TESIS UPAYA PENINGKATAN MUTU PELAYANAN DENGAN METODE QUALITY FUNCTION DEPLOYMENT (QFD) DI INSTALASI RAWAT JALAN RUMAH SAKIT SEMEN GRESIK
UPAYA PENINGKATAN MUTU PELAYANAN
DENGAN METODE QUALITY FUNCTION DEPLOYMENT (QFD)
ASMAUNAH ASRININGTYAS
UNIVERSITAS AIRLANGGA
FAKULTAS KESEHATAN MASYARAKAT
PROGRAM MAGISTER
PROGRAM STUDI ADMINISTRASI DAN KEBIJAKAN KESEHATAN
SURABAYA
2015
DENGAN METODE QUALITY FUNCTION DEPLOYMENT (QFD)
DI INSTALASI RAWAT JALAN RUMAH SAKIT SEMEN GRESIK
DENGAN METODE QUALITY FUNCTION DEPLOYMENT (QFD)
DI INSTALASI RAWAT JALAN RUMAH SAKIT SEMEN GRESIK TESIS Untuk memperoleh gelar Magister Kesehatan Minat Studi Administrasi Rumah Sakit Program Studi Administrasi dan Kebijakan Kesehatan Fakultas Kesehatan Masyarakat Universitas Airlangga Oleh: ASMAUNAH ASRININGTYAS NIM 101314453028 UNIVERSITAS AIRLANGGA FAKULTAS KESEHATAN MASYARAKAT PROGRAM MAGISTER PROGRAM STUDI ADMINISTRASI DAN KEBIJAKAN KESEHATAN SURABAYA 2015Puji syukur kehadirat Allah SWT atas rahmat dan hidayah-Nya sehingga penyusunan tesis dengan judul “Upaya Peningkatan Mutu Pelayanan dengan
Metode Quality Function Deployment (Di Instalasi Rawat Jalan Rumah Sakit
Semen G resik)” ini d apat t erselesaikan. Tesis in i me mbahas te ntang proses
menetapkan ke butuhan kons umen m elalui harapan da n pe nilaian p elanggan terhadap p elayanan di Instalasi Rawat Jalan Rumah Sakit Semen Gresik, yang selanjutnya d ianalisa b erdasarkan House of Q uality untuk m erencanakan da n mengembangkan pr oduk a tau j asa yang s esuai dengan ha rapan d an ke butuhan pelanggan. R ekomendasi yang di hasilkan da pat di gunakan s ebagai strategi meningkatkan mutu pelayanan pasien di IRJ RSSG.
Ucapan t erima kasih yang t ak t erhingga s aya haturkan ke pada yang terhormat Dr. Thinni Nurul Rochmah, Dra.Ec., M.Kes. selaku pembimbing utama yang telah banyak meluangkan waktu untuk memberikan bimbingan, motivasi dan saran hingga tesis ini bisa terselesaikan dengan baik. Ucapan t erima kasih yang tak t erhingga juga saya s ampaikan kepada yang t erhormat Dr. Dj azuly Chalidyanto, S.KM., M.ARS. selaku pembimbing kedua yang dengan kesabaran dan perhatiannya dalam memberikan bimbingan, pengarahan, semangat dan saran demi kesempurnaan tesis ini.
Ucapan terima kasih yang sebesar-besarnya juga kami sampaikan kepada:
1. Prof. Dr. Moh. Nasih, S.E., M.T., Ak. selaku Rektor Universitas Airlangga yang telah memberi kesempatan dan fasilitas kepada saya untuk mengikuti dan m enyelesaikan p endidikan P rogram P ascasarjana di U niversitas Airlangga
2. Prof. D r. T ri M artiana, dr ., M .S., selaku Dekan F akultas K esehatan Masyarakat U niversitas Airlangga yang t elah m emberi k esempatan d an fasilitas ke pada s aya u ntuk m engikuti da n m enyelesaikan p endidikan Program Pascasarjana di Universitas Airlangga.
3. Dr. Thinni Nurul Rochmah, Dra.Ec., M.Kes., selaku Ketua Program Studi Administrasi da n K ebijakan K esehatan, P rogram M agister F akultas Kesehatan M asyarakat U niversitas A irlangga yang t elah b anyak mencurahkan perhatian dan memberikan asuhan akademik selama proses pendidikan.
4. Dr. D jazuly C halidyanto, S .KM., M .ARS., selaku Ketua M inat S tudi Administrasi R umah S akit P rogram S tudi A dministrasi da n K ebijakan Kesehatan, Program Magister Fakultas Kesehatan Masyarakat Universitas Airlangga, yang t elah b anyak m encurahkan pe rhatian da n memberikan asuhan akademik selama proses pendidikan.
5. Seluruh dos en pe ngajar P rogram S tudi A dministrasi d an K ebijakan Kesehatan, Program Magister Fakultas Kesehatan Masyarakat Universitas Airlangga, yang te lah memberikan ilmu d an me motivasi a gar s elalu belajar untuk lebih meningkatkan wawasannya.
6. Tim p enguji Dr. M . B agus Q omaruddin, D rs., M .Sc., Widodo J .
Pudjirahardjo, dr ., M .S., M .PH., D r.PH., Dr. T hinni N urul R ochmah, drg., M .ARS., S ri R ahayu, dr ., M .ARS., da n M aya S aridewi, S .KM., M.Kes. yang t elah b anyak m emberikan m asukan yang b erharga p ada kesempurnaan penulisan tesis ini.
7. Dr. Erry Gautama., selaku Direktur Utama PT. Cipta Nirmala yang telah memberikan i jin da n f asilitas ke pada s aya unt uk m enempuh pe ndidikan Program Magister Fakultas Kesehatan Masyarakat Universitas Airlangga.
8. Dra. F erdiana G afar, s elaku D irektur K euangan PT. C ipta N irmala yang telah m emberikan i jin da n f asilitas ke pada s aya unt uk m enempuh pendidikan Program Magister Fakultas Kesehatan Masyarakat Universitas Airlangga.
9. Dr. Muchdor, SpB., selaku Kepala Rumah Sakit Semen Gresik yang telah memberikan i jin da n ke sempatan ke pada saya unt uk m enempuh pendidikan Program Magister Fakultas Kesehatan Masyarakat Universitas Airlangga, serta melakukan penelitian di Rumah Sakit Semen Gresik.
10. Teman-teman T im M utu Rawat J alan R umah S akit S emen G resik, yang selama pe nelitian m emberi dukun gan da n b antuan da lam pe ngumpulan data.
11. Responden penelitian, pasien klinik penyakit dalam Rumah Sakit Semen Gresik yang telah bersedia meluangkan waktu dan memberikan masukan demi terlaksananya tujuan pembuatan tesis ini.
12. Teman-teman k uliah M inat S tudi A dministrasi R umah S akit A ngkata 2013, yang selama kuliah dan penelitian memberi dukungan dan motivasi dalam menyelesaikan tesis ini.
13. Mbak A de, m bak Lusi, m as K ukuh da n mas H usni, s elaku s taf administrasi staf AKK FKM Unair, yang selama ini membantu kelancaran proses perkuliahan dan ujian mahasiswa.
14. Ibunda Manise, yang selalu mendoakan dan memberi dukungan sehingga saya dapat menyelesaikan pendidikan ini.
15. Suami tercinta Donny Imanul Rochimadjaja, SH. MH., dan anak-anakku tersayang R izki A ditia, W indy W indya, R onaldi R izkiawan, D ias R esti Cahyani d an A nandito Ridho R achmadi, yang telah m emberi dukun gan serta s emangat u ntuk m enyelesaikan p endidikan. T erima k asih at as kesabaran, kerelaan dan pengorbanannya dalam penyelesaian tesis ini.
16. Semua pi hak yang t idak bi sa s aya s ebutkan s atu-persatu, yang t elah membantu sampai tesis ini selesai.
Semoga hasil penelitian ini berguna bagi peningkatan mutu pelayanan IRJ RSSG dan semoga juga bermanfaat bagi yang menggunakannya.
Surabya, 3 November 2015 Penulis
Improvement of Service Quality by Quality Function Deployment (QFD)
Method
(In the purpose of improving the Service Quality of Outpatient Installation at
Semen Gresik Hospital)
Outpatient Installation ( OI) is th e f ront-line s ervice uni t of hos pital as many patients are admitted to the hospital through OI for the first time. Therefore, unsatisfying OI visit can turn into a failure. The problem raised in this study is the low l evel of s atisfaction o utpatients r eached 73.75% of M inimum S ervice Standard of Hospital (≥ 90%) in the years of 2014 at O I of Semen G resik Hospital (SGH). This research objective is to formulate a recommendation on the service q uality i mprovement b y QFD m ethod a s a s trategy t o i ncrease s ervice quality at SGH. The specific purposes of this research ar e: (1) Determining the customer's needs in every customer service at OI of SGH, (2) Develop a planning matrix of customer's needs which includes: the ratio improvement, the magnitude of the weight of crude (raw weight) and the weight of net (net / normalized raw weight) of t he customer's ne eds in each s ervice at O I of S GH, (3 ) Prepare technical r esponse o f e ach service at O I of S GH, ( 4) Determine t he s trong relationships of technical response to customer's needs in every service at OI of SGH, (5) Determine the priority of technical response and priority of Customer's Need of every service at OI of SGH, (6) Prepare the structure of house of quality of each service at OI of SGH, (7) Prepare recommendation efforts to improve the quality o f s ervice in each OI of S GH by the m ethod of Q uality Function Deployment.
This research is an observational study using the cross sectional method in the d ata co llection. T his r esearch w as co nducted in four s teps. S tep I, w as preparing the questionnaire used in the study. The questionnaire was then tested for its validity and reliability before using it at a later stage. At this stage besides determining external respondents which are patients, we also established a team of the Quality Improvement of OI as internal respondents in this study. Step II, was getting expectations and the actual fact of customer service through questionnaires that h ave b een t ested for its validity a nd r eliability and compiled gap b y comparing b etween t he expectations an d the r eality of t he s ervice b ased o n i ts scale. Step III , was t he step of Preparation o f t he H ouse of Q uality w hich comprises t he s teps of ( 1) P reparation of C ustomer's N eeds, ( 2) P reparation of Planning M atrix, n amely th e d etermination G oal, c ounting Improvement R atio, Raw W eight a nd Normalized R aw W eight, ( 3) P reparation of Response Technical, ( 4) D etermining the ma trix tie s ( relationship), (5) P reparation of priority of technical response, (6) Determining the Technical Correlation on the roof of House of Quality. Step IV, which was the stage of analysis and preparation of recommendations. Four stages of this research were conducted for 8 m onths, from October 2014 to Juni 2015. Sources of information of the research in phase I and II were patients who had received services more than two times at the disease clinic o f O I of S emen Gresik H ospital. In step IV , to achieve t he goal a nd by m anagers a nd h eads of uni ts i n out patient SGH t otaling 9 pe ople, w hile t he relationship was obtained through the scoring of all 9 managements.
The Result of the first phase of the study is to determine the Customer's needs of OI of SGH. Data of patients interest level is obtained based on the patient expectations, w hile C ustomer S atisfaction P erformance i s obt ained ba sed on assessment of the current services. Next all the data obtained are calculated for the Improvement R atio an d R aw W eight an d Net R aw W eight, b esides it a lso determines the technical response, technical response relationship and the priority of response t echnique. Calculations a re t hen s ummarized i n a hous e of qua lity. The house of quality obtains the priority of customer’s needs and order of priority technical r esponse t o d raft r ecommendations of O I of S GH s ervice quality improvement . Then we draft a strategic issue for FGD. FGD aims to describe the results of research and make clarification.
Based o n t he an alysis o f t he r esearch u sing Q FD, t here are s ome Conclusions as the following:1) The results of an analysis of the House of Quality got f irst pr iority t he ne eds of t he c ustomer a re ( 1) t he a ccuracy o f t he ope ning hours doctor service, (2) a discussion of nurses with patients and family enough, (3) th e w aiting time o f p atients a t e nrollment q uickly, (4) th e waiting time laboratory r esults q uickly, ( 5) th e w aiting time f ast r adiology r esults. 2 ) Recommendation efforts to improve the quality of service that must be done is (1) physician s ervices are 1 ) t he e valuation of t he implementation of t he S PO, 2) supervision of c ompliance w ith t he doc tor t o S PO, 3) a s ystem of r eward a nd punishment to the doctor, 4) SMS Gateway RSSG as a reminder hour Physician practices, 5 ) P hysician Practice reschedule h ours. ( 2) N ursing s ervices ar e 1 ) training of Customer Services, 2) evaluation of the implementation of the SPO, 3) undergraduate nursing education programs, 4) the reward s ystem for nurses. (3) Patient Enrollment S ervices are 1) the evaluation of patient enrollment S PO, 2) registration is divided into BPJS and Non BPJS, 3) updates to the master patient index according SPO, 4) training of Customer S ervices. (4) Laboratory services are 1) supervision of the implementation of the SPO, 2) the evaluation of the SPO 3) t raining pl ebotomi, 4 ) M oU repair LIS, 5) i ncreasing t he vol ume o f us e of laboratory equipment, 6) Increase the use of LIS. (5) Radiology services are 1) the evaluation of t he i mplementation of t he SPO, 2) s upervision of t he implementation of the SPO, 3) D4 Radiografer education program.
As f or s uggestions a s follows: 1) the hospital ne eds to socialize and implement the results of the research and steps are taken to improve the quality of customer service at OI of SGH. 2) the hospital needs to improve the coordination between t he related units to ach ieve the customer s ervice qua lity i mprovement program at OI of SGH. 3) the hospital needs to evaluate the implementation of quality of service at OI of SGH or in other units.
Improvement of Service Quality by Quality Function Deployment (QFD)
Method
(In the purpose of improving the Service Quality of Outpatient Installation at
Semen Gresik Hospital)
In t he years of 2014 the l evel o f O I p atient s atisfaction at O I o f S emen Gresik Hospital is low with an average of 73.75% of Minimum Service Standart of Hospital ( SPM-RS) (≥ 90%). This r esearch i s meant to f ormulate a recommendation on t he s ervice qua lity improvement b y Quality Function Deployment ( QFD) m ethod as a s trategy t o i ncrease s ervice q uality at S emen Gresik H ospital. This r esearch i s an o bservational s tudy w hich us es t he c ross sectional method in the data collection. This research was conducted in four steps for six months from April to September 2015. The respondents of this study were patients who had received services more than twice at the disease clinic of OI of Semen G resik H ospital. This s tudy c onsists of four s teps : th e f irst s tep is to construct que stionnaire which is used i n t he s tudy, t he s econd s tep is g etting expectations an d t he actual f act o f customer s ervice t hrough que stionnaires and compiling ga p b y comparing b etween t he expectations a nd the r eality of t he service based on i ts scale, the third step is to build the House of Quality which comprises t he s teps of ( 1) P reparation of C ustomer's N eeds, ( 2) P reparation of Planning M atrix, na mely the d etermination G oal ( goal), c ounting Improvement Ratio, R aw Weight a nd N ormalized R aw Weight, ( 3) P reparation of R esponse Technical, ( 4) D etermining the ma trix tie s ( relationship), ( 5) P reparation o f priority of technical response, (6) Determining the Technical Correlation on the roof of House of Q uality. T he f ourth s tep is analysis a nd formulating recommendations.
The results from the House of Quality are priorities of the most important customer’s needs and management response based priority technical response and strong r elationships be tween t echnical r esponse. R esults of this s tudy a re proposed as efforts to improve quality of service.
Keywords: Quality Function Deployment, satisfaction.
Halaman SAMPUL DEPAN ........................................................................................... i SAMPUL DALAM .......................................................................................... ii HALAMAN PRASYARAT GELAR .............................................................. iii HALAMAN PENGESAHAN .......................................................................... iv HALAMAN PERSETUJUAN ......................................................................... v PERNYATAAN TENTANG ORISINALITAS .............................................. vi KATA PENGANTAR ..................................................................................... vii
SUMMARY ....................................................................................................... ix
ABSTRACT ....................................................................................................... xi
DAFTAR ISI .................................................................................................... xii DAFTAR TABEL ............................................................................................ xix DAFTAR GAMBAR ....................................................................................... xxii DAFTAR LAMPIRAN .................................................................................... xxiii DAFTAR ARTI LAMBANG, SINGKATAN DAN ISTILAH ....................... xxiv BAB 1 PENDAHULUAN ............................................................................
1 1.1 Latar Belakang .....................................................................
1 1.2 KajianMasalah .....................................................................
5 1.2.1 Faktor Rumah sakit ..................................................
6 1.2.2 Faktor Pasien ............................................................
12 1.2.3 Proses ........................................................................
14 1.2.4 Kepuasan Pasien .......................................................
16 1.3 Batasan Masalah ..................................................................
17 1.4 Rumusan Masalah ................................................................
18 1.5 Tujuan Penelitian .................................................................
19 1.5.1 Tujuan Umum ...........................................................
19 1.5.2 Tujuan Kusus ............................................................
19 1.6 Manfaat Penelitian ...............................................................
20
1.6.1 Manfaat b agi Bagi M anajemen d an P engelola Instalasi Rawat Jalan Rumah Sakit Semen Gresik ...
20 1.6.2 Manfaat bagi Iinstitusi Pendidikan ...........................
20 1.6.3 Manfaat bagi Peneliti ................................................
21 BAB 2 TINJAUAN PUSTAKA ....................................................................
22 2.1 Rumah Sakit .........................................................................
22 2.1.1 Pengertian Rumah Sakit ...........................................
22 2.1.2 Tugas dan Fungsi Rumah Sakit ...............................
23 2.1.3 Alur Pelayanan Rumah Sakit ...................................
24 2.1.4 Ciri Jasa pelayanan Rumah Sakit .............................
25 2.1.5 Standar Pelayanan Minimal IRJ RS .........................
28 2.2 Mutu Pelayanan Kesehatan ..................................................
29 2.2.1 Pengertian Mutu Pelayanan Kesehatan ....................
29 2.2.2 Penilaian Mutu Pelayanan Kesehatan ......................
31
2.3 Harapan ................................................................................
36 2.3.1 Kebutuhan ................................................................
40 2.3.2 Keinginan .................................................................
41 2.4 Kepuasan Pelanggan ............................................................
41 2.4.1 Pengertian Kepuasan Pelanggan ................................
41
2.4.2Pengukuran da n A nalisis T ingkat K epuasan Pelanggan .................................................................
46 2.5 Perilaku Pelanggan ..............................................................
49 2.6 Quality Function Deployment (QFD) ..................................
54 2.6.1 Definisi Quality Function Deployment (QFD) .........
54 2.6.2 Fungsi Quality Function Deployment (QFD) ...........
56 2.6.3 Konsep Quality Function Deployment (QFD) ..........
58
2.6.4 Tahapan Penerapan Quality Function Deployment (QFD) .......................................................................
59 2.7 Konsep FGD (Focus Group Discussion) .............................
69 2.7.1 Alasan Menggunakan FGD .......................................
70 2.7.2 Tahapan FGD ............................................................
71 BAB 3 KERANGKA KONSEPTUAL ........................................................
73 3.1 Kerangka Konseptual ...........................................................
73 3.2 Penjelasan kerangka Konseptual Penelitian ........................
74 BAB 4 METODE PENELITIAN..................................................................
77 4.1 Jenis dan Rancang bangun Penelitian ..................................
77 4.2 Lokasi dan Waktu Penelitian ...............................................
77 4.2.1 Lokasi Penelitian .....................................................
77 4.2.2 Waktu Penelitian ......................................................
77 4.3 Populasi dan Sampel Penelitian ...........................................
77 4.3.1 Populasi Penelitian ....................................................
77 4.3.2 Sampel penelitian .......................................................
78 4.3.3 Besar Sampel dan Teknik Pengambilan Sampel ........
78 4.4 Kerangka Operasional .........................................................
80
4.5 Variabel Penelitian, Definisi Operasional dan Cara Pengukuran ..........................................................................
83 4.5.1 Variabel Penelitian ....................................................
83
4.5.2 Definisi Operasional dan Cara Pengukuran Variabel .....................................................................
84 4.6 Teknik dan Prosedur Pengumpulan Data ............................
93 4.6.1 Teknik Pengumpulan Data .......................................
93 4.6.2 Instrumen pengumpulan Data Penelitian .................
93 4.6.3 Uji Validitas dan Reliabilitas ...................................
94 4.7 Pengolahan dan Analisis Data .............................................
95
5.1 Gambaran UmumRumah Sakit Semen Gresik .................... 102
Improvement R atio)
Customer’s NeedsPelayanan Laboratorium ............. 128
5.3.5 Harapan, P enilaian K enyataan P elayanan d an Customer’s NeedsPelayanan Radiologi ...................
130
5.4 Rasio P erbaikan (Improvement R atio) Pelayanan di IRJ RSSG ................................................................................... 133
5.2.1 Rasio Perbaikan ( Improvement R atio) PelayananDokterdi Instalasi Rawat Jalan RSSG ..... 133
5.2.2 Rasio P erbaikan (
PelayananPerawatdi Instalasi Rawat Jalan RSSG ... 134
Instalasi Rawat Jalan ................................................ 126
5.2.3 Rasio P erbaikan ( Improvement R atio) PelayananPendaftaran Pasien Instalasi Rawat Jalan di RSGG ................................................................... 135
5.2.4 Rasio P erbaikan (
Improvement R atio)
PelayananLaboratoriumdi Instalasi R awat J alan RSSG ........................................................................ 137
5.2.5 Rasio P erbaikan ( Improvement R atio) PelayananRadiologi di Instalasi Rawat Jalan RSSG 137
5.5 Bobot M entah ( Raw W eight) da n B obot B ersih (Normalized Raw Weight) Pelayanan IRJ di RSGG ........... 138
5.3.4 Harapan, P enilaian K enyataan P elayanan d an
Customer’s N eedsPelayanan Pendaftaran P asien
5.1.1 Visi, Misi dan Motto Rumah Sakit Semen Gresik ... 102
5.2.2 Sumberdaya Manusia Instalasi Rawat Jalan Rumah Sakit Semen Gresik .................................................. 111
5.1.2 Jenis Pelayanan Rumah Sakit Semen Gresik ............ 103
5.1.3 Sumber Daya Manusia Rumah Sakit Semen Gresik 106
5.1.4 Struktur Organisasi Rumah Sakit Semen Gresik ...... 108
5.1.5 Peralatan Rumah Sakit Semen Gresik ...................... 109
5.2 Gambaran U mum Instalasi R awat J alan r umah S akit Semen Gresik ....................................................................... 109
5.2.1 Jenis Pelayanan di Instalasi Rawat Jalan RSGG ...... 110
5.2.3 Alur Pelayanan IRJ Rumah Sakit Semen Gresik ..... 113
5.3.3 Harapan, P enilaian K enyataan P elayanan d an
5.2.4 Hasil Pelayanan Rawat Jalan Tahun 2014 ............... 118
5.2.5 Struktur O rganisasi Instalasi R awat J alan R umah Sakit Semen Gresik .................................................. 120
5.3 Customer ‘ s N eeds Pelanggan Instalasi R awat J alan Rumah Sakit Semen Gresik ................................................. 121
5.3.1 Harapan, P enilaian K enyataan P elayanan d an
Customer’s NeedsPelayanan Dokter ........................ 121
5.3.2 Harapan, P enilaian K enyataan P elayanan d an
Customer ‘s NeedsPelayanan Perawat ..................... 123
5.5.1 Bobot Permasalahan padaPelayanan Dokter ........... 139
5.5.3 Bobot P ermasalahan padaPelayanan Pendaftaran Pasien Instalasi Rawat Jalan .................................... 141
5.5.4 Bobot Permasalahan padaPelayanan Laboratorium . 142
5.5.5 Bobot Permasalahan padaPelayanan Radiologi ....... 143
5.6 Penetapan R espon T eknik ( Technical R esponse) IR J RSGG ................................................................................... 144
5.6.1 Penetapan Respon Teknik PelayananDokter ........... 144
5.6.2 Penetapan Respon Teknik PelayananPerawat ......... 147
5.6.3 Penetapan R espon T eknik Pelayanan Pelayanan Pendaftaran Pasien IRJ ............................................ 149
5.6.4 Penetapan Respon Teknik Pelayanan Laboratorium 153
5.6.5 Penetapan Respon Teknik Pelayanan Radiologi ...... 156
5.7 Penilaian Hubungan Respon Teknik terhadap Customer’s
Needs .................................................................................... 159
5.7.1 Nilai Hubungan Respon T eknik PelayananDokter terhadap Customer’s Needs ...................................... 160
5.7.2 Nilai Hubungan Respon Teknik Pelayanan Perawat terhadap Customer’s Needs ...................................... 161
5.7.3 Nilai Hubungan Respon T eknik Pelayanan Pendaftaran Pasien IRJ terhadap Customer’s Needs 163
5.7.4 Nilai Hubungan Respon T eknik Pelayanan Laboratorium terhadap Customer’s Needs ............... 165
5.7.5 Nilai Hubungan Respon T eknik Pelayanan Radiologi terhadap Customer’s Needs ..................... 166
5.8 Prioritas R espon T eknik t erhadap Customer’s N eeds
(Technical Matrix) ............................................................... 168
5.8.1 Perhitungan Prioritas R espon T eknik Pelayanan Dokter t erhadap Customer’s N eeds (Technical
Matrix) ...................................................................... 168
5.8.2 Perhitungan Prioritas R espon T eknik Pelayanan Perawat t erhadap Customer’s N eeds (Technical
Matrix) ...................................................................... 170
5.8.3 Perhitungan Prioritas R espon T eknik Pelayanan Pendaftaran Pasien IRJ terhadap Customer’s Needs
(Technical Matrix) .................................................... 171
5.8.4 Perhitungan Prioritas R espon T eknik Pelayanan Laboratorium t erhadap Customer’s N eeds (Technical Matrix) ....................................................
172
5.8.5 Perhitungan Prioritas R espon T eknik Pelayanan Radiologi t erhadap Customer’s N eeds (Technical
Matrix) ...................................................................... 173
5.9 Hubungan Antar Respon Teknis .......................................... 175
5.9.1 Hubungan a ntar R espon T eknis (Technical
Correlation) Pelayanan Dokter ................................ 176
Correlation) Pelayanan Perawat .............................. 176
5.9.3 Hubungan a ntar R espon T eknis (Technical Correlation) Pelayanan Pendaftaran Pasien ............
177
5.9.4 Hubungan a ntar R espon T eknis (Technical
Correlation) Pelayanan Laboratorium ..................... 178
5.9.5 Hubungan a ntar R espon T eknis (Technical
Correlation) Pelayanan Radiologi ........................... 179
5.10 Matrik Rumah Mutu (House of Quality) Pelayanan IRJ RSSG ................................................................................... 180
5.10.1 Matrik Rumah Mutu (House of Quality) Pelayanan
IRJ RSSG Pelayanan Dokter .................................... 180
5.10.2 Matrik Rumah Mutu (House of Quality) Pelayanan
IRJ RSSG PelayananPerawat ................................... 183
5.10.3 Matrik Rumah Mutu (House of Quality) Pelayanan
IRJ RSSG PelayananPendaftaran Pasien ................ 185
5.10.4 Matrik Rumah Mutu (House of Quality) Pelayanan
IRJ RSSG PelayananLaboratorium .......................... 188
5.10.5 Matrik Rumah Mutu (House of Quality) Pelayanan
IRJ RSSG PelayananRadiologi ................................ 191
5.11 Isu Strategis .......................................................................... 194
5.12 Rekomendasi P erencanaan U ntuk M eningkatkan M utu Pelayanan IRJ RSGG ........................................................... 201
BAB 6 PEMBAHASAN .................................................................................. 208
6.1 Harapan, P enilaian K enyataan d an Customer’s N eeds Pelayanan IRJ RSSG tahun 2015 ........................................ 209
6.1.1 Customer’s NeedsPelayanan Dokter. ....................... 211
6.1.2 Customer’s NeedsPelayanan Perawat ...................... 213
6.1.3 Customer’s NeedsPelayanan Pendaftaran Pasien Rawat Jalan .............................................................. 216
6.1.4 Customer’s NeedsPelayanan Laboratorium ............. 217
6.1.5 Customer’s NeedsPelayanan Radiologi ................... 219
6.2 Rasio P erbaikan (Improvement R atio) Pelayanan di IRJ RSSG tahun 2015 ................................................................ 220
6.2.1 Improvement R atioCustomer’s N eeds terhadap Pelayanan Dokter ..................................................... 220
6.2.2 Improvement R atioCustomer’s N eeds terhadap Pelayanan Perawat ................................................... 221
6.2.3 Improvement R atioCustomer’s N eeds terhadap Pelayanan Pendaftaran Pasien Rawat Jalan ............. 222
6.2.4 Improvement R atioCustomer’s N eeds terhadap Pelayanan Laboratorium .......................................... 223
6.2.5 Improvement R atioCustomer’s N eeds terhadap Pelayanan Radiologi ................................................ 224
(Normalized R aw Weight) Customer’s N eeds IRJ R SGG tahun 2015 ........................................................................... 224
NeedsPelayanan Perawat ......................................... 239
6.6.3 Prioritas R espon T eknik t erhadap Customer’s
241
6.6.2 Prioritas R espon T eknik t erhadap Customer’s NeedsPelayanan Perawat .........................................
NeedsPelayanan Dokter ........................................... 241
6.6.1 Prioritas R espon T eknik t erhadap Customer’s
(Technical Matrix) ............................................................... 240
6.6 Prioritas R espon T eknik t erhadap Customer’s N eeds
NeedsPelayanan Radiologi ....................................... 240
6.5.5 Hubungan R espon T eknik t erhadap Customer’s
NeedsPelayanan Laboratorium ................................ 240
6.5.4 Hubungan R espon T eknik t erhadap Customer’s
239
6.5.3 Hubungan R espon T eknik t erhadap Customer’s NeedsPelayanan Pendaftaran Pasien Rawat Jalan ...
6.5.2 Hubungan R espon T eknik t erhadap Customer’s
6.3.1 Bobot M entah ( Raw W eight) da n B obot B ersih (Normalized R aw W eight)Customer’s N eeds pada Pelayanan Dokter ..................................................... 225
NeedsPelayanan Dokter ........................................... 238
6.5.1 Hubungan R espon T eknik t erhadap Customer’s
NeedsPelayanan IRJ RSSG .................................................. 238
6.5 Hubungan R espon Teknik t erhadap Customer’s
6.4.5 Respon Teknik pada Pelayanan Radiologi .............. 237
6.4.4 Respon Teknik pada Pelayanan Laboratorium ........ 235
6.4.3 Respon Teknik pada Pelayanan Pendaftaran Pasien Rawat Jalan .............................................................. 234
6.4.2 Respon Teknik pada Pelayanan Perawat ................. 232
6.4.1 Respon Teknik pada Pelayanan Dokter ................... 231
6.4 Respon Teknik (Technical Response) pada Pelayanan IRJ RSSG ................................................................................... 230
6.3.5 Bobot M entah ( Raw W eight) da n B obot B ersih (Normalized R aw W eight)Customer’s N eeds pada Pelayanan Radiologi ................................................ 229
6.3.4 Bobot M entah ( Raw W eight) da n B obot B ersih (Normalized R aw W eight)Customer’s N eeds pada Pelayanan Laboratorium .......................................... 228
6.3.3 Bobot M entah ( Raw W eight) da n B obot B ersih (Normalized R aw W eight)Customer’s N eeds pada Pelayanan Pendaftaran Pasien Rawat Jalan ............. 227
6.3.2 Bobot M entah ( Raw W eight) da n B obot B ersih (Normalized Raw W eight)Customer’s N eeds pada Pelayanan Perawat ................................................... 226
NeedsPelayanan Pendaftaran Pasien Rawat Jalan ... 242
NeedsPelayanan Laboratorium ................................ 243
6.6.5 Prioritas R espon T eknik t erhadap Customer’s NeedsPelayanan Radiologi .......................................
243
6.7 Hubungan Antar Respon Teknis Pelayanan IRJ RSSG ....... 244
6.7.1 Hubungan a ntar R espon T eknis (Technical
Correlation) Pelayanan Dokter ................................ 244
6.7.2 Hubungan a ntar R espon Teknis ( Technical Correlation) Pelayanan Perawat ..............................
245
6.7.3 Hubungan a ntar R espon T eknis ( Technical
Correlation) Pelayanan Pendaftaran Pasien ............ 246
6.7.4 Hubungan a ntar R espon T eknis ( Technical
Correlation) Pelayanan Laboratorium ..................... 247
6.7.5 Hubungan a ntar R espon T eknis ( Technical
Correlation) Pelayanan Radiologi ........................... 247
6.8 Matrik R umah M utu ( House of Q uality) P elayanan IRJ RSSG ................................................................................... 248
6.8.1 House of Quality Pelayanan Dokter ......................... 251
6.8.2 House of Quality Pelayanan Perawat ....................... 253
6.8.3 House of Q uality Pelayanan P endaftaran P asien Rawat Jalan .............................................................. 256
6.8.4 House of Quality Pelayanan Laboratorium .............. 258
6.8.5 House of Quality Pelayanan Radiologi .................... 260
6.9 Rekomendasi U paya P eningkatan M utu P elayanan IRJ RSSG .................................................................................. 261
6.9.1 Rekomendasi U paya P eningkatan M utuPelayanan Dokter ...................................................................... 262
6.9.2 Rekomendasi U paya P eningkatan M utuPelayanan Perawat ..................................................................... 264
6.9.3 Rekomendasi U paya P eningkatan M utuPelayanan Pendaftaran Pasien Rawat Jalan ............................... 265
6.9.4 Rekomendasi U paya P eningkatan M utuPelayanan Laboratorium ............................................................ 267
6.9.5 Rekomendasi U paya P eningkatan M utuPelayanan Radiologi .................................................................. 269
BAB 7 PENUTUP ......................................................................................... 271
7.1 Kesimpulan ......................................................................... 271
7.2 Saran .................................................................................... 272 DAFTAR PUSTAKA ...................................................................................... 276 LAMPIRAN ..................................................................................................... 279
Nomor Judul Tabel Halaman
NeedsPelayananPendaftaran Pasien Rawat JalanInstalasi
Tabel 5.10 Kunjungan Rumah Sakit Semen Gresik Tahun 2014.... 118Tabel 5.11 Harapan, P enilaian Pelayanan d an Customer’sNeedsPelayanan DokterInstalasi R awat J alan Rumah
Sakit Semen Gresik ……..…………………………… 121 Tabel 5.12
Customer’s N eeds Pelayanan D okter Instalan Rawat
Jalan Rumah Sakit SemenGresik………………………. 123
Tabel 5.13 Harapan, P enilaian Pelayanan d an Customer’sRawat Jalan Rumah Sakit Semen Gresik……………… 124 Tabel 5.14
Tabel 5.9 Alur pelayanan p asien d i Instalasi R awat J alan R SSGCustomer’s N eeds Pelayanan P erawat Instalasi R awat
Jalan Rumah Sakit Semen Gresik…………….............. 125
Tabel 5.15 Harapan, P enilaian Pelayanan d an Customer’sNeedsPelayananPendaftaran Pasien Rawat JalanInstalasi
Rawat Jalan Rumah Sakit Semen Gresik……………..... 126 Tabel 5.16
Customer’s Needs Pelayanan Pendaftaran Pasien Rawat Jalan Instalasi Rawat Jalan Rumah Sakit Semen Gresik..
128
Tahun 2014……………………………………………... 113
2014……………………………..……………………… 112
Tabel 1.1 Hasil E valuasi S tandar P elayanan Minimal I RJ Tahun2014…………………………………………..2015…………………………………………………….. 105
3 Tabel 1.2 Hasil Kepuasan Pelanggan IRJ Tahun 2013-2014……...
3 Tabel 4.1 Variabel, Definisi Operasional, Cara Pengukuran, Hasil Pengukuran dan Skala Data.............................................
84 Tabel 4.2 Pilihan J awaban da n Interpretasi S kala Kuesioner Berdasarkan Harapan Pasien……………………………
96 Tabel 4.3 Pilihan J awaban da n Interpretasi S kala Kuesioner Berdasarkan Kenyataan Pelayanan yang diterima Pasien
96 Tabel 4.4 Contoh Pilihan Jawaban dan Interpretasi Skor Goal
97 Tabel 5.1 Pelayanan Rumah Sakit Semen Gresik Tahun 2015…… 103
Tabel 5.2 Rawat Inap Paviliun Rumah Sakit Semen Gresik TahunTabel 5.3 Kelas P erawatan Instalasi R awat Inap R umah SakitTabel 5.8 Sumber Daya Manusia Instalasi Radiologi RSSG TahunSemen Gresik Tahun 2015……………………………… 105
Tabel 5.4 Sumber D aya M anusia R umah S akit S emen G resikTahun 2015……………………………………………... 106
Tabel 5.5 Peralatan Rumah sakit Semen Gresik…………………... 109Tabel 5.6 Sumber D aya M anusia Instalasi R awat J alan R umahSakit Semen Gresik…………………………………….. 111
Tabel 5.7 Sumber D aya M anusia Instalasi Laboratorium R SSGTahun 2014 ………………............................................ 112
Tabel 5.17 Harapan, P enilaian Kenyataan P elayanan d anCustomer’s N eeds PelayananLaboratorium I nstalasi
Rawat Jalan Rumah Sakit Semen Gresik …….………… 129
Customer’s N eedsPelayanan L aboratoriumInstalasi
Tabel 5.18 Rawat Jalan Rumah Sakit Semen Gresik ……..……….. 130
Tabel 5.19 Harapan, P enilaian Kenyataan P elayanan d anCustomer’s N eeds PelayananRadiologi Instalasi R awat
Jalan Rumah Sakit Semen Gresik …..…………………. 131
Customer’s Needs Pelayanan Radiologi Instalasi Rawat
Tabel 5.20 Jalan Rumah Sakit Semen Gresik ……………………… 132
Tabel 5.21 Rasio Perbaikan (Improvement Ratio) PelayananDokterInstalasi Rawat Jalan di RSGG…………………………. 134
Tabel 5.22 Rasio P erbaikan ( Improvement R atio) PelayananPerawat Instalasi Rawat Jalan Pelayanan…..…………... 135
Tabel 5.23 Rasio P erbaikan ( Improvement R atio) PelayananPendaftaran PasienInstalasi Rawat Jalan di RSGG 136
Tabel 5.24 Rasio P erbaikan ( Improvement R atio) PelayananLaboratorium Instalasi Rawat Jalan di RSGG ……. 137
Tabel 5.25 Rasio P erbaikan ( Improvement R atio) PelayananRadiologi Instalasi Rawat Jalan Pelayanandi RSGG …. 138
Tabel 5.26 Bobot M entah ( Raw W eight) da n B obot B ersih(Normalized R aw Weight)Customer’s N eedspada PelayananDokter di IRJ RSGG……………………….... 139
Tabel 5.27 Bobot B obot M entah (Raw W eight) d an B obot Bersih(Normalized R aw Weight)Customer’s N eedspada PelayananPerawat di IRJ RSGG ……………………… 140
Tabel 5.28 Bobot B obot M entah (Raw W eight) d an B obot Bersih(Normalized R aw Weight) C ustomer’s N eedspada Pelayanan P endaftaran Instalasi R awat J alan di IRJ RSGG…………………………………………………... 141