Journal of Hospital Administration and Excellent Health Service

IMPLEMENTASI PENDEKATAN OPPORTUNITY SOLUTION TREE DAN FISHBONE ANALYSIS DALAM PENGUATAN MANAJEMEN RISIKO RUMAH SAKIT: STUDI KUALITATIF DI RSU MUHAMMADIYAH METRO

Wed, 15 Jul 2026 00:00:00 +0700

Risk management is an important component in ensuring the quality of service and patient safety in hospitals. The implementation of risk management, which is still reactive, causes various potential risks not to be identified and mitigated optimally. This study aims to explore the implementation of the Opportunity Solution Tree (OST) and Fishbone Analysis approaches in strengthening risk management at RSU Muhammadiyah Metro. The research uses a qualitative approach with a case study design. Informants were selected through purposive sampling, consisting of directors, department heads, managers, assistant managers, quality team leaders, and unit heads involved in hospital risk management. Data collection was carried out through in-depth interviews, observation, Focus Group Discussions (FGD), and document review. Data analysis used the interactive model of Miles, Huberman, and Saldaña through the stages of data reduction, data presentation, and drawing conclusions. The research results show four main themes: increased management awareness of the importance of proactive risk management, ease of identifying root causes through Fishbone Analysis, OST's ability to develop more structured alternative solutions, and implementation obstacles such as limited HR competencies, a reporting culture that is not yet optimal, and the lack of integration in the risk management information system. The implementation of OST and Fishbone Analysis is considered capable of improving cross-unit collaboration in the process of risk identification and mitigation. This study concludes that applying OST and Fishbone Analysis contributes positively to strengthening risk management at RSU Muhammadiyah Metro and supports shifting the risk management paradigm from reactive to proactive.

PENGARUH KELENGKAPAN DATA UNIT CASEMIX TERHADAP KETEPATAN WAKTU PROSES KLAIM BPJS KESEHATAN DI RUMAH SAKIT GLADIS MEDICAL CENTER

Tue, 21 Jul 2026 00:00:00 +0700

The Casemix Unit plays a crucial role in ensuring the completeness of BPJS Kesehatan claim documents. Delays in data completion can hamper the verification and claim submission process, resulting in delays in claim payments, disruptions to cash flow, and hospital operations. Therefore, research is needed to analyze the effect of delays in data completion on the timeliness of BPJS Kesehatan claim processing. This study aims to analyze the effect of delays in data completion in the Casemix Unit on the timeliness of BPJS Kesehatan claim processing at Gladis Medical Center Hospital. Risk management, hospitals, Opportunity Solution Tree, Fishbone Analysis, qualitative research. This research is a quantitative analytical study with a cross-sectional approach. The study population is all BPJS Kesehatan claim files processed at the Casemix Unit of Gladis Medical Center Hospital during the study period. The sample was determined using a total sampling technique. Data were obtained through document observation and claim file completeness checklists. Data analysis was performed univariately to describe the characteristics of the variables, and bivariately using the Chi-Square test with a 95% significance level (α = 0.05). The results showed that the majority of delays in the BPJS Kesehatan claims process were caused by delays in data completion at the Casemix Unit. The bivariate analysis revealed a significant correlation between delays in data completion and the timeliness of BPJS Kesehatan claims processing (p<0.05). The higher the level of delay in data completion, the greater the risk of claims processing delays. Hospitals need to improve coordination between units, strengthen compliance with complete medical record documentation, and optimize information systems to support a more effective and efficient claims process.

ANALISIS MANAJEMEN PELAYANAN PEMERIKSAAN KLASIFIKASI ATLET PENYANDANG DISABILITAS DI NATIONAL PARALYMPIC COMMITTEE INDONESIA PROVINSI LAMPUNG

Tue, 21 Jul 2026 00:00:00 +0700

Introduction: Athlete classification is a fundamental component of para-sports, ensuring fair competition by determining athletes' eligibility based on functional abilities according to the International Paralympic Committee (IPC) standards. At the regional level, classification requires not only accurate clinical assessment but also efficient health service management. However, the classification process at the National Paralympic Committee of Indonesia (NPCI) Lampung Province still faces challenges related to scheduling, infrastructure, and administrative management. Objective: This study aimed to analyze the health service management of athlete classification and propose strategies to improve service efficiency at NPCI Lampung Province. Methods: A qualitative descriptive approach was employed. Data were collected through in-depth interviews, observations, focus group discussions, and document reviews involving NPCI administrators, medical classifiers, physiotherapists, technical classifiers, and para-athletes. Data were analyzed using the Miles, Huberman, and Saldaña interactive model. Results: Three major challenges were identified, including scheduling inconsistencies, limited examination infrastructure, and paper-based administrative management. Based on these findings, an Integrated Para-Classification System (IPCS) was proposed to integrate administrative processes, medical screening, physiotherapy assessment, technical classification, and documentation into a single service pathway. Conclusion: The proposed integrated service model has the potential to improve service efficiency, strengthen multidisciplinary collaboration, and enhance the quality of athlete classification management at NPCI Lampung Province.

IMPLEMENTASI STRATEGI PENGENDALIAN PERILAKU SEDENTARI DALAM MENEKAN BEBAN OSTEOARTRITIS LUTUT DAN PENGUATAN SISTEM PELAYANAN KESEHATAN: STUDI KASUS-KONTROL DI RSU MUHAMMADIYAH METRO

Tue, 21 Jul 2026 00:00:00 +0700

Knee osteoarthritis is one of the main causes of chronic pain, disability, and reduced quality of life in adult and elderly populations. Sedentary behavior, like spending a lot of time sitting due to changes in work patterns and technology use, is thought to increase the burden of this musculoskeletal disease. This study aimed to analyze the relationship between sedentary behavior and the occurrence of knee osteoarthritis, as well as to outline strategic policy implications for the healthcare system. The study used a case-control design at RSU Muhammadiyah Metro. The results showed that sedentary behavior has a very strong connection with the occurrence of knee osteoarthritis. Individuals with sedentary behavior are 23.276 times more likely to develop knee osteoarthritis compared to those who are not sedentary (OR = 23.276; p < 0.001). Based on the strength of this association, committing to promoting physical activity, integrating early screening into primary healthcare services, and strengthening community-based prevention programs are high-value healthcare investment choices to maintain the sustainability of National Health Insurance (JKN) funding. Keywords: knee osteoarthritis, sedentary behavior, healthcare services, case-control, JKN.

OPTIMALISASI PENGELOLAAN PERMINTAAN DAN PENDISTRIBUSIAN OBAT DI GUDANG FARMASI MELALUI DIGITALISASI BARCODE: ACTION RESEARCH DI RS YUKUM MEDICAL CENTRE

Tue, 21 Jul 2026 00:00:00 +0700

Pharmaceutical logistics management plays an important role in ensuring service quality and patient safety in hospitals. Suboptimal logistics management can lead to stock mismatches, delays in drug distribution, and increased workload. This study aims to explore operational obstacles in the demand and distribution of drugs at Yukum Medical Centre (YMC) Hospital and to formulate practical optimization strategies. This study uses a qualitative method with a descriptive-analytical approach through an Action Research design. Data was collected through participatory observation, Focus Group Discussions (FGD), in-depth interviews, and review of logistics documents in April 2026. Analysis using the Urgency, Seriousness, Growth (USG) method and Fishbone Diagram identified that there is no structured routine request schedule, stock card recording is still manual, and there are limitations in the integration of the Hospital Information System (SIMRS). and inefficient warehouse organization is the root cause of the problem. As a practical solution, this study designs an intervention in the form of standardizing the depot unit request schedule and implementing GS1 DataMatrix barcode (2D barcode) based digitalization. This combination of interventions has the potential to significantly improve staff work efficiency, minimize administrative errors (human error), maintain real-time stock data accuracy, and support patient safety through reliable drug traceability. Keywords: barcode, distribution, innovation, pharmaceutical logistics, hospital.

PENGEMBANGAN SIPS ARCHIVING (SMART INTELLIGENT PROCESSING SYSTEM) SEBAGAI SISTEM DIGITAL PENGARSIPAN FAKTUR UNTUK MENINGKATKAN EFISIENSI PENGELOLAAN DOKUMEN DI RSABL

Tue, 21 Jul 2026 00:00:00 +0700

Introduction: Conventional invoice archiving in hospitals often faces bottlenecks such as delayed document retrieval, risks of physical damage, and financial workflow inefficiencies. This study aims to develop SIPS Archiving (Smart Intelligent Processing System) as a digital invoice management solution at RSABL. Method: This study utilized a Research and Development (R&D) design with the FAST (Framework for the Application of System Thinking) system development model. Data were gathered through document workflow observations, in-depth interviews with finance staff, and system usability testing using the System Usability Scale (SUS) questionnaire at RSABL. Result: The implementation of SIPS Archiving successfully digitized 100% of incoming invoices using OCR (Optical Character Recognition) automatic data extraction. Document search times significantly improved from an average of 15 minutes to under 5 seconds, and the SUS score reached 82.4, falling into the "excellent" usability category. Conclusion: The development of SIPS Archiving is proven to be highly effective in improving the management efficiency, security, and accessibility of invoice documents at RSABL. Keyword: sips archiving, invoice digitization, document efficiency, hospital administration

ANALISIS IMPLEMENTASI BUDAYA KINERJA 5R DALAM UPAYA OPTIMALISASI DAN PENINGKATAN MUTU PELAYANAN OPERASIONAL PADA UNIT RAWAT JALAN RSUD JENDERAL AHMAD YANI METRO

Tue, 21 Jul 2026 00:00:00 +0700

Introduction: The 5R culture (Sort, Set in order, Shine, Standardize, Sustain) is an essential approach to creating an efficient, orderly, and safe hospital work environment. However, its implementation in high-activity service units is often inconsistent and sub-optimal. This study aims to analyze the implementation of the 5R culture in the Outpatient Unit of RSUD Jenderal Ahmad Yani Metro. Method: This study utilized a qualitative descriptive approach through direct observation, in-depth interviews with healthcare and administrative staff, and Focus Group Discussions (FGD) during Field Learning Practices. Problem prioritization was analyzed using the Urgency, Seriousness, Growth (USG) method. Result: The results indicated that the implementation of 5R principles in the outpatient unit has been inconsistent. Based on the USG analysis, the lack of 5R implementation emerged as the top priority with the highest score (14). The dominant causes hindering optimal 5R execution are limited storage infrastructure and a high daily patient workload, even though basic SOPs and supervision are already in place. Conclusion: Improving the 5R culture in the Outpatient Unit requires optimization through physical storage upgrades, visual management standardization, routine monitoring enforcement, and a structured reward and punishment scheme.

INOVASI PENANGANAN DOWNTIME SYSTEM KOMPUTER DALAM UPAYA MENINGKATKAN EFEKTIVITAS PELAYANAN PASIEN DI RUMAH SAKIT ANUGERAH MEDICAL CENTRE METRO

Tue, 21 Jul 2026 00:00:00 +0700

Introduction: The implementation of Hospital Management Information Systems (HMIS) and Electronic Medical Records (EMR) has significantly improved healthcare service efficiency. However, system downtime remains a major challenge affecting patient registration and service continuity. This study aimed to analyze the causes of computer system downtime and develop innovative strategies to improve patient service effectiveness at Anugerah Medical Centre Hospital Metro. Method: A qualitative descriptive approach was employed through observation, in-depth interviews, documentation, and Focus Group Discussions. The Urgency, Seriousness, and Growth (USG) method was used to prioritize problems, while Fishbone Analysis identified root causes. Results: Computer system downtime emerged as the highest priority problem. Root causes included obsolete hardware, lack of preventive maintenance, limited maintenance budgets, absence of downtime SOPs, and insufficient user competence. Proposed innovations consisted of standardized downtime SOPs, scheduled preventive maintenance, equipment monitoring dashboards, staff training, and digital incident reporting. These interventions are expected to reduce downtime frequency, accelerate recovery time, and improve service efficiency. Conclusion: Comprehensive downtime management innovation improves the reliability of hospital information systems and supports better patient service quality.

IMPLEMENTASI AKTIVITAS STIMULASI MOTORIK HALUS BERBASIS BERMAIN PADA BALITA DI POSYANDU BUNGA TANJUNG

Tue, 21 Jul 2026 00:00:00 +0700

Introduction: Fine motor development is a crucial aspect of child growth and development that should be stimulated early through play activities appropriate to the child's developmental stage. Posyandu (Integrated Health Service Posts) have the potential to serve as promotive and preventive community-based health services for providing developmental stimulation. This study aimed to describe the implementation of play-based fine motor stimulation activities for toddlers at Posyandu Bunga Tanjung. Methods: This study employed a descriptive observational design with a cross-sectional approach. The participants were all toddlers who attended the fine motor stimulation activities at Posyandu Bunga Tanjung on April 18, 2026, selected using a total sampling technique. The stimulation activities included color matching games, a marble maze, puzzles, and a ball relay using bottle caps. Data were collected through direct observation and analyzed descriptively using frequency distributions and percentages. Results: A total of 49 toddler participations were recorded, consisting of color matching games (n=22), marble maze (n=13), puzzles (n=8), and ball relay (n=6). The color matching games showed the greatest variation in repetition frequency, whereas the other three activities were predominantly completed with a single repetition. Conclusion: Play-based fine motor stimulation activities can be implemented in Posyandu as a promotive strategy to stimulate various components of fine motor skills according to the characteristics of each activity. The variation in repetition frequency reflects toddlers' participation patterns during the activities rather than the effectiveness of the intervention or improvements in fine motor skills.