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Volume 3, Issue 10, October– 2018 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Swot Analysis in Establishment of Nursing Service


Quality in RS. TK. III Dr Reksodiwiryo Padang
Widya Wati, Rizanda Mahmud, Pretty Pricilla
Nursing Masters Study Program, Faculty of Nursing Andalas University

Abstract:- Quality control of nursing services, in threats. The hospital is also an organized place in
order to be designed a comprehensive strategic plan providing health services to patients, basic, specialistic
so as to improve the quality of hospital services in the and subspecialistic. In addition, hospitals may also be
future and to formulate the strategic plan is needed used as health professional institutions (Adisasmito,
various methods that can take decisions on what will 2007: 1).
be done to solve all the problems that exist. The
purpose of this study is to know and describe the According to WHO (2008) the hospital is an
development of SWOT Analysis in determining the individual health care facility and is a reference care unit,
relevant strategies to be implemented by RST Level which empowers a wide range of trained and educated
III Reksodiwiryo in improving the quality of nursing personnel in dealing with and handling medical problems
service. Types of research This qualitative study is for the recovery and maintenance of good health. It is
more specifically directed to the use of case study also an integral part of social and medical organization,
methods (Case Study). The study participants which serves to provide comprehensive, curative and
amounted to 7 people, consisting of: Karumkit, Ka. preventive public health services and outpatient services
Installation of Inpatient, Ka. Outpatient Installation, to reach families and home environments; the hospital is
Nursing Committee, Ka. Education Installation, Head also a training center for health workers and biosocial
of Outpatient and Head of Inpatient. This research research.
was conducted on unit of TK III Reksodiwiryo The development of the hospital is currently
Padang Hospital. Methods of collecting interview undergoing a major transformation. Where in the present
data, interviews and documentation. Data analysis is hospital is in a global atmosphere and competitive,
done qualitatively in accordance with the procedure. including competing with alternative health services. In
The results of this study illustrate that Strengthening such circumstances health services must be managed on
(Strenght) in improving the quality of nursing service the basis of a management concept that has an effective
in RST Level III Reksodiwiryo. Described Weakness direction and strategy. In running the hospital, the
(weakness) in improving the quality of nursing service management has an obligation to be able to build a good
in RST Level III Reksodiwiryo. Described hospital management system, because only good
Opportunity (opportunity) in improving the quality of governance that can make the hospital survive for long
nursing service in RST Level III Reksodiwiryo. period of time with the service quality that can be
Described Challenges (Treat) in improving the quality accepted by the users. Therefore hospitals that have
of nursing services in RST Level III strategic planning will lead in hospital management and
Reksodiwiryo.Terdeskripsinya relevant external something that is expected in the future can be realized.
strategies to be implemented in improving the quality Strategic planning has an important role to be able to
of nursing services in RST Level III Reksodiwiryo answer the environmental demands around the hospital.
Described relevant internal strategies to be
implemented in improving the quality of nursing Organizing good health services should be
services in RST Level III Reksodiwiryo . Advice For structured in accordance with a good strategic plan to
hospitals to improve the quality of care in hospitals is achieve the desired objectives. Implementation of a
necessary to improve the nursing service and health health service if not supported by a good plan, it will be
promotion for patients. difficult to expect the achievement of the purpose of
health services. In other words, the organization of good
Keywords:- Quality of Service, Strenght, weakness, health institutions depends on the ability of management
opportunity, Treat. in managing professionals and inter-profession
interaction as well as managing all other resources wisely
I. INTRODUCTION and wisely.
Hospitals as health care producers must be able to Strategic planning is a framework agreement for
anticipate change and know its position to take advantage current decisions to have long-term implications,
of existing opportunities and stay away from future whereas operational planning is a framework that

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Volume 3, Issue 10, October– 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
produces short-term impact decisions. System strategy Given the growing number of hospital services and
has a real influence in improving the quality of the community hospitals over the next few years, shortage of
hospital. Some of the issues in hospital strategy planning nurses will pose a serious challenge to the effectiveness
are patient care strategies, staff medical strategies, of any health care system. One way to improve
facility planning and budget and funding models. professional development and reduce turn over is through
In reaching the opportunities that are required effective clinical monitoring. Clinical surveillance has
management strategy that is telling. The strategic traditionally started from western countries, providing
management process consists of three stages; strategy professional development nurses and career
formulation, strategy implementation, and strategy development. Furthermore, clinical supervision when
assessment. Menuru David (2009) strategy formulation done properly will be able to solve some of the basic
includes vision and mission development, identification problems the nurse faces. The implementation of clinical
of opportunities and external threats of an organization, supervision will enhance the support provided to the
awareness of internal strengths and weaknesses, setting nurse and provide career development.
long-term goals, searching for alternative strategies and The nurse is a person who has a profession based on
selecting specific strategies to achieve goals. scientific knowledge, skills and work attitude based on a
Widaryanto (2005) in his research entitled "Analysis of sense of responsibility and devotion (Mansoureh: 2007.
Hospital Performance Improvement Strategy Through The Department of Health defines a nurse as someone
Influential Factors on Service Behavior" states that the who provides professional health services where the
internal environment includes all resources owned by service is in the form of social, psychological, addressed
hospitals consisting of human resources (HR), to individuals, families and communities Nursing care is
organizational resources such as leadership, given due to physical and mental weakness, limited
organizational culture, organizational climate, knowledge and lack of understanding of the patient's
organizational structure, teamwork, and networking, ability to perform activities independently.This activity is
information systems resources, physical resources such done in an effort to achieve health improvement with an
as facilities and infrastructure used by hospitals in emphasis on health service efforts that enable each
providing health services, and financial resources. From individual achieve a healthy and productive life.
its nature, resources are grouped into tangible resources
and intangible resources. Intangible resources are Nursing as a service to individuals, families and
resources as the result of human thinking in the form of communities based on the science and nursing tips that
knowledge and the ability of human thinking to produce shape the attitude and intellectual ability and technical
creativity and innovation. With creativity and innovation, skills of individuals to help humans, both sick and
hospital human resources are able to create something the healthy in order to be able to address health needs
hospital needs to improve the quality of patient health (Kusnanto, 2004). Nursing is a form of professional
and safety services, build brand and image of the hospital service that is an integral part of health care, based on
and other values for its stakeholders. The external nursing science and tips, in the form of a comprehensive
environment and internal environment of the hospital bio-psycho-social-spiritual service addressed to
need further discussion so as to provide a more concrete individuals, families and communities, both sick and
and applicable picture.SWOT consists of the strength healthy, which encompasses the entire process of life.
(strenght) and weakness (weaknesses) internal hospitals Nursing service is an effort to help individuals both sick
as well as opportunities (opportunities) and threats and healthy, from birth to death in the form of increased
(threaths) in the environment facing the hospital. knowledge and ability (patient) so that the individual is
optimally perform daily activities independently
The prominent internal capability of the hospital (Thomas and H. Wan: 2003. It can be concluded that
compared to other hospitals. Strength is an existing what is meant by nursing and nursing service is health
competitive force and will be made by the hospital as a service aid given to individual, family and society in the
competitor's comparison. What's in the hospital form of bio, psycho, social and spiritual service by using
represents the power in the market. These characteristics the knowledge and tips of nursing both ill and healthy to
may not be unique but they are positive in character. The be independent and not depend on others in taking care
properties of the hospital tend to reduce competent values of themselves.
and comparisons with their competitors.
In an effort to improve the quality of nursing
Research conducted by Tien Jia Ning (2017) under services in hospitals, has prepared Hospital Service
the title Implementing clinical nursing supervision in Standards through Minister of Health Decree No. 436 /
Singapore hospitals. The results of the study illustrate MENKES / SK / VI / 1993 and Nursing Care Standards
that Lack of commitment and professional development through SK Dirjen Yanmed No. YM.00.03.2.6.7637 year
in nursing practice has been an important factor for 1993. Service standard and Nursing Care Standard serves
nurses to increase turnover rates and shortage of nurses. as a measuring tool to know, monitor and conclude

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Volume 3, Issue 10, October– 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
whether service / nursing care held in hospital has been puskesmas. The purpose of this study is to find out and
followed and meet the requirements in the standard or describe the development of SWOT Analysis in
not (MOH RI , 2005). determining the relevant strategies to be implemented by
RS Level III dr Reksodiwiryo in improving the quality of
Quality of nursing care is a factor that affects the nursing service
quality of the hospital (Azwar, 2006). This is
understandable, because among other health II. MATERIALS AND METHODS
professionals the service required by patients for 24
hours is nursing service. During the 24 hours the nurse This type of research is used in qualitative
helps the patient to meet the needs of the patient (Aprilia, approach. The study participants amounted to 7 people,
2011). In addition, the nurse is a health professional with consisting of: Karumkit, Ka. Installation of Inpatient, Ka.
the highest number in the hospital. This makes the Outpatient Installation, Nursing Committee, Ka.
nursing service a reference for patients to determine the Education Installation, Head of Outpatient and Head of
quality of a hospital. If the nursing service in a hospital is Inpatient. This research was conducted on unit of TK III
good then the public judges good quality of the hospital. Reksodiwiryo Padang Hospital. which is a referral
Similarly, vice versa, if the quality of nursing services is hospital within Korem 032 / Wbr, and also serves as an
getting worse then people judge the poor quality of the Integration Hospital for the TNI community in West
hospital. Hospitals that are judged to be of poor quality Sumatra. Data collection method of the author using
will eventually be abandoned by patients as people lose descriptive method, namely by collecting data to
confidence in the hospital. determine the actual state of nursing service in the
hospital TK III Reksodiwiryo Padang. Data collection
The quality of nursing care is the quality associated methods used to conduct research are: 1) Interview
with providing care that should be available, acceptable, (interview), 2) documentation. Analysis of data and
comprehensive, continuous and documented. This information obtained subsequently processed and
statement is supported by (Esther and Fernando: 2012) in analyzed qualitatively descriptive.
a study entitled A pilot study of satisfaction in oncology
nursing care: an indirect predictor of quality of care, III. RESEARCH RESULT
stating that the quality of care is the application of
Results of interviews conducted with 7 informants
appropriate medical knowledge for the care of the patient
related to Strength (Strenght) in improving the quality of
while balancing the risks attached to nursing orders and
nursing service in RS III Dr. Reksodiwiryo Hospital
the expected benefits of nursing orders. The nursing
Some nurses conduct assessments related to the task
service is said to be of quality if the nursing service is
performed as a nurse can be a role model in providing
provided in accordance with the established standard, to
services to patients the role of nurse formulated the
measure how well the nursing service provided is
diagnosis nursing by providing disease prevention efforts
required a clinical indicator of nursing service quality
for patients, Some nurses plan nursing actions and Some
(MOH, 2008). From the restrictions on the above
nurses take nursing actions, some nurses conduct
definition, it can be concluded that the definition of
evaluation of nursing actions. The nurse is in charge of
nursing service quality is nursing service performed by
planning all the nursing actions of the patient starting
nurses in accordance with the standard of profession
from doing the assessment to the implementation of the
determined based on nursing service indicator which
action (Rakhmawati, 2009).
shows the level of nursing service ability in giving
satisfaction to each patient. A good quality of nursing RS dr Reksodiwiryo already has a network with
care means patients receive prompt service, proper private institutions and government owned in Padang
diagnosis and therapy, considerable hospitality, fast City. Institutions such institutions are RS M.Djamil,
administration services and affordable costs. Thus the PMI, Dinas Kesehatan, and other institutions related to
service provided is to meet the customer's wishes. the provision of public health services and other hospitals
located in the city of Padang and Nurses who work in
Nursing service is often used as a benchmark image hospitals. Dr. Reksodiwiryo has diploma and Bachelor
of a hospital service in the eyes of the community, thus degree.
demanding a clear quality indicator of nursing service in
the hospital. This is a strong basis to say that the quality Strength in the SWOT analysis is the strength or
indicator of nursing becomes an absolute must have and strength that exists within a company or organization that
implemented in the hospital. Nursing services have an influences Kotler's strategic decision-making process
important role in the implementation of health services in (2002: 88). Aadapun who became strength (strength)
the hospital as a whole. The success of hospital services contained in Dr. Reksodiwiryo Hospital based on
is highly dependent on the performance of nurses of interviews with Mr. Karumkit as head of the hospital. In
puskesmas in implementing nursing services at addition, the strength of the hospital. dr Reksodiwiryo

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Volume 3, Issue 10, October– 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
others are: RS dr Reksodiwiryo has a vision mission, should patient wait 30 minutes but because of constraint
vision mission RS. dr Reksodiwiryo installed in strategic on medical team caused by distance of specialist doctor
place so easy to read by patient and officer of RS, RS. far from RS. dr Reksodiwiryo so that the waiting time of
Dr. Reksodiwiryo has a clear organizational structure, the patient often shifts from the time specified. It can also
RS. Reksodiwiryo has a clear organizational structure, be seen from respondents who are not satisfied with the
RS. dr Reksodiwiryo Padang has high support from the speed and timeliness given by medical personnel with a
Ministry of Defense and Security, RS. dr Reksodiwiryo percentage of 24.2%.
Padang has accredited 5 basic services, RS. dr
Reksodiwiryo Padang using a strong command system This fact prevents the worker to update their
with military leadership style, so the function of superior knowledge and be aware of trends and the latest advances
and subordinate running with bailk, RS. dr Reksodiwiryo in the field of their actions, that is in nursing, counseling,
Padang has 47 military personnel, 42 civil servants and psychological support, Many structures operated by
422 PNBP, RS. dr Reksodiwiryo Padang also serves personnel who are really necessary in many cases not
patients who use BPJS card, RS. Dr. Reksodiwiryo has a enough to cover the increased needs. This, combined
strong structural nursing committee that assists in the with decisions delayed by the state on program
management of functional nursing services, RS. Dr. participation and viability, creates stressful working
Reksodiwiryo has complete medical facilities and conditions for program worker (Sotiriadou, Kyriali and
adequate medicines so as to support in providing optimal Antonopoulou, 2014).
services, Nurses provide time of service in accordance The organizational structure of RS. dr
with the wishes and understand the needs of patients. Reksodiwiryo and nursing have been formed, The
The nurses pay careful attention to the patient, the number of personnel that exist based on the calculation
doctor listens to the complaints about the illness that the of energy, quality control team has been formed, Nurses
patient suffers and provides a way out in consultation, prioritize patient satisfaction for the quality of nursing
Nurses in serving to be polite and friendly, medical service, RS. dr Reksodiwiryo Padang is a hospital
personnel willing to respond to complaints of patients, dedicated to TNI members and their families and the
Doctors have the ability and knowledge in establishing general public, RS. dr Reksodiwiryo Padang is a Type C
the patient's disease diagnosis is quite good , so as to be Hospital that has a Nursing Education Institution and
able to answer each patient's questions conclusively, the Became a practice area for health and nursing students,
Nurse notifies the type of illness completely, tells how to RS. dr Reksodiwiryo Padang is the referral of the
care and how to take medication. For patients the most primary service unit also establish cooperation with
notable requirement is not related to self-esteem or to be BPJS, RS. dr Reksodiwiryo Padang cooperates with
recognized for its greatness but is a necessity of specialists and subspecialists. RS. dr Reksodiwiryo
belongingness and social needs. Being loved, being Padang is easy to reach with various types of
listened to, is not considered a troublesome person nor transportation and the environment is quite comfortable
treated as a useless human being (Tobing, 2008). Anita and fun and RS. dr Reksodiwiryo became one of the
research (2013) shows the higher the quality of nurses, references in the event of a disaster due to the location
the higher the patient's satisfaction level. and structure of buildings that are safe against earthquake
hazards.
Weaknesses are deficiencies or negative things that
exist within the company that can threaten the decline in Research conducted by Tien Jia Ning (2017) under
the competitiveness of the company. RS Reksodiwiryo the title Implementing clinical nursing supervision in
weaknesses include: The selection process has not led to Singapore hospitals. The results of the study illustrate
the achievement of the vision and mission hospitals and that Lack of commitment and professional development
punishman Reard delivery system has not been arranged in nursing practice has been an important factor for
in writing, supervision system is not yet clear and nurses to increase turnover rates and shortage of nurses.
structured, education is still limited nursing staff, the Given the growing number of hospital services and
nurses 18.3%, S1 Nursing 5.2%, D3 nursing by 60%, D4 community hospitals over the next few years, shortage of
Midwifery 1.3%, D3 Midwifery 7.6%. nurses will pose a serious challenge to the effectiveness
of any health care system. One way to improve
Weakness in the SWOT analysis is the weakness professional development and reduce turn over is through
that exists within an organization or company that effective clinical monitoring. Clinical surveillance has
influences the strategy decision-making process, which traditionally started from western countries, providing
becomes weakness (lack) on RST Through the interview professional development nurses and career
with Ibu Sri Mulyani as Ka. Installation of inpatient at development. Furthermore, clinical supervision when
RS. dr Reksodiwiryo, lack of discipline in accordance done properly will be able to solve some of the basic
with MOH standards for example in service which problems the nurse faces. The implementation of clinical

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Volume 3, Issue 10, October– 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
supervision will enhance the support provided to the populations increase the likelihood of desirable and
nurse and provide career development. consistent health outcomes with current professional
knowledge. Previous events / activities determine the
The challenge of improving the quality of nursing application of quality nursing care and they should
service in RST Level III RS dr Reksodiwiryo Besides RS always be available for quality assurance because they
dr Reksodiwiryo also stands a private Hospital that also determine the dimensions of treatment outcomes. A study
operates which has a much nicer and new building as by Chen, 2015 on patient satisfaction revealed that
well as more sophisticated equipment, and RS Private is patients most appreciate the nature of "patient",
more visible clean and comfortable. It is thus feared will "responsibility", "caution"; "Attention" is perceived by
many people who choose treatment at Private Hospital. the participants as ideally important but carried out
In addition, the threat posed by RS dr below. If effective nursing structures and processes are
Reksodowiryo is: Besides RS dr Reksodiwiryo also continuously monitored, the system ensures good results
stands a private Hospital that also operates. The private including improving service uptake, improving client
hospital has a much nicer and new building. So that satisfaction and increasing the prevalence of positive
Private Hospital look more clean and comfortable. It is client outcomes. This strategy relates to how the
thus feared will many people who choose treatment at company's efforts in maximizing all its strength so that
Private Hospital. Basically the service is an activity the company can take advantage of opportunities while
undertaken by a person or group of people on the basis of avoiding possible threats that will occur in the future
material factors through certain systems, procedures, and (Basri, 2017).
methods in order to meet the needs of others in Internal strategy dr. Reksodiwiryo is a disaster
accordance with their rights, with another understanding response hospital RST's flagship program is the center of
that the needs of such customers can be met in Trauma Center, Providing clear information to patients to
accordance with their expectations. Just as the services get preventive services Providing clear information to
provided by a hospital is an important aspect to note. The people who need alternative modern treatment of nursing
service performance provided by all medical teams in a promotion program is a rehabilitative practice to improve
hospital is closely related to the satisfaction felt by the the quality of hospital services held training.
patient as the hospital customer.
Nursing services, the standard is very helpful
Medical team is required to provide the best service nurses and midwives to achieve quality care, so nurses
to patients so that patients are satisfied with the services and midwives should think realistically about the
provided by the medical team. Similarly, applied by RS importance of systematic evaluation of all aspects of high
dr Reksodiwiryo Padang, to satisfy the patients, they quality care. But success in implementing the standards
always improve the performance of the services is highly dependent on the individual nurses or midwives
provided. So the patient will feel satisfied with the themselves, the joint efforts of all staff within an
service given. In RS dr Reksodiwiryo Padang also has a organization, in addition to the participation of all
form of service that has been given to the patient in order members of the profession. Standard Operating
to support improving the quality of service performance. Procedure (SOP) is a clear guideline on what is expected
The strategy generated in improving nurses' and required by all employees in carrying out their daily
performance at RS Reksodiwiryo is to support an activities ("Developing standard operating procedures in
aggressive growth policy (Growth oriented strategy), Wildland Fire Management", 2003).
where internal analysis of strengths and weaknesses and The function of the standard operating procedure is
external aspects including opportunities and threats have to define all the important concepts and techniques and
good strengths and opportunities. David (2009) strategy requirements required, which are in every activity poured
formulation includes vision and mission development, into a form that can be directly employed by the
identification of opportunities and external threats of an employee in the course of day-to-day activities (Stup
organization, awareness of internal strengths and 2001). The objectives of standard operating procedure
weaknesses, setting long-term goals, searching for are: (1). To know clearly the role and function of each
alternative strategies and selecting specific strategies to position in the organization. (2) Protecting organizations
achieve goals (Mhlanga, Zvinavashe, Haruzivishe, & and staff from malpractice or other administrative errors.
Ndaimani, 2016). (4) To avoid failure / error, doubt, duplication and
The quality of nursing care requires meeting client inefficiency. (5) Clarify the work flow, authority and
needs and expectations, through adjustment to relevant responsibilities of the staff. Research result (Arshad &
standards / requirements and comprehensive care Noordin, 2017).
implementation through the nursing process. This is the Health care is a public service sector and has been
extent to which health services for individuals and providing its services for public health improvement

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Volume 3, Issue 10, October– 2018 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
since it was established at the communal level. To work [9]. Sotiriadou, Kyriali and Antonopoulou, L. (2014).
efficiently and effectively, the sector relies heavily on PEST and SWOT Analyses of the "Home
true and complete health information from people and Care" Program in Greece. Hellenic Journal of
integrated health knowledge management information Nursing Science, 02(02), 35–40. Retrieved from
systems that manage this information http://journal-ene.gr/wp-
content/uploads/2010/11/Tomos02_teyxos02-aggl-
IV. CONCLUSION dragged1.pdf
Strength (Strenght) in improving the quality of [10].Widyaranto.(2005). Analisis strategi peningkatan
nursing service in RS Level III dr Reksodiwiryo. kinerja rumah sakit melalui factor-faktor yang
Weakness (weakness) in improving the quality of nursing berpengaruh terhadap perilaku pelayanan. Article
service in RS Level III dr Reksodiwiryo. Opportunity Review.
(opportunity) in improving the quality of nursing service
in RS Level III dr Reksodiwiryo Challenge (Treat) in
improving the quality of nursing service in RS Level III
dr Reksodiwiryo. Relevant external strategies to be
implemented in improving the quality of nursing service
in RS III Dr. Reksodiwiryo. Internal strategies relevant to
be implemented in improving the quality of nursing
service at RS Level III dr Reksodiwiryo.

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