Analisis Proses Bisnis Imolementasi Sistem Manager On Duty di Rumah Sakit

Suwandhi, Martina Sinta Kristanti, S.Kep., Ns., M.N., Ph.D ; dr. Dewi Ratnasari, MPH

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar belakang: Rumah sakit menyelenggarakan pelayanan selama 24 jam, sedangkan struktur manajemen reguler tidak selalu berada di tempat sepanjang waktu. Kondisi tersebut memerlukan mekanisme koordinasi operasional untuk menjaga kesinambungan pelayanan, terutama ketika terjadi masalah lintas unit, keterbatasan sumber daya, gangguan patient flow, maupun kebutuhan eskalasi keputusan. Manager on Duty (MOD) menjadi salah satu mekanisme yang digunakan rumah sakit, namun proses bisnis implementasinya belum banyak dikaji secara komprehensif.

Tujuan: Menganalisis proses bisnis implementasi MOD dalam supervisi operasional pelayanan rumah sakit selama 24 jam, meliputi alur aktivitas, koordinasi, pengendalian, eskalasi, integrasi pelayanan klinis dan nonklinis, hambatan, serta kontribusinya terhadap stabilitas pelayanan, mutu, dan keselamatan pasien.

Metode: Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus multipel di RSA UGM dan RS Siti Khodijah Pekalongan. Sebanyak 22 informan dipilih secara purposive sampling. Data diperoleh melalui wawancara mendalam, FGD, observasi, dan telaah dokumen. Analisis menghasilkan 126 open coding, 14 kategori, dan 5 tema.

Hasil: Model proses bisnis kondisi aktual (AS-IS) mencakup identifikasi masalah, assessment, koordinasi lintas unit, pengambilan keputusan, implementasi solusi, monitoring, handover, dan pelaporan. Bottleneck ditemukan pada beberapa titik proses dengan lima kelompok akar penyebab, yaitu sumber daya manusia, proses bisnis, organisasi, teknologi dan sistem informasi, serta kebijakan dan tata kelola. Berdasarkan temuan tersebut dikembangkan rancangan TO-BE yang menekankan standardisasi kewenangan, kompetensi, koordinasi, integrasi informasi, patient flow, dan dokumentasi.

Kesimpulan: MOD berfungsi sebagai mekanisme integrasi proses operasional yang mendukung kesinambungan koordinasi pelayanan selama 24 jam. Penguatan MOD memerlukan perbaikan sistemik pada aspek sumber daya manusia, proses, organisasi, teknologi informasi, dan tata kelola.

Background: Hospitals provide services 24 hours a day, while the regular management structure is not always physically present at all times. This condition requires an operational coordination mechanism to maintain continuity of care, particularly when cross-unit problems, resource limitations, patient flow disruptions, or decision escalation needs occur. The Manager on Duty (MOD) is one mechanism used by hospitals to address these needs; however, its implementation as a business process has not been comprehensively studied.

Objective: To analyze the business process of MOD implementation in supervising hospital operations over 24 hours, including activity flow, coordination, process control, escalation, integration of clinical and non-clinical services, implementation barriers, and its contribution to service stability, quality, and patient safety.

Methods: This qualitative study employed a multiple-case study design at RSA UGM and Siti Khodijah Hospital Pekalongan. A total of 22 informants were selected through purposive sampling. Data were collected through in-depth interviews, Focus Group Discussions, observations, and document reviews. The analysis generated 126 open codes, 14 categories, and 5 themes.

Results: The current-state business process model (AS-IS) includes problem identification, assessment, cross-unit coordination, decision-making, solution implementation, monitoring, handover, and reporting. Bottlenecks were identified at several process points and were associated with five groups of root causes: human resources, business processes, organizational factors, technology and information systems, and policy and governance. Based on these findings, a TO-BE model was developed, emphasizing standardization of authority, competencies, coordination, information integration, patient flow, and documentation.

Conclusion: MOD functions as an operational process integration mechanism that supports continuity of hospital coordination over 24 hours. Strengthening MOD requires systemic improvements in human resources, processes, organizational capacity, information technology, and governance.

Kata Kunci : Kata kunci: Manager on Duty, proses bisnis, Business Process Management, patient flow, rumah sakit.