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TESIS

UPAYA PENINGKATAN MUTU PELAYANAN DENGAN METODE QUALITY FUNCTION DEPLOYMENT (QFD)

DI INSTALASI RAWAT JALAN RUMAH SAKIT SEMEN GRESIK

ASMAUNAH ASRININGTYAS

UNIVERSITAS AIRLANGGA FAKULTAS KESEHATAN MASYARAKAT

PROGRAM MAGISTER PROGRAM STUDI ADMINISTRASI DAN KEBIJAKAN KESEHATAN

SURABAYA 2015

ADLN-PERPUSTAKAAN UNIVERSITAS AIRLANGGA

TESIS UPAYA PENINGKATAN MUTU ASMAUNAH ASRININGTYAS

TESIS



ASMAUNAH ASRININGTYAS NIM 101314453028



SURABAYA 2015

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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



SURABAYA 2015

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KATA PENGANTAR Puji syukur kehadirat Allah SWT atas rahmat dan hidayah-Nya sehingga

penyusunan t esis 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 t esis i ni b isa t erselesaikan dengan baik. Ucapan t erima k asih 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,

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Dra.Ec., M.Kes., Dr. Djazuly Chalidyanto, S.KM., M.ARS., Dwi Aryani, 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, p asien kl inik penyakit da lam Rumah Sakit Semen Gresik yang t elah 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 te rcinta Donny Imanul Rochimadjaja, S H. 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

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SUMMARY

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 s tudy. 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 r esponse, (6) Determining th e Technical Correlation on the roof of House of Quality. Step IV, which was the stage of analysis and preparation of r ecommendations. Four s tages of t his r esearch 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

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technical response obtained based on Focus Group Discussion (FGD) conducted 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 f irst phase of the s tudy i s 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 e ducation programs, 4) t he r eward s ystem for nu rses. (3) Patient E nrollment S ervices a re 1 ) th e evaluation o f p atient enrollment S PO, 2 ) registration is divided into BPJS and Non BPJS, 3) updates to the master patient index according SPO, 4) t raining of Customer S ervices. (4) Laboratory s ervices 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.

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ABSTRACT

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 s cale, t he t hird s tep i s to build t he 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 r esponse, (6) Determining th e 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.

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DAFTAR ISI

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

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2.2.3 Pelayanan Pelanggan ............................................... 33 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

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BAB 5HASIL DAN ANALISIS DATA .......................................................... 102 5.1 Gambaran UmumRumah Sakit Semen Gresik .................... 102

5.1.1 Visi, Misi dan Motto Rumah Sakit Semen Gresik ... 102 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 5.2.2 Sumberdaya Manusia Instalasi Rawat Jalan Rumah

Sakit Semen Gresik .................................................. 111 5.2.3 Alur Pelayanan IRJ Rumah Sakit Semen Gresik ..... 113 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 5.3.3 Harapan, P enilaian K enyataan P elayanan d an

Customer’s N eedsPelayanan Pendaftaran P asien Instalasi Rawat Jalan ................................................ 126

5.3.4 Harapan, P enilaian K enyataan P elayanan d an 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 ( Improvement R atio)

PelayananPerawatdi Instalasi Rawat Jalan RSSG ... 134 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 5.5.1 Bobot Permasalahan padaPelayanan Dokter ........... 139

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5.5.2 Bobot Permasalahan padaPelayanan Perawat .......... 140 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 t erhadap 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

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5.9.2 Hubungan a ntar R espon T eknis (Technical 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

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6.3 Bobot M entah ( Raw Weight) da n B obot B ersih (Normalized R aw Weight) Customer’s N eeds IRJ R SGG tahun 2015 ........................................................................... 224 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

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

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

6.3.4 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

6.3.5 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

6.4 Respon Teknik (Technical Response) pada Pelayanan IRJ RSSG ................................................................................... 230 6.4.1 Respon Teknik pada Pelayanan Dokter ................... 231 6.4.2 Respon Teknik pada Pelayanan Perawat ................. 232 6.4.3 Respon Teknik pada Pelayanan Pendaftaran Pasien

Rawat Jalan .............................................................. 234 6.4.4 Respon Teknik pada Pelayanan Laboratorium ........ 235 6.4.5 Respon Teknik pada Pelayanan Radiologi .............. 237

6.5 Hubungan R espon Teknik t erhadap Customer’s NeedsPelayanan IRJ RSSG .................................................. 238 6.5.1 Hubungan R espon T eknik t erhadap Customer’s

NeedsPelayanan Dokter ........................................... 238 6.5.2 Hubungan R espon T eknik t erhadap Customer’s

NeedsPelayanan Perawat ......................................... 239 6.5.3 Hubungan R espon T eknik t erhadap Customer’s

NeedsPelayanan Pendaftaran Pasien Rawat Jalan ... 239 6.5.4 Hubungan R espon T eknik t erhadap Customer’s

NeedsPelayanan Laboratorium ................................ 240 6.5.5 Hubungan R espon T eknik t erhadap Customer’s

NeedsPelayanan Radiologi ....................................... 240 6.6 Prioritas R espon T eknik t erhadap Customer’s N eeds

(Technical Matrix) ............................................................... 240 6.6.1 Prioritas R espon T eknik t erhadap Customer’s

NeedsPelayanan Dokter ........................................... 241 6.6.2 Prioritas R espon T eknik t erhadap Customer’s

NeedsPelayanan Perawat ......................................... 241 6.6.3 Prioritas R espon T eknik t erhadap Customer’s

NeedsPelayanan Pendaftaran Pasien Rawat Jalan ... 242

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6.6.4 Prioritas R espon T eknik t erhadap Customer’s 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

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DAFTAR TABEL

Nomor Judul Tabel Halaman Tabel 1.1 Hasil E valuasi S tandar P elayanan Minimal I RJ

Tahun2014………………………………………….. 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 Tahun

2015…………………………………………………….. 105 Tabel 5.3 Kelas P erawatan Instalasi R awat Inap R umah Sakit

Semen Gresik Tahun 2015……………………………… 105 Tabel 5.4 Sumber D aya M anusia R umah S akit S emen G resik

Tahun 2015……………………………………………... 106 Tabel 5.5 Peralatan Rumah sakit Semen Gresik…………………... 109 Tabel 5.6 Sumber D aya M anusia Instalasi R awat J alan R umah

Sakit Semen Gresik…………………………………….. 111 Tabel 5.7 Sumber D aya M anusia Instalasi Laboratorium R SSG

Tahun 2014 ………………............................................ 112 Tabel 5.8 Sumber Daya Manusia Instalasi Radiologi RSSG Tahun

2014……………………………..……………………… 112 Tabel 5.9 Alur pelayanan p asien d i Instalasi R awat J alan R SSG

Tahun 2014……………………………………………... 113 Tabel 5.10 Kunjungan Rumah Sakit Semen Gresik Tahun 2014.... 118 Tabel 5.11 Harapan, P enilaian Pelayanan d an Customer’s

NeedsPelayanan 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’s NeedsPelayananPendaftaran Pasien Rawat JalanInstalasi Rawat Jalan Rumah Sakit Semen Gresik……………… 124

Tabel 5.14 Customer’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’s NeedsPelayananPendaftaran 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

Tabel 5.17 Harapan, P enilaian Kenyataan P elayanan d an

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Nomor Judul Tabel Halaman Customer’s N eeds PelayananLaboratorium I nstalasi Rawat Jalan Rumah Sakit Semen Gresik …….…………

129

Tabel 5.18 Customer’s N eedsPelayanan L aboratoriumInstalasi Rawat Jalan Rumah Sakit Semen Gresik ……..……….. 130

Tabel 5.19 Harapan, P enilaian Kenyataan P elayanan d an Customer’s N eeds PelayananRadiologi Instalasi R awat Jalan Rumah Sakit Semen Gresik …..…………………. 131

Tabel 5.20 Customer’s Needs Pelayanan Radiologi Instalasi Rawat Jalan Rumah Sakit Semen Gresik ……………………… 132

Tabel 5.21 Rasio Perbaikan (Improvement Ratio) PelayananDokter Instalasi Rawat Jalan di RSGG…………………………. 134

Tabel 5.22 Rasio P erbaikan ( Improvement R atio) Pelayanan Perawat Instalasi Rawat Jalan Pelayanan…..…………... 135

Tabel 5.23 Rasio P erbaikan ( Improvement R atio) Pelayanan Pendaftaran PasienInstalasi Rawat Jalan di RSGG 136

Tabel 5.24 Rasio P erbaikan ( Improvement R atio) Pelayanan Laboratorium Instalasi Rawat Jalan di RSGG ……. 137

Tabel 5.25 Rasio P erbaikan ( Improvement R atio) Pelayanan Radiologi 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

Tabel 5.29 Bobot B obot M entah (Raw W eight) d an B obot Bersih (Normalized R aw Weight)Customer’s N eedspada Pelayananlaboratorium di IRJ RSGG …….…………... 142

Tabel 5.30 Bobot P ermasalahan B obot M entah ( Raw W eight) da n Bobot B ersih ( Normalized R aw Weight) Customer’s Needspada pelayananRadiologi di IRJ RSGG ..………. 143

Tabel 5.31 Penetapan Respon Teknik Pelayanan DokterIRJ RSSG.. 145 Tabel 5.32 Penetapan Respon Teknik Pelayanan PerawatIRJ RSSG 147 Tabel 5.33 Penetapan Respon Teknik Pelayanan Pendaftaran Pasien

Rawat Jalan di IRJ RSSG ……………………………… 149 Tabel 5.34 Penetapan R espon T eknik P elayanan LaboratoriumIRJ

RSSG…………………………...………………………. 153 Tabel 5.35 Penetapan R espon T eknik P elayanan R adiologi IRJ

RSSG …………………………………………………... 156 Tabel 5.36 Respon T eknik M anajemen Instalasi R awat J alan

berdasarkan FGD Tim Mutu RSSG RSGG Tahun 2015.. 158

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Nomor Judul Tabel Halaman Tabel 5.37 Nilai H ubungan R espon T eknik t erhadap Customer’s

Needs Pelayanan Dokter di IRJ RSSG ……..………….. 160 Tabel 5.38 NilaiHubungan R espon T eknik t erhadap Customer’s

Needs PelayananPerawatdi IRJ RSSG …..…………….

162 Tabel 5.39 Nilai H ubungan Respon T eknik t erhadap Customer’s

Needs Pelayanan Pendaftaran Pasien IRJ RSGG ……… 163 Tabel 5.40 Nilai H ubungan Respon T eknik t erhadap Customer’s

Needs PelayananLaboratorium di IRJ RSSG ….……… 165 Tabel 5.41 Nilai H ubungan Respon T eknik t erhadap Customer’s

NeedsPelayananRadiologi di IRJ RSSG …..………….. 167 Tabel 5.42 Perhitungan P rioritas R espon T eknis terhadap

Customer’s Needs (Technical Matrix) Pelayanan Dokter di IRJ RSGG…………………………………………. 169

Tabel 5.43 Perhitungan Prioritas Respon teknis terhadapCustomer’s Needs (Technical M atrix) Pelayanan perawat d iIRJ RSGG ………………………………………………… 170

Tabel 5.44 Perhitungan Prioritas R espon t eknis terhadap Customer’s N eeds (Technical M atrix) Pelayanan Pendaftaran Pasien diIRJ RSGG ……………………..... 171

Tabel 5.45 Perhitungan P rioritas Respon terhadap Customer’s Needs (Technical M atrix)Teknik P elayanan Laboratorium diIRJ RSGG ……..……………………... 172

Tabel 5.46 Perhitungan P rioritas Respon terhadap Customer’s Needs (Technical M atrix) Teknik P elayanan Radiologi di IRJ RSGG ……...…………………………………… 174

Tabel 5.47 Hubungan Antar Respon Teknik pada Pelayanan Dokter di IRJ RSGG …………………………………………… 176

Tabel 5.48 Hubungan A ntar R espon T eknik pa da P elayanan Pendaftaran Pasien Instalasi Rawat Jalan Di IRJ RSGG.. 177

Tabel 5.49 Hubungan A ntar R espon T eknik pa da P elayanan Laboratorium di IRJ RSGG ……………………………. 178

Tabel 5.50 Hubungan Antar R espon T eknik pa da P elayanan Radiologi di IRJ RSGG ………………………………... 179

Tabel 5.51 Isu Strategis dan Hasil FGD …………………………… 195

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DAFTAR GAMBAR

Nomor Judul Gambar Halaman Gambar 1.1 Kajian Masalah Penelitian……………………………… 5 Gambar 2.1 The house of Quality (Cohen, 1995)…………………… 62 Gambar3.1 Kerangka Konseptual ………………………………….. 73 Gambar 4.1 Kerangka Operasional Penelitian……………………….. 80 Gambar 5.1 Struktur Organisasi Rumah Sakit Semen Gresik……….. 108 Gambar 5.2 Struktur Instalasi R awat J alan R umah S akit Semen

Gresik…………………………………………………… 120 Gambar 5.3 Rumah Mutu (House of Quality)Pelayanan Dokter……. 182 Gambar 5.4 Rumah Mutu (House of Quality)Pelayanan Perawat…... 184 Gambar 5.5 Rumah Mutu (House of Quality) Pelayanan Pendaftaran

Pasien ……………………………………....................... 186 Gambar 5.6 Rumah M utu ( House of Q uality) Pelayanan

Laboratorium………………………………………….. 189 Gambar 5.7 Rumah M utu ( House of Q uality) Pelayanan

Radiologi……………………………………………… 192

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DAFTAR LAMPIRAN

Nomor Judul Lampiran Halaman Lampiran 1 Penjelasan Sebelum penelitian ……………………….. 279 Lampiran 2 Panduan Focus Group Discussion 1………………….. 283 Lampiran 3 Panduan Focus Group Discussion 2………………….. 286 Lampiran 4 Informed Concent……………………………………... 288 Lampiran 5 Kuesioner untuk pasien ………………………………. 290 Lampiran 6 Lembar Isian Respon Teknis………………………….. 296 Lampiran 7 Lembar Isian Skoring Goal untuk petugas……………. 300 Lampiran 8 Lembar Isian S koring Hubungan Customer’s N eeds

terhadap Respon Teknis………………………………. 306 Lampiran 9 Hasil Uji validitas dan reliabilitas…………………….. 312 Lampiran 10 Rangkuman Hasil Uji Statistik………………………... 319 Lampiran 11 Sertifikat Kaji Etik…………………………………….. 327 Lampiran 12 Daftar Hadir Focus Group Discussion1……………… 328 Lampiran 13 Daftar Hadir Focus Group Dcussion 2………………... 329 Lampiran 14 Jadwal Jaga Dokter Spesialis………………………….. 330

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DAFTAR ARTI LAMBANG, SINGKATAN, DAN ISTILAH

Daftar Arti Lambang & = dan % = persen n = besar sampel ∑ = jumlah √ = centang > = lebih dari < = kurang dari ≤ = kurang dari sama dengan ≥ = lebih dari sama dengan α = Alpha @ = setiap Daftar Singkatan BPJS = Badan Penyelenggara Jaminan Sosial CN = Customer’s Needs CNRW = Cumulative Normalized Raw Weight CS = Customer Services CSP = Customer Satisfaction Performance dr. = dokter HoQ = House of Quality IC = Importance to Customer IR = Improvement Ratio IRJ = Instalasi Rawat Jalan Jl. = Jalan KIA = Kesehatan Ibu dan Anak KNC = Kejadian Nyaris Cidera KTD = Kejadian Tidak Diharapkan No. = Nomor NRW = Normalized Raw Weight PJ = Penanggung jawab RSSG = Rumah Sakit Semen Gresik RT = Respon Teknis RT = Respon Teknis RW = Raw Weight SDM = Sumber Daya manusia SOP = Standard Operating Procedure SPM = Standar Pelayanan Minimal TR = Technical Response (Technical Requirement) TT = Tempat Tidur QFD = Quality Function Deployment VoC = Voice of Customer

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