HEALTH CARE

QUALITY
1. PRODUK (output). Kesehatan:
OUTCOME HEALTH CARE)
2. PRICE (Output: ABC Analysis)
3. PROCESS (TECHNICAL, SERVICE,
AMENITY)
4. INFARSTRUCTURE (PHYSICAL,
CONVENIENCE, ACCESS) : INPUT
5. POLICY, MANAGEMENT)

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 21s
Customer Value Analysis and
Voice of Customer Initiatives

20s Customer
Customer Value
Value
90s Meeting
Meeting critical
critical
needs
needs of
of
80s
targeted
targeted
Customer
Customer customer
customer
Customer
Customer Loyalty
Loyalty
Out
Out Performing
Performing
Conformance
Conformance Satisfaction
Satisfaction Retaining
Retaining our
our competitor
competitor
Quality
Quality Providing customer
Providing customer (Brand)
(Brand)
Delivering
Delivering what
what Getting
Getting them
them Creating
Creating new
new
what
what we
we customer
customer to
to unique
unique benefits
benefits
promise
promise expectation
expectation recommend
recommend
Meeting
Meeting Responding
Responding us
us
standard
standard to
to customer
customer
complaint
complaint

2C 3C 3,5C 4C
Gambar 1.3 Kecenderungan perubahan mutu layanan
The
4 MUTU JanKes
NE W
ON
1. Mutu
P E R C E P TI Gambaran dan karakteristik menyeluruh dari barang
OF
atau jasa yang menunjukan kemampuannya dalam
QUUAALL I T
TY memuaskan kebutuhan pelanggan baik berupa kebutuhan
yang dinyatakan maupun kebutuhan yang tersirat.

2. Kebijakan mutu
Keseluruhan maksud dan tujuan organisasi yang
berkaitan mutu yang secara formal dinyatakan oleh
pimpinan puncak.
ISO 9000
3. Sistem mutu
Sistem mutu memuat struktur organisasi, tanggung
jawab, prosedur dan sumber daya untuk menerapkan
manajemen mutu (sistem manajemen mutu).

4. Manual mutu
Berisi ringkasan tertulis dari semua aktifitas
manajemen mutu dalam organisasi

5. Manajemen mutu
Keseluruhan aspek dari fungsi manajemen yang
McGraw-Hill/Irwin menetapkan dan melaksanakan kebijakan
2003. The McGraw-Hill mutu (Planning-
Companies. All Rights Reserved
 Jaman Strategic
Quality Management

Jaman inspeksi

Jaman Quality Jaman Statistical Inspeksi

Assurance Quality Control

Desain Produksi \Hasil Pelanggan

Produk

Gambar Sistem Mutu Layanan

 MUTU LAYANAN JASA KESEHATAN
Standarisasi
Masuka tenaga, sarana, alat,
Struktur n akreditasi, obat
Pasien
Standard Operation
Organizat procedure
ion Policy (kebijakan mutu)
Work behavior : Upaya/
Isi
kegiatan yang ada:
(Aktivit
diagnosis sampai
Proses as)
pengobatan) (How to
Configur deliver & Amenity)
Work Performance
asi (alokasi waktu per
kegiatan, hasil antara)
Hasil
Work
Outcom langsuung
effectiveness/efficiency
e dari proses
Hasil (hasil per upaya/kegiatan)
(output) Status Kesehatan Dan
tdk Kepuasan
McGraw-Hill/Irwin langsun 2003. The McGraw-Hill Companies. All Rights Reserved
 HEALTH CARE
QUALITY
Technical Quality
(Core Care)
(What is
H.C Quality delivered=service
(Mutu layanan) encounter=CORE=Mo
Functional Quality
(How is itT)delivered;
interpersonal comuni
ation)(SERVIS= EXPECTED
CARE))(Time, Where,
Amenity
Procedure, Free dom,
convenience) (PENUNJANG=
AUGMENTED
Teknik Medis, keperawatan, penunjang medis/non CARE)
medis non perawatan,
adminiasi
Interpersonal communication
Amenity (kenyaman, keamanan, keselamatan,
McGraw-Hill/Irwin prosedur
2003. The poli/admisi)
McGraw-Hill Companies. All Rights Reserved
 3 ELEMEN KUNCIMUTU LAYANAN

TECHNICAL
INTERPERSONAL CARE
CARE AMENITY

SERVICE EXCELLENCE
1. service with smile
2. Empathy (Passion and action
3. to act cepat
4. Happines, etc
 Kepuasan Pelanggan

Produk yang
menyenangkan
(delighters)
Kinerja nyata

100%

Produk yang
memuaskan
(satisfiers) Produk yang tidak
memuaskan (disatisfiers)

Gb Diagram Kano
Produk yang bukan pemuas (disatisfiers) ialah karakteristik produk/jasa yang
pelanggan puas bila produk itu ada, sedangkan tidak puas bila produk/jasa
tidak tersedia. Ketidakpuasan akan produk terjadi karena tidak tersedianya
produk yang diharapkan. Misal: keberadaan dokter di Balai Pengobatan
Puskesmas, Keberadaan bidan di RB, keberadaan pelayanan spesialis di
Puskesmas. layanan prima, layanan aman, keberadaan laboratorium rumah
sakit, Apotik. Produk ini terkait dengan expected product.
Produk yang memuaskan (satisfiers) bila produk/jasa yang diinginkan dan
diharapkan tersedia. Makin kita menyediakan produk tersebut makin senang
pelanggan. Satisfiers kadang kadang disebut mutu yang diinginkan. Misal:
Cabut gigi tidak sakit, pelayanan yang ramah, harga murah, kecepatan
pelayanan, mudah dihubungi, penyediaan makanan yang enak dan bervariasi,
pelayanan yang ramah. Produk pemuas ialah produk yang diinginkan (desired
quality)
Delighters ialah atribut produk/jasa yang membuat pelanggan
bangga, sangat senang, surprise. Produk ini bila tidak tersedia
pelanggan belum tentu tidak puas, karena mereka tidak
menyadari apa yang hilang, tetapi bila ada mereka Sangat
senang. Produk ini dikenal exciting quality, or unexpected
quality or Augmented quality. Ciri
McGraw-Hill/Irwin
mereka ialah mau
2003. The McGraw-Hill Companies. All Rights Reserved
 Customer Perceptions
of Service (Barang), Jasa (Interpersonal
Communication)

Customer Perceptions (RATER)

Customer Satisfaction
Service Quality
Service Encounters: The Foundations for
Satisfaction and Service Quality
Strategies for Influencing Customer
Perceptions

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Customer Perceptions of Service Quality (Interpesonal
Communicaion) and Customer Satisfaction

Interperso
nal Com/
Sevice
Quality

Amenity Technical Kesembuhan &

Quality/ Kepuasan
Product
Quality

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Factors Influencing
Customer Satisfaction
Product/service quality (Barnag dan asa)
Product/service attributes or features
Consumer Emotions
Attributions for product/service success or failure
Equity or fairness evaluations

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Product
quality

Service
quality
Overal customer Profit
loyality
satifaction ability

Emotional
factor

Cost of
price
acquiring
 Outcomes of
Customer Satisfaction
Increased customer retention
Positive word-of-mouth communications
Increased revenues

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Figure 4.4
Relationship between Customer Satisfaction and
Loyalty in Competitive Industries

Source: James L. Heskett, W. Earl Sasser, Jr., and Leonard A. Schlesinger, The Service Profit Chain, (New York, NY: The Free Press, 1997), p. 83.

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Service Quality

The customers judgment of overall excellence of

the service provided in relation to the quality that
was expected.
Service quality assessments are formed on
judgments of:
Outcome quality
Process quality
Physical environment quality

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 The Five Dimensions of
Service Quality

Reliability Ability to perform the promised

service dependably and accurately.
Assurance Knowledge and courtesy of
employees and their ability to
convey trust and confidence.
Tangibles Physical facilities, equipment, and
appearance of personnel.
Empathy Caring, individualized attention the
firm provides its customers.
Responsiveness Willingness to help customers and
provide prompt service.
McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved
 Exercise to
Identify Service Attributes
In groups of five, choose a services industry and spend 10 minutes
brainstorming specific requirements of customers in each of the five
service quality dimensions. Be certain the requirements reflect the
customers point of view.
Reliability:

Assurance:

Tangibles:

Empathy:

Responsiveness
:

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 SERVQUAL Attributes

RELIABILITY EMPATHY
Providing service as promised Giving customers individual attention
Dependability in handling customers Employees who deal with customers in a
service problems caring fashion
Performing services right the first time Having the customers best interest at heart
Providing services at the promised time Employees who understand the needs of
Maintaining error-free records their customers
Convenient business hours
RESPONSIVENESS
Keeping customers informed as to TANGIBLES
when services will be performed Modern equipment
Prompt service to customers Visually appealing facilities
Willingness to help customers Employees who have a
Readiness to respond to customers neat, professional
requests appearance
Visually appealing materials
ASSURANCE
associated with the service
Employees who instill confidence in
customers
Making customers feel safe in their
transactions
Employees who are consistently courteous
Employees who have the knowledge to
answer customer questions
McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved
 The Service Encounter (MOT)
is the moment of truth
occurs any time the customer interacts with the firm
can potentially be critical in determining customer
satisfaction and loyalty
types of encounters:
remote encounters, phone encounters, face-to-face encounters
is an opportunity to:
build trust
reinforce quality
build brand identity
increase loyalty

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Figure 4.5
A Service Encounter
Cascade for a Hotel Visit

Check-In
Check-In
Bellboy
BellboyTakes
Takesto
toRoom
Room

Restaurant
Restaurant Meal
Meal

Request
Request Wake-Up
Wake-Up Call
Call
Checkout
Checkout

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 A Service Encounter
Cascade for an Industrial Purchase

Sales
SalesCall
Call
Delivery
Deliveryand
andInstallation
Installation

Servicing
Servicing

Ordering
OrderingSupplies
Supplies
Billing
Billing

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 KESEHATAN

3 S (Salam, Senyum, Sapa)

ANAMNESA

PEMERIKSAAN

LABORATORIUM

DIAGNOSE

PENGOBATAN

APOTIK
McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved
 Critical Service Encounters Research

GOAL - understanding actual events and

behaviors that cause customer dis/satisfaction in
service encounters
METHOD - Critical Incident Technique
DATA - stories from customers and employees
OUTPUT - identification of themes underlying
satisfaction and dissatisfaction with service
encounters

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Sample Questions for Critical Incidents
Technique Study
Think of a time when, as a customer, you had a
particularly satisfying (dissatisfying) interaction
with an employee of .
When did the incident happen?
What specific circumstances led up to this
situation?
Exactly what was said and done?
What resulted that made you feel the interaction
was satisfying (dissatisfying)?
McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved
 Common Themes in Critical
Service Encounters Research

Recovery: Adaptability:
Employee Response Employee Response
to Service Delivery to Customer Needs
System Failure and Requests

Coping: Spontaneity:
Employee Response Unprompted and
to Problem Customers Unsolicited Employee
Actions and Attitudes

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Recovery

DO DONT
Acknowledge Ignore customer
problem Blame customer
Explain causes Leave customer to
Apologize fend for him/herself
Compensate/upgrade Downgrade
Lay out options Act as if nothing is
Take responsibility wrong

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Adaptability

DO DONT
Recognize the Promise, then fail to
seriousness of the need follow through
Acknowledge Ignore
Anticipate Show unwillingness to
Attempt to try
accommodate
Embarrass the customer
Explain rules/policies
Laugh at the customer
Take responsibility
Exert effort to Avoid responsibility
accommodate
McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved
 Spontaneity

DO DONT
Take time Exhibit impatience
Be attentive Ignore
Anticipate needs Yell/laugh/swear
Listen Steal from or cheat a
Provide information customer
(even if not asked) Discriminate
Treat customers fairly Treat impersonally
Show empathy
Acknowledge by name
McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved
 Coping

DO DONT
Listen
Take customers
Try to accommodate dissatisfaction personally
Explain Let customers
Let go of the customer dissatisfaction affect others

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

 Figure 4.7
Evidence of Service from the
Customers Point of View

Contact employees
Customer
Operational flow of him/herself
Other customers
activities People
Steps in process
Flexibility vs. standard
Technology vs. human
Physical Tangible
Process
Evidence communication
Servicescape
Guarantees
Technology
Website

McGraw-Hill/Irwin 2003. The McGraw-Hill Companies. All Rights Reserved

Pengertian mutu :

Mutu adalah kualitas (tidak cacat)

Mutu adalah kesesuaian
penggunaan
Mutu adalah kepuasan pemakai
Kepuasan konsumen (internal &
esternal)
 Mutu sesuai dengan orientasi kebutuhan
manusia (james S Robert)
Mutu Model Iso.
Mutu dalam bidang layanan
kesehatan terbagi :

Prespektif pemberi layanan

kesehatan/produsen
Prespektif konsumen
 Ad1. Prespektif produsen
( what to offer, delivered (content) )

Technical (Medical & Nursing) , 1. available,

2. acceptable, 3. Appropriate 4. profesional
competence, 5. safety, 6. continous care
Interpersonal kom komunikasi
horisontal,vertikal RATER
Amenity infrastruktue: fisical, where,
prosedur, environment
Ad 2.Mutu dalam perspektif
konsumen
Produk quality
Service quality RATER
Emotional factor
Price
Cost of acquiring
Konsep Service Quality

Mutu layanan kesehatan suatu hal yang

dinamis

Jelek prima
 Process performance matrix

performance
+

- + + +
Do the wrong Do the right
things right things right
process - +
- - + -
Do the wrong Do the right
things wrong things wrong
 Service Excellence

Quality Planning; Qualtiy Control: Continuos Quality

Improvement). Trilogi JURAN
 Service Excellence
Pelayanan prima
Pelayanan yang sangat memuaskan
klien
Pelayanan tanpa cacat

Relatif sangat ditentukan oleh tingkat permintaan

& harapan akan mutu
 Service Excellence :
Pelayanan yang selalu berfokus pada
kebutuhan dan harapan customer
Pelayanan yang sesuai atau melebihi standar
yang berlaku

Target : klien, keluarga, povider, karyawan

RS/pusk, pihak ke 3 yg membiayai
 4 faktor penentu kepuasan
pelanggan :
The humanitic reason : emosi, rasa sakit,
gelisah prediksi akan kesembuhan,lama
sakit dll
The economic reason nilai yg hilang akibat
sakit (besarnya biaya)
The marketing reason ant. Janji & apa yang
diterima
The efficiency reason klien puas, mudah
dilayani
 MENGAPA PERLU SERVICE
EXCELLENCE ?
Kepuasan pelanggan adalah jaminan
kelangsungan usaha dalam konteks persaingan
yang makin ketat

Alam reformasi: meningkatnya choice dan voice

pelanggan

Harus disertai perubahan mindset dari para

pelakunya
 INDIKASI ADANYA PELAYANAN PRIMA
PASIEN
PASIEN & KELUARGA PUAS KARYAWAN PUSK/RS PUAS

PELAYANAN
PELAYANAN SESUAI
SESUAI KEBU PELAYANAN DPT DISAJI KAN
TUHAN
TUHAN DAN
DAN SELERA
SELERA SESUAI KEBUTUHAN &
HARGA
HARGA TERJANGKAU
TERJANGKAU SELERA PELANGGAN
TERSEDIA
TERSEDIA PADA
PADA SAAT
SAAT ADANYA BALAS JASA YANG
DIBUTUHKAN
DIBUTUHKAN SEPADAN
SIKAP
SIKAP PROVIDER:
PROVIDER: TANGGAP,
TANGGAP, ADANYA PELUANG UNTUK
RAMAH,
RAMAH, SOPAN
SOPAN PENGEMBANGAN
ORGANISASI DAN DIRI
ADA
ADA EMPATI
EMPATI DARI
DARI PROVIDER
PROVIDER KARYAWAN
ADA
ADA KOMUNIKASI
KOMUNIKASI YANG ADA KEPUASAN KERJA
JELAS
JELAS DARI
DARI PROVIDER
PROVIDER TTG
TTG
APA
APA YG
YG AKAN
AKAN DIKERJAKAN MEMINIMALKAN KOMPLAIN
 SERVICE
EXCELLENCE
ADALAH INDIKATOR
LAYANAN MUTU

STRATEGI CERMINAN
MEMENANGKAN KASIH SAYANG
PERSAINGAN (LOVE &
EMPATHY)
Service Quality Improvment
 Service Quality Improvement
Beberapa hal tentang pengembangan kualitas
pelayanan :

1. Harapan Pelanggan
2. Pengembangan Kinerja
3. Pengembangan proses
4. Budaya untuk terus berkembang
Figure : Four facets of service Quality

Customer

Perfomance
improvement

Process
improvement

Supportive
Culture
Harapan Pelanggan akan mendorong

Pengembangan kualitas pelayanan

Membangun perubahan mindset untuk perbaikan
proses pelayanan

Pengembangan Kinerja

Dilakukan dengan mengembangkan kinerja karyawan

sesuai dengan standar
Proses pelayanan merupakan hal yang utama
Pengembangan Proses

Peningkatan / pengembangan proses merupakan hal

yang mendasar
Dalam pelayanan jasa maka kepuasan pelanggan
tergantung pada proses bukan sekedar kinerja
karyawan

Budaya untuk terus berkembang

Budaya organisasi merupakan hal yang penting dalam

pengembangan pelayanan
Perlu perubahan mind-set dalam memberikan
pelayanan
Perubahan Mind Set dalam Pelayanan
10 Kunci dalam pergeseran Mind-Set

From To

1. Provider Orientation 1. Customer Orientation

2. Tolerance 2. Higher Standards
3. Directing 3. Empowering
4. Employee as expendable 4. Employee as customer
resources
5. Reactive 5. Proactive
6. Tradition and safety 6. Experimentation and risk
7. Busy-ness 7. Result
8. Turf Protection 8. Teamwork across lines
9. We-they Thinking 9. Organizational perspective
10. Cynicism 10. Optimism
Hal hal yang perlu pemikiran dalam pengembangan
pelayanan

Dilakukan dengan koordinasi yang baik dan

pengembangan strategy yang menyeluruh

Mengembangkan VISI pelayanan yang berkualitas

Keunggulan pelayanan terletak pada proes bukan

program

Pelayanan prima harus ditanamkan untk menjadi budaya

organisasi
KESIMPULAN SERVICE QUALITY
Bagaimana melakukan suatu pelayanan secara efektif
dan efisien serta melakukan improvement terus menerus
agar mencapai outcome yang max kepuasan
Dilakukan secara terus menerus perlu manajemen :
TQM, TIM etc
Perlu paradigma customer focus . meningkatkan
kinerja( training,SOP) proses improvement ( 10 Pilar)
Didukung budaya organisasi
Service quality + improvement terus menerus service
excellence
Komponen Quality (What to offer) : people skill
(prepesionalisme), amenity (customer service), sistem &
proses, lingkungan, tehnical & clinical comptence, serta
cost
 MABUHAI

terima kasih