Analisis kecukupan dan kesesuaian tenaga fungsional dalam upaya kenaikan status rumah sakit kelas C menjadi kelas B di RSJD Abepura Provinsi Papua

MAJAR, Lukas, Prof. dr. Laksono Trisnantoro, MSc., Ph.D

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang Masalah. Dalam upaya peningkatan pelayanan RSJ dari Kelas C ke Kelas B, RSJD Abepura sebagai rumah sakit milik Pemerintah (Daerah) menghadapi dilema dalam pengadaan tenaga kebutuhan organisasinya. Di era otonomi daerah dengan terbitnya PP No 41 Tahun 2007, rumahsakit milik Pemerintah Daerah, di satu sisi dituntut meningkatkan kemampuan pelayanannya dengan cara menaikkan kelas rumah sakit, di sisi lain menghadapi kendala berupa kurangnya tenaga fungsional dalam menjalankan roda organisasi dari aspek struktural maupun fungsional. Masalah yang dihadapi RSJD Abepura dalam meningkatkan akreditasi adalah bagaimana kecukupan dan kesesuaian tenaga fungsional dalam upaya peningkatan kelas rumah sakit C ke kelas B di RSJD Abepura? Metode Penelitian. Penelitian ini merupakan penelitian deskriptif eksploratif dengan rancangan studi kasus untuk memperoleh pemahaman secara lebih mendalam mengenai kecukupan dan kesesuaian tenaga fungsional di RSJD Abepura. Unit analisisnya adalah RSJD Abepura sedangkan subjek penelitian adalah pegawai RSJD Abepura yang berjumlah 92 orang. Responden yang menjadi key person dalam penelitian ini adalah 13 tenaga fungsional dan 7 orang pejabat struktural yang terdiri dari Direktur RSJD, Kepala Sub Bagian Tata Usaha, Kepala Seksi Medis, Kepala Seksi Perawatan, Kepala Instalasi Laboratorium, Penanggungjawab Instansi Apotik, Penanggungjawab Unit Pelayanan Kesehatan Jiwa dan Penanggungjawab Unit Rehabilitasi. Hasil Penelitian. Berdasarkan hasil penelitian kebutuhan tenaga fungsional di RSJD Abepura Kelas C sebanyak 19 orang dan kekurangan kesesuaian tenaga fungsional sebanyak 91 orang untuk peningkatan Akreditasi B disebabkan oleh hambatan-hambatan dalam menyusun kebutuhan tenaga fungsional di RSJD Abepura. Di lingkungan internal RSJD Abepura hambatan terjadi karena belum adanya standar manajemen perencanaan kebutuhan tenaga fungsional sehingga RSJD tidak memiliki tim penyusun kebutuhan SDM. Kebutuhan pendanaan peningkatan kualitas tenaga fungsional RSJD Abepura untuk menjadi Tipe B dalam jangka 5 tahun ke depan, dari aspek sumber daya manusia membutuhkan dana sebesar Rp 4.272.750.000,- sedangkan Pemerintah Propinsi Papua hanya mampu menyediakan dana sebesar Rp 1.504.000.000,, bebarti masih kekurangan dana sebesar Rp 2.768.750.000,- sementara bantuan pembiayaan dari Depkes tidak ada karena dampak kebijakan desentralisasi kesehatan. Jika hambatan pendanaan menjadi masalah utama maka alternatif solusinya adalah RSJD Abepura dengan terpaksa dihapuskan menjadi BUMD dan ditawarkan ke investor swasta menjadi Rumah Sakit Jiwa Swasta atau dilakukan penggabungan (merger) dengan RSUD. Kesimpulan. Kebutuhan tenaga fungsional di RSJD Abepura Kelas C sebanyak 19 orang sedangkan untuk kesesuaian jenis tenaga dengan jenis kegiatan yang harus ditangani RSJD Abepura dalam peningkatan akreditasi B membutuhkan tenaga fungsional sebanyak 91 orang. Pendidikan dan pelatihan tenaga fungsional belum mampu meningkatkan kualitas tenaga fungsional karena permasalahan minimnya pendanaan. Kebijakan SDM di RSJD Abepura belum mampu memecahkan permasalahan kebutuhan dan kekurangan tenaga fungsional di setiap kegiatan unit-unit organisasi.

Background: In efforts to improve services of mental hospital from class C to class B, Abepura Mental Hospital owned by the local government focus dilemma in staff recruitment. In the era of local autonomy the hospital on the one hand is required to improve its services by elevating the level of hospital class, but on the other hand has constraints of lack of functional staff that runs organization both in structural and functional aspects. The problem encountered by Abepura Mental Hospital in improving accreditation is how to attain sufficiency and relevance of functional staff in efforts to elevate hospital class from C to B. Objective: The study aimed to identify sufficiency and relevance of functional staff in efforts to elevate the class of Abepura Mental Hospital from C to B both from aspect of quantity and quality. Method: The study is an explorative describtion with designing a case study to get deeper comprehension about sufficiency and relevance of functional staff at Abepura Mental Hospital. The analysis unit was Abepura Mental Hospital and subject of the study were as many as 92 people as staff of Abepura Mental Hospital. Respondents as key person of the study consisted of 13 functional and 7 structural staff comprising the director of the hospital, head of administration department, head of medical section, head of nursing section, head of laboratory installation, head of pharmacy installation, head of mental health service unit and head of rehabilitation unit. Result: Abepura Mental Hospital required as many as 19 functional staff for class C and 91 people or functional staff for accreditation B elevation due to constraints in the proposition of functional staff requirement that happened in the internal as well as external environment of Abepura Mental Hospital itself (in this case was human resources policy of Papua Provincial Government). Constraints encountered in the internal environment of Abepura Mental Hospital because there was no standard management of planning on functional staff need so that the hospital did not have team of human resources need proposition. Weak internal condition was also due external environment which did not support the planning of functional staff need. While Abepura Mental Hospital lacked functional staff, Papua Provincial government imposed policy of “Zero growth” in all institution including public service institution. The condition obviously was not beneficial for the hospital which had to maintain more complex mental health service. Conclusion: The need for functional staff at Abepura Mental Hospital class C was 19 people; whereas to adjust to types of staff and activities that had to be handled by Abepura Mental Hospital to elevate to accreditation B the hospital needed 91 functional staff. Education and training of functional staff were still unable to improve quality because of limited budget and personnel practices that digressed from the regulation. Human resources policies at Abepura Mental Hospital were unable to solve the problem of lack of functional staff in all units of organization.

Kata Kunci : Kecukupan dan kesesuaian tenaga fungsional,Status rumah sakit,Papua