The Strategy in Improving Quality of health Services for
190 Indian Journal of Public Health Research & Development, April-June 2018, Vol.9, No. 2 Another obstacle faced by Imbi puskesmas is the
inadequate supply of drugs. The number of generic drugs available has not been able to meet the existing needs, while essential drug supplies have exceeded the required amount. And sometimes prescriptions given by doctors are not available at Imbi Puskesmas and require patients to redeem drugs in pharmacies, while pharmacies in Imbi District available drugs are also not complete yet. Imbi Puskesmas when viewed from the physical side of the building is still good and feasible because it has just undergone a renovation, but on the existing media equipment at Imbi Puskesmas, the patient’s bed is not sufficient to be used, also in the Emergency Room (UGD) there arefew equipment which hasn’t sterile yet.
According to the information that the authors get,Imbi Puskesmas already included in the Puskesmas Plus2.
To find out whether if Imbi Puskesmas has succeeded in providing high satisfaction to the patient, a study of patient satisfaction level is needed. This research is a tool to gather information about the needs and wants of patients. Information generated from this study can be used to better understand the needs of patients, and know the level of patient satisfaction and can be used as input in formulating strategies to improve patient satisfaction.
Imbi Puskesmas as a public organization that has the main duty and function of providing health services require information about the quality of services that exist within the organization, so that can be done by the organization can meet the expectations and satisfy the service users. Concerning the quality of service occurs because the quality has not been considered as an important thing and it shows the government’s inability to make the quality of service as an important policy agenda, so it is not uncommon to find a recruitment of a position based on consideration like and dislike leadership and paternilism culture.
MATeRIAlS ANd MeThOd
In this research, the method has used mixed methodology. Mixed methodology produces more comprehensive facts in researching research problems, as the researcher has the freedom to use all data collection tools according to the type of data required. While quantitative or qualitative is only limited to certain types of data collection tools only.
Mixed methods are methods that combine quantitative and qualitative approaches in methodology (as in the data collection phase), and mixed model studies incorporate two approaches in all stages of the research process. The mixed method is also referred to as a methodology that provides philosophical assumptions in pointing directions or providing guidance on how data is collected and analyzing data and combining quantitative and qualitative approaches through several phases of research.
The strategy of mixed methods used in this study was to identify the concept component (subconsep) through quantitative data analysis and then collect qualitative data to expand the available information. The point is to unite quantitative and qualitative data in order to obtain a more complete analysis4.
The research specifications has used descriptive analysis which aims to create a description or description of the facts, properties and the relationship between the phenomena being investigated. This descriptive research is a study that is not intended to test a particular hypothesis but merely describes what it is about something variable, symptom, or state4. Data collection by depicting as it is, is not accompanied by a review or analytical view of the author5.
As the basis of the research is survey research.
Survey research is a study that takes samples from a population and uses a questionnaire as a basic data collection tool6-8. While the characteristics of this study is to collect data from respondents who many in number by using questionnaires.
While the scope studied in this study is to discuss about the strategy in the quality of Imbi Puskesmas’s service to improve patient or community satisfaction in north Jayapura District Jayapura District. The location of this research took place at Imbi Public Health Center located in Imbi village precisely in north Jayapura District Jayapura District. In this research, the researcher will share question (questionnaire) to the Community who did the treatment at Imbi Puskesmas.
Key Informant: Key informants are people who really understand of the issues being studied. The key informants in this study were Head of Imbi Puskesmas District of north Jayapura, Head of Sub Unit, and all medical and non medical medical officer who served in Imbi Puskesmas and community (Patient) who did the treatment at Puskesmas Imbi.
Indian Journal of Public Health Research & Development, April-June 2018, Vol.9, No. 2 191 data Collection Technique: There are several
techniques performed by researcher as follows:
(a) To obtain the primary data, the authors use research techniques as follows:
z Interview is a way of collecting data that is done by researcher with asking the questions orally to the respondent to obtain the necessary data, in this case the researcher will do question and answer with the community who perform treatment at health center and employees-officers who served in Imbi Puskesmas.
z Questionnaire is a data collection technique that was done by giving written questions to respondents to be answered.
Data collection technique was done by distributing questionnaires to respondents.
The mechanism of data collection by giving questionnaires to the community as recipients of services in Imbi Puskesmas;
z Observation is a technique of data collection by way of observation and record with systematic symptoms related to the problem under study.
(b) Secondary data is obtained data through literature study (Library Reseach) by reading or researching books, magazines or brochures and regulations or materials relevant to the issues discussed.
Processing Techniques and data Analysis: On this data, research uses three stages:
1. data reduction: the obtained data from fieldpretty enough, for which the researcher will record carefully by detail, summarizing, selecting the main points, focusing on the important things, and throwing things that are not important.
2. Presentation of data: as a set of arranged information that gives the possibility of drawing conclusions and taking action for researchers to answer research.
3. Conclusion: The third step is a drawing conclusion and verification.
data Analysis Technique: Data analysis tools being used in research are as follows;
(a) Descriptive analysis, which is part of statistic studying tools, techniques, or procedures used to describe the data collection or observation results that have been done, in other words explain in detail the answers of respondents to questions (questionnaires) that have been disseminated or distributed. To analyze qualitative descriptive data, quantitative by using Likert scale with purpose to measure attitude, perception or opinion of someone or group about social phenomenon that happened.
(b) For the purposes of quantitative analysis, the accepted answers will be scored, then the value of each indicator is measured using Likert scale.
The overall data that has been in the analysis will use the help of computer software application program SPSS (Statistical Product and Service Solutions). This data analysis does not use manual calculations.
(c) Quantitative descriptive analysis, which explains in detail the results of research by using multiple regression. Multiple regression is a statistical method used to determine the effect between more than one independent variable with one dependent variable.
dISCuSSION
1. Respondent’s Characteristics: In this chapter, we will discuss the satisfaction of the patients who did the treatment at Imbi Puskesmas. This calculation serves to determine the extent to which the influence of independent variables consisting of Tangibles, Realibility, Responsinevess, Assurance and Empaty of dependent variable in the form of patient satisfaction10. This calculation process using SPSS program and obtained the results of the analysis as follows:
Respondents who fill out the questionnaire and answer the interviews are the people who did the treatment as well as the health officers at the Imbi Puskesmas. The total results of the questionnaires were 100 questionnaires / respondents. In the study of the characteristics of respondents will focus on several factors, among others: (1) Gender, (2) Latest Education, (3) Employment, (4) Income month.
192 Indian Journal of Public Health Research & Development, April-June 2018, Vol.9, No. 2 2. Service Quality Effects on Patient Satisfaction:
Based on the result of statistical test showed that tangibels, reliability, responsiveness, assurance and empaty simultaneously have significant effect on patient satisfaction at Imbi District north Jayapura Puskesmas and tangibels variables partially influence the satisfaction of patient at PHB District Health Center of North Jayapura.
Thus the quality of service which includes tangibels, reliability, responsiveness, assurance and empathy greatly affect the patient satisfaction at PHCM of District of North Jayapura, this is indicated by the improvement of service given to the patient in the case of comfortable building, the availability of seat, location, ,timeliness of service, nurse appearance, doctor, service accuracy, communication ability, empathy to patient, attention to patient and others.
From the results of research also found that the satisfaction of patients in the Public Health Center Imbi District North Jayapura most dominant influenced by variable tangibels. In relation to the influence of these tangibels the Imbi District Health Center of North Jayapura did not in terms of physical buildings, tools, cleanliness of the room for patients to feel satisfied. Health centre gives total service means able to provide services from the beginning of the patient to come thoroughly given so that patients feel satisfied services provided9-14.
Efforts to Increase Patient Satisfaction: In order to keep the patient for using the services provided by the Imbi Puskesmas District of North Jayapura and increase the satisfaction of the Public Health Center Imbi District North Jayapura through the following efforts:
a. Tangibels (Physical Means), in an effort to show the performance of Imbi Puskesmas District of North Jayapura for patient has provided convenient facilities with good interior arrangement, equip with equipment with high technology equipment and also show the officers who always neat in serving customer.
b. Reliability (Reliability), in order to ensure reliability of the services of the Imbi District North Jayapura Puskesmas, nurses and doctors have the knowledge and skills in providing patient care accurately, on time, so that patients feel satisfied.
c. Responsiveness, in an effort to improve communication between PHOTI Puskesmas Imbi District staff of Jayapura Utara with the patient, the form of service that need to be given is determined by attitude, profession and response to patient complaint Responsiveness shown to the patient that is: appearance and facial expression in giving Service to patient, mastery, skill and skill of officer in giving service to patient and response from puskesmas for service given.
d. Assurance (Assurance), in effort to provide assurance in the form of a convincing attitude, the motivation shown, the suitability in a variety of services that certainly provide a separate value that can be believed by every patient for the quality of services provided.
e. Emphaty (Empathy), in effort to foster loyalty to the services of the Imbi Puskesmas District of North Jayapura, emphasizes patient satisfaction in its services by improving communications among staff (nurses) with patients by understanding what patients need in terms of information technology and modern tools.
SWOT Analysis: After the SWOT analysis done, then it can be explained alternative strategies being used to improve patient satisfaction at Imbi Puskesmas, that is:
(a) Alternative SO strategies (Strengths - Opportunities)> Comparative Advantage
This alternative strategy is a blend of two elements into an advantage when used with a tub will providesatisfaction to the patients who perform treatment at Imbi Puskesmas.
(b) Strategic alternative ST (Strengths - Threats)>
Mobilization
This alternative strategy is an interaction between the strength and the threat, namely by mobilizing resources which is a force to soften the threat from outside, even turning threats into opportunities.
(c) Alternative WO strategy (Wekanesses-Opportunities)> Divestment / Investmen
This alternative strategy is an interaction between weakness and external fraying based on the utilization of existing opportunities by minimizing existing weaknesses.
(d) Alternative strategy WT (Weaknesses - Threats)>
Damage Control