TATAP MUKA 1:

BEDA TATA KELOLA DAN MANAJEMEN

TATA KELOLA RUMAH SAKIT

S2 KARS , 3 SKS, KELAS PAW
SEMESTER GASAL, 02SEP2019 – 03JAN2020
Jumat 13.00-15.30, G 204
 Helath Care Sector and Humanity

The nature and philosophy of the healthcare

sector as an industry is different from any
other industry.
Its main driver is humanitarian, which manifests
itself through providing curative, preventive
and rehabilitative services to patients. `
 Health Care Sector and Humanity
The sector’s commitment to high standards of
ethics and principle-centrism is of utmost
importance to ensure that no patient is
excluded or discriminated.
Its humanitarian value is clearly reflected in
bringing quality healthcare services to the
entire community regardless of race, religion,
social class, gender or political affiliation.
 Health Care and Humanity
By nature the healthcare sector is multi-faceted
and consists of a large number of stakeholders
and beneficiaries  it upholds many
conflicting interests  to be settled in a way
that balances between different stakeholders’
interest.
Proper governance and disclosure practices
would help in achieving this in an integrated
manner.
• http://siteresources.worldbank.org/EXTGLORE
GPARPROG/Resources/grpp_sourcebook_cha
p12.pd
• GRPP
• Global and Regional Partnership Programs
 World Bank
• "Governance“ = the strategic task of
setting the organisation's goals,
direction, limitations and accountability
frameworks.

• "Management" is the allocation of

resources and overseeing the day-to-day
operations of the organisation.
 World Bank
• Governance determines the "What?" -
what the organisation does and what it
should become in the future.

• Management determines the "How?" -

how the organisation will reach those
goals and aspirations.
• Governance deals with political
leadership

• Management deals with business

leadership.
• governance is concerned with “doing the right
thing,”

• management is concerned with “doing things

right.
Management concerns the day-to-day
operation of the program within the context
of the strategies, policies, processes, and
procedures that have been established by the
governing body.
Management is how decisions are turned
around through efficient allocation and use of
various capital assests to achieve desirable
ends.
 Governance and Decision Making
Governance refers to
• processes and traditions of decision making.
• about who makes decisions and
• how the decisions affect the target audiences.
• involving social functions of hospital: deals
with rights, humanity, should be collectively
desirable.
 RESPONSIBILITIES IN HOSPITAL
GOVERNANCE
• Dapat bertanggungjawab dalam tata kelola
dan akuntabilitas rumah sakit
• Dapat memimpin rumah sakit sesuai
peraturan perundang-undangan yang berlaku
• dapat bekerja sama dalam menjalankan misi
rumah sakit dan menjamin kebijakan.
• dapat melakukan identifikasi dan
merencanakan jenis pelayanan klinis yang
perlu untuk memenuhi kebutuhan pasien.
 FUNCTIONS OF GOVERNANCE
1.Strategic direction.
Exercising effective leadership to optimizes use
of financial, human, social, and technological
resources of the program.
Establishing a vision or a mission for the
program,
Reviewing and approving strategic documents,
Establishing operational policies and guidelines.
Monitoring the effectiveness of the program’s
and making changes as needed.
2. Management oversight.
Monitoring managerial performance and
program implementation, appointing key
personnel, a
Approving annual budgets and business plans,.
Establishing an appropriate balance between
control by the governing body and
entrepreneurship by the management unit.
Monitoring compliance with all applicable laws
and regulations
3. Stakeholder participation.
Establishing policies for inclusion of
stakeholders in programmatic activities
Ensuring adequate consultation,
communication, transparency, and disclosure
in relation to program stakeholders
4. Risk management.
Establishing a policy for managing risk and
monitoring the implementation of the policy.
Ensuring that the volume of financial resources
is commensurate with the program’s needs
and that the sources of finance are adequately
diversified to mitigate financial shocks.
5. Conflict management.
Monitoring and managing the potential
conflicts of interest of members of the
governing body and staff of the management
unit.
Monitoring and managing conflicting interests
among program partners and participants,
especially those that arise during the process
of program implementation.
6. Audit and evaluation.
Ensuring the integrity of the program’s accounting
and financial reporting systems, including
independent audits.
Setting evaluation policy, commissioning
evaluations in a timely way, and overseeing
management uptake and implementation of
accepted recommendations.
Ensuring that evaluations lead to learning and
programmatic enhancement.
 FUNCTIONS OF MANAGEMENT
1. Program implementation. Managing financial
and human resources.
Reviewing proposals for inclusion in the
portfolio of activities
Allocating financial resources among activities.
Supervising implementation of activities
Contracting executing agencies to implement
activities.
Ensuring that these agencies are self-monitoring
and reporting their progress in a timely way.
2. Regulatory compliance.
Ensuring compliance with all applicable laws and
regulations at the international, national, and
institutional levels
Adhering to these requirements and standards
on a day to- day basis.
3. Reviewing and reporting.
Taking stock of the overall performance of the
portfolio in relation to the program’s
objectives and strategies.
Reporting progress to the governing body,
including any adverse effects of the program’s
activities.
5. Administrative efficiency.
Maintaining a lean administrative cost structure
Proposing ways to maintain high performance
while reducing costs to increase operational
effectiveness.
6. Stakeholder communication.
Implementing board-approved policies for
stakeholder inclusion in programmatic
activities.
Finding ways to increase the effectiveness of
stakeholder participation in all aspects of the
program.
7. Learning.
Distilling and discerning lessons from the
implementation of activities across the
portfolio.
Transmitting these lessons to both governing
partners and beneficiaries in order to inform
policy making and to enhance implementation
of activities
8. Performance assessment.
Reviewing the performance of operational
staff on a regular basis, as well as the
performance of consultants at the end of their
assignments.
The boundary between governance and management is
depends on the maturity and the size of the
programs
Lessmature programs may take time to establish formal
governance mechanisms.
Smaller programs with limited staffing and financial
resources tend to blend responsibilities between
those who govern and those who manage, and to
call on governing body members to be more involved
in specific day-to-day management decisions.
The extent of governance should be proportionate to
the size of the program in order not to result in an
over-governed and under-performing program
 Corporate Governance
Corporate governance =
Procedures and processes according to which an
organization is directed and controlled.
The corporate governance structure specifies the
distribution of rights and responsibilities among
the different participants in the organization –
such as the board, managers, shareholders and
other stakeholders
There is rules and procedures for decision-making.”
 Benefits of Governance
Hopsital is big unit, a big community
• Strong governance practices lay the foundation
for enhanced general performance.
• can meet the demands of patients while
containing costs.
• Sound governance practices would help in
ensuring long term organizational sustainability
by setting structures and processes for decision
making processes and by facilitating a free flow of
information.  help in identifying opportunities
and managing risks.
 Benefits of Governance

Hopsital is big unit, a big community

• Because of the large number of stakeholders
and beneficiaries around the hospital, this
upholds many conflicting interests. Satisfying
the interest of one stakeholder should not put
the interests of others in jeopardy. Proper
governance practices help in achieving this.
Successful Long- term Governance
1. Adaptiveness, sensitivity and understanding
to the the social and cultural needs
2. Capable to provide Simplified solutions
3. Continuously investing in its' own people
4. Honest and morally upright management
 TAKEL RS SNARS 2017
• Pemilik
• Direksi rs
• Kab bidang divisi rs
• Ka unit kera dan unit yan
• Standard maksud tujuan elemen penilaian pemilik
• Direktur direksi rs
• Kepala bidang divisi rs
• Manajemen peningkatan mutu dan keselamatan poasien
• Manjemen kontrak
• Manajemen sdm
• Organisasi staf klinis an tanggung jawab
• Unit yan
• Etika porganisasi dan etiak klinik
• Budaya keselamatan
 TAKEL RS
Untuk PEMILIK
TKRS 1:
• Ada regulasi
• Ada struktur organisasi

TKRS 2:
• Misi rs
• Rencana Tsrategis
• Rencana Kerja

TKRS 3
• Program peninkatan Mutu dan Kslamatan Pasien
 TAKEL RS
Untuk DIREKTUR/ DIREKSI RUMAH SAKIT
TKRS 2:
• Ada regulasi tentang kualifikasi Direktur Rumah Sakit dan
uraian tugas, tanggung jawab, dan wewenang
• kualifikasi Direktur Rumah Sakit sudah sesuai dengan
persyaratan dan peraturan perundang-undangan. (D,W)
• patuh terhadap peraturan perundang-undangan. (D,W)
• mengatur operasional rumah sakit setiap hari termasuk
semua tanggung jawab yang dijelaskan dalam uraian tugas.
(D,W)
• menyusun dan mengusulkan rencana strategis serta anggaran
biaya kepada pemilik atau representasi pemilik sesuai dengan
regulasi. Direktur/Direksi Rumah Sakit telah memastikan
kepatuhan staf rumah sakit terhadap regulasi rumah sakit
yang sudah ditetapkan. (D,W)
• menindaklanjuti semua hasil laporan pemeriksaan internal
dari pemerintah atau badan ekternal lainnya yang mempunyai
kewenangan melakukan pemeriksaan rumah sakit. (D,W)
Kepala Bidang/Divisi Rumah Sakit
• TKRS 3
• TKRS 3.1
• TKRS 3.2.
• TKRS 3.3