Evaluasi Mutu Rekam Medis Di Rs Pku 1 Muhammadiyah Yogyakarta: Studi Kasus Pada Pasien Sectio Caesaria

Hutama, Hafid; Santosa, Erwin

doi:10.18196/jmmr.5103

Cited by 9 publications

(14 citation statements)

References 2 publications

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“…This was because sometimes the officer waited for medical records of other patients who were still undergoing hospitalization to be returned together to the Medical Record Unit. 7 Rahayu et al (2016) argues that health personnel involved in the medical records consist of interdisciplinary professions such as doctors, nurses, pharmacists, laboratory workers, and others. 15 Pamungkas and Hariyanto (2015) conducted a study at general hospital of Ngudi Waluyo Wlingi and found that the main cause of incomplete medical record file was inability of the doctor when filling the medical record file because the doctor prioritizes the service so that he does not have enough time to complete the medical record file.…”

Section: Resultsmentioning

confidence: 99%

“…The medical record unit and medical staff are responsible for the management of the medical records which involve the completeness of content, storage policies, destruction and confidentiality, ownership, utilization and organization. 7 Medical record documents in hospitals have the purpose of supporting the achievement of orderly administration to improve the quality of health services in hospitals. 8 The contents of the patient's medical records are sources of information about the patient's medical history.…”

Section: Introductionmentioning

confidence: 99%

“…The incompleteness of medical records cause less optimal services to patients and it will affect the quality of service even impact on patient safety. 7 The process of conducting medical records is a continuing process. 9 The process of keeping the medical record begins when the patient is admitted to the hospital, followed by recording the patient's medical data by a doctor or dentist or worker of other health services that provide direct services to patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“ABED TANGI” As a Solution for Time Inaccuracy in Returning Medical Record at X Hospital

Susanti

Hamzah

Anggraeni

et al. 2018

JMMR

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This study aims to determine the root of problem and alternative solutions of inaccuracy return medical record inpatient files. The research was conducted through qualitative descriptive approach in X hospital from September until October 2017. Data was collected by document review, field observation and unstructured interview with Head of Services, Head of Nursing Services, 1 doctor, 2 head of ward, Head of Medical Record Installation, Head of Nutrition Installation and Head of Pharmacy Installation. Root of problem was analyzed with fishbone diagram, focus group discussion (FGD) method and urgency, seriousness, growth (USG) method. Priority determination solution is carried out using filter analysis method with CARL (Capability Accessibility Readiness Leverage). The results show that factor inaccuracy return inpatient medical records file because are incomplete of medical record file, absence of standard operating procedure and unavailability of monitoring and evaluation, and the increasing number of medical record form according to hospital quality standard. The root problem is not optimally main task and function of professional care giver when filling medical record. Alternative proposed solutions is socialization to professional care giver, revised standard of operational procedure, and monitoring evaluation of the completeness and timeliness of medical record file returns with innovation "ABED TANGI".Penelitian ini bertujuan mengetahui akar masalah serta alternatif solusi terkait ketidaktepatan waktu pengembalian berkas rekam medis rawat inap. Penelitian dilakukan di rumah sakit X melalui pendekatan deskriptif kualitatif sejak bulan September sampai Oktober 2017. Data dikumpulkan menggunakan metode telaah dokumen, observasi lapangan, dan wawancara tidak terstruktur dengan

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

“ABED TANGI” As a Solution for Time Inaccuracy in Returning Medical Record at X Hospital

Susanti

Hamzah

Anggraeni

et al. 2018

JMMR

View full text Add to dashboard Cite

show abstract

“…Thus, the process of documentation often faces obstacles. Pasaribu, Sihombing, 2017, Hutama, Santosa, 2016, and Yusuf et al, 2017, found that average rate of incomplete documentation in conventional method recording was at 36.8%, thus it can slow down the process of reporting, the process of searching the data of the patients, and it takes a many storages or a large room to save the patients' documents (Hutama & Santosa, 2016;Pasaribu & Sihombing, 2017;Yusuf et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Midwifery documentation, particularly in family planning case is still written in paper-based. This method may face several barriers such as it takes a lot of time to record, the data may invalid, inaccuracy of documentation, the slow process in searching the acceptors' data which cause the health service for patient become slow and less optimal, take many storages to save the documentation in paper-based, often missing and not found (Hutama & Santosa, 2016;Pasaribu & Sihombing, 2017;Torry, Koeswo, & Sujianto, 2016).…”

Section: Introductionmentioning

confidence: 99%

Responsiveness in Family Planning Service Using Android-Based Smart Contraception Application

Irmadani¹,

Syarif²,

Ahmad³

et al. 2019

GJHS

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Introduction: Midwifery documentation is a process of recording, reporting, and storing the information or meaningful data which based on the accurate and complete written communication. The documentation is an evidence of the implementation of midwifery care which is useful for midwives, patients, and other health workers. Materials and Methods:The study employed comparative method with quasi-experiment design. By employing purposive sampling technique, 84 acceptors of family planning were chosen. Moreover, they were divided into two groups; 42 acceptors who used conventional documentation and 42 acceptors who used Smart Contraception documentation. The data were analyzed by using Univariate analysis to find out the mean and Bivariate analysis by using Chi-square test.Results: From 29 out of 42 (69%) samples, it was found that the accessibility of documentation by using Smart Contraception was easier than using conventional method, meanwhile 13 out of 42 (31%) samples found it difficult. In conventional method, 23 out of 42 (54,8%) samples found it easier in documenting by using conventional method than using Smart Contraception application, meanwhile 19 out of 42 samples found it difficult. The statistical result showed that p value 0.006 (<0.05) which means that there was difference between the use of Smart Contraception application and conventional method in doing documentation. Conclusion:Based on the results of the study, it can be concluded that Smart Contraception was better on documentation accessibility than conventional documentation.

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Sosialisasi Rekam Medik Elektronik pada Fasilitas Kesehatan Tingkat Pertama

Saputro,

Rusidah,

Budianita

2023

Muria J. Layanan Masy.

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Electronic medical record is a clinical data storage application, as a clinical decision support system, standardization of medical terms, computerized data entry, as well as medical and pharmaceutical documentation in an organized manner. The First Level Health Facility is one of the places used by patients to request health services so that they have a record of interactions with patients. So this socialization is very important to do to reduce losses in terms of time and energy for both medical record officers and patients. This community service activity is carried out in first-level health facilities by providing education and socialization provided in the form of using Electronic Medical Records. Community service activities are carried out using the presentation/lecture method at IDI Kudus Regency on June 11, 2022. The use of electronic medical records is expected to improve and strengthen services for patients, including clinical (medical) and administrative services. Information generated from electronic medical records is also useful for education, regulation formulation, research, community health management, policy support, and to support referral health services. It is hoped that the application of electronic medical records can be easily used by all officers, both from medical record officers and medical personnel, the creation of integrated patient data, no duplication of medical record numbers that can make it difficult to find patient data at the time of re-treatment and holding further socialization regarding the application electronic medical record. The benefits will be felt optimally if the application of electronic medical records is evenly distributed and is supported by updated information systems and technological materials.

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Evaluasi Mutu Rekam Medis Di Rs Pku 1 Muhammadiyah Yogyakarta: Studi Kasus Pada Pasien Sectio Caesaria

Cited by 9 publications

References 2 publications

“ABED TANGI” As a Solution for Time Inaccuracy in Returning Medical Record at X Hospital

“ABED TANGI” As a Solution for Time Inaccuracy in Returning Medical Record at X Hospital

Responsiveness in Family Planning Service Using Android-Based Smart Contraception Application

Sosialisasi Rekam Medik Elektronik pada Fasilitas Kesehatan Tingkat Pertama

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