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Unnes Journal of Public Health 10 (1) (2021) Unnes Journal of Public Health Unnes Journal of Public Health 10 (1) (2021) Unnes Journal of Public Health http://journal.unnes.ac.id/sju/index.php/ujph Satisfaction Index of Employees on Service Quality through Quality Leadership at Three Hospitals B-Type, Central Java Province Faik Agiwahyuanto1 , Suharyo2 , Via Ayusasmita3, Baju Widjasena4 1,2Faculty of Health, Universitas Dian Nuswantoro, Indonesia 3Culture Science Faculty, Universitas Dian Nuswantoro, Indonesia 4Public Health Faculty, Universitas Diponegoro, Indonesia Article Info Abstract Article History: One achievement of leadership style is job satisfaction. Therefore, this research aims to Submitted January 2020 analyze the effect of job satisfaction on service quality through the leadership of hospital Accepted December 2020 Published January 2021 directors at various Type B Regional General Hospitals. This was done by processing data contained in the Decree of the Minister of Administrative Reform (Kepmenpan) Keywords: No. Kep/25/M.PAN/2/2004. The research had a cross sectional study design and 500 quality leadership, satisfaction samples who were employees from both civil servants and BLUD (300 respondents from index, service quality hospital B type at Semarang city, 100 from Jepara regency, and 100 from Kendal re- gency). A simple random sampling was the technique used to obtain the subjects. Data processing and analysis was performed using the Community Satisfaction Index of Gov- DOI https://doi.org/10.15294/ ernment Agencies Service Units. The results show that employee satisfaction index, ser- ujph.v10i1.36806 vice quality and the quality leadership of hospital B type at Semarang city and at Kendal Regency is decreasing. But hospital B type at Jepara regency is increasing. Therefore, a transformational leadership style can increase employee satisfaction. INTRODUCTION cardi et al., 2014; Al Maqbali, 2015; Yarbrough et Hospital is health service institution that al., 2017; Hariyati & Safril, 2018; Koning, 2014; organizes two types of services to the communi- Leineweber, et al., 2016; Legrain et al., 2015; Lin ty, namely the first health service and the second et al., 2015). Job satisfaction must be maintaining administrative service. Job satisfaction is very in order to improve hospital performance. instrumental in shaping discipline, commitment To optimize job satisfaction Hospital staff and employees performance which then affects need to pay attention to factors that influence the service quality in an effort to achieve hospi- employee satisfaction, including leadership style. tals goals (Legrain et al., 2015; Viscardi et al., To achieve good employee satisfaction requires 2014; Hariyati & Safril, 2018). Job satisfaction leadership that has the ability. With good leader- can be viewed from two sides, namely in terms ship style, employee satisfaction can be increa- of employees and hospitals. The employees side, sing and will have an impact on improving Hos- job satisfaction will bring up pleasant feeling at pital performance. Effective leadership style in a work, while the hospital side, job satisfaction will work unit will affect work behavior as indicating increase productivity, improve employee attitudes by increasing job satisfaction. and behavior in providing excellent service (Vis- Employment satisfaction has been an Correspondence Address: Faculty of Health, Dian Nuswantoro University, Semarang, Central Java, Indonesia pISSN 2252-6781 E-mail: [email protected] eISSN 2548-7604 F Agiwahyuanto, Suharyo, V Ayusasmita, B Widjasena / Unnes Journal of Public Health 10 (1) (2021) important topic for researchers to review. Emp- cially in the specialty health services of the Non- loyees deserve to be treated equally and with dig- Type Type B Hospital. Based on the Regulation nity. Employment happiness is, to some degree, a of the Social Health Insurance Administering result of fair care. Job happiness can also be used Agency in Health (BPJS-Kesehatan) Number 7 of as a measure of mental well-being. Managers 2018 concerning Management of Administration should work on the job satisfaction of workers of Health Facilities Claims in the Implementati- and employees who are unhappy are more like- on of Health Insurance that that referral seek tre- ly to deliver inadequate services. Jobs are both a atment through type D hospitals before going to major source of income and an important part types C, B, and A. Number of hospitals in Cent- of life. Work eats up a good part of the working ral Java in 2018 type A were 8 hospitals, type B day and therefore adds to one’s social status. Job were 34 hospitals, type C were 142 hospitals, and happiness is an essential component of employee type D were 116 hospitals. Thus, the effect of the well-being (Nemmanivar & Deshpande, 2016). BPJS Health Director’s regulation is that type C Nurse satisfaction is one indicator of the hospitals must be referred to type B hospitals to quality of health services in the hospital (Rizany become the most referral hospitals compared to et al., 2019). On the contrary, nurse’s dissatisfac- type A hospitals. tion will affect the hospital. Hospital may lose its Type B Hospitals in Kendal, Semarang resources due to high turnover, absence, and sick and Jepara are General Hospitals owned by Re- leave (Legrain et al., 2015). In the end, the hos- gency/City Governments with type B. In 2009 pital will suffer losses due to poor performance. they were Regional Hospitals in Central Java Management of health system in Netherlands is that have been declared Regional Public Service better than in any other countries, which lead to Agency (BLUD). The average number of nurses lower dissatisfaction among nurses. A study con- hospitalized in 2019 is 393, consisting of 173 civil ducting in United Kingdom and Netherlands re- servants and 220 contract employees. This num- vealing lower satisfaction in patients as result of ber has decreased in the last 3 years due to out- lower performances among nurses (Aiken et al., going transfers / transfers of nurses since 2016. 2018). The achievement of the average BOR (Bed Job satisfaction is one of achievements of Occupancy Rate) over the last three years is still leadership style. Leadership style plays an impor- approaching the lower limit of the BOR standard tant role in influencing job satisfaction both at by the Indonesian Ministry of Health (60-85%), the leader level and subordinate level. Hospitals were 66% (2016), 69.06% (2017) and 69.21% of varying styles and ownership status can have (2018). Based on medical record data, visits in an effect on the management style and work satis- the last three years have increased. Meanwhile, faction. Research result showing that nursing ma- the ratio of the number of nurses to beds is 8:10. nagers varies performance in type B government This does not meet the provisions of the Minister hospitals in West Java (Firmansyah et al., 2018). of Health Regulation (PMK) No. 30 in 2019 that Leadership of room head has an impor- the ratio of the number of nurses to beds in type tant role in implementing the quality manage- B hospitals is 1:1. This shortage of personnel will mentsystem in the room because the room head cause high workloads carried by nurses. The high has the responsibility in managing, planning, and workload will affect the job satisfaction of nurses. controlling the performance of his staff in qua- Then the data on the list of complaints in lity management. To overcome the problems in the hospital’s Customer Service section found quality management, it can be overcome by the that the nursing and infrastructure section ranked quality leadership of hospital directors orienting first per section in December 2019. Meanwhile, to the quality of service (Armstrong-Stassen, et the hospital staffing attendance recap of nurses al., 2015; Lin et al., 2015; Koning, 2014). in April-May 2019 decreased were 12% and May- One indicator of the objectives of the June 2019 were 15%. Judging from the number Central Java Strategic Plan (Renstra) in 2018-2023 of hospital nurse Human Resources (SDM) from is to improve organizational governance so that the last 3 years from 2016 to 2019, it has dec- satisfaction is achieved with the goal of increa- reased with the outgoing/transfer of nurses. sing performance accountability as measured by Based on the description, the purpose of the Government Institution Performance Ac- this study is to analyze the satisfaction index of countability System (SAKIP) value and the target Type B Hospital employees in Semarang City, of increasing service quality as measured by sa- Kendal Regency, and Jepara Regency on service tisfaction value. Good governance is the focus of quality through quality leadership by processing promotive and preventive primary services, espe- the data containing in the Decree of the Minis- 79 F Agiwahyuanto, Suharyo, V Ayusasmita, B Widjasena / Unnes Journal of Public Health 10 (1) (2021) Table 1. NRR and IKM Interpretation NRR IKM Service Quality Service Unit Performance 1,00–1,75 25–43,75 D Not Good 1,76–2,50 43,76–62,50 C Deficient 2,51–3,25 62,51–81,25 B Good 3,26–4,00 81,26–100,00 A Very Good ter of Administrative Reform (Kepmenpan) No. Director’s regulation is that type C hospitals must Kep/25/M.PAN/2/2004. The results of this stu- be referred to type B hospitals to become the most dy are expecting to be using as evaluation mate- referral hospitals compared to type A hospitals. rial for the Director of Type B Hospital in Sema- Sample are 500 employees from both civil ser- rang City, Kendal Regency, and Jepara Regency vants and BLUD (hospital B type at Semarang to improve employees satisfaction with service city are 300 respondents, Jepara regency are 100 quality through quality leadership providing. respondents, and Kendal regency are 100 res- . pondents). The sampling technique using simple METHOD random sampling. The research instrument using This type of quantitative research is ana- questionnaire consisting of organizational integ- lytic survey method.
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