STRATEGIC LEADERSHIP

& SYSTEM THINKING

Public Health Organization
& System Thinking

Ede Surya Darmawan - 0811-184-713

edesurya@ui.ac.id
 Outline
• Public Health & Public Health Services
• Health System & Public Health Services
• The Ecosystem of Health Care (Hospital)
• Towards System Thinking
 Public Health
"...the science and art of preventing disease, prolonging life and
promoting health and efficiency through organized community
effort for the sanitation of the environment, the control of
communicable infections, the education of the individual in
personal hygiene, the organization of medical and nursing
services for the early diagnosis and preventive treatment of
Charles Edward disease, and for the development of the social machinery to
Amory Winslow insure everyone a standard of living adequate for the
1877-1957 maintenance of health, so organizing these benefits as to enable
every citizen to realize his birthright of health and longevity."
(CEA Winslow, 1920)
 Public Health
CEA Winslow 1920

a foundation of people’s welfare ESD 2020

PUBLIC HEALTH IS THE SCIENCE AND THE ART OF:

PROCESS OBJECTIVES/ INTERMEDIATE GOAL
RESULTS
ORGANIZING 1. a sanitary environment; in order to attain:
COMMUNITY’S 2. control of community infections; 1. preventing disease,
EFFORTS TOWARD: 3. education of the individual in principles of 2. prolonging life,
personal hygiene; 3. promoting physical health
4. organization of medical and nursing service and mental health
for the early diagnosis and treatment of 4. and efficiency
disease;
5. development of the social machinery

to ensure to every individual in the community a standard of living adequate for the maintenance of health, so
organizing these benefits as to enable every citizen to realize his birthright of health and
longevity.
 PERAN KESEHATAN MASYARAKAT
(Fungsi Negara dalam Kesehatan)

2. Mempertahankan Eksistensi Bangsa 4. Berterimakasih

1. Menyambut Kepada Bangsa
3. Meningkatkan Produktivitas Bangsa
Manusia Baru

1. Investasi Bidang Kesehatan harus menjadi prioritas apalagi pandemi yg mengancam kehidupan bangsa
2. Investasi Bidang Kesehatan harus berwujud nyata hingga di tingkat Keluarga  Individu
Bagaimana Caranya?
Essential Public Health Services

EPHS, CDC 1988 EPHS, CDC 2020

 OPERASIONALISASI KEBIJAKAN
PUBLIK/KESEHATAN
Tataran Penjelasan Contoh
Sistem Gambaran tujuan kebijakan dan berbagai komponen dan SANRI, SPPN, SPN, SKN, dll
program-program untuk mencapai tujuan kebijakan SKN: Sistem Kesehatan
Nasional

Program Komponen/program utama untuk mencapai tujuan Kebijakan 7 Komponen SKN

Upaya Kesehatan:
UKM & UKP

Organisasi Pengorganisasian komponen dan program-program untuk UKM: Puskesmas

mencapai tujuan kebijakan UKP: FKTP, FKTRL

Instrumen Seperangkat instrument/sumber daya untuk menerapkan Sumber Daya dan Penjaminan
kebijakan dengan baik (good governance) sehingga menjalankan Mutu:
organisasi/melaksanakan program untuk mencapai tujuan • Perizinan
kebijakan • Akreditasi
• Registrasi
 Adalah semua aktivitas yang tujuan utamanya ialah
SKN
WHO 2000 untuk meningkatkan, mengembalikan/ memulihkan,
dan mempertahankan kesehatan.

Governance

Service
Information
Delivery

People
Medicine & Human
Technology Resources

Financing
 Manusia adala Fokus Utama dari Sistem
Pelayanan Kesehatan
• Penyedia: barang dan layanan kesehatan
• Konsumen: perilaku sehat
• Kontributor: pembiayaan
• Warganegara: stewardships/pengawasan

Karena itu pelayanan kesehatan haruslah:

• Dipilih dengan baik
• Dikelola dengan baik
• Diberikan insentif dg baik
 ALUR PIKIR
SISTEM KESEHATAN NASIONAL

PARADIGMA NASIONAL
(PANCASILA, UUD 1945,WASANTARA, TANNAS,)

(UU 23/1992 Kesehatan, UU 17/2007 RPJPN)

KONDISI SAAT INI
Derajat Kesehatan
Masyarakat Rendah

RPJPK DAN SKN

DERAJAT
MASALAH MENDASAR (Arah, dasar, KESMAS RAKYAT
TUJUAN
BANGKES: bentuk dan cara YG
SEHAT
NASIONAL
PRODUKTIF
- KETIDAKPASTIAN penyelenggaraan SETINGGI-
HUKUM
- PERILAKU MASYARAKAT
Bangkes) TINGGINYA
BURUK
- INGKUNGAN BURUK.
- RAWAN PANGAN DAN
RAWAN GIZI
LINGKUNGAN STRATEGIS:
- AKSES PELAYANAN
PUBLIK BURUK (Ideologi, Politik, Ekonomi Sosial Budaya dan
Pertahanan Keamanan)
- SUMBER DAYA
KESEHATAN TERBATAS GLOBAL, REGIONAL, NASIONAL, LOKAL

PELUANG/KENDALA
SKN: Perpres 72/2012
 Administrasi/Manajemen
Organisasi Kesehatan Masyarakat
Selalu dihadapkan:
• Pencapaian Tujuan
• Pengelolaan Sumberdaya
• Ekosistem Rumah Sakit
• Peraturan Pemerintah
• Perkembangan Teknologi
• Perkembangan Penyakit
The Process/Function of Management
Planning
Select goals and
ways to attain them

Resources Performance
• Human •
• Financial Controlling Organizing Attain goals
• Products
• Raw materials Monitor activities and Assign responsibility for • Services
• Technological make corrections task accomplishment • Efficiencies
• Information • Effectveness

Sumber Leading Kinerja

Daya Use influence to
motivate employees

Transforming Process
Functions of Hospital Administration

PLANNING
M M
ORGANIZING M A A M
M M E T C A
ACTUATING
CONTROLLING
A
N
O
N
T
H
E
R
H
I
R
K GOAL
E O I N E
EVALUATING Y D A E T
L
• Number of Patients
• Length of Stay
• Patient Satisfaction
• Efficiencies, etc.
Source: https://reader.elsevier.com/reader/sd/pii/S1532046411000402?
token=46CE8B6B64220BA1A706EC1AAE99517221F0E740809F237DF528EAC32E47630A78AA820F7AD91AD0C24C890DD0D53B5F&originRegion=eu-west-
1&originCreation=20210819043804
 How is Our Live Now ?

Changing & Growing ! More Complexity !

Ambiguity ! Uncertainty !

Volatility !
Old Approaches Will Not Effective !
Source: https://reader.elsevier.com/reader/sd/pii/S1532046411000402?
token=46CE8B6B64220BA1A706EC1AAE99517221F0E740809F237DF528EAC32E47630A78AA820F7AD91AD0C24C890DD0D53B5F&originRegion=eu-west-
1&originCreation=20210819043804
 System Thinking
• Systems thinking is a holistic approach to analysis that focuses on
the way that a system's constituent parts interrelate and how
systems work over time and within the context of larger systems
(Peter Senge, 2005)
• Suatu pendekatan pemecahan permasalahan yang kompleks dan
dinamis (Trilestari dan Almalik, 2018)

How ? System
What? Why ?
Thinking
Silahkan Tonton 2 Video Singkat Berikut:

• https://www.youtube.com/watch?v=2vojPksdbtI&t=20s
• https://www.youtube.com/watch?v=-sfiReUu3o0
• (208) Peter Senge: "Systems Thinking for a Better World" - Aalto Syst
ems Forum 2014 - YouTube

• Buat ringkasan singkat dari video itu apa. Lalu diskusikan, apa saja hal
penting terkait System Thinking dan perkirakan bagaimana semua itu
berlaku di Rumah Sakit
Terimakasih Banyak