Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb <p>Jurnal Kedokteran Brawijaya, ISSN (online): 2338-0772, is a communication media and a scientific publication in the field of medical science published by Faculty of Medicine, Universitas Brawijaya.</p> <p>Jurnal Kedokteran Brawijaya is a <strong>B accredited national journal</strong> based on the Decree of the Directorate General of Strengthening Research and Development of the Ministry of Research, Technology, and Higher Education Republic of Indonesia No. <strong>040/P/2014 dated February 14, 2014. </strong></p> <p>The accreditation status has been renewed base on the Decree of Director General on Strengthening Research and Development of the Ministry of Research, Technology, and Higher Education Republic of Indonesia <strong>23/E/KPT/2019, August 8, 2019</strong>, accredited as <strong>SINTA 2.</strong></p> <p>Jurnal Kedokteran Brawijaya contains articles from research focused on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).</p> <p>Jurnal Kedokteran Brawijaya is regularly published twice in one year (at the end of February and at the end of August). Jurnal Kedokteran Brawijaya was first published in April 1984.</p> <p>Brawijaya Medical Journal has been indexed in <a title="Google Scholar" href="https://jkb.ub.ac.id/index.php/jkb/management/settings/context//index.php/jkb/manager/setup/Jurnal%20Kedokteran%20Brawijaya%20is%20published%20twice%20a%20year,%20at%20the%20end%20of%20February%20and%20at%20the%20end%20of%20August.%20Jurnal%20Kedokteran%20Brawijaya%20was%20first%20published%20in%20April%201984.%20ISSN%20(print)%200216-9347,%20ISSN%20(online)%202338-0772.">Google Scholar</a>, <a title="Portal Garuda/Inonesian Publication Index (IPI)" href="http://id.portalgaruda.org/?ref=browse&amp;mod=viewjournal&amp;journal=4387">Portal Garuda / Indonesian Publication Index (IPI)</a>, <a title="SINTA" href="http://sinta2.ristekdikti.go.id/journals/detail?id=759">SINTA Science and Technology Index</a>, and <a title="CrossReff" href="https://search.crossref.org/?q=jurnal+kedokteran+brawijaya">CossReff</a>.</p> <p>Citation Profile at <a title="Google Scholar" href="https://scholar.google.co.id/citations?user=SEmvMR4AAAAJ&amp;hl=id&amp;authuser=1">Google Scholar</a> as of August 2022:</p> <p>Number of citations: 3679</p> <p>h-index: 25</p> <p>index i10: 100</p> en-US Authors who publish with this journal agree to the following terms:<br /><br /><ol><li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="http://creativecommons.org/licenses/by/3.0/" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="http://opcit.eprints.org/oacitation-biblio.html" target="_new">The Effect of Open Access</a>).</li></ol> jkb@ub.ac.id (Dr. dr. Viera Wardhani, M.Kes) jkb@ub.ac.id (Dini Suryaning Mentari) Wed, 19 Oct 2022 04:23:00 +0000 OJS 3.3.0.13 http://blogs.law.harvard.edu/tech/rss 60 Causes of Medication Errors in Inpatient Wards at Private Hospital in Malang https://jkb.ub.ac.id/index.php/jkb/article/view/3213 <p><em>The absence of medication errors is a sign of successful implementation of patient safety management, particularly safe treatment. The quality indicator data report at the Pharmacy Installation of a private hospital in Malang in 2020 showed a number of drug administration errors in the inpatient unit. This study aimed to explore the incidence and causes of medication errors in the inpatient unit. The study was conducted at a private hospital in Malang in August-September 2021. The study design was descriptive with data collected through focus group discussions (FGD) with five inpatient pharmacy staff, four inpatient nurses, and the head of the medical support. The study results indicated no clear regulation, especially the Standard Operational Procedure (SOP) for administering drugs to inpatients, which becomes a latent cause of medication errors. Hospitals need to develop SOPs for administering drugs to inpatients according to the 7 Pillars, followed by socialization to nurses in inpatients and periodic monitoring.</em></p> Faris Faruqi, Viva Maiga Mahliafa Noor, Suryanto Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3213 Mon, 24 Oct 2022 00:00:00 +0000 Stock Procurement and Documentation as Emergency Trolley Content Discrepancy Factors in Emergency Installation (Study on a Private General Hospital in Malang Regency) https://jkb.ub.ac.id/index.php/jkb/article/view/3206 <p><em>One of the common problems in managing emergency logistics is the emergency trolley that conflicts with the standard operating procedures. It causes a mismatch of the emergency trolley contents. In fact, the availability of unstandardized emergency trolleys will impact the quality of emergency services in the emergency department</em><em>. The emergency medicine shortage and emergency trolley content discrepancy also occurred several times in the ER</em><em>. This study was conducted to analyze the determinant factor of content discrepancy in the emergency trolley in the emergency room of a private hospital in Malang Regency. The research method used was descriptive quantitative. The methods of identifying the root of the problem were carried out through field observations, literature studies, brainstorming, and Focus Group Discussions (FGD). Statistical tests were done using Bartlett’s test of sphericity and Kaiser-Mayer Olkin (KMO) with a value higher or equivalent to 0.5. The study results formed two determinants of content discrepancies in the emergency trolley in the ER. The stock procurement factor is able to explain the problem by 48.02%, and the process documentation factor is able to explain the problem by 17.63%.</em></p> I Ketut Yoga Sedana, Kararawi Listuhayu, Nanik Setijowati Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3206 Mon, 24 Oct 2022 00:00:00 +0000 Decreased Motivation as a Reason for Switching Normal Labor from Obstetricians to Midwives in Hospitals https://jkb.ub.ac.id/index.php/jkb/article/view/3204 <p><em>Based on the regulations, normal delivery with complications referred to a mother and child hospital is not under the right and obligation of the midwife as a maternity leader but must be led by an obstetrician. However, 58% of the normal deliveries were referred to midwives at Puri Bunda Mother and Child Hospital. This study aimed to explore the cause of the transfer of leadership in normal deliveries from obstetricians to midwives as the basis for developing solutions to the problems. This research was qualitative with a case study approach. Data were collected through focus group discussions, unstructured observations, and in-depth interviews. The total number of participants involved in this study was 16 people. Focus group discussions were conducted with midwives in the delivery room. In-depth interviews were conducted with the hospital director, the head of the delivery room, and obstetricians who provide normal delivery services. The results showed no guidelines and policies regarding the transfer of normal deliveries.</em></p> Eka Chandra Kusuma Wardhana, Merry Nuthea, Tita Hariyanti Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3204 Thu, 20 Oct 2022 00:00:00 +0000 Comparing Personal Protective Equipment Practice among Health Worker’s Job Role and Hospital Unit https://jkb.ub.ac.id/index.php/jkb/article/view/3027 <p>Health workers have the highest risk exposure that can increase the pathogen infection risk during the COVID-19 pandemic. The use of Personal Protective Equipment (PPE) is the most significant prevention, but mistakes while using PPE may occur in the donning (putting on) and doffing (taking off) process. This study compares the practice of using PPE among groups of health providers and hospital service units. The study design was a cross-sectional study conducted on non-infectious hospital employees in one specific hospital in Surabaya, totaling 102 employees. The Infection Prevention and Control Link Nurse (IPCLN) of the hospital conducted observations and analyses of health personnel in inpatient and triage units, treatment units, and support units. Based on the job roles, the employees were divided into health providers, healthcare support workers, and other health workers. Work units were categorized into inpatient units, outpatient and triage units, treatment units, and support units (cashier and registration areas). The results of the assessment were measured using One-Way ANOVA. Based on the job role, significant errors occurred when removing masks (p=0.048) made by health workers (38%). Meanwhile, in the hospital unit category, significant errors occurred in removing masks (p=0.000) and the use of gloves (p=0.002). Most mistakes were made in the outpatient and triage units, 92% and 42%, respectively. The complexity of wearing and removing PPE requires increased awareness and updated training on the correct use of PPE for all health workers who work in hospitals based on WHO recommendations during the COVID-19 pandemic.</p> Fandaruzzahra Putri Perdani, Djazuly Chalidyanto Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3027 Wed, 19 Oct 2022 00:00:00 +0000 Determinant Factors of Limited Oxygen Supply at Marsudi Waluyo Hospital during the COVID-19 Pandemic https://jkb.ub.ac.id/index.php/jkb/article/view/3226 <p>The demand for oxygen in hospitals has been increasing during the COVID-19 pandemic due to oxygen therapy required by most COVID-19 patients. Fulfillment of oxygen supply is related to logistics management. This study aimed to determine the factors affecting the limited oxygen supply at Marsudi Waluyo Hospital, Malang. This research was conducted with a qualitative descriptive method. Data collection was carried out by observing the process of ordering and replacing oxygen cylinders for central oxygen fulfillment at the Facility Maintenance Unit (FMU), reviewing oxygen usage and supply reports, and conducting Focus Group Discussion (FGD) to identify the root of the problem. The FGD respondents consisted of the Head of General Affairs and Administration, the Head of Finance, the Coordinator and Staff of the Facility Maintenance Unit, and the Head of the Inpatient Installation. The root of the problem was compiled using the 5 Whys method and grouped into Man, Material, Money, Method, Machine, Management, and Environment categories. The root of the problem identified was the limited number of human resources in the Facility Maintenance Unit, the procedure for procuring oxygen cylinders that did not include a case of oxygen demand surge, and no oxygen supply other than oxygen cylinders.</p> Engelbertha Retno Suryaningati, Kristiwi Hanggriyani, Eriko Prawestiningtyas Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3226 Mon, 24 Oct 2022 00:00:00 +0000 Talk Show Program as an Effort to Build Brand Awareness of Udayana University Hospital’s Instagram https://jkb.ub.ac.id/index.php/jkb/article/view/3221 <p><em>Non-COVID-19 service closure has formed a stigma that hospitals only serve COVID-19 patients. This condition affects brand awareness and decreases the number of hospital visits. An interactive talk show using Instagram can be used to reintroduce hospital services to the public. This study aimed to measure the success of the talk show program in building brand awareness of Udayana University Hospital’s Instagram account. One group pretest-posttest research was carried out at Udayana University Hospital on October 7, 14, and 21, 2021, by intervening the Instagram content of Udayana University Hospital. After the live broadcast ended, the talk show content was published on the Instagram feed. The success of the talk show program was seen by comparing the audience growth, engagement rate, and brand awareness measurements before and after the talk show took place. Brand awareness can be seen in profiles, post-impressions, and profile visits the Instagram account. The results showed the highest post-engagement (36.46%) was obtained in the first episode of the talk show and the very high category. Instagram followers and engagement rates increased and categorized very high. Profile impression and visit profile increased, indicating a wide range of content on the Udayana University Hospital’s Instagram account. This study shows that a talk show program can be implemented as a routine program that builds brand awareness on the Instagram account of Udayana University Hospital. This program can be used as a solution to introduce Udayana University Hospital to Instagram users by inviting quality guest stars and using easy-to-understand material.</em></p> I Wayan Agus Wirya Pratama, I Gusti Agung Gede Utara Hartawan, Kuswantoro Rusca Putra Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3221 Mon, 24 Oct 2022 00:00:00 +0000 Time Waste at Specialist Clinic Service of Primasatya Husada Citra (PHC) Hospital Surabaya https://jkb.ub.ac.id/index.php/jkb/article/view/3218 <p><em>Waiting time in outpatient services is a factor that causes patient dissatisfaction and affects hospital image. The standard waiting time for outpatient services in hospitals, starting from the registration until the end of the doctor’s examination, is 60 minutes. This study was conducted to identify time waste in the registration process of outpatient services. This descriptive study was done at the Specialist Clinic of Primasatya Husada Citra Hospital (PHC Hospital) Surabaya. The time waste identification on waiting time was carried out using the Value Stream Mapping (VSM) method using observation data at PHC Hospital, which were categorized as defect, overproduction, waiting, non-utilized talent, transportation, inventory, motion, and extra processing. Activities carried out were identified and grouped into categories, namely waiting, service, and transport document, and then reclassified into value added, non-value added, and necessary non-value added. The results show that the waiting time wastes were waiting after verification (± 60.2 minutes), filling out e-RM (± 139.6 minutes), and waiting for the doctor to come.</em></p> Indra Mulyawan, Rony Kurniawan, Viera Wardhani Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3218 Wed, 19 Oct 2022 00:00:00 +0000 Instagram Optimization as Digital Marketing Media: Study at a Private Hospital in Batu City https://jkb.ub.ac.id/index.php/jkb/article/view/3216 <p><em>During the COVID-19 pandemic, up-to-date information becomes a necessity for the public, and social media, especially Instagram, play a significant role in digital marketing, including hospitals. The Instagram account of a private hospital in Batu City had a decreasing performance and has become inactive since the COVID-19 pandemic outbreak. This study aimed to find a solution to the decreasing performance of the hospital’s Instagram account to increase visits, trust, and patient satisfaction. This research was a quasi-experimental study with a pre- and post-test design without control conducted from September to October 2021. The intervention carried out was conducting training on optimizing the Instagram features. The research sample was ten people obtained through the total sampling method. The data were analyzed using a descriptive analysis test. The training was carried out twice in a period of one week. The first training session discussed the basic features of Instagram and their use, and discussions on the technical aspects of content creation were done in the second session. Measurement of training understanding was carried out by pre-test and post-test. All points in the questionnaire showed positive points of increasing knowledge after the training. Instagram optimization training at the hospital in Batu City can improve staff understanding of digital marketing and is expected to expand the business and introduce the hospital to new patients.</em></p> Nico Christian Sunaryo, Wiwin Indriani, Nikma Fitriasari Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3216 Mon, 24 Oct 2022 00:00:00 +0000 Factor Analysis of Incomplete Informed Consent in Medical Record Installation Bangil Hospital in 2021 https://jkb.ub.ac.id/index.php/jkb/article/view/3214 <p><em>Medical action is an action taken on a patient in the form of diagnostic or therapeutic. All medical procedures to be performed on the patient must in consent. To conduct an informed consent filling, is when the patient agrees to be used as a medical action after being given an explanation by the officer. The one whose in charges to take a medical action must be a medical personnel. According to the hospitals’s standart minimum services,&nbsp; the completeness informed consent filling must be 100%. Bangil Hospital achieved 37% of completeness informed consent filling. This study aims to analyze the causative factors of informed consent incompleteness at Bangil Hospital. This study using a descriptive data analysis. Data collection techniques in this study are using a document studies, interviews and FGD. Document studies were conducted on 100 informed consent documents, interviews and FGDs were conducted to related officers to determine the causative factors of informed consent incomplteness documents which were analyzed using fishbone diagrams. From the results of the analysis, were determined that the priority of the root of the problem to be solved first are the man factor and the method. Thus, The CARL method&nbsp; used to find out an alternative solutions&nbsp; to cope the priority of the root of the problem. From the results of the scoring conducted, the main factor of informed consent incompleteness at Bangil Hospital was due to the absence of a flow in filling out the informed consent.</em></p> <p><strong><em>Keywords: </em></strong><em>Informed consent, medical action, incompleteness.</em></p> Mahbubah, Arma Roosalina, Holipah Holipah Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3214 Mon, 24 Oct 2022 00:00:00 +0000 Determinants of Suboptimal Use of Digital Marketing at X Hospital https://jkb.ub.ac.id/index.php/jkb/article/view/3211 <p class="Englishversionofabstract">During the COVID-19 pandemic era, digital-based hospital activities were chosen as an alternative solution to support the physical distancing policy. Digital marketing is a digital-based marketing activity to reach customers widely. This study aimed to determine the determinants of suboptimal digital marketing in X Hospital. This research was conducted using a qualitative descriptive method. Data were collected using observation, document review, and Focus Group Discussion (FGD). FGD respondents determined were six respondents consisting of the Head of General and Administrative Division, Head of Finance, two Public Relations and Marketing Staff, Hospital Management Information System (SIMRS) staff, and Patient Registration Coordinator. The root of the problem is presented in the fishbone diagram and followed by the 5-Whys method. The priority of the root of the problem found was that the PR and marketing unit staff of X Hospital had not optimally used the features on social media for marketing activities. The alternative solution was chosen using a scoring method on Capability, Accessibility, Readiness, and Leverage (CARL), which was optimizing the Instagram business feature as the main social media for X Hospital in the digital marketing activities.</p> Endy Wira Pradana, Kristiwi Hanggriyani, Eriko Prawestiningtyas Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3211 Mon, 24 Oct 2022 00:00:00 +0000 Teleconsultation in Hospital Service: Implementation Challenge https://jkb.ub.ac.id/index.php/jkb/article/view/3205 <p>Teleconsultation is one of the telemedicine services provided by hospitals and is getting popular during the COVID-19 pandemic. As a new service model, developing a quality management system that can ensure the effectiveness and safety of this service to provide users’ satisfaction is necessary. This research aimed to identify and analyze the process and problems of teleconsultation services. This research was qualitative with a descriptive case study approach to get a detailed picture of the teleconsultation process in a hospital and its issues. The study was conducted from September to October 2021 in a type C private hospital in Malang. Data were obtained from interviews with officers and patient feedback on teleconsultation services. Problems in teleconsultation services in the hospital were ineffective communication, limited-service coverage, lack of support for medical support facilities, technological constraints, lack of understanding of service flow, and cost affordability.</p> Cicilia Maria Ernawati, Else Agustina, Suryanto Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3205 Thu, 20 Oct 2022 00:00:00 +0000 Initial Assessment Form of Medical Record Document: Is it Important to Complete? https://jkb.ub.ac.id/index.php/jkb/article/view/3203 <p class="Englishversionofabstract">Medical record document completeness is crucial because it serves as a means of communication, quality evaluation, payment, and legal protection. A preliminary study showed that none of the initial assessment forms in the outpatient unit of Puri Bunda Mother and Child Hospital were filled completely. This study aimed to explore the causes of incomplete initial assessment forms to avoid lawsuits against the hospital. The method used was qualitative research with a case study approach. Data were collected using triangulation, which included in-depth interviews with 15 participants, flow observations, and document studies on 150 medical record files. Data were analyzed using thematic analysis. The document study found none of the medical records with a complete initial assessment form (0%). A total of 141 documents (94%) were not filled at all, and only 9 (6%) of the initial assessment forms were filled in certain fields. The flow observation disclosed that file availability was one of the contributing problems to the completeness of filling. Seven reasons for incomplete initial medical assessment documents were categorized into individual internal and external factors. The internal factors include the lack of awareness of doctors and feeling a high workload, and the external factors include the absence of communication between management and doctors, unavailability of work procedures, the absence of a reward and punishment system, the format and availability of initial assessment forms, and individual culture.</p> Zhafira Anisah Kesuma, Merry Nuthea, Tita Hariyanti Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3203 Thu, 20 Oct 2022 00:00:00 +0000 COVID-19 Countermeasure Policy in the Province of Jakarta Capital City https://jkb.ub.ac.id/index.php/jkb/article/view/2960 <p><em>Jakarta is the highest province of positive COVID-19 cases nationally and the epicenter region in Indonesia. This study aims to analyze the development of the number of cases and COVID-19 countermeasure policy in the Province of Jakarta Capital City. This study uses a qualitative method with in-depth interviews and document review. Primary data was collected from selected informants, namely the Head of Jakarta Health Office and Assistant to the Provincial Secretary for Governmental. Secondary data is taken from legal and policy documents, reports, websites, and press releases. The fluctuation of COVID-19 cases in Jakarta depends on the capacity of the examining laboratory and the capacity of contact tracing. Until April 30, 2020, The Provincial Government of Jakarta Capital City has made 74 policies. They made COVID-19 as a serious policy agenda and collaborates with the whole of government, privates, professional / community / religious organizations, and society. Situational factors are the most influential factors in the policymaking process. The Provincial Government of Jakarta Capital City concerns early since the Wuhan Pneumonia case with the epidemiological surveillance system of the Health Office, which has been running regularly monitoring infectious diseases from the community health center level. Policy formulation is based on research and scientific studies. Monitoring and evaluation are carried out both formatively and summatively to address problems and obstacles in policy implementation. The Provincial Government of Jakarta Capital City took the early response to collaborates with the whole of government, privates, and society in policymaking and implementation.</em></p> Irma Yunita, Anhari Achadi, Maman Saputra, Rangga Kusumo, Nurul Hasani, Farhannuddin Rusdi Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/2960 Wed, 19 Oct 2022 00:00:00 +0000 Implementation of Google Forms as Alternative for Quality Indicator Recording and Reporting Systems in the Time of COVID-19 Pandemic https://jkb.ub.ac.id/index.php/jkb/article/view/3224 <p><em>Recording and reporting are parts of health services aiming to create administrative discipline to improve health service quality. COVID-19 pandemic prevalence has impeded unit quality indicator recording and reporting, causing suboptimal quality measurements. This study aimed to see the implementation of Google Forms as a solution to overcome obstacles in unit quality indicator recording and reporting. This study was a one-group pre-experimental with a pre-and post-intervention design without control. The sample was seven people who were Laboratory Unit staff of a Private Hospital in Batu City. The results showed that applying Google Forms can provide staff’s ability and timeliness in measuring unit quality indicators. A good quality measurement method can increase the effectiveness of monitoring and evaluation related to patient-centered quality improvement</em><em>.</em></p> Marshal Octavianus, Wiwin Indriani, Nikma Fitriasari Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3224 Mon, 24 Oct 2022 00:00:00 +0000 Instagram Optimization as Hospital Digital Marketing Tool https://jkb.ub.ac.id/index.php/jkb/article/view/3220 <p>Social media, one of which is Instagram, has been proven effective as a hospital marketing medium. A private hospital in Tulungagung Regency has had an Instagram account for four months but has not been well managed. As a result, the account does not function optimally and reflect digital marketing facilities. Based on this condition, the researchers aimed to analyze the ways to optimize Instagram as a hospital digital marketing tool. The method used was experimental research with pre- and post-experimental design without control in a private hospital in Tulungagung Regency in October 2021. The unit analyzed was the hospital marketing department. Two interventions were implemented, providing digital marketing training through Instagram and optimizing the hospital’s Instagram management. The knowledge instrument was measured using a questionnaire, and the Instagram management instrument was measured by examining Instagram Insights. The results showed that Instagram training and management could optimize the use of Instagram as a hospital digital marketing tool. Knowledge about Instagram and activity increased after training and management on Instagram had been implemented. Yearly, monthly, and daily schedule preparation needs to be implemented to increase marketing optimization. The absence of a dedicated settle team in charge of managing the Instagram account makes the implementation challenging to evaluate. A team specifically addressing hospital social media will be able to focus the work and improve the management, so digital marketing through social media can be optimized.</p> Dina Nofitria Rahayu, Anang Imam Massa Arif, Nikma Fitriasari Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3220 Mon, 24 Oct 2022 00:00:00 +0000 Emergency Room Medical Record Modification to Optimize Patient Education at X Hospital https://jkb.ub.ac.id/index.php/jkb/article/view/3217 <p><em>Regularly delivering information to patients and their families becomes a challenge for medical personnel in the Emergency Room (ER). Patients, or their families, often do not remember that education about their illness has been delivered. It can also happen because family members who took the patients into the emergency room differed from those who received the education. This situation can lead to misunderstandings, especially if there are legal problems in the future. This study aimed to find the priority problem in the hospital, the root of the problem, and solutions to optimize patient education in the ER. The methods used in the problem-finding were interviews, Focus Group Discussions (FGD), and USG (Urgency, Seriousness, and Growth) scoring. The solution selection method used FGD, fishbone analysis, 5-whys table, and CARL (Capability, Accessible, Readiness, and Leverage) scoring. The problem found was the lack of optimal patient education in the ER. The priority of the root of the problem found was no written documentation in the patient’s medical record regarding providing education to patients or families. The chosen solution was to modify the ER medical record by including a checklist of educational points and a column for patients or families to sign. Further research is needed to prove the effectiveness of this medical record modification in optimizing education in the ER.</em></p> Engelbert Hariyanto, Wening Prastowo, Lilik Zuhriyah Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3217 Wed, 19 Oct 2022 00:00:00 +0000 Optimization of Online Pharmacy System to Lower the Late Billing for Chronic Disease Drugs https://jkb.ub.ac.id/index.php/jkb/article/view/3215 <p><em>One of the biggest cost control problems among hospitals in the National Health Insurance is chronic disease drug services. Billing fee delays or unpaid billing fees often occur due to patient failure to revisit the doctor according to the requirement of 30 (thirty) days from the last visit. It resulted in the hospital’s inability to collect the financing for chronic disease drugs from </em><em>Social Security Administrative Agency</em><em> (</em><em>BPJS). This study aimed to discover the root cause of the pending billing of chronic disease drug costs and executable solutions in hospitals. This research was conducted at X Hospital Malang. This research used mix-method of qualitative and quantitative. The qualitative method were observations of the service flow for chronic disease patients, interviews with all unit coordinators, and focus group discussion with the Pharmacy Unit and Casemix Unit coordinators. The quantitative method was done using CARL scoring to determine the priority of the problem solution. The root of the problem was the lack of adequate systems and resources in chronic disease drug services. The possible solution is to modify the flow in the outpatient pharmacy. It is necessary to apply patient screening through the Online Pharmacy Application at the outpatient pharmacy to prevent patients who visit for less than 30 days. The results of the solution implementation are expected to reduce the amount of money from pending billing for chronic disease drug costs, thereby minimizing hospital financial losses.</em></p> Deltania Herwendanasari, Sri Andarini, Lilik Zuhriyah Copyright (c) 2022 Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb/article/view/3215 Wed, 19 Oct 2022 00:00:00 +0000