Health Service Institutions Research Articles

Abstract C110: Mobile low dose computerized tomographic (LDCT) scanning program identifies pre-malignant lung cancer lesions in a Native American population: A study of Indian Health Service and Levine Cancer Institute

Abstract BACKGROUND: Native Americans (NA) are an under-served population for healthcare, including lung cancer screening. Randomized trials have shown LDCT screening for lung cancer improves survival but with severe under-representation of NA due to financial and insurance constraints, geography and lack of access. They are over-represented in national statistics of presentation with advanced disease and lung cancer deaths. In our region, the Indian Health Service (IHS) has recorded less than 5% of eligible heavy smokers from the Catawba and other tribes have undergone LDCT lung screening. We previously reported that a free, mobile LDCT unit achieved a shift to earlier diagnosis in African Americans (AAs) and other under-served groups with improved 4 year survival and reduced costs of care (1).We adapted our initial trial to include a structured evaluation of efficacy and utility of mobile LDCT in heavy smokers in our NA population. We hypothesized that mobile LDCT would overcome key obstructions to lung cancer screening in NA. METHODS: We used a coach fitted with a portable 32 slice low-dose CT scanner; all films were reviewed by a central panel via the LUNGRADS protocol (1). Eligible subjects were invited to participate by IHS staff. Levine Cancer Institute committed to treat any identified cancers, irrespective of insurance status to avoid delay. Technical details of the unit have been reported (1). RESULTS: 91 heavy smokers have been screened, representing 60% participation rate, with the following characteristics: M:F=1:1; median age 61 years (44-77 years); 68% had some form of health insurance which did not cover lung cancer screening (termed "under-insured") and 32% were uninsured; 73% still smoking; median pack year history 48 (range 22-98). No lung cancers were identified but 10% had LUNGRADS 3-4 (moderate-high risk) lesions, 36% had LUNGRADS 2 lesions and 20% had scattered, non-diagnostic lung lesions; patients with LUNGRADS 4 lesions were offered biopsy to define whether cancer was present. All subjects have been recruited into ongoing follow up LDCT and smoking cessation programs. DISCUSSION: NA traditionally have had the highest level of advanced lung cancer at presentation with high mortality rate from lung cancer. We have increased participation in LDCT lung cancer screening from 5% to 60% of eligible heavy smokers, and have identified a unique sub-population of 10% with potentially premalignant disease that will require meticulous follow-up to achieve early diagnosis of lung cancer. Our previous studies in impoverished AAs and other under-served groups have identified a shift from 20% to 60% early stage cancer at diagnosis; similar benefits are expected in NAs. This is the first such study in NAs and suggests mobile LDCT should be considered by health services responsible for their care. Studies of the science of cancer in the under-served should also focus on pragmatic solutions with potential for early improvement in outcome. REFERENCES: 1. Raghavan D et al, The Oncologist, 2020, 25: e777-e781. Citation Format: Kia Dungan, Hollis Reed, Darcy Doege, Daniel Carrizosa, Melissa Wheeler, Derek Raghavan. Mobile low dose computerized tomographic (LDCT) scanning program identifies pre-malignant lung cancer lesions in a Native American population: A study of Indian Health Service and Levine Cancer Institute [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C110.

Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 11, techniques and complications of local anesthesia for cataract surgery in the United Kingdom.

To describe variation in local anesthesia techniques and complications over a 10-year period for cataract surgery in the United Kingdom. Reporting centers to the Royal College of Ophthalmologists (RCOphth) National Ophthalmology Database (NOD). Retrospective cross-sectional register-based study. Data from the RCOphth NOD were used. Eligible for analysis were 1 195 882 cataract operations performed using local anesthesia between April 1, 2010, and March 31, 2020, in 80 centers. Overall, topical anesthesia alone was used in 152 321 operations (12.7%), combined topical and intracameral in 522 849 (43.7%), sub-Tenon in 461 175 (38.6%), and peribulbar/retrobulbar in 59 537 (5.0%). In National Health Service (NHS) institutions, 48.3% of operations were topical with/without intracameral vs 88.7% in independent sector treatment centers (ISTCs). 45.9% were sub-Tenon in NHS vs 9.6% in ISTCs. 5.8% were peribulbar/retrobulbar in NHS vs 1.7% in ISTCs. Anesthetic complication rates decreased from 2.7% in the 2010 NHS year to 1.5% in the 2019 NHS year (overall, 2.1% for NHS; 0.2% for ISTCs). Overall anesthetic complication rates were 0.3%, 0.3%, 3.5%, and 3.1% for topical alone, combined topical/intracameral, sub-Tenon, and peribulbar/retrobulbar, respectively. Complication rates were higher for sharp-needle anesthesia (peribulbar/retrobulbar) in patients taking warfarin rather than direct oral anticoagulants (4.8% vs 3.1%; P = .024). Considerable variation was observed between centers on anesthetic choices and anesthetic complication rates. Combined topical and intracameral is the most common choice of anesthesia for cataract surgery in the United Kingdom and is associated with lower anesthetic-related complication rates than sub-Tenon and peribulbar/retrobulbar anesthesia. Variation in the anesthetic choice exists between centers and between NHS and ISTC sectors.

Sustainability of integrated hypertension and diabetes with HIV care for people living with HIV at primary health care in South Ethiopia: implication for integration

BackgroundPeople living with human immunodeficiency virus (PLWH) have an increased risk of developing noncommunicable diseases (NCDs) compared with people without HIV. The multimorbidity of NCDs and HIV increases the need for integrated care. However, there is a paucity of evidence on the implementation of integrated sustained hypertension and diabetes with HIV care to address the multiple chronic care needs of PLWH in Ethiopia.ObjectiveThis study aimed to determine the sustainability of integrated hypertension and diabetes within HIV care for PLWH in primary healthcare (PHC) in southern Ethiopia.MethodsThe National Health Service Institute for Innovation and Improvement Sustainability Model (NHS- SM) self-assessment tool was used to assess sustainability. HIV care and NCD team members from five PHC facilities in South Ethiopia were included. Participants completed the self-administered NHS-SM assessment tool independently.ResultThe overall mean sustainability was 43.74 (95% CI: 42.15–45.33). All facilities had an overall sustainability score of less than 55. The perceived benefit beyond helping the patient, the likelihood of adaptability, and perceived alignment with the organizational goal were identified as potential factors promoting sustainability. The perceived lack of an effective system to monitor progress, staff behavior, inadequate staff involvement and training, inadequate senior leadership support and clinical leadership engagement, and infrastructure limitations could negatively affect sustainability.ConclusionsIntegrating hypertension and diabetes with HIV care sustainably at PHC requires staff involvement and training, staff behavior change communication, ensuring PHC management and clinical leadership (doctors and senior clinicians) engagement, and addressing infrastructure limitations.

Interventions to improve access to primary care for inclusion health groups in England: a scoping review

BackgroundEveryone in England has the right to primary care without financial charges. Nevertheless, evidence shows that barriers remain for inclusion health populations such as vulnerable migrants, people experiencing homelessness, Gypsy, Roma, and Traveller (GRT) communities, and people who sell sex. There is little evidence for what works to improve access. This study was a scoping review of interventions to improve access to mainstream primary care for inclusion health groups in England. MethodsIn this scoping review, we searched databases (Embase, Medline, APA PsychInfo, the Cochrane Collaboration Library, Web of Science and CINAHL) and grey literature sources, including the National Health Service and National Institute for Clinical Excellence, for articles published in English between Jan 1, 2010, and Dec 31, 2020, with no limit on study design. Data were extracted according to inclusion criteria, including interventions taking place in England and targeting people with insecure immigration status, people who sell sex, people experiencing homelessness, and GRT communities. Results were presented in a narrative synthesis. Findings39 studies describing one or more interventions were included: four peer-reviewed articles (one randomised trial, two quality improvement projects, and one mixed-methods study protocol) and 25 grey literature items (38 interventions in total). Interventions mostly targeted people with insecure immigration status (17/38, 45%), and a majority (12/38, 32%) took place in London. The most common types of intervention were training, education, and resources (such as leaflets or websites) for patients or staff (25/38, 66%), and most interventions targeted GP registration processes (28/38, 74%). Interventions commonly involved voluntary and community sector organisations (16/38, 42%). Most interventions were not evaluated to understand their effectiveness (23/38, 61%). Sources with evaluations identified staff training, direct patient advocacy, and involvement of people with lived experience as effective elements. InterpretationInterventions to improve access to primary care for inclusion health groups in England were heterogeneous, commonly undertaken at community level, and developed to serve local inclusion health groups. Considerations for policymakers and practitioners include groups and geographical areas less commonly included in interventions, the elements of positive practice identified in evaluations, and the need for evaluation of future interventions. FundingNational Institute for Health and Care Research (NIHR 202050).

Analysis of east java mata masyarakat hospital based on malcolm baldrige performance criteria

A hospital is a health service institution that provides complete individual health services, providing inpatient, outpatient and emergency services. Quality of Service is one form of effort made by each Hospital in carrying out actions that make patients feel comfortable, safe, fast and precise in getting their needs. This research aims to explain performance analysis using the Malcolm Baldrige criteria in hospitals Mata Masyarakat of East Java. This research is a cross-sectional study where data is collected at a certain time to describe the situation at that time. Employees selected as respondents will fill out a questionnaire that has been prepared with a number of questions based on Malcolm Baldrige's criteria. The data that will be taken in the research is the characteristics of employees at the hospital Mata Masyarakat and performance measurement based on hospital employee perceptions. The population in this study were hospital employees Mata Masyarakat are 40 employees consisting of management staff and unit heads. In this study, the samples used were managers and unit heads in hospitals Mata Masyarakat are 30 people. The research results show that the criteria with the highest percentage scores are Customer Focus, Process Management and Results with each score (85%) while the lowest is Leadership with a score of (79%). total score obtained by hospital Mata Masyarakat's score for all Malcolm Baldrige Criteria based on the questionnaire results is 837.6 or 83.69% of the maximum score of 1000 which is in the very good category.

Relational Database for Health Care

The development of activities within a company will increase the complexity of business processes with transactional data that will increase from time to time. This is also experienced in health services, which are health service institutions for the community and certainly involve a lot of data in their operations. Starting from the registration process, medical/paramedical examinations, hospitalization, purchasing drugs, laboratories, etc. These data certainly require a container that can be used to manage the data needed in the transaction. So that later these data can be easily integrated and processed into a useful output. Database as one of the media that can be used to accommodate all supporting data. By using a database, and the features of a Database Management System (DBMS) can help companies carry out their operations more effectively and efficiently. The research method used refers to the analysis and design. In the method of analysis, literature studies are carried out from various supporting sources and observations of samples of research objects. While the design method refers to database design using the Database Lifecycle approach

Navigating knowledges: Community health workers as liminal professionals

Abstract Community health workers (CHWs) occupy a liminal position in two senses: they are situated between the communities they come from and serve, and the health and social service professionals with whom they connect patients; and also between two forms of knowledge. In interacting with health and social service institutions, they draw on the ‘technical knowledge’ that dominates these settings. However, they must also draw on ‘communicative knowledge’, which is the situated and embodied knowledge needed to gain the trust of their community peers and to carry their voice, but which is often relegated to a secondary position. In this US-based study, we analyze interviews with CHWs, their supervisors, and advocates of their work, to better understand how CHWs mobilize discursive resources to combine these two forms of knowledge and, in doing so, constitute their liminal position as an essential asset. Our findings support valuing CHWs’ incorporation within healthcare teams, so that health and social service professionals can directly interact with CHWs’ situated and embodied knowledge of patients.

Attitudes of Chinese maternal and child health professionals toward termination of pregnancy for fetal anomaly: a cross-sectional survey.

This study explores the attitudes of Chinese maternal and child health professionals toward the termination of pregnancy for fetal anomaly (TOPFA) based on four case scenarios and further identifies the factors that influence their attitudes. This cross-sectional study, conducted from February 14-21, 2022, aimed to explore the attitudes of maternal and child health professionals toward TOPFA in Hunan Province. We targeted health service institutions across 14 prefecture-level cities and the autonomous prefecture. A questionnaire was made available online and shared via the instant communication platform, WeChat. Participants were recruited through the same platform and completed the survey online. Descriptive statistics were used to analyze the data, and binary logistic regression was performed to determine factors affecting the health professionals' attitudes toward TOPFA, expressed as the odds ratio (OR) and 95% confidence intervals (CI). The study found that 63.5% of health professionals approved of the birth of a fetus with cleft lip and palate, while 36.5% opposed it. Similarly, 39.7% approved of the birth of a fetus with phenylketonuria, while 60.3% opposed it. The percentages of those in favor of and against the birth of a fetus with precocious heart disease were 45.5 and 54.5%, respectively, and those for and against the birth of a fetus with missing fingers were 50.8 and 49.2%, respectively. The top three factors considered by health professionals when agreeing on TOPFA were "the impact of fetal disease on fetal function and growth," "the severity of fetal disease," and "the assessment of indications for fetal disease by professionals and related professional advice." The majority of health professionals (75-78%) preferred joint decision-making by parents regarding the right to decide TOPFA. Our study indicates that the attitudes of health professionals toward TOPFA can differ significantly depending on the specific birth defect under consideration. Notably, the majority of health professionals prioritized "the impact of fetal abnormalities on fetal function and development" when deciding their support for TOPFA, advocating for the decision to be a joint one between the parents. Additionally, factors such as religious beliefs, professional training, age, and job title appeared to influence these attitudes toward TOPFA. Our findings could serve as a reference point in the development of guidelines for the prevention and management of birth defects.

Problematic parental substance use, childhood family structures and adverse outcomes in young adulthood

Aim: The aim of the present study was to investigate the association between childhood family structures, including the presence or absence of problematic parental substance use (PPSU), and adverse outcomes during adolescence/young adulthood. Methods: The study population included 9,770 young people (aged 15–25 years) from samples drawn for two national surveys in Denmark during 2014–2015. By combining surveys with national register data, five types of childhood family structures were constructed based on whether the child experienced PPSU and/or family separation and the number of years the child lived with a parent with substance use problems. Using binary logistic regression models, the relationships between family structure and adverse outcomes in young adulthood (i.e., hospital admissions, mental disorders and criminality) were investigated. Results: Young people who experienced PPSU and did not live with both parents had higher odds of the different long-term adverse outcomes compared with young people who did not experience PPSU, and similar odds of the outcomes compared to youth who had not experienced PPSU and did not live with both parents. The highest odds of adverse outcomes were found among young people who experienced PPSU and lived with the parent with substance use problems for less than five years. Conclusions: Living with both parents protected against adverse outcomes in young adulthood, and if PPSU was present, the odds of adverse outcomes increased. The hypothesis that there would be a positive association between years living with a parent with substance use problems and adverse outcomes in young adulthood was not supported. Awareness should be raised in health service, educational and legal institutions about the risk for young people from families with PPSU who do not live with both parents.

The Influence of Independence, Objectivity, Proficiency and Professional Accuracy of Internal Auditors on Fraud Prevention in X Hospital

Hospital is a health service institution that provides complete individual health services that provide inpatient, outpatient and emergency services. In carrying out hospital operations, it is possible for fraud to occur. This study aims to determine whether the independence, objectivity, skills, and professional accuracy of the internal auditors affect the prevention of fraud in X Hospital. This research uses a population with a total of 54 respondents. The type of data used in this study is quantitative data using primary data sources derived from questionnaires distributed to employees at X Hospital and then processed using SPSS. The results of the study show that (1) the independence of the internal auditors has a significant effect on fraud prevention, (2) the objectivity of the internal auditors has a significant effect on fraud prevention, (3) the competence of the internal auditors has a significant effect on fraud prevention and (4) the professional accuracy of the internal auditors has a significant effect on fraud prevention.

Analysis of Patient Satisfaction in The Context of Health Worker Performance at The Community Health Center Ngoro District Mojokerto In 2023

Human Resources are the main factor of problems that often arise in an organization such as in health service institutions. Puskesmas as a health service that is directly related to the lower community has an important role in achieving the quality of health services. the phenomenon of patient satisfaction the results of interviews with researchers at UPT Puskesmas Ngoro in July 2023 obtained data, out of 15 people, 10 still complained that they were not satisfied, and 7 were satisfied with the performance of health workers. The purpose of this study was to analyze patient satisfaction with the performance of health workers at UPT Puskesmas Ngoro in 2023. The research method used in this research is quantitative survey research (survey research). Research design in this study is quantitative research with cross sectional method. The sampling technique used accidental sampling and data analysis using the Spearman Rank statistical test. The results showed that of the 68 respondents, most (73.5%) stated that the performance of health workers was very good, namely 50 respondents. From the results of this study indicate that the level of patient satisfaction from each dimension of satisfaction ranges from 87% to 90%, which is very satisfied, meaning that patients at the puskesmas have rated well the services provided by the puskesmas. Based on the Spearman Correlation test using SPSS, the p value is 0.008 α 0.05, meaning that H0 is rejected and H1 is accepted, which can be concluded that this study shows that there is a relationship between the performance of health workers and the level of patient satisfaction at UPT Puskesmas Ngoro, Mojokerto Regency in 2023.

ANALYSIS OF HOSPITAL MANAGEMENT INFORMATION SYSTEM (SIMRS) AND ITS RELATION TO THE READINESS OF ELECTRONIC MEDICAL RECORD (RME) IMPLEMENTATION IN RSUP. SANGLAH DENPASAR

A hospital is a health service institution that provides plenary individual health services that provide inpatient, outpatient, and emergency services. This study focuses on the implementation of SIMRS using PIECES analysis where researchers assess SIMRS using six aspects, namely performance, information, economy, control, efficiency and service. Where the results of this system analysis aim to ascertain whether the system created has no error functions or the system is running properly. The method used in this analysis is the PIECES framework which includes 6 aspects of reference, namely: Performance, Information and data, Economics, Control and Security, Efficiency, and Service. This method is applied to calculate the level of user satisfaction with the system which later the results are used for evaluation of the system related to the development of system quality. Performance according to performance calculations in the PIECES analysis obtained a value of 3.96 with the predicate Satisfied, but there are several things that must be improved.

Development of Mental Healthcare Model in Seoul.

To develop an integrated and comprehensive community-based mental healthcare model, opinions were collected on various issues from practitioners in mental health service institutions currently offering mental healthcare services in Seoul through a focus group interview, qualitative research method, and Delphi survey. The focus group interview was conducted with six practitioners from mental health welfare centers and six hospital-based psychiatrists. A questionnaire of opinions on the mental healthcare model was filled by these practitioners and psychiatrists. A Delphi survey was additionally conducted with a panel of 20 experts from a community mental health welfare center and hospital-based psychiatrists. The focus group interview results showed the need for integrated community-based mental healthcare service and the need to establish a system for managing mental and physical health in an integrated manner. Based on the survey results, the current status of community-based mental healthcare services was investigated, and the direction of the revised model was established. The Delphi survey was then conducted to refine the revised model. The present study presents the Seoul-type community-based mental healthcare model with integrated services between a psychiatric hospital with a mental health welfare center as well as combined mental and physical health services. This is ultimately expected to help people with mental illnesses live healthy lives by meeting their needs as community members.

Analysis on the relationship between professional identity and turnover intention among general practitioners: The mediating role of job burnout

ObjectiveWe aimed to understand the current situation and contributory factors associated with professional identity, turnover intention and job burnout among general practitioners (GPs) in eastern, central and western China. MethodsA total of 3244 GPs from community health service institutions in 12 provinces of China were recruited, from October 2017 to February 2018. Demographic information such as sex, region and mode of employment was sought, and issues regarding job burnout, professional identity and turnover intention of GPs were measured with the corresponding scale, and softwares such as SPSS and AMOS were used. T-test, analysis of variance, and covariance matrix were used for analysis. ResultsThe average total scores of job burnout, turnover intention and professional identity of GPs in China were 44.12, 15.07 and 51.23, respectively. The results of intermediary effect analysis showed that in the GPs group, there were differences in the distribution of the three indicators. Professional identity had a significant negative effect on job burnout (β = −0.373), while job burnout had a significant positive effect on turnover intention (β = 0.528), and job burnout had an indirect effect in the relationship between professional identity and turnover intention. Job burnout played an intermediary role in professional identity and turnover intention. ConclusionsThe turnover intention of GPs in China has improved, but it is still at a high level. Job burnout plays an intermediary role between professional identity and turnover intention.

Analisis Dampak Kepuasan Pasien terhadap Kualitas Pelayanan IGD

Patient satisfaction depends on the quality of service and the Emergency Department (IGD) is one of the components of the hospital that is most concerned about the quality of service. The purpose of writing this article is to analyze the impact of patient satisfaction on the quality of emergency room services. The research method used is qualitative method, this study is descriptive analytic, this is to describe and analyze the system of Islamic financial institutions with the system of conventional financial institutions. The results of this study concluded that the impact of patient satisfaction on the quality of emergency room services is to increase the popularity of hospital emergency room services, increase patient loyalty, become the best means of promotion and improve the reputation of hospital service quality. And the satisfaction of health service users can be concluded as the difference in the performance of health service institutions with patient expectations, patient satisfaction can be formulated by, 1) Performance < Expectation which means patients feel less satisfied with the services received, 2) Performance = Expectation, meaning patients are satisfied with the services received, 3) Performance > Expectation, meaning patients feel very satisfied with the services received

Sistem Informasi Manajemen Rumah Sakit (SIMRS) Untuk Meningkatkan Mutu Pelayanan Kesehatan Di Indonesia

The quality of service at hospitals must always be improved to provide the best service to people in Indonesia. In accordance with Permenkes Number 82 of 2013 it states that every hospital is required to implement and develop a Hospital Management Information System (SIMRS). The Hospital Management Information System (SIMRS) is very important to do to support the efficiency of the management process in hospitals starting from information to patients, data, data processing and all activities in the hospital. By implementing a Hospital Management Information System, it is necessary to know how it is applied in improving the quality of health services in Indonesia. This research was conducted with literature reviews and journal searches using Google Scholar. The research results show that the implementation of the Hospital Management Information System (SIMRS) can improve the quality of health services because it facilitates the management activities of health service institutions.

PERLINDUNGAN HUKUM TERHADAP PASIEN RAWAT INAP BERDASARKAN UNDANG-UNDANG NOMOR 44 TAHUN 2009 TENTANG RUMAH SAKIT

Legal protection means recognition, compliance, and support for the rights of all individuals, all families and all groups, as well as aspects of their implementation. Thus, patient protection law is the entirety of the principles and rules that regulate and protect patients in the relationship and problems of medical services with medical personnel and medical providers, in terms of obtaining medical services. Legal protection is a protection given to legal subjects, namely individuals or legal entities in the form of tools, both preventive and repressive, both oral and written. In Law No. 44 of 2009 concerning Hospitals Article 1 Regarding General Provisions, it is a health service institution that provides complete individual health services that provide inpatient, outpatient, and emergency services.

Analisis penerapan Standard Operating Procedure (SOP) sanitasi peralatan makan dengan angka kuman di Instalasi Gizi RSUD Meuraxa Banda Aceh

Background: the application of SOP is very important to pay attention to, because having SOP will help every job, where a hospital is a health service institution for many people it is so important to pay attention to the sanitation of its equipment. Improper sanitation can result in things that can be detrimental to patients such as poisoning, because food contamination can occur from various sources, one of which is cutlery that does not meet the requirements.Objective: to find out the application of the SOP for sanitation of cutlery with germ numbers in the Nutrition Installation of Meuraxa Hospital, Banda Aceh.Methods: the design used in this research is quasi-experimental with one group pretest posttest design. This research was conducted on 20 June-26 August 2022 at the Meuraxa Hospital in Banda Aceh. A sample of 9 servers was taken by saturated sampling technique. Data processing through four stages, namely editing, coding, processing, tabulating. Data analysis used the Dependent T-test.Results: there is a difference in the behaviour of the servers before the socialization and after the socialization regarding the implementation of the SOP for eating utensils sanitation (p= 0.002). The value of the germ count on cutlery before being given socialization regarding SOP for sanitation of cutlery obtained an average laboratory result of 275.67 colonies/cm2 and there was a decrease in laboratory results of the germ count after socialization to 77.56 colonies/cm2, 0.023.Conclusion: there is a significant difference in implementing of the SOP for the sanitation of cutlery with the number of germs in the Nutrition Installation of the Meuraxa Hospital in Banda Aceh. Conduct further research with different designs to find out more about what factors can affect the number of germs on cutlery.

Perhitungan Kebutuhan Rak Penyimpanan Berkas Rekam Medis (BRM) 5 Tahun Kedepan Di Gedung Y Rumah Sakit X

The hospital is a health service institution that provides complete individual health services by providing inpatient, outpatient and emergency services. Plenary Health Services, namely health services that include promotive, preventive, curative, and rehabilitative. The availability of medical record file storage racks in health care facilities is very important in maintaining security and avoiding damage to patient data. The file rack is a place to store archives or medical record documents which aim to facilitate storage and retrieval of medical record documents in the filing room and maintain the confidentiality of medical record documents. The storage of medical record files can exceed the capacity due to the large number of new patient visits and the disproportionate file shelves. Planning or procuring storage racks based on the number of medical record documents stored, the shape of the racks and the size of the storage racks according to ergonomic standards, namely storage racks can be in the form of roll o'pack racks and taking into account the area of an available room. Calculation of the need for shelves is done by using the smallest quadrant calculation. Calculations are made based on the number of new patient visits in the previous 5 years, namely 2018 to 2022. Based on the calculation results, the results show that the need for shelves for the next 5 years is 3 shelves.

Analisis Pengaruh Kualitas Pelayanan terhadap Kepuasan Pasien di Rumah Sakit Sumatera Utara:

The hospital is a health service institution for the community with its own characteristics which are influenced by developments in health science, technological advances, and the socio-economic life of the community which must continue to be able to improve services that are of a higher quality and are affordable to the community in order to realize the highest degree of health. In hospital health services patient satisfaction is one indicator of the quality of health services. Patient satisfaction is an integral and comprehensive part of health service quality assurance activities. Public perception of the quality of health services and their impact on the utilization of health services is the main indicator of the success of health services. This study aims to analyze the effect of service quality on patient satisfaction in North Sumatra hospitals. This research uses a literature review or Literature Review using the PRISMA (Preferred Reporting Items for Systematic Review) systematic review with the Google Scholar database. The results of the study include 5 measurement tools for patient satisfaction in North Sumatra hospitals, namely Physical Evidence (6 good rating journals), Responsiveness (6 good rating journals), Caring (6 good rating journals), Reliability (5 good rating journals) and Assurance (8 good rating journals).
 Keywords: service quality, patient satisfaction