PUSKESMAS READINESS IN ACCREDITATION IMPLEMENTATION AS EFFORTS TO IMPROVE THE HEALTH SERVICE QUALITY IN SUMBAWA DISTRICT

ABSTRACTIn achieving Universal Health Coverage in 2019, it is necessary to increase access and quality of health services to the community. Puskesmas accreditation is a method of improving the quality of service and patient safety as well as a condition to do collaboration with BPJS. According to Donabedian, quality of services needs to be supported by standardized structures, processes and outcomes which are oriented to internal and external customers. This study aims to analyze the readiness of Puskesmas in accreditation implementation as an effort to improve the quality of health services in Sumbawa Regency. This effort is an implementation act of Health Minister Regulation number 75/2014 on Puskesmas and number 46/2015 on FKTP accreditation by comparing it to those successful accreditation implementation of basic health services in various countries. This study design is a qualitative research uses the Rapid Assessment Procedure design, through in-depth interviews combined with literature review studies sourced from online data bases. This study result showed that the readiness of accredited Puskesmas in Sumbawa district was seen from three aspects: (1) Structure: resources not yet fulfil the Permenkes 75/2014 standards, (2) Process: stages of the accreditation preparation process is in accordance with the guidelines, but the implementation was not optimal. (3) Outcomes: the accreditation implementation has positive impact on improving the quality of health services. It is necessary to evaluate the implementation of Puskesmas accreditation by involving the Community, the Health Office and the Regional Government. ABSTRAKDalam mencapai Universal Health Coverage tahun 2019 perlu dilakukan peningkatan akses dan mutu pelayanan kesehatan kepada masyarakat. Akreditasi Puskesmas merupakan salah satu langkah dalam meningkatan kualitas mutu layanan dan keselamatan pasien sekaligus sebagai syarat dalam melakukan kerjasama/kredensialing dengan BPJS. Menurut Donabedian tiga aspek pelayanan yang berkualitas perlu ditunjang oleh standar mutu input, proses dan output yang berorientasi pada pelanggan internal maupun eksternal. Penelitian ini bertujuan menganalisis kesiapan pelaksanaan akreditasi Puskesmas di kabupaten Sumbawa sebagai implementasi kebijakan Peraturan Menteri Kesehatan Nomor 75/2014 tentang Puskesmas dan Nomor 46/2015 tentang akreditasi FKTP dengan membandingkan keberhasilan gambaran pelaksanaan akreditasi pelayanan kesehatan dasar di berbagai negara. Penelitian kualitatif inimenggunakan desain Rapid Assesment Procedure (RAP), melalui wawancara mendalam yang dikombinasikan dengan studi kepustakaan literatur review yang bersumber jurnal/artikel/tesis/disertasi dari data base online ataupun studi pustaka keabu-abuan. Hasil penelitian menunjukkan gambaran beberapa Puskesmas yang telah terakreditasi di kabupaten Sumbawa dilihat dari tiga aspek : (1) aspek struktur: sumberdaya masih belum sesuai standar permenkes 75/2014, diperlukan biaya besar dalam pelaksanaan akreditasi. (2) aspek proses: proses penyiapan akreditasi Puskesmas sudah sesuai, mulai dari workshop penggalangan komitmen, workshop pemahaman standar, self assesment, pendampingan sampai dengan survey yang dilakukan surveyor akreditasi. Proses persiapan akreditasi dinilai terburu-buru terhitung dalam beberapa bulan. (3) aspek outcomes: pelaksanaan akreditasi memliki dampak positif pada proses perubahan perbaikan mutu pelayanan kesehatan, prosedur pelayanan tercatat dan terdokumentasi dengan baik. Solusi diperlukan komitmen kuat antara Puskesmas, Masyarakat, Dinas Kesehatan dan Pemerintah Daerah