Despite most Indonesian women now receiving antenatal care on the nationally recommended four occasions and being delivered by skilled birth attendants, the nation’s maternal mortality ratio (MMR) is estimated as 177 per 100,000 live births. Recent research in a rural district of Indonesia has indicated that poor service quality due to organizational and personnel factors is now a major determinant of this high MMR. The present research is an in-depth analysis of possible health service organizational and quality of care related causes of death among 30 women admitted to a peak referral hospital in a major Indonesian city. Despite their condition being complex or deteriorating, most of these women arrived at the hospital in a state where it was feasible to prevent death with good quality care. Poor application of protocols, poor information flow from frontline hospitals to the peak referral hospital, delays in emergency care, and delays in management of deteriorating patients were the main contributing factors to these deaths. Pyramidal referrals also contributed, as many women were initially referred to hospitals where their condition could not be effectively managed. While generic quality improvement measures, particularly training and monitoring for rigorous application of clinical protocols (including forward planning for deteriorating patients) will help improve the situation, the districts and hospitals need to develop capacity to assess their local situation. Unless local organisational factors, staff knowledge and skill, blood and blood product availability, and local reasons for delays in providing care are identified, it may not be possible to effectively reduce the adverse pregnancy outcomes.
The emergency hospital is intended to prevent transmission of COVID-19 in the community by isolating patients without symptoms, with mild or moderate symptoms. This study evaluated the clinical characteristics and outcomes of COVID-19 patients who were admitted to this facility. This retrospective study reviewed data of patients treated at the National Emergency Hospital Wisma Atlet Kemayoran in Jakarta, Indonesia, from March 23 to April 30, 2020. Patient characteristics (clinical symptoms, laboratory test results, Chest X-Ray, SARS-CoV-2 immunoserology, and RT-PCR results from nasopharyngeal/ oropharyngeal preparations) were compared between severity groups. There were 413 COVID-19 cases analyzed, of which 190 (46%) were asymptomatic, 93 (22.5%) were mild, and 130 (31.5%) were moderate cases. Most asymptomatic cases were male, with young age, and without comorbidity. Mild cases were dominated by female and young patients, while most moderate cases were male and older patients. The number of patients with comorbidities was higher in mild and moderate cases. The patient’s overall outcome was good and did not differ based on the severity of symptoms. Despite the many challenges, patients with moderate symptoms can be safely treated in the emergency hospital.
Sistem informasi berbasis komputerisasi merupakan salah satu faktor penting bagi perusahaan - perusahaan dalam mengelola segala aktifitas perusahaan. Bahkan penggunaan teknologi komputer tersebut akan menjadi syarat utama untuk menunjukkan kualitas suatu bidang dan menjadi modal terpenting dalam memenangkan persaingan. Sistem Informasi Gudang di PT. PLN (Persero) Area Surabaya Utara dibangun karena masih menggunakan cara manual untuk melakukan penerimaan barang datang, permintaan barang, dan pemberian barang, sehingga mempengaruhi dalam pelaksanaan operasional kerja, baik dalam segi kecepatan, pelayanan, dari segi informasi yang dihasilkan. Untuk itu diperlukan suatu sistem yang dapat memudahkan manajemen dalam mengelola seluruh aktifitas yang ada di gudang. Sistem Informasi Gudang PT.PLN (Persero) Area Surabaya Utara adalah suatu sistem yang mengelola data barang, data rayon, dan transaksi yang ada di gudang. Sistem ini menggambarkan rangkaian kegiatan dari mulai mengelola barang datang, permintaan barang, barang keluar hingga pelaporannya. Setelah melalui tahapan analisis dan implementasi, kemudian dilakukan tahapan selanjutnya yaitu tahap pengujian sistem dimana pengujian ini menggunakan metode pengujian white box yang berfokus pada pengujian perangkat lunak. Dari hasil pengujian, dapat ditarik kesimpulan bahwa Sistem Informasi Gudang di PT.PLN (Pesero) Area Surabaya dibangun untuk mempermudah manajemen dalam melakukan pengawasan dan pengendalian di gudang.
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