Provide Quality Health Services Research Articles

Multi-layered factors contribute to irrational use of antibiotics among pediatric patients in Tanzania: ADDO dispensers perspective

BackgroundAntimicrobial resistance (AMR) is a major public health problem affecting both current and future generations. Development of resistance to the commonly available antibiotics has been directly linked to their irrational use. The World Health Organization (WHO) has clearly stated on the Global Strategy on AMR, judicious antibiotic use as well as adequate knowledge and awareness about AMR, as important tools in curbing the existing problem. Therefore, this study aimed to explore the level of knowledge among accredited drug dispensing outlet (ADDO) dispensers on factors contributing to irrational use of antibiotics among Tanzanian pediatric patients.MethodsA qualitative study employing focused group discussions was conducted among 6–10 ADDO dispensers with at least 6 months dispensing experience in 14 regions between July and August 2020. Thematic analysis was used to analyze the data.ResultsFindings from this study indicate that the ADDO dispensers have adequate knowledge on antimicrobial resistance. Participants were aware of the general meaning and the use of antimicrobials. They were aware that antimicrobials are used for treating infections caused by microbes such as bacteria, fungi, and viruses. Participants knew AMR increases health related costs and that the increasing burden of AMR is not an outcome of a specific group of people such as health care providers or patients, rather a contribution of many factors that bring change in microorganism behavior. Despite this knowledge, participants felt that most of the private health care facilities are profit-oriented; they practice polypharmacy to maximize profit rather than focusing on providing quality health services. Participants revealed that dose shortage after symptomatic relief strongly contributes to AMR. Lastly, the ADDO dispensers expressed that continuous medical education and community education to patients is necessary in the efforts to fight against AMR.ConclusionsTo mitigate the increasing AMR burden in our society, integrated interventions must include both communities, ADDOs as first point of contact and other healthcare providers. Periodic refresher training with an emphasis on proper practices is crucial to help the dispensers transform their knowledge into action. Responsible authorities should ensure that ADDOs and other private health care facilities adhere to regulations.

Provision of prostate cancer services in Tanzania: perspectives from five tertiary hospitals

BackgroundAccess to quality prostate cancer services remains a global challenge, particularly in Low- and Middle-Income countries. This is often due to weak health systems that struggle to meet the population’s needs. The provision of quality health services to patients with prostate cancer requires a comprehensive approach involving multiple stakeholders and structural inputs. However, few studies have comprehensively assessed the relationship between these structural inputs and prostate cancer treatment outcomes. This study, therefore, aimed to determine the availability of selected structural inputs and descriptions of how they influence the provision of quality services to patients with prostate cancer in Tanzania.MethodsWe conducted a cross-sectional study using an explanatory sequential mixed-method approach to collect data from five tertiary hospitals providing cancer services in Tanzania. A validated checklist was used to collect information on available structural inputs for prostate services at tertiary hospitals. A semi-structured interview guide was used to conduct 42 in-depth interviews with 20 healthcare providers, five hospital managers, and 17 patients undergoing treatment for prostate cancer. Descriptive analysis was performed for the quantitative data, and thematic analysis was conducted with the aid of NVivo 14 qualitative software for the interview transcripts.ResultsAll five assessed tertiary hospitals had inadequate human resources for health to provide prostate cancer services. Only one had 70% of the required HRH, while none had above 40% of the required HRH. Within the hospitals, the skill mix imbalance was severe across cadres. Five themes emerged: inadequate infrastructure, delays in diagnosis, delays in treatment, shortage of human resources for health (HRH), and inefficient organization of prostate cancer services.ConclusionThe findings of this study, underscore the major health system deficiencies for the provision of prostate cancer services in tertiary hospitals. With the increased aging population, strong health systems are vital in addressing conditions of old aging, including prostate cancers. Studies on optimization of the available HRH and infrastructure are needed to improve the provision of prostate cancer in tertiary hospitals as an interim solution while long-term measures are needed for improving the HRH availability and conducive infrastructure.

Health professional regulation and provision of quality health services; cross sectional analysis of private health care providers in Wajir County, Kenya

Background: Health professional regulatory bodies oversee and enforce standards in healthcare to safeguard patient safety and prevent harm. However, international consistency in these regulations remains limited. The Kenya health sector relies on various bodies to enforce standards among professionals and institutions, albeit constrained by financial and human resources that hinder effective oversight. This study aimed to assess how regulatory practices- such as licensing, training oversight, inspection of practice, and quality assurance mechanisms- affect the quality of healthcare provided by private providers. Methods: The study targeted 108 healthcare providers from 36 private health facilities, primarily nurses and clinical officers. A sample of 86 participants was drawn using purposive sampling. The data were collected using a structured questionnaire. Results: The licensing of health professionals, training, inspection of practice, and quality assurance mechanisms collectively influenced 47.9% of the variation in service quality. Statistical analysis revealed significant associations between licensing (p=0.003), practice inspections (p=0.01), quality assurance (p=0.001), and service quality. Conclusions: Regulatory bodies play a crucial role in ensuring healthcare standards; however, their effectiveness hinges on tailored strategies that address local challenges and foster collaborative efforts towards sustainable quality improvement in healthcare services. Routine inspections, conducted in a supportive manner, are likely to ensure ongoing adherence to standards. Moreover, adequate resource allocation for regulatory compliance and continuous quality improvement activities, including the formation of internal quality improvement (QI) teams and the maintenance of regular QI meetings and assessments, was deemed essential.

Patient Satisfaction with Physiotherapi Services In Hospital

Hospitals are one of the various facilities owned by each country which are used to provide health services to the entire community, therefore every hospital is obliged to provide quality health services so that they can satisfy every patient who is undergoing treatment. To realize the stated goals of every hospital in terms of building health services in hospitals, especially in Physiotherapy services, every hospital must have services that are at a good level. Such as in terms of therapist competency, knowledge that is always upgraded by each health worker, professionalism of health workers, and good communication between health workers and patients. This research aims to analyze patient satisfaction with physiotherapy services using a literature review method based on data from Google Scholar or Google Scholar. We use the literature of 4 journals. The results and conclusions of this research obtained from 4 previous journals stated that patients were satisfied with the physiotherapy services provided at the hospital with a p-value < 0.05.

Analisis Faktor-Faktor yang Berhubungan dengan Kinerja Petugas Kesehatan di Puskesmas Kota Soe Kabupaten TTS Tahun 2023

Health workers are required to have the ability and skills to work in order to produce good performance, thus providing quality health services. The minimum service standards have not been achieved at the Kota Soe Health Center mean that the performance of health workers is not optimal. Performance is influenced by various factors, from motivational factors, work environment, rewards, and work discipline. The purpose of this study was to determine the factors associated with the performance of health workers at the Kota Soe Health Center in 2023. This research is an analytic survey research with cross sectional approach. The sample in this study consisted of 45 people with a sampling technique that is simple random sampling. Data collection used questionnaires, data analysis was carried out univariate and bivariate, then tested using the chi square statistical test. The results showed that there was a relationship between motivation and the performance of health workers with a value (p=0.025), there was a relationship between the work environment and the performance of health workers with a value (p=0.001), there was a relationship between appreciation and the performance of health workers with a value (p=0.004), and there was a relationship between work discipline and the performance of health workers with a value (p=0.001). It is expected that Health workers need to pay attention to health facilities again, organize the work environment properly, improve the distribution of incentives, leader can appreciate the work of health workers, and affirm time discipline.

First-aid training for primary Healthcare providers on a remote Island: a mixed-methods study

BackgroundEnsuring ongoing first-aid training for primary healthcare providers (PHPs) is one of the critical strategies for providing quality health services and contributing to achieving universal health coverage. However, PHPs have received insufficient attention in terms of training and capacity building, especially in the remote areas of low-to-middle-income countries. This study evaluated the effectiveness of a first-aid training program for PHPs on a Vietnamese island and explored their perspectives and experiences regarding first-aid implementation.MethodsA mixed-methods study was conducted among 39 PHPs working in community healthcare centers. The quantitative method utilized a quasi-experimental design to evaluate participants’ first-aid knowledge at three time points: pre-training, immediately post-training, and three months post-training. Sixteen of the PHPs participated in subsequent semi-structured focus group interviews using the qualitative method. Quantitative data were analyzed using repeated measures analysis of variance (ANOVA), while qualitative data were subjected to thematic analysis.ResultsThe quantitative results showed a significant improvement in both the overall mean first-aid knowledge scores and the subdimensions of the first-aid knowledge scores among healthcare providers post-training. There was a statistically significant difference between the baseline and immediate posttest and follow-up knowledge scores (p < 0.001). However, the difference in knowledge scores between the immediate posttest and three-month follow-up was not significant (p > 0.05). Three main themes emerged from the focus group discussions: perception of first-aid in remote areas, facilitators and barriers. Participants identified barriers, including infrastructure limitations, shortage of the primary healthcare workforce, inadequate competencies, and insufficient resources. Conversely, receiving considerable support from colleagues and the benefits of communication technologies in implementing first aid were mentioned as facilitators. The training bolstered the participants’ confidence in their first-aid responses, and there was a desire for continued education.ConclusionsImplementing periodic first-aid refresher training for PHPs in a nationwide resource-limited setting can contribute significantly to achieving universal health coverage goals. This approach potentially enhances the preparedness of healthcare providers in these areas to deliver timely and effective first aid during emergencies, which may lead to more consistent primary healthcare services despite various challenges.

Perbandingan Motivasi Kerja Ruang Rawat Inap Dan Ruang Operasi Dalam Pelaksanaan Pendokumentasian Di RS MTSJ

As providers of health services, hospitals are required to provide quality health services. Quality service is reflected in documentation in the form of client nursing notes. Nursing documentation is a very important tool that can be used as an indicator of the implementation of nursing care in hospitals (Fitri, 2019). Nursing care documentation is documentation that contains complete, real and recorded data, not only about the client's level of pain, but also the type, quality and quantity.

Peningkatan Keselamatan di Rumah Sakit melalui APAR dengan Teknologi (Literatur Review)

Improving safety in hospitals is a crucial aspect in efforts to provide quality health services. This article is a literature review that discusses the important role of Light Fire Extinguishers (APAR) supported by technology in increasing the level of safety in hospitals. This review explores a number of studies that reveal the benefits of using fire extinguishers equipped with advanced technology, such as fire sensors, automatic monitoring and rapid notification, in reducing the risk of fire in hospital environments. Apart from that, this article also reviews regulatory aspects, personnel training, and other factors that are key to the successful implementation of APAR technology in the hospital context. The writing method used is descriptive qualitative with a literature review approach where the data comes from various online sources, such as Google Scholar. The results of this literature review provide a better understanding of how the use of APAR integrated with technology can be an effective solution to improve the safety of patients, medical staff and facilities in hospitals.

Effectiveness and Efficiency of Using LINAC Precise and Cobalt-60 Medical Devices at Dr. Mohammad Hoesin Hospital Palembang

Hospitals are social institutions that provide quality health services to every customer. To meet expected service standards, hospitals should have effective procurement of medical equipment. This study aims to evaluate the effectiveness and efficiency of utilities in the use of medical devices in supporting services at RSUP Dr. Mohammad Hoesin Palembang, with descriptive analytical research using quantitative methods with a cross sectional research design. The research results show that there is a significant difference between the Break Event Point (BEP) value before and after purchasing the Cobalt 60 aircraft from the target of 90 patients per day to 87 patients per day, and there is a significant difference between the BEP value before and after purchasing the Precise LINAC aircraft from the target of 70 patients per day to 55 patients per day. Based on the calculation of the effectiveness and efficiency of the utility of using the Cobalt 60 and Linac Precise aircraft, it can be concluded that the utility of using the Cobalt 60 aircraft at RSUP Dr. Mohammad Hoesin Hospital Palembang is considered ineffective (50%) but efficient (70.88%) with a BEP value of 5.5 years; while the utility of using the Linac Precise aircraft at RSUP Dr. Mohammad Hoesin Hospital Palembang is considered effective (113%) and efficient (51.77%) with a BEP value of 4.1 years. The data above shows that hospitals experienced slight losses due to the Covid-19 pandemic because the number of patients using medical equipment did not reach the target, but hospitals were able to manage expenditure well so that there was a decrease in the efficiency ratio every year in the procurement of medical equipment.

Good Governance (Tata Kelola) Dan Kualitas Pelayanan Kesehatan, Pengaruhnya Terhadap Kepuasaan Pasien, Di Rsud. Sogaten, Kota Madiun

Abstract— This research is motivated by limited efforts to build good governance in hospital management, so that it has not been able to produce quality health services that are easy, reasonable, affordable and high quality. With the increasingly complex demands of the community using hospital services in the form of comfort and convenience in health services, good governance is needed in the management of health service programs so that they can be presented in accordance with the hopes and desires of the community as health service patients. The presence of quality health services is very important to increase patient satisfaction, because with patient satisfaction the patient will use health services, but conversely if the patient feels dissatisfied they will switch to another hospital. The research method was carried out using a quantitative approach, and sampling was carried out by purposive sampling of 200 respondents from a total population of 400 respondents taken based on data on the average daily patient visits at RSUD. Sogaten, Madiun City. Data collection was carried out by observation, documentation and questionnaires. Meanwhile, data analysis was carried out through multiple linear regression with data processing through the SPSS program. The research results show that (1) there is an influence of Good Governance (Hospital Management) on Patient Satisfaction in RSUD. Sogaten, Madiun City. (2) there is an influence of the quality of health services on patient satisfaction with health services at RSUD. Sogaten, Madiun City. (3) there is an influence of Good Governance and Quality of Health Services on Patient Satisfaction with Health Services at RSUD. Sogaten, Madiun City. Good governance for public institutions is no exception to RSUD. Sogaten, Madiun, implementing the principles of good governance is not just an obligation but has become a necessity. There are 9 (nine) principles of good governance, namely: Participation, Rule of Law, Transparency, Responsiveness, Consensus Orientation, Effectiveness and Efficiency, Equity, Accountability, and Strategic Vision. The presence of good governance in hospital management will encourage improvements in the quality of health services, because all health personnel resources will be focused on carrying out their duties and obligations well, especially in the context of providing quality health services.

PENGUKURAN KINERJA ASRI MEDICAL CENTER DALAM PERSPEKTIF BALANCED SCORECARD

The company performance is a reflection of an activity results and condition of the company. The results of the activities of the company being analyzed, where the results will show the condition of the company's management during the period of performance analysis done. Asri Medical Center (AMC) is one of Muhammadiyah University of Yogyakarta units in health care, education and research belong to da’wa infrastructures. To realize its goal in providing quality health services for people, AMC has to make a performance appraisal regularly and continuously. The objective of this research is to measure the performance of AMC based on the Balanced Scorecard with reference to the performance standards in the AMC. This research is an eksploratoris case study that measured management performance with the Balanced Scorecard, which is assessing the performance not only from the financial aspect but also from non-financial aspects. The subjects of this research are AMC managers, and the data used is the data of 2010 and 2011. The data used are the primary data i.e field studies in the form of interview and observation and also secondary data in the form of general data and specific data on the AMC which includes financial and non financial data. AMC has been running the Balanced Scorecard stages, that is strategy formulation arranged as a result of the macro, industry environments analysis as well as SWOT analysis and has formulated a vision, mission, purpose, basic beliefs, basic values and strategy. The next phase, AMC has developed a strategic plan that includes strategic goal, target and strategic initiatives. The strategic targets have been formulated considering the financial perspective, customer perspective, business process perspective and learning and growth perspective. AMC has to define planning into work program with key performance indicators that can be measured and in accordance with performance standards for each medical center.

A survey on the effects of patient safety training programs based on SBAR and FMEA techniques on the level of self-efficacy and observance of patient safety culture in Iran hospital, Shiraz in 2022-2023.

Patient safety and medical personnel self-efficacy are among the main factors involved in providing quality health services. Moreover, safety culture in an organization is considered one of the most critical factors regarding patients' safety. Therefore, the present study aimed to determine the effects of patient safety programs based on Situation, Background, Assessment, Recommendation (SBAR) and Failure Model Effects Analysis (FMEA) techniques on self-efficacy and patient safety culture in Iran Hospital of Shiraz in 2022-2023. This two-stage quasi-experimental study was conducted in 2022-2033. Considering inclusion criteria, the present study included 80 nurses working in Iran Hospital. The participants were divided into groups of SBAR (40 participants) and FMEA (40 participants). All the data were collected using a Hospital Survey on Patient Safety Culture questionnaire and Sherer General Self-Efficacy Scale. Then, the collected data were analyzed using SPSS 13, Fisher's exact test, paired t-test, and independent t-test with a significant level of P < 0.05. The mean score of total patient safety culture between the two groups was insignificant before the intervention (P = 0.58). However, it was more significant in the FMEA group than the SBAR group after the intervention (P < 0/05). In addition, the mean self-efficacy score between the two groups was insignificant before the intervention (P = 0.80). However, after the intervention, the mean score of the FMEA group was significantly higher than the SBAR group (P < 0.05). According to the findings of this study, there is a meaningful relationship between patient safety training programs based on SBAR and FMEA techniques on patient safety and self-efficacy of nurses; however, FMEA training has more positive effects on self-efficacy and patient safety compared to other techniques. As a result, these techniques, along with other plans, are recommended to authorities in order to help improve patient safety.

Sistem Informasi Inventaris Barang Berbasis Web Pada Dinas Kesehatan Kabupaten Gresik

The Gresik District Health Service, as one of the public service institutions in the health sector, has a big responsibility in providing quality health services for the community. In carrying out its duties, the Gresik District Health Service certainly cannot be separated from the need for inventory of goods. In reality, many government agencies, including health agencies, still manage inventory manually. Often, this method causes problems such as stock monitoring, asset tracking, and inefficient and inaccurate reporting. As a result, a solution is needed that can increase the efficiency and effectiveness of inventory management. Web-Based Goods Inventory Information System at the Gresik District Health Service with the aim of making it easier to process and report goods inventory data. This research applies a waterfall software development approach, which involves the stages of analysis, design, implementation and testing.

The Relationship Of Motivation For Entering The Faculty Of Medicine And Dentistry On Students' Academic Achievement

Education is essential in modern society, both politically and economically. Medical training plays a critical role in producing qualified doctors. Competent doctors, the result of training provided by quality medical education institutions, provide quality health services to the community. Motivation is significant in determining learning success. This research aims to determine the relationship between motivation for entering medical and dental faculties and student's academic achievement. An online survey was used to collect data for this research. The sample population of the research was medical and dental students from Prima Indonesia University. The strength of the Motivation for Medical Students (SMMS) instrument, translated into Indonesian, was used to collect data for student motivation. 123 out of 493 medical and dental students participated in this research. Survey results show that suitability and interest are why students enter medical and dental faculties. The Spearman's rho correlation test shows no significant relationship between motivation variables and GPA, with Sig. (2-tailed) of 0.303 where p &gt; 0.05. The Mann-Whitney test shows no statistically significant difference between the two genders with Sig. (2-tailed) of 0.558 where p &gt; 0.05. This study shows that although there are various reasons and motivations for entering medical and dental faculties, there is no relationship between the above and academic achievement.

The Effect of Fitness Level, Organizational Support, and Compensation on the Work Productivity of Tangerang City Health Office Employees Mediated by Organizational Motivation

Work productivity is one of the important factors in organizational success. In the health sector, employee work productivity has a very important role in providing quality health services to the community. The purpose of this study was to analyze the effect of body fitness level, organizational support, and compensation on the work productivity of Tangerang City Health Office employees mediated by organizational motivation. This research uses quantitative research methods. Data collection techniques in this study used literature study and questionnaire methods. The data that has been collected is then analyzed using regression analysis. The results showed that the level of body fitness, organizational support, and compensation had a positive effect on the work productivity of employees of the Tangerang City Health Office. Then, organizational motivation is proven to mediate the influence of body fitness level, organizational support, and compensation on the work productivity of Tangerang City Health Office employees.

"Sickness has no time": Awareness and perceptions of health care workers on universal health coverage in Uganda.

Each person having access to needed health services, of sufficient quality, and without suffering financial hardship, defined as universal health coverage (UHC) by the World Health Organization, is critical to improve population health, particularly for vulnerable populations. UHC requires multisectoral collaboration and good governance, and this will require buy-in of key stakeholders; but their views are under-documented. The aim of this stakeholder analysis was to explore the awareness and perceptions of UHC by health care workers (HCWs) in Uganda. A mixed-methods study was conducted based on primary data from HCWs including an online QualtricsXM survey of 274 HCWs (from a database of persons who had received training at an academic institution), 23 key informant semi-structured interviews, and one eight-person focus group discussion. Data was collected from February to April 2022. Microsoft Excel and R Programme were used for quantitative analyses and NVivo version 12 for qualitative analyses. HCWs attributed a high level of importance to UHC in Uganda. Participants discussed national communication and management practices, organisational roles, health financing and power dynamics, health care demand and the impact of and learnings from COVID-19. Four main themes-each with related sub-themes-emerged from the interview data providing insights into: (1) communication, (2) organisation, (3) power, and (4) trust. There is a critical need for better communication of UHC targets by policymakers to improve understanding at a grassroots level. Results indicated that ensuring trust among the population through transparency in metrics and budgets, strong accountability measures, awareness of local cultural sensitivities, sensitisation of the UHC concept and community inclusion will be essential for a multisectoral roll out of UHC. Further provision of quality health services, a harmonisation of efforts, increased domestic health financing and investment of HCWs through fair remuneration will need to underpin the delivery of UHC.

Model of Health-Promoting Community Health Center in the Islands to Support Healthy Cities in South Sulawesi Province

Purpose: This study aims to find a model of Health-Promoting Puskesmas in the archipelago in supporting healthy cities in South Sulawesi Province.&#x0D; &#x0D; Theoretical Reference: Some healthy setting thinkers believe that the healthy cities approach as a tool in solving regional health problems is seen as a too broad concept. The Healthy Islands Concept (HIC) is one of the initiatives which has elemental settings to promote health in island people and communities. Healthy Island refers to island settings, one of which is the Community Health Center (Puskesmas). Realizing Health-Promoting Hospitals has become a global movement. Otherwise, realizing Health-Promoting Puskesmas which has a different position and roles and responsibilities in improving health has raised difficulties. Moreover, health problems in Puskesmas in urban areas can be different from Puskesmas on the island.&#x0D; &#x0D; Methods: This study uses quantitative analysis. There were 700 respondents selected as sample. They were the community that go to the Puskesmas or those in the working area of the Puskesmas. The research locations are in 3 archipelagic regencies/cities, namely islands in Makassar City, Pangkajene Islands Regency, and Selayar Islands Regency. The data were analyzed quantitatively using Confirmatory Factor Analysis (CFA) and then analyzed using Structural Equation Modeling/SEM.&#x0D; &#x0D; Results and Conclusion: Based on the data collection, it was found that there are 7 dimensions with 28 indicators that can form a model of a health-promoting Puskesmas in the islands. Further, the dimension that has the strongest contribution in establishing the model of a health center in islands is the work group dimension of healthy puskesmas with an average loading factor value for each indicator of &gt; 9 so that it can be illustrated that these indicators are stronger than other indicators existing in other dimensions of the Puskesmas models in the islands. A Puskesmas model that is suitable for archipelagic areas has implications for efforts to prevent and improve health, as well as provide quality health services.&#x0D; &#x0D; Implication of Research: Thus, this Puskesmas model can improve the health status of the island community.&#x0D; &#x0D; Originality: The results of this research are expected to be input for the Ministry of Health, the Health Service, Provincial and district/city Governments, and also for society as a whole in realizing a Health-Promoting Puskesmas.

Patients’ perceptions of quality health services delivery in Tanzania: Engendering gaps for policy action

Background: Patients’ perceptions drive healthcare quality globally. Therefore, understanding their views on professionalism and satisfaction is crucial. A patient-centric approach is essential, offering insights into meeting their needs and expectations. Objective: This study aimed to determine patients’ perception of the quality of health service provision in Tanzanian zonal referral hospitals. Methods: The study employed a cross-sectional design in four zonal referral hospitals in Tanzania. Data were collected using a questionnaire survey from 376 participants conveniently selected from May to June 2023. Data were analyzed using IBM SPSS version 26 for descriptive analysis and one-way ANOVA. Results: The proficiency of care and health workers’ ability to instill trust and confidence in patients and their ability and willingness to provide services accurately and reliably influenced patients’ perceptions. Furthermore, personalized attention, workers’ appearance, physical facilities, and other working materials increased patients’ ratings of the health service delivery. Conclusion: The proficiency of care, promptness, and accuracy of service delivery are essential components in health service provision that can influence patients’ ratings. Therefore, policymakers, government, and other stakeholders should train health workers continuously to improve their competencies while ensuring the entire health system is effectively monitored.

Evaluation of Drug Management and Improvement Strategies Using the Hanlon Method in the Pharmacy Installation of Dr. Moewardi General Hospital, Surakarta, Indonesia

A hospital pharmacy (FRS) is a unit in a hospital that carries out health efforts by providing quality health services. Medication management in FRS is an important management aspect in achieving service quality. Therefore, IFRS must be managed effectively and efficiently. Inefficiency in use can have a negative impact on hospitals both medically and economically. The aim of this study was to evaluate drug management, including selection, procurement, distribution, and use, based on the 2020 National Formulary standards and improvement strategies using the Hanlon method at the pharmacy installation of Dr. Moewardi General Hospital in 2020. This research is a type of descriptive research with retrospective and concurrent data collection. Data was taken from retrospective data in 2020 and data at the time the research was conducted. Research materials include primary data obtained from observation of research data in the form of document selection, procurement, distribution, and use of medicine in the IFRS Dr. Moewardi General Hospital. Secondary data was obtained from interviews with the head of the pharmacy installation at Dr. Moewardi General Hospital Surakarta, the head of planning, and the head of ULP (procurement services unit). The results of the research show that 1) Medication management in the pharmacy installation at Dr. Moewardi General Hospital Surakarta is not yet efficient at this stage of selection. It is known that the availability of existing medicines does not comply with FORNAS standards in 2020. then, in stage procurement, there is 1 out of 5 indicators that meet the standard; in stage distribution, 5 indicators were obtained, or all of them were not standard, and in staged use, it was found that 1 of the 5 indicators met the standard. 2) The improvement strategy uses the Hanlon method in drug management, namely prioritizing problem repairs sequentially, starting from the percentage of conformity with the number of drug items available with FORNAS to the number of drug items per prescription sheet.

Perspectives on the Strategic Health Impact in Romania

The health system and management of medical services is a sector of major importance, considering that it concerns the entire population, emphasis should be placed on the medical act, on the motivation and training of medical personnel to provide quality health services that respond fully meet patient expectations. It should be remembered that it is easier to prevent than to treat, and primary prevention represents the basis of a healthy society and the most effective and inexpensive method to stop the occurrence and evolution of chronic diseases. In this sense, new concepts and methodologies have been developed, both worldwide and in our country, especially recently, that try to meet the needs. It is approached differently and specifically depending on the individual needs, the resources we have at hand, all of which have as the result the improvement of the medical act and the satisfaction of the patient.