Quality Management of Emergency Room (ER) Services in the District General Hospital of Kudus

Abstract

Mutu pelayanan Instalasi Gawat Darurat (IGD) RSUD Kudus yang meliputi sumber daya manusia, kebijakan dan prosedur serta sarana prasarana IGD belum sesuai standar IGD RS level III. Penelitian ini bertujuan untuk mengetahui manajemen mutu pelayanan IGD yang meliputi proses manajemen mutu, kepemimpinan mutu dan organisasi mutu. Jenis penelitian ini dilakukan secara kualitatif menggunakan metode observasi, Focus Group Discussion (FGD) dan wawancara mendalam. Subyek sebanyak 13 orang terdiri atas: 4 orang sebagai informan utama, 9 orang sebagai informan triangulasi terdiri atas 3 orang petugas IGD RSUD Kudus dan 6 orang keluarga pasien. Variabel yang diukur adalah proses manajemen mutu, kepemimpinan mutu, organisasi mutu dan mutu pelayanan IGD RSUD Kudus. Hasil penelitian ini meliputi perencanaan mutu: jumlah dan kompetensi petugas kurang, belum ada pedoman orientasi, belum ada pedoman mutasi, pengadaan, pemeliharaan dan kalibrasi alat kurang. Pengendalian mutu : evaluasi kinerja belum ada. Peningkatan mutu : peningkatan sumber daya manusia kurang, belum ada pedoman pelatihan, belum ada pengaturan anggaran terintegrasi dengan pengadaan sarana prasarana dan sarana prasarana kurang. Kepemimpinan mutu : gaya demokratis dengan kebijakan yang jelas. Organisasi mutu: pengalaman manajemen dan kompetensi Kepala IGD baik, perubahan yang mundukung mutu pelayanan IGD bisa diterima baik. Mutu pelayanan IGD meliputi SDM yaitu kepala IGD yang mempunyai kriteria khusus baik, petugas IGD yang mempunyai kriteria khusus kurang, sarana prasarana kurang, kebijakan dan prosedur kurang. Kesimpulan penelitian ini adalah proses manajemen mutu IGD RSUD Kudus belum berjalan baik, gaya kepemimpinan demokratis dengan kebijakan jelas, organisasi mutu berjalan baik, petugas IGD belum memenuhi kriteria khusus. Saran penelitian ini adalah mengadakan rapat kerja guna menyusun rencana strategis dan kebijakan pimpinan yang jelas sebagai arah dan pedoman yang dituangkan dalam program kerja tahunan di RSUD Kudus.

Service quality of an emergency room unit (IGD) of Kudus District General Hospital (RSUD) included human resource, policy, procedure and facility of IGD. This was not fit properly with level III IGD standard. Objective of this study was to identify service quality management of IGD including quality management process, quality of leadership, and quality of organization. This was a qualitative study using observation, focus group discussion, and in-depth interview methods. Study subjects were 13 people: four main informants, nine triangulation informants. Triangulation informants included 3 workers at IGD of RSUD Kudus, and six patient’s family members. Measured variables were quality management, quality of leadership, organizational quality, and service quality of IGD of RSUD Kudus. Results of this study included quality planning: the number of workers and worker’s competence were insufficient; no orientation guideline and transfer or workers guideline were provided; maintenance and instrument calibration were insufficient. Quality control: no evaluation of work performance was provided. Quality improvement: human resource improvement was not adequate; no training guideline was provided; no integrated budget regulation was performed; supply of facilities was not adequate. Quality of leadership: Democratic style with understandable policy was applied. Organizational quality: management experience and the competence of head of IGD were good; changes that supported IGD service quality were well accepted; Service quality of IGD, that included human resource such as chief of IGD with special criteria, was good. IGD workers with special criteria were insufficient. Facilities were insufficient. Policy and procedure were insufficient. In conclusion, the quality management process of IGD RSUD Kudus was insufficient; democratic leadership with understandable policy was applied; organizational quality was good; IGD workers were not matched with specific qualification. Suggestions: to conduct meeting to formulate clear strategic plan and clear leader policy as guidelines. It should be included in the annual working program in RSUD Kudus.