Dewi, TutikMahananiUmiChaliati (2012) Perubahan Pendistribusian Insentif Langsung dalam Sistem Remunerasi: Studi Kualitatif Resistensi Perawat UGD Rumah Sakit X. Magister thesis, Universitas Brawijaya.
Abstract
Rumah Sakit X sebagai Badan layanan Umum (BLU) akan memberlakukan sistem baru dalam pendistribusian insentif langsung. Terdapat gejala resistensi terhadap perubahan tersebut. Penelitian ini bertujuan mendeskripsikan resistensi perawat Unit Gawat Darurat (UGD), mengetahui faktor-faktor yang mempengaruhi resistensi dan mengetahui peran sub budaya perawat terhadap resistensi tersebut. Penelitian ini menggunakan metode penelitian kualitatif dengan pendekatan studi kasus. Pengumpulan data dilakukan dengan wawancara, observasi dan pemeriksaan dokumen. Hasil penelitian menunjukkan bahwa resistensi perawat terjadi pada seluruh tingkatan mulai menerima ( acceptance ) sampai resistensi aktif ( active resistance ). Tingkatan resistensi ini dipengaruhi oleh status pekerjaan dan masa kerja perawat. Perawat dengan status Pegawai Negeri Sipil dan masa kerja 3 tahun cenderung mempunyai tingkat resistensi aktif. Perawat kontrak dan masa kerja 3 tahun cenderung berada pada tingkat menerima ( aceptance ). Tiga faktor yang tidak terpenuhi dari lima faktor prinsip manajemen imbalan yang menyebabkan terjadinya resistensi yaitu faktor keadilan, komitmen dan kebersamaan. Satu faktor dari lima faktor resistensi individu yang menyebabkan terjadinya resistensi yaitu faktor ekonomi. Perawat UGD mempunyai sub budaya supporters, helpers , socio-cultural dan participation. Terjadi pergeseran sub budaya perawat harmonious , symbiotic, delegation dan group consensus ke arah sub budaya medik dominant dan technical dan sebaliknya sub budaya medik bergeser ke group consensus . Sub budaya moral dogma pada perawat melemah dan bergeser ke agresif. Sub budaya supporters , helpers, symbiotic, socio-cultural dan participation pada perawat berperan pada terjadinya acceptance. Pergeseran budaya perawat ke arah dominant dan technical serta moral dogma yang melemah berperan terhadap terjadinya resistensi. Manajemen perlu mengembalikan peran dan membuat kewenangan klinik yang dituangkan dalam hospital by law sehingga resistensi dapat dicegah.
English Abstract
Being corporatized as Badan Layanan Umum (BLU), hospital X will experience the payment system from direct incentive distribution to now remuneration system. The implementation of performance related payment as part of remuneration system in hospital lead to change in incentive distribution that induce inequity feeling and resistance. This study aims at describe the nurse resistance to change in incentive distribution in the Emergency Department, factors affecting the resistance and the role nurse of the sub culture in resistance. This study used qualitative research methods with a case study approach. The data were collected by interview, observation and examination of documents. The results showed that nurses demonstrate resistance ranging form acceptance to active resistance level. Resistance levels were influenced by employment status and working experience. Nurses work as civil servant with more than 3 years working experience tend to have this level of active resistance while nurse with employment contracts and work less than 3 years tend to have acceptance level. Three factors were not fulfilled from the five factors in reward management principles which are fairness, commitment and togetherness that lead to resistance. Economic factor as one of five individual resistance factors was resistance. Nurses in ED have a supporters, helpers, socio-cultural and participation sub-culture. There was a shift from Harmonious, Symbiotic, delegation and group consensus to the medical sub-culture technical and otherwise dominant, sub-culture of medical group shifted to a consensus. One sub-culture of moral dogma on nurses weakened and shifted to aggressive. Subculture supporters, helpers, symbiotic, socio-cultural and participation in the nurse willead to acceptance resistance level. Cultural shifting in nurse into dominant,emphasizes by technical and moral dogma weakening and with aggressive subculture resistance to insentives distribution changes. Management needs to restore the role and develop clinical authority as outlined in the hospital by law which in return the resistance can be prevented.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/331.21/DEW/p/041204293 |
| Subjects: | 300 Social sciences > 331 Labor economics > 331.2 Conditions of employment |
| Divisions: | S2/S3 > Magister Manajemen Rumah Sakit, Fakultas Kedokteran |
| Depositing User: | Endro Setyobudi |
| Date Deposited: | 08 Feb 2013 15:57 |
| Last Modified: | 08 Feb 2013 15:57 |
| URI: | http://repository.ub.ac.id/id/eprint/155631 |
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