Redesain proses pelayanan kasus bedah dengan metode failure mode and effect analysis di unit gawat darurat RSUD Ade Mohamad Djoen Sintang Kalimantan Barat

TRIFINA, Rosa, dr. Tjahjono Kuntjoro, MPH, DrPH

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang : Rumah Sakit Umum Daerah Ade Mohamad Djoen Sintang merupakan RSUD tipe C milik Pemerintah daerah Kabupaten Sintang Propinsi Kalimantan Barat, dengan jumlah tempat tidur sebanyak 132. RSUD ini sebagai pusat rujukan bagi derah timur Kalimantan Barat . Dengan semakin meningkatnya kunjungan pasien ( rata-rata 3%) dalam 3 tahun terakhir RSUD ini seharusnya semakin meningkatkan pelayanan terhadap kebutuhan masyarakat. Banyaknya keluhan dari masyarakat baik yang dimuat di mass media maupun keluhan langsung menunjukan bahwa pelayanan yang diberikan belum bermutu. Tujuan Penelitian : Merancang desain mutu pelayanan yang baru di Unit Gawat Darurat RSUD Ade Mohamad Djoen Sintang dengan mengidentifikasi faktor-faktor yang mempengaruhi pelayanan, dan mengidentifikasi potensi kegagalan yang ditimbulkan serta membuat desain baru proses pelayanan kasus Bedah di UGD RSUD Ade Mohamad Djoen Sintang. Metode Penelitian : Jenis penelitian deskriptif dengan rancangan studi kasus tunggal terpancang. Rancangan studi kasus tunggal terpancang oleh karena penelitian ini dilakukan di satu rumah sakit pada unit pelayanan gawat darurat. Subjek penelitian adalah prosess pelayanan kasus bedah yang dilakukan petugas kepada pasien dan identifikasi melalui Rekam medis. Hasil Penelitian : Penelitian studi kasus tentang proses pelayanan gawat darurat kasus bedah di RSUD Ade Mohamad Djoen Sintang Kalimantan Barat ini menggunakan metode FMEA (Failure Mode and Effect Analysis).Sesuai dengan langkah-langkah penerapan FMEA didapatkan Criticality Index (CI)/Risk Priority Number tertinggi pada proses pemeriksaan fisik sehingga menjadi prioritas penanganan. Faktor penyebabnya adalah: 1.Sarana/prasarana 2. Metode 3.Petugas/SDM 4.Pasien 4. Lingkungan Kesimpulan : Hasil dari penelitian ini menunjukkan bahwa pelayanan di Unit Gawat Darurat Rumah Sakit Umum Daerah Ade Mohamad Djoen Sintang selama ini belum memberikan pelayanan yang prima dan bermutu seperti yang ingin dicapai sesuai dengan visi misi rumah sakit. Dari rangkaian proses pelayanan di UGD RSUD Ade Mohamad Djoen Sintang yang dimulai dari pendaftaran, anamnesa, pemeriksaan fisik, terapi dan tindak lanjut ternyata proses pemeriksaan fisik yang mempunyai Risk Priority Number tertinggi sehingga merupakan prioritas yang harus didesain ulang. Dengan demikian maka redesain proses pelayanan kasus bedah di unit gawat darurat RSUD Ade Mohamad Djoen lebih ditujukan pada dua faktor yaitu sumber daya manusia dan lingkungan khususnya pada tata ruang unit gawat darurat sesuai standar rumah sakit tipe-C.

Background: Ade Mohamad Djoen Regional General Hospital, Sintang, form of C type hospital of government own in Sintang Regency, Kalimantan Barat Province, with bed number is 132. As a referral center for east region of West Borneo, by the more increasing of patient visiting (average was 3%) in three years later, its must to more increase the service to the public need. Its proved by many public’s complained in mass media and direct complain to the management. Objectives: To designing a new service quality in Emergency Care Unit of Ade Mohamad Djoen Regional General Hospital, Sintang, by identifying the factors that influencing, and identifying a failure potency which rise as well as made new design of service process of surgical case in Emergency Care Unit of Ade Mohamad Djoen Regional General Hospital, Sintang. Methods: The research was descriptive research using staked single case study design. Staked single case study design was choose for the research was performed in one hospital at emergency care unit. The subject of the research was service process of surgical case which performed by the staff to the patient, and identification through medical record. Results: This case study on service process of surgical case emergency in Ade Mohamad Djoen Regional General Hospital, Sintang, West Borneo, using Failure Mode and Effect Analysis (FMEA) methods. According to the implementation steps of FMEA, it was obtained the highest Criticality Index (CI) on physical examination process, so be management priority. The causal factors was: 1) infrastructure, 2) methods, 3) the staff/human resources, 4) patients, 4) environment. Conclusions: The research result showed that the service in Emergency Care Unit of Ade Mohamad Djoen Regional General Hospital, Sintang, in the meantime not provide excellent and quality service as desired to achieve according to the vision and mission of the hospital. From the service process arrangement in Emergency Care Unit of Ade Mohamad Djoen Regional General Hospital, Sintang that initiated by registration, anamnesis, physical examination, therapy and follow up really the physical examination process had highest Risk Priority Number, so form of priority to redesign. Thus, redesign of surgical case service process in emergency care unit of Ade Mohamad Djoen Regional General Hospital, more addressed to two factors, that was human resources and environment, especially at spatial management of emergency care unit according to Type C hospital standard.

Kata Kunci : Unit gawat darurat,Falure mode and effect analysis,Redesain, Emergency Care Unit, Failure Mode and Effect Analysis (FMEA), and redesign.