efficiency. However, the study also identifies obstacles to the adoption of e-government, such as limited digital infrastructure, resistance from government officials, and the digital divide in society, which can reduce its effectiveness. This study concludes that e-government can serve as a strategic instrument for public administration reform if supported by infrastructure improvements, human resource training, and increased public digital literacy. Consequently, e-government not only enhances the quality of public services but also strengthens accountability and public trust in the government. The study’s recommendations include strategies to improve information technology capacity, formulate policies that support digital transformation, and raise awareness and public participation in utilizing digital government services.

Integrating community health workers into HIV care clinics: a qualitative study with health system leaders and clinicians in the Southern United States

BackgroundCommunity health workers (CHWs) can support patient engagement in care for a variety of health conditions, including HIV. This paper reports on the experiences of HIV clinics and health departments that integrated CHWs into their health systems as part of a capacity-building initiative to address HIV-related disparities in the United States.MethodsSemi-structured interviews were conducted with key informants (n = 14) in two Ryan White HIV/AIDS program jurisdictions: Mississippi (jurisdiction covers the entire state) and the city of New Orleans, Louisiana. This work was part of a larger evaluation of an initiative that used a Learning Collaborative model to facilitate the implementation of evidence-informed interventions to address HIV care continuum gaps in four jurisdictions. The two jurisdictions that focused on integrating CHWs into HIV care clinics and support service agencies were selected for this sub-analysis. Interview participants included HIV clinic leaders and staff, health department leaders, and other Learning Collaborative leaders. Interview transcripts were coded and analyzed for themes related to the acceptability, feasibility, and perceived impact of CHW integration.ResultsOverall, participants expressed interest in having support from CHWs at HIV clinics and service agencies to assist with patient retention and engagement efforts. However, there were challenges integrating CHWs into existing systems (e.g., gaining access to electronic health records, changing policies to conduct home visits, and clarifying roles and scope of work). Negotiating contracts and accessing funding for CHW positions presented major challenges that often contributed to turnover and conflicts around scope of practice. When health departments leveraged existing funding streams to support CHW positions, the clinics and agencies where the CHWs worked had limited flexibility over the hiring process.ConclusionsOur findings reinforce the value and acceptability of CHWs as part of the workforce in HIV clinical and support service settings; however, integrating CHWs into clinics and service agencies required effort. Training the CHWs was not sufficient; other staff and clinicians had to understand the role of CHWs to facilitate their integration into health systems. Resources are needed to support organizations in incorporating CHWs effectively, and long-term, flexible sources of funding are necessary for these positions.

Serving Innovation: Exploring Patent Agency Service Networks in China

ABSTRACTPatent agency services are crucial for the codification of technical knowledge and inventions. Drawing on an inter‐firm network analysis of the patent agency service relationships between patent agencies and their innovation clients during the last two decades in China, this paper seeks to explore the structure of urban patent agency service networks and how it is shaped by China's unique institutional and market forces. The study found that although the patent agency service network generally follows the basic structure of China's innovative and economic landscapes, it is still deeply shaped by China's unique intellectual property institutions, administrative hierarchy factors, market forces driven by patent agency service demand, and multidimensional proximities in a complex manner. Analyzing how these factors function should be related to the characteristics of patent agencies and the actors of networks. The study will help us understand how city patent service networks might be shaped by institutional and spatial factors, and provide new evidence on how cities are interlinked within patent agency service networks.

Implementation of the Indonesian Food and Drug Authority Agency's (BPOM) Health Service Policy on the Sale of Non- Prescribed Prescription Drugs at Pharmacies in Makassar

Implementation of the Indonesian Food and Drug Authority Agency's (BPOM) Health Service Policy on the Sale of Non- Prescribed Prescription Drugs at Pharmacies in Makassar

Association of the distance travelled, and the call to hospital arrival time with early neonatal mortality in neonates born to mothers using emergency medical services at term gestation: a retrospective observational study

BackgroundMost neonatal deaths in India occur due to a lack of timely and proper care just before and during delivery. Timely availability of an ambulance for institutional delivery has led...

A qualitative exploration of the client-provider relationship and its role in discussing sexual health and HIV among African American women in the US South

ObjectiveSexually transmitted infections (STIs), including HIV, are a key contributor to psychological and physical morbidity across the United States (US). African American (AA) women are disproportionately impacted by STIs, particularly in the Deep South of the US. Strong patient-provider communication can help to increase client understanding of STI prevention and treatment options. This study aimed to explore factors influencing effective patient-provider relationships and communication around STIs (including HIV) and sexual health broadly, which will ultimately inform the refinement of a patient-provider communication tool for discussing PrEP as an HIV prevention method. MethodsAs part of a larger study focused on PrEP implementation, in-depth, semi-structured qualitative interviews were conducted among cisgender AA women who are PrEP-eligible, both with and without PrEP experience, as well as providers from three federally qualified health centers (FQHCs) and HIV service agencies in Alabama. Data were analyzed using content analysis. ResultsA total of 41 participants enrolled, including 21 clients (n = 6 PrEP experienced; n = 15 PrEP naïve) and 20 providers. Qualitative data were organized across the following domains: meaning of health and sexual health, factors influencing the client-provider relationship, and factors influencing sexual health discussions among clients and providers. Key factors influencing client-provider relationships were organized at client, provider, and clinic levels. Factors impacting sexual health discussions between clients and providers were organized at client, provider, and structural levels. ConclusionThese interviews identified key determinants of effective client-provider communication pertaining to sexual health among cisgender AA women in the US South who were receiving care at FQHCs and HIV service organizations. Individual, provider, and clinic-level factors were identified that have implications for designing sexual health interventions for cisgender AA women.

Implementation of Risk Management in Asset Management Governance Towards Optimizing Asset Utilization at Public Service Agency State Universities (Case Study of UPN Veteran Yogyakarta)

This study aims to analyze the application of risk management in asset governance at UPN Veteran Yogyakarta to achieve optimal asset utilization. As a Public Service Agency State University (PTN-BLU), UPN Veteran Yogyakarta faces various challenges in asset management, including budget constraints, lack of consistent monitoring, and the unavailability of formal risk evaluation standards. Qualitative descriptive research methods are used to gain in-depth understanding through interviews with asset managers and field observations. The results show that the implementation of risk management can have a significant impact on the efficiency of budget allocation, which includes more appropriate budget distribution based on priority needs and risks. Risk management also has the potential to extend the useful life of assets, with risk mitigation measures taken on assets that show signs of wear or early damage, thus preventing major repair costs due to serious damage. This research highlights that a technology-based monitoring system is an indispensable aspect to support the effectiveness of risk management in asset management. The implementation of structured risk assessment procedures helps in determining asset maintenance priorities, so that the assets that are most critical to the sustainability of campus operations receive greater attention. With the implementation of this comprehensive risk management, optimization of asset utilization can be achieved, which in turn supports the stability and sustainability of UPN Veteran Yogyakarta's operations as a quality higher education institution.

Performance Analysis of Higher Education Public Service Agencies: A Case Study of the Indonesian Civil Pilot Academy Banyuwangi

A Public Service Agency, known by the Indonesian nomenclature as Badan Layanan Umum (BLU), is a government institution with the autonomy to manage its finances effectively and efficiently and provide public services. BLU is crucial for delivering essential services in Indonesia, including specialized education in the transportation sector. Despite their significance, BLU institutions like the Indonesian Civil Pilot Academy Banyuwangi face operational inefficiencies, financial constraints, and human resource challenges that hinder organizational performance. This study investigates these challenges, focusing on how financial management, human resource issues, and operational inefficiencies affect educational outcomes. The research employed a qualitative case study approach using semi-structured interviews, document analysis, and field observations. Data were collected from key stakeholders, including students, lecturers, and staff, to assess organizational performance in the educational process, human resource management, and general operations. Findings reveal that while facilities and educator engagement have improved, issues such as lecturer absenteeism, student input quality, and the need for continuous staff training persist. This study contributes to the body of knowledge by demonstrating the critical role of Total Quality Management (TQM) and Cross-Functional Integration (CFI) in improving public service agency performance. The research offers practical recommendations for enhancing lecturer performance, refining student admissions, and developing powerful individuals through sustainable training. This expectation can give Public Service Agency management an outlook for increasing performance organization and support mission, as well as the Agency of Human Resources Development (BPSDM) on Transportation vision.