J. Appl. Environ. Biol. Sci., 8(1)42-47, 2018 | ISSN: 2090-4274 |
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STIKes Surya Mitra Husada Kediri, Indonesia
Received: September 13, 2017 Accepted: December 2, 2017
Performance is the work of someone who describes the quality and quantity of work done. Quality of health services is the level of perfection of health services held in accordance with the code of ethics and standards of service. This study aims to identify post-accreditation performance and service quality of outpatient as well as to analyze the effect of post-accreditation performance on outpatient service quality. The study design was Cross Sectional Study. Used Proportional Random Sampling technique and analyzed using ordinal regression test, with the number of respondents as many as 578 respondents. This research was conducted in Gambiran Hospital Kediri on May 16 to 22, 2017. From the result of data of frequency distribution of performance post-accreditation of hospital got the highest value of performance that is nurse / midwife performance with category "A" counted 417 respondents (72,1%), and from the performance that has the lowest value of performance is the performance of doctors with the category of "A" as much as 220 respondents (38.1%) while the results of data distribution frequency of service quality of outpatients obtained the highest value of service quality is nurse / midwife service quality with the category "Very Good "as many as 410 respondents (70.9%) and from the quality of service that has the lowest value of service quality is the quality of doctors with the category" bad "as many as 405 respondents (70.1%). Ordinal regression statistic test showed that the simultaneous test obtained the result that is significant value 0,00 which means there is influence of post hospital accreditation performance to outpatient service quality in Gambiran Hospital Kediri. From the results of the research, it is better for the doctors to increase the discipline of time of attendance, for the nurse / midwife to maintain the time discipline of the present hour which is good and for some nurses should better maintain the privacy of the patient while performing the action, for non medical worker (laboratory, radiology, pharmacy) it is advisable to take the results of a supplementary examination there should be a maximum time limit for the patient to obtain the results, so that there is a clear timeline for the patient to wait for the outcome and the patient is also treated soon. KEYWORDS: Performance, service quality, outpatient, hospital
Human resources are the most important asset in an organization to maintain and develop the organization in globalization era. Good resource performance is important for organizational survival. If organizations want to grow rapidly, organizations must have human resources capable of performing well. Performance appraisal is actually an assessment of human behavior in performing the role they play in the organization because basically the organization is run by humans. In the framework of fostering and developing human resources elements of welfare need to be considered seriously because the welfare of employees is a very decisive factor in performance productivity. [1]
According to the World Health Organization (WHO), hospitals are an integral part of a social and health organization with the function of providing comprehensive services, curative and preventive cures to the community. The hospital is also a training center for medical personnel and medical research centers. In an effort to achieve optimal health degree this can’t be separated from the role of the hospital as an implementing element in the field of health services. Hospitals as the media facing directly with patients should be able to provide quality services. [2] Hospital accreditation is government recognition at the hospital, as it provides quality, standardized and patient safety services, and is established by KARS. According to Permenkes RI No. 012 Year 2012 on hospital accreditation that is, accreditation is the recognition of hospital
Corresponding Author: Sentot Imam Suprapto, STIKes Surya Mitra Husada Kediri, Indonesia. Email: sentotimam12@gmail.com
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(RS) which is given by independent accreditation organizational institution stipulated by the Minister of Health, after assessed that the hospital fulfill the hospital service standard continuously. With the occurred of service standard, the Hospital is expected to improve employee performance, so that the quality of service in patients can also increase.
Along with the development of the era, the hospital is currently faced with the era of global competition in various health sectors. Indonesia health profile data in 2013, states that the number of hospitals in Indonesia, both general hospitals (RSU) and special type hospitals (RSK) has increased significantly since last four years. In 2009 it was found that there were 1,523 hospitals then increased by 44.42% to 2,201 in 2013. [3] In order to survive and develop in a rapidly changing and competitive environment, hospitals had to change the management paradigm of the hospital towards the consumer's point of view. Approach of quality service and customer satisfaction becomes one important strategy that can’t be ignored. [4]
Through the preliminary research in Gambiran Hospital Kediri on 9 January 2017 from several wards in Gambiran Hospital Kediri, there are still complaints from some patients because too long queue waiting for doctors, hours of doctor's presence to check the patient is uncertain, less seating facilities, so some patients become standing and the situation is hot due to lack of circulation and the absence of air conditioning, the patient is too crowded to queue up waiting for a call at the registration counter. And sometimes there are employees who are less friendly to patients. This study aims to determine the effect of post-accreditation performance on service quality in outpatients in Gambiran Hospital kediri.
The study design was Cross Sectional Study. Using Proportional Random Sampling technique was analyzed using ordinal regression test, the number of respondents as many as 578 respondents. This research was conducted at Gambiran Hospital Kediri on 16 -22 May 2017
Characteristics of the Subject
Table 1. Characteristics of respondents in this research include parent age, parent education, parent occupation, child age and parent role.
Characteristics ΣN Σ% | ||
---|---|---|
sex | ||
male | 264 | 46 |
female | 314 | 54 |
Occupation | ||
Students | 66 | 11.4 |
Entrepreneur | 18 | 3.1 |
Private | 210 | 36.3 |
Civil government | 95 | 16.4 |
Jobless | 114 | 19.7 |
Farmer | 70 | 12.1 |
Etc | 5 | 9 |
Performance value | ||
The lowest | 220 | 38.1 |
The higest | 417 | 72.1 |
Quality servive | ||
Very good/ excellent | 410 | 70.9 |
Very bad | 405 | 70.1 |
Total | 578 | 100 |
Based on table 1 above from total of 578 respondents most of female gender as many as 314 patients (54%), private sector work as many as 210 patients (36.3%), the results of data distribution frequency performance post-accreditation hospital got the highest performance value of performance. nurse / midwife with the category "A" as much as 417 respondents (72.1%) and from the data distribution frequency of post-hospital accreditation performance obtained the lowest value of doctor's performance with the category "A" as
J. Appl. Environ. Biol. Sci., 8(1)42-47, 2018
many as 220 respondents (38.1%) and data results distribution of quality of outpatient service quality got the highest value of service quality that is service quality of nurse / midwife with "Excellent" category as many as 410 respondents (70,9%). And from result of data of frequency distribution of service quality of outpatient got lowest value of service quality that is service quality of doctor with category "very bad" as many as 405 respondent (70,1%).
From the result of statistical test of doctor's performance after hospital accreditation to doctor service quality, there is influence 20,1%, the rest 79,9% because other factor.
Table 3. Statistical Results Performance nurses / Midwife Performance on Quality Nurses / Midwives
From the result of statistic test of nurse / midwife after hospital accreditation to nurse service quality / midwife got influence 25,3%, rest 74,7% because other factor.
From the result of statistical test of non medical performance after hospital accreditation to non medical service quality, there was an effect of 15%, the rest 85% because of other factors.
From result of ordinal regression statistic test simultaneously got result there is influence of post hospital accreditation performance to outpatient service quality with significant value (0.00) which mean there is influence between variable1 and variable2, so there is influence of post-accreditation performance to service quality of outpatient.
Post-Hospital Accreditation Performance
Based on the interpretation of performance data obtained data that shows the highest value of post-accreditation performance is the performance value of nurses / midwives with the category "A" as many as 417 respondents (72.1%). Performance is the result of work in quality and quantity achieved by an employee in performing its duties according to the responsibilities given to it. Performance is the comparison of work achieved by employees with predetermined standards. [5] Performance is a condition that must be known and confirmed to certain parties to determine the level of achievement of an agency results associated with the vision of an organization or company and to know the positive and negative impact of an operational policy.
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Based on the interpretation of performance data, it is found that the performance shows the lowest value of post hospital accreditation performance is the value of doctor performance with the category "A" as many as 220 respondents (38.1%). Performance is a successful achievement, information about the performance is very important that is used to evaluate whether the performance process has been so far in line with what the expected goal yet. [6]
According to the Researcher, performance is the result of work achieved by an individual adjusted to the role or task of a particular period of time, which is associated with a company for a given period of time, connected to a certain size or standard of the company in which the individual works. There are several factors that affect the doctor's performance that many doctors present are not working hours or late, so the patient becomes long waiting to get medical service from the doctor and there are some doctors who lack patient privacy during consultation with patients, patient examination, even action on the patient. It should be a secret between doctors and patients, and patients become less comfortable when consulting about the disease to the doctor, and also less comfortable when the examination and medical treatment by doctors.
Based on the data quality interpretation, the data showed that the highest value of outpatient service is the quality of nurse / midwife with the category of "Very Good" as many as 410 respondents (70.9%). Quality is an effort to meet or exceed customer expectations. A product or service is said to be qualified / not qualified if it can provide full satisfaction to customers / users. Quality includes products, services, people, processes, and environments where quality is a dynamic condition. Quality of health services is the level of perfection of health services held in accordance with the code of ethics and standard of service set, thus giving satisfaction for each patient. [7]
Based on data quality interpretation, the data showed that the lowest value of outpatient service quality is physician quality value with the category of "bad" as many as 405 respondents (70.1%). Quality of health services is a health service that can satisfy every user of health care services in accordance with the average level of satisfaction and the organizers in accordance with standard and professional code of ethics. [8]
According to the researchers, the service of the health is the level of perfection of health services in causing a sense of satisfaction in each patient. The more perfect the satisfaction, the better the quality of health services. There are several factors that affect the quality of service physicians in outpatients that patients do not immediately get the services of doctors because doctors present not on time so that patients become long waiting, doctors do not explain the therapy given to patients, just write prescription drugs to be redeemed at the pharmacy , sometimes there are some doctors who pay less attention when invited by the patient to consult about the illness so that the patient becomes less satisfied and less fully clarified about the disease he suffered.
Based on statistical test ordinal regression simultaneously shows significant value 0,00 which means there is influence between variable1 and variable2, so got there influence of variable X (Performance) to variable Y (Quality of Service), which mean show influence Post Performance Accreditation Quality of Service Outpatient patients. Quality of Service is any effort held alone or collectively in an organization to maintain and improve health, prevent and cure diseases and restore the health of individuals, families, groups and or society. [9] According to the researchers, the performance performed by employees to the patient affects the quality of service results in patients. There should be regular evaluation and corrective action from criticism of every patient who complains or complains, in order to create good performance and produce good quality so that patients will feel satisfied and feel confident in health service agencies.
From the statistical test shows the influence of doctor’s performance on doctor’s quality of 20.1%, the rest 79.9% due to other factors. Performance describes what an individual has achieved or in other words the actual result achieved when the individual sets goals and strives to achieve that goal, then individual will gain and see the results of what he or she has done or done. Performance is quantity, quality, time spent, occupation, absence and safety in performing job duties, criteria of quality and quantity of work, cooperation, leadership, prudence, knowledge of position, craft, loyalty, and initiative. [10] Performance is influenced by several factors namely, quality of work, quantity of work, timeliness, effectiveness and independence in work. [11]
J. Appl. Environ. Biol. Sci., 8(1)42-47, 2018
Based on data interpretation, the effect of nurse / midwife's performance on nurse / midwife quality is 25,3%, and the rest 74,7% influenced by other factors. Performance is the work that can be achieved by a person or group of organizations, in accordance with their respective powers and responsibilities in an effort to achieve the objectives of the organization concerned legally, not violating the law and in accordance with the moral or ethical. The performance of nurses is an activity that nurses give to clients in the form of nursing care to improve adaptation response. [5] Some of the factors that affect performance are effectiveness and efficiency, authority (authority), discipline at work, and initiatives at work. Quality is an effort to meet or exceed customer expectations. A product or service is said to be qualified / not qualified if it can provide full satisfaction to customers / users. Quality includes products, services, people, processes, and environments where quality is a dynamic condition. Quality of health services is important in healthcare organizations, raising health awareness, raising public awareness about health and health care services, encouraging every health care organization to be particularly concerned with the quality of health services. [8]
Based on the interpretation of data showed there is non-medical performance influence on non-medical quality of 15%, and the remaining 85% influenced by other factors. Performance or performance is the result or output of a process. [5] According to the researchers, performance is the result of good work both quality and quantity achieved by a person in carrying out the task according to the responsibility given. Based on the results of research conducted non-medical performance has an effect on non-medical quality in terms of health services, there are some things that affect the waiting time to register too long, so the patient becomes too long wait and become crowded to wait for the registration number, waiting time to the laboratory is too long, so the patient waits too long and there is no time standard for laboratory results, so sometimes when the laboratory results are over but the outpatient poly is closed, and the patient has to return tomorrow to the hospital to consult the doctor in the poly the way to read out the results and determine the action or therapy for the patient, and it harms the patient into inefficient time and cost. Waiting time in the radiology room is too long, the patient is too long to wait for x-ray results because doctors who read the results come not timely because doctors are still open practice outside the hospital, sometimes even the hospital that should take to the doctor's practice for Rontgen patients immediately can be read out the results and the patient is not getting older to wait and immediately get the right action.
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