Search

Achievement of the Minimum Service Standards (MSS) coverage for the Health Sector in Mojo PrimaryHealth Center in 2011€“2012 showed that many indicators did not meet the targets. In 2012, it still could not meet13 MSS national indicators, 12 MSS East Java Province indicators, and 9 MSS Surabaya District indicators. This study aimed to identify the determinant factors of determinants factor of low coverage in health serctor minimum service standards achievement of Mojo Primary Health Care. This was an observational study with by crosssectional approach. Data was obtained from direct interviews with respondents using questionnaires. This study showed that characteristics of human resources (HR) of Training and Teamwork indicated percentage coverage of more than 50%, categorized as good; while that for Workload was less than 50%, categorized as good. The percentage coverage of Availability of funds was 50%, categorized as poor; Planning Management Functions(P1) was less than 50%, categorized as good; Implementation (P2) was 50%, categorized as good; Monitoring, Control, and Assessment (P3) was 75 %, categorized as good. The determining factors of the low achievement of the Minimum Service Standards for Health Sector in the PHC Mojo, Surabaya, were the factors of Training, Workload, and Planning Process (P1). Keywords: determining factors, indicators of minimum service standards, management functions, program management

The coverage of under-five children weighed at Posyandu represent the level of participation mothers in Posyandu activities. During three-year period, the coverage of under-five children weighed at Posyandu Puskesmas Sidotopo Wetan Surabaya City has not reached the target. It is also the responsibility of cadres. The object of this study was to to analyze the effect of motivation on the performance of health cadres based on Victor Vroom expectancy theory motivation in Posyandu Puskesmas Sidotopo Wetan Kota Surabaya. This research was an analytic observational research with quantitative approach. Design was cross sectional. Sampling was done by using simple random sampling method. The results showed that the performance varied health cadres that was lacking, enough and good. Level of health cadres motivation was high. Health cadres had high score of expectancy, instrumentally, and valency.Ordinallogistic regression analys was showed the influence of motivation (p-value = 0.000) on the performance of cadres (p-value <α (0.05)). In conclusion, motivation influenced the performance of health cadres in Posyandu Puskesmas Sidotopo Wetan Surabaya City.

Hospital is a health institution that provide comprehensive health service which is including aspects of promote, preventive, curative, and also rehabilitative. To achieve the goal, the government has been releasedRegulation of the Minister of Health Number 4 Year 2012 about Technical Instructions of Health Promotion in Hospital. In means by all hospitals must implement health promotion in their institution. Based on the earliersurvey, the implementation of the regulation of Health Promotion Hospital (PKRS) in the Universitas Airlangga Hospital was considered less than optimal. The purpose of this research was to analyze the planning factor ofHPH policy implementation. The number of respondents are seven which chosen by purposive sampling. This research was conducted by deep interview and observation method. The results showed that the planning ofPKRS unit has not been prepared as it should be as set out in the regulations. There is neither strategic planning nor operational planning. Unit PKRS not yet have a systematic and structured organization. Qualification ofhuman resources in general are already qualified, but need additional quantity. PKRS unit does not have special health worker health promotion.

In 2014 patient visits to pharmacy services increased 75% from the previous year. Man power in the pharmacy unit was not comparable with the number of pharmacy service.The availability of human resources isinadequate when being compared to the number of outpatient pharmacy visits, therefore it influenced the respon time up to 43,91% for non paten drugs which as not in accordance with the standart services minimum pharmacy services. This data indicate that there was overload capacity on man power in outpatient pharmacy unit. The purpose of this study was to show wordload category on man power in outpatient pharmacy unit, particularly to pharmacists and assistants pharmacists. This was quantitative descriptive study. There were 26 samples consisting of 1 pharmacist, 16 asisstants pharmacists in depo 1 and 9 asisstants pharmacists in depo 5 outpatient pharmacy unit. Data collected by observation for 2 week in working hours. Result of the study was pharmacicts and assitants pharmacists in depo 1 had subjective and objective workload in overload category while depo 5 inmoderate category.

Measles is one of endemic diseases in East Java especially in north Surabaya, the home of specific ethnic which resist of immunization. Surabaya District Health Office targeted their Measles immunization is above 90%,but unfortunately this target are never been reached. The purpose of this study was to analyze the management process of immunization program, especially the supervision. The guidance of supervision is regulated in HealthMinister Regulation number 42, on 2013. Supervision is involved performance standard setting, monitoring and corrective action. This is a quantitative study with descriptive and cross sectional design. The sampling wascalculated by using simple random sampling. The interviews through open and close question were conducted to 38 Managers of Immunization program in Public Health Centre. The result showed that the implementation ofsupervision has implemented by guidance the supervision of immunization programme. The study showed that only 2.63% or just one of Public Health Centre has already supervised by District Health Office and 5.26% or twoPublic Health Centres has supervised three times and suit with guidance implementation of general supervision. From this study, it is important for District Health Office to add new person as Supervisor and Public HealthCentres and ensure that its supervision follow the supervision guidance.

More than 80.0% maternal deaths occured in hospital in Surabaya between 2012-2014. Most of them who died in hospital were referral patients from midwife, private clinics, and public health centers. This study assessed the effectiveness of maternal referral system based on perspective of public health centers and hospitals in Surabaya. This was a descriptive cross sectional study. Samples were 43 public health centers in Surabaya and two main referral destination hospitals. Data was collected by interviewing one representative midwife in each public health center and hospital. This study showed that a total of 81.4% health centers assess that maternal referral system in Surabaya District was quite effective. While, one of the hospital assessed quite effective, and the other assessed less effective. The reason was because public health centers difficulty to contacting hospitals about referral, hospitals often rejected referral case, pregnant women often do self-referral to hospital, and incompatibility referral reason by most of public health centers. So it was necessary to repair maternal referral system at Surabaya based on identification of each variables in effectiveness of maternal referral system.

The survey about coordination in hospital showed that the coordinaton between units have low score including the lack of communication and problem solving between units. The objectives of this study is to describe coordination in hospital considered by high performance practices that consist of 5 items : selection for cross-functional teamwork, rewards for cross-functional teamwork, cross-functional teamwork conflict resolution, cross-functional meetings, and cross-functional boundary spanner. This research is descriptive study using cross sectional design. Samples or respondents are 16, selected using purposive sampling according to the units which their function and job still related with the medical service in the hospital. The result showed that there are a specific criteria to select their employee. The most responden said that education level is the most important criteria for the selection. There is a reward for the best employee those are trophy and some money given to the best employee and the best group of the months. There is conflict resolution through the meeting with the supervisor and director to discuss their problems. There is functional meeting that is weekly report, and there is boundary spanner to coordinated with the other unit if they have problems. This study conclude that coordination in hospital can complete four items of performance work practice, but aspect cross-functional meetings still not working properly. Therefore, it needs to be repaired because this meeting is important to discuss about development of the medical service in this hospital.

The coverage of under-five children weighed is an indicator of community participation in Posyandu. During 2012 until 2014, Puskesmas Kenjeran had not reached the target of this indicator. The objective of this study is to arrange recommendations for Posyandu utilization improvement based on total customer sacrifice analysis. This was a quantitative analytical study with observational approach and cross sectional design. The sampling was calculated by using multistage random sampling method. The interviews through instrument were conducted to 112 respondents to obtain information on Posyandu utilization and respondents sacrifice required to utilize Posyandu. The results showed that respondents thought time was the greatest sacrifice among monetary, energy, and psychological sacrifices. Spearman correlation test on any sacrifice required showed significant correlation (p<0.05), except for monetary sacrifice.This study concluded that even total customer sacrifices was very small, but the huge expense of time spent still made respondents to be less likely to utilize Posyandu. Therefore, efforts are needed to reduce the magnitude of the sacrifice required by community utilizing Posyandu in Puskesmas Kenjeran area.

The fulfillment completeness of medical record in Muhammadiyah hospital is very poor. The study aimedto identify the precaution of incompleteness fulfillment of medical record in the inpatient of Muhammadiyahhospital lamongan. This was a descriptive study with observational and cross sectional design. The populationwas all file of inpatient medical record. Observations were hold in 94 medical record files of 7 inpatient rooms.Thisstudy include interview with the officer of medical record to complete the result of this study. The result of thestudy showed that the fulfilment completeness of medical record file had different performance. Standardoperating procedure; job description; reward and punishment regulating the medical record fulfillment were verygood. In other side, the evaluation of medical record filling process was also in very good category. Although,monitoring in filling process was not implemented. This study concluded that the determinant of inpatient medicalrecord fulfillment incompleteness in Muhammadiyah hospital is the failure of fulfilment monitoring. This studysuggests that should be more routine medical record filling process monitoring.Keywords: incompleteness, medical record

In healthcare services, gap between quality service by provider and the expectation of consumer arefrequently found. This research was aimed to analyze why the number of outpatient visit in Usada HospitalSidoarjo gradually decreased. This research identified 7 kind of gap using service quality gaps model. This wascross-sectional study with descriptive approach. Interview using questionnaire had done to 100 outpatient, 13management official, and 18 Usada hospital€™s employees. The expected service¸ perceived service, externalcommunication to consumer, service delivery, service quality specification, management perceptions of consumerexpectations, and employee perceptions of consumer expectation were measured using service quality KeyQuality Characteristics Assessment for Hospitals (KQCAH) scale. The research showed that the only gap whichhas the positive value was gap 3. This means that the service provided by the hospital was still not fulfilled thepatient expectation. By improve the employee commitment, hold marketing research, and upgrade the taskstandardization for quality improvement goal, hospital can increase the number of patient visit.Keywords: gap, service quality, outpatient

Based on Surabaya District Health Office, in 2010-2012, there were only three Primary Health Centers that reach the target of UCI. Unfortunately, there were 15 other Primary Health Centers with 0% UCI coverage, one of them was Kalirungkut Primary Health Center. This study aimed to develop efforts in increasing the UCI coverage in Kalirungkut. Benchmarking to Sidosermo Primary Health Care which had 100% UCI coverage was done to design the best model. Data were obtained through direct interviews with respondents using some questionnaires. Questionnaires identified about knowledge, motivation, perception of workload, attitudes and immunization program management in Sidosermo Primary Health Center. The results showed its knowledge, motivation, and immunization program management were better than Kalirungkut. The perception of the workload and attitudes were good for both Primary Health Center. This study recommended Kalirungkut to perform guidance in program implementation plan and give rewards to the achievement officer. Moreover, District Health Office also need to repair the Primary Health Center personnel rotation, provide certified training and improve management skill of the Head of Primary Health Center. Keywords: benchmarking, immunization, management, program, UCI

Cross Functional Teamworks (CFTs) was considered increasing the efficiency in health care business. Less implementation of CFTs decreased the Muhammadiyah Surabaya Hospital performance. The study aimed to analyze High Performace Work Practices (HPWP) as performance improvement of Muhammadiyah Surabaya Hospital. This was observational cross sectional research. There 29 members in 12 Cross Functional Team who met the inclusion criteria. Data was taken by questionnaires and interviews. The research showed that CFTs had several weaknesses, i.e. uncomplate document of CFTs€™ task, function and job description. All respondents showed good CFTs even the cross functional boundary was not clear. HPWP which measured by six criterias (selection, reward, performance measurement, conflict resolution, cross functional meetings, cross functional boundary spanner) were mostly not good. The implementation of High Performance Work Practices by CFTs only good in 4 teams (Accreditation Team, Patient Safety Team, Education and Training Team, Folmularium Team). Muhammadiyah Surabaya Hospital management needs to reorganize the CFTs, increase the frequency of informal meeting and complement the team€™s role document.Keyword: Cross Functional Teamworks, High Performance Work Practices, Hospital Performance

The number of antenatal care fourth visit in 2009 to 2011 were still did not reach the target which setted by District Health Office. This reasearch aimed to arrange a recomendation for utilization improvement in antenatal care services based on voice of the customer. This was a cross sectional study using a qualitative descriptive approach. There 62 pregnant women in Pacarkeling calculated by simple random sampling participating in this study. This research showed that most of respondents who visit the antenatal care service in Pacarkeling Community Health Center were over 35 years and senior high school educated. Most of respondents had more than four children. By focusing on voice of the customer there were 24 recomendations for utilization improvement. These 24 recomendations were related into what customer expect from midwives as providers, especially relating to competency, assurance, responsiveness, empathy, communication, caring, physical environment, comfort and safety of antenatal care services.Keywords: antenatal care services, fourth visit, public health center, Voice of the Customer (VOC)

The completeness of the documentation of nursing care in Ibnu Sina District Hospital of Gresik less optimal which may be due to nurse obedience. This study to identify the internal and external variables that affect to nurse obedience based on the Milgram€™s theory. The study was a cross sectional design using a quantitative approach. Data collected in 12 nursing teams by questioner. Research subjects use a total population. The independent variables are nurse responsibility, status of the location, legitimacy of authority figures, status of authority figures, peer support, proximity of authority figures and the dependent variable was nurse obedience in nursing documentation. The result was nursing teams with good responsibility (50,0%), good status location assesment (55,6%), good legitimacy of authority figure (71,4%), good status of authority figure (75,0%), good proximity of authority figure (71,4%) have a good obedience. Nursing teams with good peer support (55,6%) have a fair obedience. The conclusion is nurse€™s responsibility, status location assesment, legitimacy of authority figure, proximity of authority figures are affecting to the obedience in nursing documentation. The nurses obedience in documenting can be improved by increasing responsibility, the legitimacy of authority figure, regular meetings, give positive support, competitions and giving awards for the best nursing care documentation. Keywords: nursing care documentation, nurse obedience, Milgram€™s theory