PENINGKATAN MUTU PELAYANAN KESEHATAN PUSKESMAS PASCA AKREDITASI DI KABUPATEN TANGGAMUS PROVINSI LAMPUNG TAHUN 2024

Abstract

Service quality is a critical component in healthcare delivery, particularly in ensuring patient safety, service effectiveness, and community satisfaction. Quality management principles, initially developed in the industrial sector, have been widely adopted in healthcare systems through mechanisms such as quality assurance, Total Quality Management (TQM), and accreditation of healthcare facilities, including Community Health Centers (Puskesmas). However, evidence from Tanggamus Regency suggests that despite full accreditation status across all Puskesmas, post-accreditation quality improvement has not been optimally sustained. Persistent challenges include limited human resources, inadequate infrastructure and funding, weak institutionalization of quality culture, and an overemphasis on administrative compliance rather than continuous service improvement. This study aims to assess post-accreditation service quality in Puskesmas and to formulate context-based strategies for sustainable quality enhancement. A mixed methods approach was employed by integrating quantitative and qualitative analyses. Quantitative data were analyzed using the SERVQUAL model to identify gaps between community expectations and perceived service performance, while qualitative data were collected through in-depth interviews and document review. The findings reveal that all service quality dimensions exhibit negative gap scores, with an overall average of -0.67, indicating that service performance has not yet met community expectations. The Empathy dimension demonstrated the largest gap (-0.95), highlighting insufficient personal attention from healthcare providers, whereas the Assurance dimension recorded the smallest gap (-0.30), reflecting relatively higher public trust. These results underscore the need for continuous quality improvement strategies, including strengthening health workers’ competencies and communication skills, upgrading service facilities, ensuring consistent implementation of standard operating procedures, and reinforcing systematic monitoring and evaluation mechanisms.

ABSTRAK
Mutu pelayanan kesehatan merupakan aspek fundamental dalam penyelenggaraan layanan publik yang berorientasi pada keselamatan pasien dan kepuasan masyarakat. Konsep mutu yang berasal dari sektor industri telah diadaptasi ke dalam sistem pelayanan kesehatan melalui berbagai pendekatan, seperti penjaminan mutu, Total Quality Management (TQM), dan akreditasi fasilitas pelayanan kesehatan, termasuk Pusat Kesehatan Masyarakat (Puskesmas). Meskipun seluruh Puskesmas di Kabupaten Tanggamus telah memperoleh status akreditasi, implementasi peningkatan mutu pasca akreditasi belum menunjukkan hasil yang optimal. Berbagai kendala masih dijumpai, antara lain keterbatasan sumber daya manusia, sarana prasarana yang belum memadai, keterbatasan anggaran, lemahnya internalisasi budaya mutu, serta kecenderungan pelaksanaan akreditasi yang berorientasi administratif. Penelitian ini bertujuan untuk mengevaluasi mutu pelayanan Puskesmas pasca akreditasi serta merumuskan strategi peningkatan mutu yang berkelanjutan. Metode penelitian yang digunakan adalah metode campuran (mixed methods) dengan pendekatan kuantitatif dan kualitatif. Pengukuran mutu pelayanan dilakukan secara kuantitatif menggunakan model SERVQUAL untuk menganalisis kesenjangan antara harapan dan persepsi masyarakat, sedangkan data kualitatif diperoleh melalui wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa seluruh dimensi mutu pelayanan masih berada pada gap negatif dengan nilai rata-rata sebesar -0,67, yang menandakan bahwa pelayanan belum sepenuhnya memenuhi ekspektasi masyarakat. Dimensi Empathy menunjukkan kesenjangan terbesar (-0,95), sementara dimensi Assurance memiliki gap terkecil (-0,30). Temuan ini menegaskan perlunya strategi peningkatan mutu yang berkelanjutan melalui penguatan kompetensi dan komunikasi petugas, perbaikan fasilitas layanan, konsistensi penerapan standar operasional prosedur, serta penguatan sistem monitoring dan evaluasi mutu pelayanan.