Hospitals In Indonesia Research Articles

Shift schedule realignment and patient safety culture.

The purpose of this paper is to assess the association between shift schedule realignment and patient safety culture. Using difference in differences model, BIMC Hospitals and Siloam Hospital Bali were compared before and after shift schedule realignment to test the association between shift schedule realignment and patient safety culture. Shift schedule realignment was associated with a significant improvement in staffing (coefficient 1.272; 95% CI 0.842 - 1.702; p<0.001), teamwork within units (coefficient 1.689; 95% CI 1.206 - 2.171; p<0.001), teamwork across units (coefficient 1.862; 95% CI 1.415 - 2.308; p<0.001), handoffs and transitions (coefficient 0.999; 95% CI 0.616 - 1.382; p<0.001), frequency of error reported (coefficient 1.037; 95% CI 0.581 - 1.493; p<0.001), feedback and communication about error (coefficient 1.412; 95% CI 0.982 - 1.841; p<0.001) and communication openness (coefficient 1.393; 95% CI 0.968 - 1.818; p<0.001). With positive impact on patient safety culture, shift schedule realignment should be considered as quality improvement initiative. It stretches the compressed workload suffered by staff while maintaining 40 h per week in accordance with applicable laws and regulations. Shift schedule realignment, designed to improve patient safety culture, has never been implemented in any Indonesian private hospital. Other hospital managers might also appreciate knowing about the shift schedule realignment to improve the patient safety culture.

Development of Cost Analysis Guidance for Indonesian Hospitals

Health technology assessment is important in the process of national health insurance system development. On the other hand, health technology assessment study needs a cost analysis as a basic, which is a troublesome if there is not any guidance. To help performing the cost analysis study, this study describes the development of a costing manual book and template as a guide for costing analysis in Indonesian hospitals. This management tool developed in stages, from tool drafting, testing in the real life environment, to approval from stakeholders. Costing templates were developed using Microsoft Excel formulas, such as IF, SUMIF and TRANSPOSE. The costing manual book and template were designed for the Indonesian hospital context. The costing template successfully assessed the unit costs of healthcare services in the study hospital. It can calculate the unit costs of healthcare services for 3 main objectives: hospital internal management, reimbursement rate setting and economic evaluation. The costing analysis tool was reviewed and approved by the study hospital staff and stakeholders. Even the model test was only tested in one district hospital, but it was designed to be flexible enough to adapt to different hospital organization structures. The cost analysis guidance is relevant and applicable to district hospitals in Indonesia. It is well accepted by stakeholders and helpful in calculating the hospital unit costs in a practical way. Hopefully, there will be further hospital cost analyses in the future. These cost analyses can then be used as inputs for universal health coverage development.

EFFECT OF SERVICE QUALITY AND PATIENT SATISFACTION: HOW DENTAL HOSPITALS IN INDONESIA DEAL WITH THAT?

The purpose of this research is to investigate how healthcare service quality and patients’ satisfaction are related. Thus, the study aims to assess patient’s expectations, patients’ satisfaction levels and measure the quality gap for SERVQUAL dimensions. This study employs a quantitative descriptive research approach to achieve the research objectives by testing a set of hypotheses. The data collection is by means of a self-administered questionnaire to collect primary data from 350 patients in Indonesian dental hospitals with special reference to Jakarta and Bali. The research findings reveal that the patients’ expectation and satisfaction with the healthcare SERVQUAL (tangibility, reliability, responsiveness, assurance, and empathy) is not matched and there is a gap in the service quality. However, the results indicate a service quality gap in both dental hospitals. In addition, the type of hospital has been found to affect patients’ satisfaction for tangibility, reliability, responsiveness, and empathy and assurance dimensions. Article visualizations:

Grief reactions and coping strategies of Muslim nurses dealing with death.

An intensive care unit (ICU) features high mortality rates. Witnessing subsequent deaths may affect nurses psychologically and spiritually. Islam has an influence on Muslims' life and death. Nevertheless, little is known about Muslim intensive care nurses' experiences of grief in dealing with the deaths of patients. This study aimed to describe the grief reactions and coping strategies of Muslim nurses in dealing with the death of patients. This is a qualitative study with a phenomenological approach. Semi-structured individual interviews were conducted. Fourteen participants from an ICU in an Indonesian tertiary public hospital participated in this study. Data were analysed by thematic analysis. Trustworthiness was established by Lincoln and Guba's criteria. The findings identified four reactions of grief, four factors influencing reactions of grief, and three coping strategies used in dealing with death in an ICU. The reactions of nurse's grief were crying, being sad, feeling disappointed, and feeling guilty. These reactions were related to several factors including the circumstances of the patient's death, nurse's expectation of patient's recovery, relationships with the patient, and the reactions of family. Coping management strategies used by nurses in dealing with their grief comprised: sharing with colleagues, avoiding dying and death situations, and engaging in spirituality. The Muslim ICU nurse participants experienced their grieving through a variety of psychological reactions influenced by several factors. Personal coping strategies were revealed in dealing with their grief. However, avoiding dying and death situations affected their duty. Attention to nurses' grief should be paid to maintain their psychological well-being and quality of end-of-life care. Providing formal support to enhance grief management is recommended.

Evaluation of Outpatient Prescription Compliance in A Bukittinggi Hospital

&lt;p&gt;&lt;em&gt;Prescriptions are written requests from doctors or dentists to pharmacists, whether in paper or electronic form to provide and deliver medicines to patients in accordance with applicable regulations. Pharmacists play an important role in preventing medication error by performing prescription screening to reduce the risks of harm on patients. The objective of the study was to evaluate the compliance of outpatient prescriptions in Bukittinggi Hospital. This research was performed using descriptive observational with a cross-sectional design. An amount of 119 prescriptions from July to September 2017 were collected. All prescriptions were screened for their compliance to Pharmaceutical Care Standard in Indonesian Hospitals, which consists of three criteria: 1) administrative requirements, 2) pharmaceutical compatibilities and 3) clinical considerations, and derived into 21 sub-criteria. Data analysis was performed using descriptive statistics. After screened thoroughly, there were no prescriptions which totally comply with the standard. There were only 10 of 21 sub-criteria which were fulfilled by the prescriptions, which were registration number, R/ mark, patient`s name, dosage form, frequency, duration of therapy, drug name, strength, drug interaction, and drug duplication. It can be concluded that the prescriptions have not fulfilled the pharmaceutical care standard. Thus, hospital pharmacists need to improve pharmaceutical services.&lt;strong&gt;&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;

An insight of Fahr’s Disease management in an Indonesian rural hospital: A case report

An insight of Fahr’s Disease management in an Indonesian rural hospital: A case report

A distribution strategy using a two-step optimization to maximize blood services considering stochastic travel times

The blood service is a health service that utilizes human blood as basic material with humanitarian purposes, not for commercial one. Indonesian hospital ability in blood transfusions is generally still low, especially in terms of blood supply adequacy. In fact, there are still some provinces that experience excess blood supply while many other provinces experience a shortage of blood supply. The Blood Bank in Jakarta has the highest excess blood supply. Therefore, the blood can be transferred evenly from one province to another nearby province. The aim of this paper is to determine the allocation and the route of blood distribution to achieve the minimum travel times. Some variations in travel time are difficult to predict, so we take into account the stochastic properties of them. The effectiveness of blood distribution is very dependent on the accuracy of the target number of beneficiaries and the accuracy of the number of blood bags received in distribution activities. Meanwhile, the efficiency of blood bag distribution is measured by distribution routes that are directly related to transportation costs. This study uses a two-step optimization model to reach optimality. The first step is utilizing the transportation model to make sure the destination points are only the fastest to arrive. The second step is making use of the capacitated vehicle routing problem to ensure the routing is global optimal. This model successfully creates better blood demand fulfillment while minimizing transportation cost.

The Effect of Risk Management, Governance and Information System on Technological Efficiency for the Inpatient Services in the Indonesian Hospital

The hospital is one of the health care institutions supported by medical personnel and non-medical personnel to provide services to the community. The increase in hospitals' number is expected to be in line with the increase in medical and non-medical personnel in hospitals. However, the increase in resources has almost doubled compared to the increase in the number of hospitals in Indonesia. This can indicate that the hospital current conditions are less efficient. To identify the condition of the hospital’s level of efficiency, it can be done using the Stocastic Frontier Analysis (SFA) method. This analysis is based on the production function involving various input and output factors. Various types of inputs and outputs that can be considered for inclusion in the analysis model. The purpose of this study is to identify the effect of risk management factors, governance, information management on the efficiency of inpatients. The results from this study, governance is the most dominant factor in determining the level of efficiency of inpatient services, then followed by risk management factors. Thus, to improve the efficiency of inpatient services the main priority can be directed to better hospital governance. spacing. Author Profile must be in Font Size 8, with single line spacing. Fore more details, please download TEMPLATE HELP FILE from the website.

EP19.14: Modified biophysical profile score and middle cerebral artery Doppler as predictor of perinatal outcome in Indonesian tertiary hospital

EP19.14: Modified biophysical profile score and middle cerebral artery Doppler as predictor of perinatal outcome in Indonesian tertiary hospital

The Knowledge Management Maturity Model for Indonesian Hospital

The hospital is a primary health care institution in a country, so the hospital must be able to offer optimum performance services for every citizen. In this study, efforts will be made to improve the performance of hospital services through an implementation method for knowledge management system that is of course adapted to current hospital conditions, so the authors propose the Knowledge Management Maturity Model to determine which strategies are appropriate for hospital use based on their maturity level. The author collects data from 33 hospitals to verify this model, where the collected quantitative data has been verified (validity and reliability test). The results of this study are a framework for identifying knowledge management maturity for hospitals and also strategic recommendations for improving the performance of hospital services.

Utilization of Data and Applications to Increase The Services Quality of Hospital Industry Accreditation in Indonesia

In recent years, information technology has become a part of the power to engage in business activities. However, no studies have tested the effects of the adoption of information technology on the performance of surveyors in performing their duties at the Indonesian Commission for Accreditation of Hospitals (KARS). The purpose of research is to test empirically the external factors that influence the adoption of applications for increased surveyors’ works performance as an assessor of hospitals in Indonesia. External factors studied were: (1) the support of top management, (2) self-efficacy, (3) the quality of the system, and (4) training. Technology Acceptance Model (TAM) is the best way to evaluate the factors that influence the decision of the assessor and the hospital professionals on the acceptance of a system. Through the distribution of questionnaires were processed using SmartPLS, proving that the four external factors studied had a significant influence on the acceptance of information technology. Based on observations also prove that through the use of Information System of Indonesian Commission for Accreditation of Hospitals or SIKARS application, assessor performance is more effective and efficient. So that, through the data and information provided on the application can support all stakeholders in decision-making. SIKARS as national accreditation database can be used as a reference for service quality improvement in Indonesian hospitals.

Educational background and clinical nursing tasks performed by nurses in Indonesian hospitals

This study aimed to describe the differences in clinical task performance between nurses with a 3-year diploma, 4-year bachelor of nursing degree, and master/specialist nursing degree in Indonesian hospitals. The study employed a cross-sectional design. An online questionnaire was developed for this study and administered to 904 nurses but completed by only 410 nurses from 95 hospitals in 19 of the 34 provinces of Indonesia (55.9%). The questionnaire detailed 158 clinical tasks about patient education, collaboration, management of patient care, observation, and therapy. In general, master/specialist nurses performed more tasks in the patient care management category. Moreover, nurses with a 3-year diploma performed significantly more tasks than did those with a 4-year bachelor of nursing in all clinical tasks (p<0.05), except in the patient care management category (p=0.68). Hospital management could play a role in strengthening the performance of patient care management of nurses with bachelor's degrees, which may have a positive impact on patient outcomes. Further study is needed to explore the non-clinical nursing tasks performed by those with different education levels, which may affect their performance of clinical tasks.

Outpatient nursing care implementations in Indonesian regional public hospitals

This study aimed to describe the nursing care implementations in the outpatient installations of several hospitals. A descriptive study design was used with purposive random sampling. A total of 292 patients were included based on the following criteria: treated at the internal, neurological, ear, nose, and throat, pulmonary, surgical, skin, sex, and heart disease polyclinics, able to read and write, and attended more than one visit. This study was conducted in three central referral hospitals in the Bogor, Depok, and Jakarta areas of Indonesia. The outpatient care implementation was not optimal in the three regional public hospitals (56.8%). The nurses minimally performed the outpatient nursing processes, namely diagnosis enforcement (63.7%) and implementation (62%). The implementation of care that is not optimal can result in a decrease in patient satisfaction and safety. The support of hospital management is needed to facilitate the availability of adequate nursing resources (both quantity and quality) and to provide equipment, facilities, and logistics to optimize nursing care.

THE EFFECT OF EXTRINSIC MOTIVATION AND INSTRINSIC MOTIVATION AGAINST LEARNING ACHIEVEMENTS OF FOOD AND BEVERAGE SERVICE STUDENT AK. MAPINDO, ACADEMIC YEAR 2018/2019

This study aims to determine the effect of extrinsic motivation and instrinsic motivation on learning achievement students in the Food and Beverage Service Program Study, Akademi Komunitas Manajemen Perhotelan Indonesia academic year 2018/2019. The questionnaire distributed to 57 respondents was all members of the population. This study, using regression analysis techniques by testing hypotheses using t test and F test. The t-test results show that extrinsic motivation has a positive and significant effect on student achievement in the Food and Beverage Service Program Study, Akademi Komunitas Manajemen Perhotelan Indonesia academic year 2018/2019. This is seen from the results of the regression coefficient X1(b1) thitung = 6.977 &gt; ttable (0.05: 54) = 1.6736 and sig t = 0,000 (p &lt; 0.05). Intrinsic motivation has a positive and significant effect on student learning achievement in the Food and Beverage Service Program Study, Akademi Komunitas Manajemen Perhotelan Indonesia academic year 2018/2019. This is seen from the results of the regression coefficient X1(b1) thitung = 3.743&gt; ttable (0.05: 54) = 1.6736 and sig t = 0,000 (p &lt;0.05). Extrinsic motivation and intrinsic motivation have a positive and significant effect on student achievement in the Dish Study Program, Indonesian Hospitality Management Community Academy academic year 2018/2019. This is based on the results of the F statistical test (ANOVA) where Fcount = 32.521 &gt; F table = 3.17 with sig F = 0,000 (p &lt; 0.05). Other information obtained from the results of the above analysis that extrinsic motivation has a more dominant influence on learning achievement when compared with intrinsic motivation Keywords: Extrinsic Motivation, Intrinsic Motivation, Learning Achievement

Analysis of the Effect of Hospital Resources on Patients in Indonesian Hospitals

Health is the most important thing in human life. Humans can sacrifice anything for health. Health needs to be supported by government facilities, one of which is a hospital. The development of hospitals in Indonesia is increasingly rapid. The availability of more hospitals needs to be supported by the resources available in the hospital. The problem that occurs at this time is that there are still many patients who complain about the lack of availability of resources both in terms of doctors, beds that must be included in the waiting schedule, medical technicians who sometimes queue up for blood collection, administrative processes that take a long time so patients are not immediately treated so on. Therefore, this study was conducted to examine the influence of resources (building area, general practitioners, specialist doctors, nurses, pharmacists, medical technicians, health workers, and non-health workers) on patients (outpatient, inpatient, and emergency room) ) in Indonesian hospitals. The method used is multiple regression with the help of SPSS 20. While the data taken is the population of all hospitals in Indonesia. The results obtained are three, first, building area, bed and medical conditions affect inpatient. Both general practitioners, medical technicians, health workers and non-health workers influence outpatients. Finally, beds, general practitioners, medical specialists, medical technicians, and health workers influence ED patients. Based on the results of these studies it can be suggested that the main focus for each type of patient needs to be considered especially those that have a significant effect.

Analysis of factors influencing length of stay in the Emergency Department in public hospital, Yogyakarta, Indonesia

BackgroundsThe increasing demand for emergency care may cause prolonged Emergency Department length of stay that has an impact on quality of care. In Indonesia, factors influencing Emergency Department length of stay are difficult to determine. The purpose of the study was to identify factors that contributed to length of stay at tertiary hospital Yogyakarta, Indonesia. MethodsA descriptive study was conducted with a cross-sectional, retrospective design. Participants (n=139) were patients aged 18 years or over who presented to Emergency Department at tertiary hospital, over seven consecutive days. Data were gathered by reviewing patients’ notes using modified data collection tool and by measuring the average time in each stage of Emergency Department patient journey. Mann–Whitney and Kruskal–Wallis tests were utilised to analyse data. ResultsThe median Emergency Department length of stay was 330min. The acuity level, specialist consultation and need for admission were associated with increased Emergency Department length of stay (p<0.05). Laboratory turn around time (median 58min) and waiting for bed availability (median 167min) contributed to prolonged length of stay, for discharged and admitted patients, respectively. ConclusionsThis study assists in understanding factors that most significantly influence Emergency Department length of stay in an Indonesian hospital and will inform policy makers in development of strategic plans to improve Emergency Department patient flow.

Epidemiology of erectile dysfunction: A cross-sectional web-based survey conducted in an Indonesian national referral hospital

Background: Many epidemiological studies have demonstrated a high prevalence of erectile dysfunction (ED) in different parts of the world. The objective of the present study was to establish the prevalence of ED in a healthy population from Indonesia and risk factors associated with ED. Methods: We performed a cross-sectional study to estimate the prevalence of erectile dysfunction in relatively healthy males in Jakarta that aged 20 to 80 years old. This cross-sectional study utilizes a web-based survey containing a translated version of The International Index of Erectile Function (IIEF-5) in Indonesian. Sexual domain functions in the IIEF-5 include 4 domains of erectile function starting from erection confidence, erection firmness, erection maintenance and sexual satisfaction. Results: The mean age of respondents is 38.7±12.6 years old. Most of the respondents were married (77.2%), had completed or undertaking tertiary education (66.3%) and worked in privately established companies (35.7%). The prevalence of ED was 35.6% (22.3% mild, 13.7% mild to moderate, 3.1% moderate and 0.8% severe). The prevalence of ED ranges from 6.5% in the 20-29 year old group, to as high as 88.0% in respondents aged 60 years old and above. Age, hypertension, stroke, history of heart disease, diabetes, kidney disease, history of prostate operations and interpersonal stress are significantly associated with ED (p-value = &lt;0.001, &lt;0.001, 0.015 0.000, 0.01, 0.002, &lt;0.001 and 0.022 respectively). Conclusion: The prevalence of ED in Indonesia is about 35.6%. The prevalence of ED in this study ranges from 6.5% to as high as 88.0%. Age, hypertension, stroke, history of heart disease, diabetes, kidney disease, history of prostate operation and interpersonal stress are significantly associated with ED.

The Needs of Type 2 Diabetes Patients for Physical Activity Programming: A Qualitative Study at a Yogyakarta Hospital Clinic

Physical activity programs offered in Indonesian hospitals are often inadequate to help type 2 diabetes (T2D) patients meet international physical activity recommendations. This study aimed to identify T2D patients’ physical activity enablers and barriers, their preferences for, and experiences with, physical activity programming, with a view to developing future programs that are suited to these patients’ needs and preferences. Four focus groups were conducted with 28 patients (50% female) of the T2D clinic at the Local General Hospital of Yogyakarta. Discussions were thematically analysed in NVivo 10. The most reported types of physical activity were walking and participation in the hospital-based exercise program. Participants were motivated to be physically active for the health benefits and for social interactions. The main barriers to physical activity were a lack of enjoyment, the absence of knowledge about appropriate activities for T2D patients, and a shortage of time due to social and family obligations. Based on study participants’ preferences, future physical activity programs need to include educational components, regular clinical evaluations, consultations with health educators, and efforts to increase the reach of the programs. This study provides practical suggestions for physical activity programming that meet the needs of T2D patients in Indonesia.

A health economic evaluation of using N-terminal pro brain natriuretic peptide for the management of acute heart failure: A pilot study in an Indonesian tertiary referral hospital

Heart failure represents a major health problem and economic burden also in development countries such as Indonesia. Based on current guidelines, the use of natriuretic peptides can improve diagnosis, risk stratification, and decrease in hospital length of stay. However, mostly due to the related high costs, many Indonesian physicians currently do not routinely use these biomarkers in their daily clinical practice. By comparing the results of guidance with N-terminal pro brain natriuretic peptide (NT-proBNP) and without NT-proBNP, this pilot study was aimed to determine the clinical effectiveness and costs of using natriuretic peptides in the management of acute heart failure (AHF) patients admitted at National Cardiovascular Center Harapan Kita Hospital, a tertiary referral hospital in Jakarta, Indonesia. This was a health economic evaluation using a single-blind, randomized controlled trial. AHF patients adjudicated following European Society of Cardiology guidelines were randomly assigned to the 2 groups: NT-proBNP group (group A) and control group (group B). In the group A, NT-proBNP level was obtained at admission and pre-discharge, with the target of achieving a decrease of ≥30%. Randomised patients were followed up to 90 days post-discharge to assess short-term outcomes and costs. In total, one hundred and twelve patients were enrolled, of whom 56 were randomized in group A and 56 patients in group B. Compared to Group B, in Group A the total costs of patients management resulted to be significantly higher (P&lt;0.05), while no significant difference between the 2 groups was observed for inhospital length of stay, total mortality rate, rehospitalization, and emergency department visits within 90 days post-discharge. In this pilot study for the management of AHF at an Indonesian National Cardiovascular Center, the routine use of NT-proBNP compared to the non use, at hospital admission and discharge resulted into a significant increase of medical cost without any evident favourable impact on patients outcomes. Larger study in greater Asia Pacific populations should be performed to confirm these preliminary results.

The Role of Governments in the Implementation of Patient Safety and Patient Safety Incident Reporting in Indonesia: A Qualitative Study.

(1) Background: A patient safety incident reporting system was introduced in Indonesian hospitals in 2006; however, under-reporting of patient safety incidents is evident. The government plays a vital role in the implementation of a national system. Therefore, this study focuses on how the Indonesian government has been undertaking its role in patient safety at provincial and city/district levels, including incident reporting according to the National Guideline for Hospital Patient Safety. (2) Methods: This study employed a qualitative approach with interviews of 16 participants from seven organizations. The data were managed using NVivo and thematically analyzed. (3) Results: The findings revealed several problems at the macro-, meso-, and micro-level as the government was weak in monitoring and evaluation. The District Health Office (DHO) and Provincial Health Office (PHO) were not involved in incident reporting, and there was a lack of government support for the hospitals. (4) Conclusions: The DHO and PHO have not carried out their roles related to patient safety as mentioned in the national guidelines. Lack of commitment to and priority of patient safety, the complexity of the bureaucratic structure, and a lack of systematic partnership and collaboration are problems that need to be addressed by systematic improvement. To ensure effective and efficient national outcomes, the three levels of government need to work more closely.