Quality of Pharmacological Services at Jasem Sidoarjo General Hospital

Pharmaceutical service is a direct service that is responsible for patients regarding pharmaceutical preparations to achieve definite results in order to improve the patient's quality of life. Pharmacists must understand and be aware of the possibility of errors occurring in the service process and even in medication (medication errors). Medication errors are events that cause harm to patients due to the use of medication while being treated by health workers that could have been prevented. Therefore, pharmacists in carrying out their practices must comply with existing standards to avoid this happening. Pharmacists must be able to communicate with other health professionals in determining therapy to support rational drug use. In the residency assignment, the author has written about various strengths, weaknesses, opportunities and threats to the quality of pharmacological services at the Jasem Sidoarjo General Hospital. In this study there are several strategies to improve the handling of health services for pregnant women and toddlers. Based on the conditions above, the author wants to implement a strategy to improve the quality of pharmacological services at the Jasem Sidoarjo General Hospital. This activity begins by collecting data on drugs that run out quickly and those that are slow, as well as creating a return/compensation system for unused drugs, and recommending to management to spend the majority of the budget to replenish drug stocks at the pharmacy depot to make things easier for patients. Create standard operating procedures down to every little thing and distribute them to every room, even to the pharmacy depot. Updating the integrated computer system using the latest SIM-RS to synchronize data. Conduct training for all employees in stages. And evaluate patient satisfaction once a month. It is hoped that health workers will routinely supervise and monitor the reliability and ability of staff in the quality of pharmacological services at the


INTRODUCTION
Pharmaceutical service is a direct service that is responsible for patients regarding pharmaceutical preparations to achieve definite results in order to improve the patient's quality of life.Pharmaceutical services include the management of Human Resources (HR), infrastructure, pharmaceutical preparations and health supplies as well as administration in clinical pharmaceutical services which include receiving prescriptions, compounding drugs, dispensing drugs, drug information and recording/storing prescriptions by utilizing personnel, funds, and infrastructure., appropriate management facilities and methods in an effort to achieve the set goals (Ministry of Health of the Republic of Indonesia, 2009).Pharmaceutical services are assisted by an accompanying pharmacist and/or pharmaceutical technical personnel consisting of Pharmacy Bachelors, Associate Pharmacy Experts and Pharmacy Intermediate Personnel/Pharmacist Assistants.Pharmacists are part of the health workforce who have the authority and obligation to carry out pharmaceutical work as stated in PP No. 51 of 2009 concerning pharmaceutical work, article one, that pharmaceutical work is the manufacture including quality control of pharmaceutical preparations, securing, and procuring, storing and distributing or dispensing medicines, drug management, drug services based on doctor's prescriptions, 2 drug information services, as well as drug development, medicinal ingredients and traditional medicines.Pharmacists must understand and be aware of the possibility of errors occurring in the service process and even in medication (medication errors).Medication errors are events that cause harm to patients due to the use of medication while being treated by health workers that could have been prevented.Therefore, pharmacists in carrying out their practices must comply with existing standards to avoid this happening.Pharmacists must be able to communicate with other health workers in determining therapy to support rational drug use (MOH RI, 2004).Previous research explains that the problem that is often encountered in health facilities is the limited number of pharmacists who understand and know about pharmaceutical services, namely the very limited number of pharmacists.There are even pharmacists who feel inadequate in providing drug information to other health workers, especially specialist doctors in several health care facilities, so further guidance and training is still needed (Subidyo, et al., 2012).Pharmaceutical workers as one of the health workers who provide health services to the community have an important role because they are directly related to the provision of services, especially pharmaceutical services.In line with developments in science and technology in the pharmaceutical sector, there has been a shift in the orientation of pharmaceutical services from managing drugs as commodities to comprehensive services in the sense of not only managing drugs but in a broader sense including providing information to support the correct and rational use of drugs., monitoring drug use to determine the final destination and the possibility of medication errors (Medication errors).Pharmaceutical services (Pharmaceutical care) is a patient-oriented service sub-system.This pharmaceutical service directs patients about habits/lifestyles that support successful treatment, provides information about the treatment program that patients must undergo, monitors treatment results and collaborates with other professions to achieve optimal quality of life for patients.

METHOD
In the residency assignment, the author has written about various strengths, weaknesses, opportunities and threats to the quality of pharmacological services at the Jasem Sidoarjo General Hospital.In this study there are several strategies to improve the handling of health services for pregnant women and toddlers.Based on the conditions above, the author wants to implement a strategy to improve the quality of pharmacological services at the Jasem Sidoarjo General Hospital.

RESULT Problem Prioritization
Based on the problem formulation described above, priority problems can be made in community service regarding the quality of pharmacological services at the Jasem Sidoarjo General Hospital.that is: Problem Prioritization Solution 1.
The computerized system is not yet perfect to support pharmaceutical services 2.
Insufficient quantity and quality of human resources 3.
Communication between pharmacists and other health workers has not been effective 4.
Lack of guidance and training for pharmaceutical personnel 5.
Patient dissatisfaction with completeness and drug information 6.
Unused (returned) medication is not returned to the depot 7.
Patients will prefer to buy medicines outside the hospital which will reduce income in the Pharmacy department 1.
Carry out data on drugs that run out quickly and those that are slow 2.
Create standard operating procedures down to every little thing and distribute them to every room, even to the pharmacy depot 3.
Updating the computerized system in an integrated manner 4.
Uses the latest SIM-RS to synchronize data 5.
Conduct training for all employees in stages 6.
Spending most of the budget to replenish drug stocks at pharmacy depots to make things easier for patients 7.
Conduct patient satisfaction evaluations once a month 8.
Create a return/compensation system for unused medication

Intervention Plan
Based on the priority of these problems, the intervention plans that can be carried out in community service are: 1. Carry out data on drugs that run out quickly and those that are slow 2. Create standard operating procedures down to every little thing and distribute them to every room, even to the pharmacy depot 3. Updating the computerized system in an integrated manner 4. Uses the latest SIM-RS to synchronize data 5. Conduct training for all employees in stages 6.Spending most of the budget to replenish drug stocks at pharmacy depots to make things easier for patients 7. Conduct patient satisfaction evaluations once a month 8. Create a return/compensation system for unused medication

DISCUSSION
In the pharmaceutical sector, it is important to collect data on drugs that run out quickly and those that are slow to optimize drug procurement.The study by Thomas et al. (2018) emphasized the importance of drug consumption analysis and efficient stock management to reduce waste and optimize drug use.Additionally, in research by Johnson et al. (2019), it was found that a return or compensation system for unused drugs can reduce costs and increase the efficiency of drug stock management.Standardized and detailed standard operating procedures (SOP) are very important in the pharmacy department.Research by Smith et al. (2020) shows that clear and comprehensive SOPs can increase efficiency and consistency in medication management.A clear understanding of SOPs can also reduce the risk of errors in drug handling.Disseminating SOPs to every room, including pharmacy depots, is an important step recommended by Roberts et al. (2017) in their research on improving the quality of pharmaceutical services.Integration of a computerized system using the latest SIM-RS is a step supported by previous research.The study by Brown et al. (2021) shows that an integrated computerized system can increase accuracy and speed in monitoring drug stocks and monitoring drug use  2020) noted that regular patient satisfaction surveys can lead to continuous improvements in the quality of pharmaceutical services.Effective drug stock management is an important focus in the pharmacy department.Research by Johnson and colleagues (2020) shows that a coordinated approach to drug stock management can reduce excessive stock shortages and overstocks.In the study, they suggested the use of accurate drug demand prediction methods and advanced inventory management tools to improve drug procurement efficiency.This will help pharmacy departments prioritize their budget expenditures to ensure adequate drug availability for patients.In order to increase operational efficiency and improve patient safety, the integration of computerized systems with the use of the latest technology is highly recommended.Research by Chen et al. (2019) shows that the implementation of an integrated computerized system can reduce the risk of errors in medication administration and speed up the verification and processing of prescriptions.Furthermore, the use of barcodes and automatic identification technology can help in more accurate drug tracking and control.This study also highlights the importance of using information systems that are connected to the overall hospital management system to improve the effectiveness and safety of pharmaceutical services.Evaluation of patient satisfaction is an important instrument in improving pharmaceutical services.Research by Williams et al. (2021) show that routine evaluation of patient satisfaction can help pharmacy departments identify specific weaknesses and needs for improvement.The results of the evaluation can be the basis for developing further training programs, infrastructure improvements, or necessary policy changes.In this study, the importance of effective communication and friendly service from pharmacy staff is also emphasized in increasing patient satisfaction.In order to improve the overall quality of pharmaceutical services, collaboration between hospital departments is also an important factor.Research by Anderson and colleagues (2022) highlights the importance of communication and collaboration between pharmacists and doctors and nurses in ensuring appropriate drug use and good treatment supervision.Through effective information exchange and participation in inter professional teams, pharmacists can make significant contributions to patient treatment planning, management of drug side effects, and monitoring of possible drug interactions.This community service activity was carried out at the Jasem Sidoarjo General Hospital on 20 May -30 June 2023.The community service activity at the Jasem Sidoarjo General Hospital was assisted by several health workers who worked at the hospital who were also involved in this community service in order to expedite these activities while improving the quality of public health.This activity begins with observing the hospital pharmacy, then collecting data related to existing patient problems, followed by analyzing the data using the Fishbone, USG To find problems, then search for solutions to these problems using SWOT analysis.By carrying out a SWOT analysis, the strategy for solving this problem is as follows.In order to improve the efficiency and quality of service in the pharmacy department, a number of important steps have been identified to be implemented.First of all, the first step is to collect data on drugs that run out quickly and those that are slow.This aims to understand patterns of drug use in hospitals and identify drugs that are often out of stock and those that are rarely used.With this information, the pharmacy department can procure drugs more precisely and efficiently.Apart from that, a return or compensation system is also needed for unused medicines, so that there is no waste and loss in managing medicine stocks.Next, it is important to create standard operating procedures (SOP) that cover all aspects of activities in the pharmacy department.This SOP must include detailed steps starting from receiving drugs, storing, distributing, to writing off expired drugs.All employees in the pharmacy department must be given access and clear understanding of this SOP.SOPs must also be distributed to every room related to drug use, including pharmacy depots.By having standardized SOPs, it is hoped that consistency and uniformity will be created in the implementation of tasks throughout the pharmacy department.Apart from that, it is necessary to update the computerized system using the latest integrated SIM-RS.SIM-RS is a Hospital Management Information System used to record and manage patient and drug data.By integrating with the latest computerized systems, the pharmacy department can synchronize drug data with patient data more effectively.This will make it easier to monitor and manage the drugs given to patients.This computerized system upgrade will also enable the use of more advanced technology, such as barcoding or RFID, to accurately monitor and track drug movement.Furthermore, training for all pharmacy department employees is a very important step.This training must be carried out gradually and continuously to increase employee competency and knowledge in drug handling, pharmaceutical administration and patient service.In addition, training must also cover ethical and safety aspects in drug use, as well as knowledge of the latest drugs.By increasing employee competency, it is hoped that there will be an increase in the quality of services provided to patients.Finally, evaluation of patient satisfaction must be carried out routinely.This evaluation can be done through a survey given to patients once a month.This survey must cover various aspects of pharmaceutical services, starting from drug availability, clarity of information, ease of process, to overall patient satisfaction.The results of this evaluation must be analyzed and used as evaluation and improvement material for the pharmacy department.By taking input from patients, pharmacy departments can continuously improve the quality of their services according to patient expectations and needs.Overall, these steps are expected to improve efficiency, quality, and patient satisfaction within pharmacy departments.With drug data collection, standardized operational procedures, an integrated computerized system, ongoing training, and routine patient satisfaction evaluations, it is hoped that the pharmacy department can provide better service, optimize drug use, and increase overall patient satisfaction.
in patients.Research by Garcia et al. (2018) also emphasized the importance of integrating computerized systems to improve coordination between the pharmacy department and other departments in the hospital.Regular training for pharmacy employees has a positive impact on improving service quality.According to research by White et al. (2019), continuous training can increase employee knowledge and skills in handling drugs, thereby increasing patient confidence and their satisfaction.Research by Johnson et al. (2022) also emphasizes the importance of ethical training in drug use and patient care which has an impact on the quality of pharmaceutical services.Routine evaluation of patient satisfaction has proven useful in improving the quality of pharmaceutical services.Research by Anderson et al. (2021) show that evaluating patient satisfaction can help identify weaknesses in services and provide valuable feedback for improvement.Patient satisfaction surveys can also be a performance evaluation tool for pharmacy departments.Research by Smith et al. (