Aplikasi Manajemen Perubahan - KMPK

AplikasiManajemen PerubahanAndreasta Melialaandremeliala@fetp.org1Health System Performance FrameworkSystem FunctionsSystem ObjectivesStewardship(oversight)Responsiveness(to people’snon-medical expectations)CreatingResources(investment & training)DeliveringServices(provision)HealthFinancing(collecting, pooling,and purchasing)Fair financialcontribution21

StateGovernment:Political undertaking/institutional SkillsFinancingPolicies,ResourcesProgramsPersonnel PoolEducationAllocationManagementServicesHealth ResultsFinancialProtectionUserSatisfactionDemand and MarketsPopulation3Analisis SituasiPusat/DepKesOtonomi daerahDinas Kesehatan PropinsiDinas Kesehatan Kabupaten/Kota42

Analisis Situasi (2)PusatOtonomi daerahDinas Kesehatan PropinsiDinas Kesehatan Kabupaten/Kota5Assessment of Health System PerformanceINPUTS:Financial ResourcesHuman ResourcesCapital StocksConsumablesInformation/knowledgeFUNCTIONS:FinancingStewardshipService ProvisionResource GenerationGOALS:Average level of healthHealth inequalityResponsivenessFair Financial ContributionsINTERMEDIATE GOALSEffective Coverage63

Recent Driver• PP 38/2007• PP 41/2007• KepMenKes 267/20087Dasar Perubahan• Alasan:– RegulasiPemerintah– Kebutuhanorganisasi– Doronganmasyarakat• Adaptasi:Top-down---LambatInternal -----ModeratEksternal ---Cepat84

KERANGKA PIKIR KINERJA ORGANISASIPerancangan SistemKomitmen danKepemimpinanPerencanaanStrategisManajemenOperasionalPengembanganSDMPeningkatanKinerjadalamrerangkaBalancedScorecardVisi &MisiPerancanganSistem KeuanganRekomendasiPerencanaanfisik RS(Diambil dariBernard J Horak,Strategic Planning9inHealth care,1999)Peran Manager“ Ability to identify the right things to do inthe future (the right products and services tooffer, the appropriate technologies to exploit,the best procedures and structures to introduce,to find, recruit and retain people withappropriate skills)”105

Mengapa Ada Perubahan• Teori Supresi Eksternal:– Tekanan pasar/ekonomi• Kompetisi• efisiensi– Tekanan peraturan– Tekanan politik– Tekanan teknologi– Ketersediaan SDM– Munculnya kasus baruPublicDemand11Mengapa Ada Perubahan (2)• Teori Intensi Internal:– Visi dan misi baru•Top down• Bottom up– Peningkatan kemampuan SDM– Tersedianya peralatan dan metode baru– Keterbatasan sumber dayaMengapa Ada Perubahan (3)• Kombinasi– Teori Supresi Eksternal:– Teori Intensi Internal126

Rule• Semakin sensitif organisasi terhadaptuntutan lingkungannya (eksternal daninternal) maka akan semakin seringperubahan dilakukan• Semakin banyak perubahan makasemakin banyak pembelajaran13Strategic Change• STRATEGIC CHANGE dapat didefinisikansebagai:– The pro-active management of change inorganizations to achieve clearly identifiedstrategic objectives– Strategic change dapat dilakukan denganmenggunakan pendekatan:• Prescriptive approach• Emergent approach147

Mekanisme:Prescriptive approach dan Emergent Approach• Prescriptive approach– Melibatkan tindakan yang terencana yangdiperlukan untuk mencapai suatu perubahan.Perubahan seyogyanya dipicu agar terjadidalam suatu organisasi– Freeze Thaw (Lewin K., 1952)• UNFREEZE current attitudes• CHANGE, move to new level• REFREEZE attitudes15DiagramRestraining forcesDesireStateRefreezingMovementStatusQuoUnfreezingDriving forcesTime168

CoherenceEnvironmentalAssessmentLeadingChangeHuman ResourceAs assets andLiabilitiesLinking StrategicAnd OperationalChange17Bagaimana KesiapanOrganisasi Kita?189