Analysis Performance of Hospital Based Criteria Malcolm Baldrige in RSUD Dr. Iskak Tulungagung Post-Determination of Accreditation Level Plenary

Criteria Malcolm Baldrige has a focus on superior performance for the entire organization in a managerial framework that is comprehensive, identify and track all the results of the organization that is the customer, product or service, finance, human resources and organizational effectiveness. The research objective is to analyze the performance of RSUD Dr. Iskak Tulungagung based on criteria Malcolm Baldrige post determination plenary level accreditation. The study design used in the study was cross-sectional. The population is all in addition to the Board of Directors Structural RSUD Dr. Iskak Tulungagung. The sample size was 44 respondents using technique. proportionate stratified random sampling Independent research variables are Leadership, Strategic Planning, Customer Focus or Patient, Measurement, Analysis and Knowledge Management, focus on human resources, focus on the process and results. Data was collected using a questionnaire, then the data were analyzed. The results showed that the majority of respondents have good leadership category as many as 40 respondents (90.9%), the Strategic Planning Category well as much as 42 respondents (95.5%), Customer Focus category patient good or as many as 41 respondents (93.2 %), Category Measurement, Analysis and Knowledge Management was good as much as 40 respondents (90.9%), Category Focus On Human Resource good as much as 34 respondents (77.3%), Category Focus On good process as many as 40 respondents ( 90.9%), research found criteria organizational criteria based on organizations the Baldrige assessment with 887.4 points as a Word Leader. Conclusion of the study was hospital has a good performance and criteria for the organization based on the Baldrige assessment as Word Leader.  


INTRODUCTION
Hospital accreditation is one of the models of the external evaluation method quality of health care. The first hospital accreditation by the American College of Surgeons (ACS) in 1918, from 692 hospitals in the United States that are accredited only 89 who meet the standards. ACS then do accredit hospitals around the world to establish a Joint Commission International (JCI). At the world level formed The International Society for Quality in Health Care (ISQua) which aims to boost the quality and safety of health services (KARS, 2012).
Hospital Indonesia accredited Joint Commission International (JCI) in the first half of 2017 as many as 25 hospitals. While hospitals accredited hospital KARS as many as 1,377 of the 2,175 hospitals. In East Java hospitals that have been accredited as many as 179 of the 392 hospitals. Hospital Dr. Isaac was the only government-owned hospitals Tulungagung type B education accredited plenary (KARS, 2012).
Accreditation is a public recognition through a national body accredits hospitals on hospital achievement in meeting accreditation standards, an assessment expert verified through peer(peer)external independent (KARS, 2012).
Based on observations on service activities RSUD Dr. Iskak Tulungagung still found the service by officers who have the appropriate Standard Operating Procedures (SOPs) which resulted in the complaints of the patient. The report results Minimum Service Standards (SPM) also cannot be achieved 100% on all service indicators, whereas the Minimum Service Standards (SPM) is the quality of basic services are entitled to be accepted by patients. 2016 achievement of MSS (MSS) amounted to 74.77%, only 67 indicators were achieved of 90 indicators.
Increasing number of private hospitals that have sprung up in Tulungagung accredited KARS as well as increasing public awareness of quality health services, education level, rapid technological development, the Regional General Hospital Dr. Isaac Tulungagung required to always provide excellent service. As a local government hospital in order to compete with private hospitals, the Regional General Hospital Dr. Isaac Tulungagung optimally utilize market opportunities according to their ability to continue to implement a social function in order to remain the most preferred hospital in Tulungagung society.
According to Djoko Wijono (2009), one of the most appropriate strategies in anticipation of an increasingly open competition is through improving the quality of hospital health care through an integrated quality system(Total QualityManageme nt).Model external evaluation methods other health service quality, among others,the International Organization for Standardization (ISO), Malcolm Baldrige and European Foundation for Quality Management (EFQM) (KARS, 2012).
According Gazpers & Fontana (2013), Criteria Malcolm Baldrige can assess the effectiveness of the quality system is applied to an organization with the approach of the 7 criteria, namely Leadership(leadership), Strategic Planning(strategic planning),Customer Focus(customer focus),Measurement, Analysis and Knowledge management(measurement, analysis, and knowledge management),Focus on Human Resources(workforce focus),Focus on process(focus operation), Results(result).
Criteria Malcolm Baldrige have a focus on superior performance for the entire organization in a thorough managerial framework, identify and track all the results of the organization that is the customer, product or service, finance, human resources and organizational effectiveness. Quality measurement using Criteria Malcolm Baldrige benefit because it enables the organization conducts Self Assessments(self-assessment).Independent measurement based on the Baldrige Criteria can be performed on various types of good organization of business, nonprofit, education and health (Gazpers & Fontana, 2013).
According Gazpers and Fontana (2013), the reason for local organizations as well as world-class chose Criteria Malcolm Baldrige as a framework in their management systems, among others, were able to identify strengths and opportunities for improvement, management framework integrated include all the factors that are clear and measurable, focusing the performance requirements to achieve performance excellence is not just application procedures / tools / techniques, easy to adapt to the business environment, can be 10 applied to organizations large and small, local organizations as well as world-class, and has proven to be a management practices globally valid for improve organizational performance excellence.

METHOD
The research design used in the study was cross-sectional. The population is all in addition to the Board of Directors structural RSUD Dr. Iskak Tulungagung. The sample size was 44 respondents using technique. proportionate stratified random sampling Independent research variables are Leadership, Strategic Planning, Customer Focus or Patient, Measurement, Analysis and Knowledge Management, Focus on human resources, focus on the process and results. Data was collected using a questionnaire, then the data were analyzed.

RESULTS
The results obtained data characteristics of respondents and frequency distribution shown in the table below: The characteristics of the 44 respondents in this study is 11, 36% is the third echelon level, as much as 31.82% is the fourth echelon and as much as 56.82% is the head of the installation or responsible for the technical service. the results showed that the majority (68.18%) of respondents have a service life of> 10 years and as many as 14 (31.82 %) of respondents have a service life <10 years of the 3 (6.82%) votes echelon level 4 and the head of the installation of 11 (25%) of people. Based on the survey results revealed that most respondents have S1 as many as 25 respondents (56.82%) and at least have a high school education as one of the respondents (2.27%) which is the head office level installation. Based on the survey results revealed that most respondents have a lifespan of 36-45 years as many as 21 respondents (47.73%), and at least have aged> 55 years by two respondents (4, 55%) at the level echelon 4. The survey results revealed that the majority of respondents are male as much as 25 respondents (56.82%), and a manifold female sex as much as 19 respondents (43.18%).
12 The results show the number of points of criteria 1-6 amounted to 512.21 that are in the band score is 481-550, the band number 8, which means the Hospital Dr. Isaac Tulungagung showed remarkable approach(outstanding)focuses on innovation. Approaches deployed fullyand demonstrated superior and sustained use of size. There is a superior integration between approaches to organizational needs. Analysis, learning through innovation, and sharing(sharing)on organizational best practicesare widespread.

DISCUSSION
Based on the results, the performance criteria that the majority of respondents have a good category (> 76%) namely Leadership (92.5%), strategic planning (96.3%), Customer Focus / patients (96%), Measurement Analysis and Knowledge Management (93.3), Focus on Human Resources (87.1%), Focus On process (94.7%). The achievement of the highest performance achieved by strategic planning with the result points approaching the maximum points is 81.9 points. While the lowest points earned gains of the focus on human resources with results of 73.6 points which have maximum points is 85.
The scoring system Malcolm Baldrige Criteria include the dimensions of the process. The term "process" refers to the method used by organizations to the requirements of item categories 1-6. Four factors in evaluating the process is ADLI, an acronym for: Approach (approach), Deployment (Deployment), Learning (Learning), and Integration (Integration) (Sadikin, 2009). Approach is the method used to enhance or improve the process, the accuracy of these methods to the needs or requirement items Criteria, Malcolm Baldrige effectiveness of the method used, the degree or the degree to which such an approach can be repeated and is based on data and information. Deployment is the approach adopted in meeting the requirements of items Malcolm Baldrige Criteria that are relevant and important to the organization or also referred to the approach applied consistently, approach used by all appropriate work units. Learning is an improvement approach through a cycle of evaluation and improvement, support groundbreaking changes to the approach through innovation, and sharing of (sharing) improvements and innovations with other relevant work units and processes within the organization. Integration is an approach that is aligned or integrated with organizational needs identified in the organization's profile or items Criteria. Malcolm Baldrige other Measurement systems, information and complementary enhancement throughout the process and work units. Plans, processes, results, analyzes, lessons learned, and actions to be harmonized throughout the processes and work units to support the scope of the organization's goals (Gazpers & Fontana, 2013).
Dimensions Results are shown by the results showed that the level of performance(performance level)indicates the place or position in the organization's performance results from the measurement scale meaningfully with good value> 76%. Level of performance allows the evaluation of the comparison of past performance, projections, objectives, and appropriate comparison. The hospital has a tendency(trend)the achievement of a good performance with the performance of the organization or the sustainability of good performance. Human resources performance compared to other hospitals may even be better comparable.