EVALUASI MONITORING PASCA AKREDITASI PUSKESMAS DI WILAYAH JAKARTA PUSAT

KRISTIANI DWI H, Prof. dr. Adi Utarini, MSc., MPH., PhD

2019 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Dalam upaya pembangunan kesehatan, fasilitas layanan kesehatan khususnya Fasilitas Kesehatan Tingkat Pertama (FKTP) perlu memberikan pelayanan sesuai standar. Standar yang digunakan merupakan ketetapan dari Kementrian Kesehatan Republik Indonesia yang dinilai melalui proses akreditasi. Selain sebagai tolak ukur standar pelayanan, akreditasi juga diharapkan sebagai bagian dari upaya peningkatan mutu yang berkesinambungan. Oleh karena itu, diperlukan adanya monitoring dan evaluasi berkala terhadap akreditasi tersebut. Hal ini merupakan tanggung jawab dari Suku Dinas Kesehatan yang diimplementasikan melalui kegiatan monitoring pasca akreditasi Puskesmas. Peranan regulasi Suku Dinas Kesehatan dalam monitoring ini maka peneliti merumuskan permasalah yang menjadi tantangan regulasi dengan adanya akreditasi dalam mendorong peningkatan mutu pelayanan kesehatan. Tujuan: Membentuk monitoring budaya mutu Puskesmas pasca Akreditasi oleh Suku Dinas Kesehatan Jakarta Pusat melalui monitoring Metode: Penelitian yang dilakukan merupakan jenis evaluasi model CIPP (Context, Input, Process, Product) yang menggunakan pendekatan kualitatif deskriptif melalui wawancara. Tempat pelaksanaan di Suku Dinas Kesehatan dan Puskesmas wilayah Jakarta Pusat. Sampel diambil berdasarkan purposive sampling dan berjumlah 38 sampel. Analisis data menggunakan teknik analisis deskriptif. Hasil: Hasil wawancara dan 3 grup FGD akreditasi memberikan dampak positif terhadap Budaya Organisasi. Baik Puskesmas Paripurna maupun non Paripurna masih sama perlu penyempurnaan dalam menyiapkan reakreditasi. Budaya organisasi yang dibentuk semua kegiatan menggunakan konsep PDCA. Membangun budaya kerja dalam peningkatan mutu Continuous Quality improvement. Ketidaksiapan Pihak Suku Dinas Kesehatan dalam monitoring masih banyak gap yang harus dipenuhi Kesimpulan: Kebijakan akreditasi sudah dipahami untuk dilaksanakan tetapi materi Manajemen Puskesmas, materi pendukung dan instrumen akreditasi belum dipahami semua pihak monitoring. Instrumen akreditasi perlu evaluasi agar mudah dijalankan pihak Pusksmas. Jadwal pelaksanaan monitoring pasca akreditasi sering berubah karena kurang SDM dan hanya sebagai tugas tambahan. Akreditasi membangun sistem dengan konsep PDCA dan perlu waktu untuk mengungkit hasil capaian.

Background: Health Service facility, especially primary public health facility, needs to follow the standard of health service. The standard is the one that is being regulated by Indonesia Ministry of Health through accreditation process. In addition of being a standard for health service accreditation, accreditation is also a way of enhancing the quality of sustainable health service. Hence, monitoring and regular evaluation are needed. Distric Health departemen takes the responsibility which is implemented through post accreditation monitoring in Public Health Center. Based on the role of Distric health Departemet’s regulation in monitoring, researcher formulate problems which is Based on field observation it founded the incompatibility of implementation of accreditation, the researcher should allocate the problem and formulate the way through accreditation to enhance health service. Goals: Develop the habit of Distric Health Departement to monitor the quality service of Public Health Centers pasca accreditation through monitoring. Methods: The study follows the of evaluation of CIPP models (context, input, process and products) using approachment of qualitative descriptive through interview method. The study is conducted in Distric Health Departement in Central Jakarta. The sample based on the purposive sampling with the total sample is 38 . Analysation of collected data uses descriptive analysis. Results: the result of interview and three accreditation FGD groups give positive impact to organization culture. Both Public health center paripurna and non-paripurna still need finishing on preparation reaccreditation. Organization culture that needs to be build is PDCA-concept based activies to enhance the quality of Continuous Quality Improvement. Distric Health Departement on monitoring public health center is not ready because there are still gaps that needs to be fulfilled. Conclusion: Accreditation regulation is understood enough to implement it. However, Public health center management and accreditation regulation has not been understood by all monitoring aspects. Accreditation instruments needs to be evaluated in order to ease implementation for Public Health Centers. Schedule of monitoring pasca accreditation that is not fixed because lack of staff and it is only be seen as additional work. Accreditation build system with PDCA concept and it needs time to see the results.

Kata Kunci : Akreditasi Puskesmas, Budaya Mutu, monitoring pasca akreditasi, Accreditation Primary Public Health Services, quality culture, monitoring pasca accreditation