One of the factors that demand hospital services is the speed of service starting from patient registration to the process of patient discharge from the hospital after receiving service 1 . The imbalance between the speed of patient arrival and the ability of service personnel to provide services is one of the factors that cause queues. The most common problem that occurs in hospitals is the length of the queue for services. One of the most common efforts is the application of a queue number (ticketing system) but it also does not break up long and long queues 2 . Shortening waiting time is one of the most relevant criteria, not only in terms of increasing patient satisfaction but also improving hospital quality, efficiency and capacity planning 3 . Methods:The method which is used in this research was a survey of 294 out-patient in interne polyclinic RS X Padang City with a cross-sectional design. Simple random sampling has been chosen to collect the respondent. Hypothesis testing was performed using Structural Equation Model with SMARTPLS 3.3.3. Result:The waiting time construct consists of fairness of queue system, needed of the patient in a queue system, use of information technology in queue system meanwhile, fast track services measure by the need in hospital, the users of the service, and is the service is going well. General Satisfaction is measured by general satisfaction in doctor service, queue system and fast track service. The Hypothesis tested in table 2 show that has t-value from bootstrapping all the result has value above than t-table value (1,96) for significant level (α) 5%. It is mean that fast track and waiting time has a strong influence on satisfaction in general and all the hypothesis was accepted. This research also tests the accuracy prediction model which shows in the R-square value. R-square shows that fast track was affected 30,1% in waiting time meanwhile general satisfaction were only affected 7,9% with fast track and general satisfaction. Conclusion:The research has shown that fast track and waiting time has a direct impact on patient satisfaction in the whole service. There is around 70% of other factors were affected the fast track rather than waiting time and more than 90% of other factors were affected the general satisfaction of patients while receiving the service that not mentioned in this research. The others factors that should be tested in future research was the satisfaction factor with the doctor services and nursing service.
The phenomenon often happens and it has faced by the patient in the hospital were queue system and waiting time. A queue caused by a group of people had needed health service at the same time. Whereas the waiting time is a long time and needed by the patient for getting health service. To shorten the service, the hospital also gives fast track service for the patient with particular criteria. This research aims to discuss the queue system, waiting tine and service outpatient of fast track in the X Hospital of Padang City. The design of this research used the method of quantitative descriptive, with the data collection by cross sectional. The result of the research shows the queue system in the X Hospital of Padang City in a condition of 83% queue system had functioned by the rules, 14% still found the patient was not in the queue, and 3% of the queue system was disorganized. Whereas the waiting time to meet with the doctor got the result 1% too fast, 79% it appropriate and 20% the waiting time to meet with the doctor was very slow. In the fast track, service got 51% of respondents had enough knowledge which is good for the fast track terms of service implementation in the X Hospital of Padang City. This recommendation has a purpose to the hospital to rearrange the queue system of the waiting time can be minimalized and the hospital employee gives more attention to the criteria of the patient that include fast track service so that it can use based on the purpose. Keywords: Queue System, Waiting Time, Fast Track, Hospital
Atrioventricular septal defect (AVSD) adalah kelainan berupa defek pada septum atrioventrikular (AV) di atas atau bawah katup AV, disertai kelainan katup AV; terjadi akibat pertumbuhan yang abnormal dari endokardial cushion pada masa janin. AVSD mewakili 4% sampai 5% bawaan cacat jantung. Dilaporkan seorang pasien laki–laki 20 tahun dengan keluhan sesak nafas saat beraktivitas dan berkurang dengan istirahat, disertai bibir dan kuku jari yang membiru, sakit kepala hilang timbul, muka kemerahan, demam, lemah letih lesu dan dada rasa berdebar-debar. Adanya sianosis, kulit kemerahan, Konjungtiva hiperemis, peningkatan JVP, hepatojugular refluks, bentuk dada abnormal. Bunyi jantung reguler, terdengar bising sistolik di RIC VI, blowing, grade 4/6, punctum maximum di apeks, penjalaran ke Axilla. Bising sistolik di RIC V linea strenalis dektra, grade 4/6, blowing punctum maksimun di RIC V linea sternalis dektra. Pada pemeriksaan laboratorium didapatkan polisitemia. Pada rontgent dada terdapat kardiomegali, dari ekokardiografi adanya CAVSD, hipertensi pulmonal Moderate-severe, Left arch, fungsi RV yang menurun. Pada pasien dilakukan prosedur flebotomi untuk mengurangi kepekatan darah. Pengobatan hipertensi pulmonal pada pasien ini adalah dengan pemberian diuretik dan dorner.
General anesthesia is a medical procedure that aims to relieve pain, lose consciousness, and be predictable. General anesthesia has side effects in the form of PONV which cancause dehydration, electrolyte imbalance, re-open wounds, pulmonary aspiration and delay in discharge from the hospital. To know the characteristics of general anesthesia patients, to know the degree of PONV, and to know the relationship between patient, intraoperative, and postoperative risk factors who experience PONV in patients undergoing surgery under anesthesia general.The type of this research used is analytic observational with a cross-sectional approach. The affordable population in this study were all general anesthesia patients at Siti Rahmah Hospital Padang with 65 samples using a consecutive sampling technique. Analysis of univariate and bivariate data presented in the form of frequency and percentage distributions, data processing using the Kolgomorov Smirnov test statistical test. General anesthesia patients aged 26-35 years (24.6%), female (56.9%), no smoking history (89.2%), surgical oncology (47.7%), 60 minutes duration (67.7%), mild pain (38.5%), opioid use (92.3%). Grade 0 PONV (87.6%). The relationship of risk factors for patients experiencing PONV with age p = 0.288, gender p = 0.997, motion sickness p = 0.443, smoking history p = 0.958. Relationship of intraoperative risk factors for PONV with type of surgery p = 1,000, duration of surgery p = 0,978. The relationship between postoperative risk factors for experiencing PONV with opioid use p = 1,000, pain degree p = 1,000. Most general anesthesia patients were aged 26-35 years, most gender was female, most motion history was no history, most smoking history ie no history, the most type of surgery is oncology, the most duration is 60 minutes, the most opioid use is using, the highest degree of pain is mild.
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