PENGALAMAN PASIEN DAN PENERAPAN STANDAR PELAYANAN BERFOKUS PADA PASIEN DI INSTALASI RAWAT INAP RUMAH SAKIT

BETHA CANDRASARI, Prof. dr. Adi Utarini,M.Sc.,MPH.,Ph.D.; Ir.Valentina Dwi Siswiyanti,M.Kes

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang. Penerapan akreditasi dan ISO 9001 merupakan upaya meningkatkan pelayanan berfokus pada pasien. Bukti-bukti penerapan akreditasi maupun ISO di RS secara internasional masih perlu dikaji kembali, apakah dengan menerapkan kedua sistem tersebut secara bersamaan di suatu RS, dapat meningkatkan pengalaman pasien. Tujuan.Mengukur pengalaman pasien di pelayanan Rawat Inap dan menjelaskan penerapan standar akreditasi dan ISO 9001 dalam menghasilkan pengalaman pasien yang positif. Metode. Penelitian mixed methods sekuensial eksplanatori. Pengumpulan data kuesioner dari picker scale, wawancara dan FGD. Lokasi penelitian di 2 RSU terakreditasi dan 2 RSU terakreditasi serta ISO 9001. Jumlah sampel pasien 358 orang, 4 kelompok FGD, 4 wawancara staf medis. Analisis data dengan uji statistik Z Test dan analisis deskriptif. Hasil dan pembahasan. Hasi pengalaman pasien pada kedua kelompok RS dengan Z test menunjukkan z=0,43, z <1,96, artinya Hipotesis diterima. Persentase pengalaman pasien kelompok RS terakreditasi dan ISO 9001 lebih baik pada variabel 1,4,5,7. Sedangkan persentase pengalaman pasien pada kelompok RS terakreditasi lebih baik pada variabel 2,3 dan 6. Faktor penguat pada kelompok RS terakreditasi berupa dukungan dokumentasi, keharusan staf mempertimbangkan nilai-nilai,budaya,keyakinan, hak dan edukasi pasien/ keluarganya, faktor penguat di kelompok RS yang menerapkan kedua sistem yaitu komitmen kuat pimpinan, keharusan engagement pasien dan keharusan kesadaran individu. Kesimpulan dan saran. Penerapan standar akreditasi RS memberi pengalaman pasien yang positif dalam hal koordinasi petugas,dukungan emosional dan kontinuitas pelayanan, sedangkan penerapan standar ISO 9001 menguatkan dalam hal pemberian informasi dan penjelasan petugas, respek terhadap pasien,keterlibatan pasien dan kesan secara keseluruhan dirawat dengan terhormat.

Background. The implementation of accreditation and ISO 9001 is an attempt of hospital in enhancing the patient centred service. The evidences of such implementation in hospital at an international scale need to be reviewed regarding whether the implementation of both systems simultaneously in a hospital can enhance the patient experience. Objective: To measure the inpatient experiences and to explain the implementation of the standards of accreditation and ISO 9001 in generating the positive patient experience. Method: This is a research with explanatory sequential mixed methods design in which the data was collected from questionnaires from picker scale, interview and Group Discussion Forum. It was conducted in 2 accredited General Hospital and 2 ISO 9001accredited hospitals. 358 patients as the sample, 4 groups of FGD, and 4 interviewee were involved. The data analysis was used using the statistical test of Z test and descriptive analysis. Results and Discussion: The result of the test on the z test in two groups of hospitals showed no differences between them. The patient experience in the group of ISO 9001 accredited hospital was found better in the variable of 1,4,5 and 7. On the other hand, the accredited hospital was found better in variable 2,3 and 6. The supporting factors giving the positive supports to the accredited hospital were in the form of documentation, staffs obligation to consider the values, culture, belief, to support the human rights and to educate the patients and their families. Meanwhile, the supporting factors in the hospital implementing both systems were in the form of strong commitment of top management, obligation of patient engagement and the awareness of individual and the commitment of leaders. Conclusion and Suggestion. The implementation of the hospital accreditation standard has given the positive experience of patient in terms of the coordination of the staff service, emotional supports and continuing of care and the implementation of ISO 9001 standard strengthened in terms of giving information and staff explanation, respects to the patients, family engagement and entire impression during the health care treatment. Here, it is suggested that there is a need of the research developments for more numbers of samples and concern with the homogeneity of hospital characteristics.

Kata Kunci : akreditasi KARS 2012, sertifikasi ISO 9001:2015, pengalaman pasien rawat inap, mixed methods, rawat inap rumah sakit,picker scale, accreditation of KARS 2012, certification of ISO 9001:2015, Experience of inpatients, mixed methods,inpatient department, pi