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Effective communication is essential for teamwork effectiveness in healthcare, particularly in inpatient units where patient care requires coordination among multiple professionals. Internal data from Hospital X showed that more than 50% of medical incidents in the last two years were related to miscommunication among healthcare workers. In addition, the 2024 employee satisfaction survey reported that workplace communication satisfaction was only 62%, below the hospital target of 75%. This study aimed to examine the influence of effective communication on teamwork effectiveness with interprofessional collaboration as an intervening variable at Hospital X.This study used a quantitative cross-sectional design involving 226 healthcare workers, including doctors, nurses, and medical support staff. Data were analyzed using the Three-Box Method and PLS-SEM. The findings revealed that effective communication significantly influenced teamwork effectiveness both directly and indirectly through interprofessional collaboration. Interprofessional collaboration also acted as a significant mediating variable between communication and teamwork effectiveness. These results indicate that communication is a key foundation for strengthening collaboration and improving teamwork in hospitals. Therefore, hospitals should enhance communication training and interprofessional collaboration programs to improve healthcare quality and patient safety

Hospitals play a strategic role in improving public health through professional, safe, and high-quality healthcare services. In modern healthcare organizations, service quality is not only determined by medical facilities and technology but also by the quality of human resources, particularly healthcare workers who directly interact with patients. This study aims to analyze the influence of authentic leadership on healthcare workers’ performance and hospital service quality. The study employed a quantitative explanatory research design involving 120 healthcare workers in a hospital setting. Data were collected using questionnaires and analyzed through multiple linear regression analysis. The findings demonstrate that authentic leadership has a positive and significant effect on healthcare workers’ performance, with a regression coefficient value of 0.648 and a significance level of 0.000. Furthermore, authentic leadership indirectly influences hospital service quality through healthcare workers’ performance, with an indirect effect value of 0.521. These findings indicate that leaders who demonstrate honesty, transparency, integrity, and interpersonal support are able to create a healthy work environment that enhances healthcare workers’ motivation, responsibility, and professionalism. Consequently, improved employee performance contributes to better hospital service quality, particularly in responsiveness, empathy, and communication with patients. This study highlights that authentic leadership is an effective leadership approach for strengthening healthcare human resources and improving hospital service quality in contemporary healthcare organizations.

The premium healthcare industry in urban areas is experiencing increasing competition along with the increase in healthcare facilities and the increasing public demand for fast, comfortable, and quality medical services. In this context, Columbia Asia Pulomas Hospital is implementing an expansion strategy by increasing facility capacity, modernizing services, and adding a Center of Excellence (COE) as a service differentiation. This study aims to analyze customer retention strategies within the Balanced Scorecard (BSC) framework, focusing on the relationship between customer perspectives, internal processes, learning and growth, and their application to the financial perspective. The research method uses a document-based policy and strategy analysis approach, field findings, and a synthesis of Balanced Scorecard theory and patient experience.The analysis shows that customer retention during the expansion phase is influenced not only by clinical quality, but also by the assurance of doctor time in practice, speed of service, physical comfort, and digitization of queues and administration. The addition of a COE has been shown to increase the perception of service value and expand market share through service specialist differentiation. Within the BSC framework, the customer perspective serves as a leading indicator for achieving the financial perspective, where increased patient retention contributes to increased revenue, ROI growth, and long-term financial expectations. The research implications emphasize that strategies for strengthening human resources, modernizing internal processes, and service innovation are important foundations in ensuring successful hospital expansion and enhancing competitive advantage.

Prolonged outpatient waiting time remains a major challenge in public hospitals and reflects inefficiencies in service process management. Internal medicine clinics are characterised by high service complexity and patient volume, making them particularly vulnerable to process waste that contributes to extended waiting times. Objective: This study aimed to develop an outpatient service flow model based on the Lean Hospital approach to reduce waiting time in the internal medicine clinic of RSUD Balaraja. Methods: A qualitative case study design was employed. Data were collected through direct observation of outpatient service processes, document review, and Focus Group Discussions (FGD) with relevant stakeholders. Process analysis was conducted using Value Stream Mapping (VSM) to identify value-added and non–value-added activities, while Fishbone Diagram analysis was applied to explore the root causes of process inefficiencies. All findings were integrated to develop a future-state outpatient service flow model. Results: The findings indicate that prolonged outpatient waiting time is primarily influenced by inefficient service flow design, repetitive administrative processes, and weak coordination among service units. The proposed service flow model demonstrates a more streamlined, integrated, and patient-centred process, with potential reductions in waiting time through systematic waste elimination and process improvement. Conclusion: The Lean Hospital approach provides an effective framework for developing outpatient service flow models in public hospitals. The proposed model offers a practical basis for improving outpatient service efficiency in complex clinical settings such as internal medicine clinics.

Chronic Kidney Disease (CKD) is a growing global health concern that significantly affects patients’ quality of life. At Bhakti Asih General Hospital, Tangerang, the number of hemodialysis patients increased by 20.42% and dialysis procedures by 25.06% between 2023 and 2024. Despite this service expansion, preliminary findings revealed that 32% of patients reported poor quality of life, 31% experienced low engagement in care, 34% demonstrated low self-efficacy particularly in dietary and fluid management and 32% faced accessibility barriers. These findings indicate a gap between increased service volume and patient-centered outcomes. This study aimed to analyze the effects of patient engagement and self-efficacy on the quality of life of hemodialysis patients, with healthcare accessibility as a mediating variable. A quantitative cross-sectional design was employed. Active hemodialysis patients were selected using purposive sampling. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling (SEM).The results demonstrated that patient engagement and self-efficacy had significant positive effects on quality of life, both directly and indirectly through accessibility. Accessibility also significantly influenced quality of life and strengthened the relationships between patient engagement, self-efficacy, and quality of life.These findings highlight the importance of integrating patient engagement strategies, strengthening self-efficacy through education, and improving service accessibility to enhance quality of life among hemodialysis patients

This study aims to analyze the marketing strategies of maternal and child healthcare services in hospitals to enhance patient experience, emphasizing a shift from traditional promotional approaches toward the creation of a positive and empathetic patient experience. This research employs a systematic literature review of relevant studies published between 2021 and 2025, with analysis conducted through identification, selection, and thematic synthesis to determine key factors influencing patient satisfaction and loyalty. The findings indicate that the quality of interpersonal interactions and the efficiency of service processes are the primary determinants of patient experience, where factors such as staff empathy, clear communication, reduced waiting times, and well-structured service flows have a greater impact than the technical aspects of medical care. Hospitals should therefore prioritize people- and process-oriented strategies by implementing empathy training, enhancing communication effectiveness, and regularly measuring patient satisfaction, while also integrating digital services, ensuring cost transparency, and developing continuity of care programs to strengthen the patient experience holistically. This study proposes a holistic marketing framework that integrates empathy, efficiency, data-driven personalization, and environmental sustainability, highlighting a shift from a purely clinical orientation to an experiential marketing approach that places human values at the core of a hospital’s competitive advantage.

In response to the evolving landscape of public healthcare services, hospitals are expected not only to maintain operational efficiency but also to adapt to the shifting needs and expectations of patients as healthcare consumers. The presence of non-BPJS patients in regional public hospitals plays a strategic role not only contributing to revenue diversification but also reflecting service quality, institutional competitiveness, and shaping public perception. The declining trend in outpatient visits by general patients at RSUD Balaraja over the past three years highlights the need to understand the factors influencing consumer behavior in determining revisit intentions. This study examines the effect of co-creation and hospital image on the revisit intention of outpatient general patients at RSUD Balaraja, with patient experience as a mediating variable. The research employed a quantitative explanatory design involving 278 outpatient general patients selected through purposive sampling. Data were collected via structured questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results indicate that patient experience plays a significant mediating role in shaping revisit intention among general outpatients at RSUD Balaraja. These findings confirm that patient experience serves as a central factor in post-service evaluation processes, which ultimately drive patients’ intention to return. Therefore, hospitals need to enhance patient involvement in service processes (co-creation), improve public perception of institutional image (hospital image), and develop patient-centered service systems as a key strategy to increase revisit intention among general outpatients.

This study examines the impact of personality and work engagement on Organizational Citizenship Behavior (OCB), with work motivation serving as a mediating variable, among inpatient nurses at South Jakarta Type B Hospital. OCB is crucial for enhancing organizational performance and service quality, especially in healthcare settings, where nurses' extra-role behaviors significantly contribute to patient care. The research utilized a quantitative approach with a survey design, involving 143 nurses from infection and critical inpatient wards. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results indicate that personality positively influences both work motivation and OCB. Work engagement also positively impacts work motivation and OCB. Additionally, work motivation significantly affects OCB and partially mediates the relationship between personality, work engagement, and OCB. These findings suggest that fostering nurses' work engagement and motivation, supported by positive personality traits, can enhance OCB, leading to better organizational performance and improved healthcare service quality.

The implementation of Electronic Medical Records (EMR) has become an important element in improving healthcare service quality, efficiency, and patient safety in hospitals. However, the benefits of EMR depend not only on system availability but also on the quality of the information provided and how actively the system is used by healthcare professionals. This study aims to analyze the influence of electronic medical record content and perceived ease of use on the net benefits of EMR, with actual system use acting as an intervening variable. The research applied a quantitative approach with a cross-sectional design conducted at RSM Hospital. The population consisted of all general practitioners and specialist doctors working at the hospital, totaling 51 respondents, and the study used a total sampling technique. Data were collected through structured questionnaires measured using a Likert scale and analyzed using the Structural Equation Modeling–Partial Least Squares (SEM-PLS) method. The results show that EMR content and perceived ease of use significantly influence the net benefits of EMR. Both variables also significantly affect the actual use of the system, while actual use significantly influences the benefits obtained. Furthermore, actual use mediates the relationship between EMR content, ease of use, and net benefits, indicating that better information quality and usability can encourage greater system utilization and maximize the advantages of EMR implementation.

Prescription waiting time is a key indicator of pharmacy service quality that directly influences patient satisfaction and hospital efficiency. Data from the Outpatient Pharmacy Installation of Pelabuhan Jakarta Hospital show average waiting times of 30.49 minutes for non-compounded medications and 35.93 minutes for compounded medications. Although these figures are still within national standards, they have not met the hospital’s internal targets, indicating inefficiencies that require systematic improvement.This study aimed to analyze prescription waiting times and identify waste in outpatient pharmacy services using Lean Hospital and Continuous Improvement approaches. A qualitative analytical method with a case study design was applied. Data collection involved participatory observation, in-depth interviews with key informants (head of pharmacy, pharmacists, and technicians), and document review. Analysis utilized Lean tools such as Value Stream Mapping (VSM), identification of Value Added (VA) and Non-Value Added (NVA) activities, bottleneck analysis, fishbone diagram, and Failure Mode and Effects Analysis (FMEA).The findings revealed that service processes were dominated by non-value-added activities, especially during prescription receipt, verification, packaging, and dispensing. Major wastes included waiting, motion, and overprocessing. Contributing factors were uneven staff distribution, suboptimal e-prescribing systems, incomplete prescriptions, and lack of standardized procedures. The proposed future state VSM demonstrated potential improvements in reducing waiting time and enhancing service efficiency.

Patient loyalty is an important indicator of success in healthcare services because it reflects patients’ tendency to reuse healthcare services and recommend them to others. Patient loyalty in healthcare facilities is influenced by various factors, including doctor availability, cost bearer systems, and patient experience during the service process. This study aims to analyze the effect of doctor availability and cost bearer on patient loyalty with patient experience as a mediating variable among patients at the Dental Clinic of Hermina Galaxy Hospital.This research used a quantitative approach with a survey design. Data were collected through questionnaires using a Likert scale from 150 patients at the Dental Clinic of Hermina Galaxy Hospital selected through purposive sampling. Data analysis was conducted using Structural Equation Modeling (SEM) with the assistance of AMOS software to examine both direct and indirect relationships among the research variables.The results showed that doctor availability and cost bearer have a positive and significant effect on patient experience. Patient experience was also found to have a positive and significant effect on patient loyalty. In addition, doctor availability and cost bearer have a direct influence on patient loyalty and an indirect influence through patient experience as a mediating variable.In conclusion, improving patient loyalty can be achieved by enhancing doctor availability, managing financing systems effectively, and creating positive patient experiences. Hospital management should optimize these factors to improve service quality and maintain patient loyalty

The development of Digital Marketing and Electronic Word of Mouth (eWOM) has encouraged hospitals to adopt digital communication strategies to attract patients’ visit intentions. However, in public hospitals, the effectiveness of these strategies in influencing patient behavior still requires empirical validation. This study aims to analyze the influence of Digital Marketing and eWOM on patient visit intention, with Brand Awareness as an intervening variable at RSUD Cengkareng.This research employed a quantitative approach with an explanatory design. Data were collected from November to December 2025 from 100 general outpatient respondents selected using the Slovin formula and a simple random sampling technique. The data were gathered through structured questionnaires and analyzed using Structural Equation Modeling (SEM) with AMOS software.The results show that Digital Marketing and eWOM have a positive and significant effect on Brand Awareness. Both variables also significantly influence patient visit intention, with eWOM demonstrating the strongest effect. These findings indicate that information shared through digital platforms and patient recommendations plays an important role in shaping potential patients’ decisions to visit the hospital. However, Brand Awareness does not have a significant effect on patient visit intention and does not mediate the relationship between Digital Marketing, eWOM, and visit intention. This suggests that, in the context of RSUD Cengkareng as a public hospital, patients’ visit decisions are more directly influenced by digital information exposure and the credibility of online recommendations rather than by brand recognition alone.

This study aims to analyze the effects of work motivation and career development on nurses’ performance through job satisfaction among nurses at Pertamina Balikpapan Hospital. Nurses’ performance is a key determinant of service quality and patient safety because nurses interact most intensively with patients and ensure continuity of nursing care. However, prior studies on the relationships among motivation, career development, job satisfaction, and performance have reported mixed findings. Therefore, further examination is needed by incorporating job satisfaction as a mediating variable to explain the mechanism of influence more comprehensively. This research employed an explanatory design with a quantitative approach. Primary data were collected using a Likert-scale questionnaire distributed to 165 permanent nurses selected through purposive sampling from a population of 292 nurses. Data were analyzed using variance-based SEM with SmartPLS 4, including outer model evaluation (convergent and discriminant validity) and construct reliability, as well as inner model assessment through the coefficient of determination, effect size, and hypothesis testing using bootstrapping. The results indicate that work motivation has a positive and significant effect on job satisfaction, and career development also has a positive and significant effect on job satisfaction. Job satisfaction has a positive and significant effect on nurses’ performance. In addition, work motivation and career development have positive and significant direct effects on nurses’ performance. Indirect effect testing confirms that job satisfaction mediates the relationship between work motivation and nurses’ performance and also mediates the relationship between career development and nurses’ performance. These findings emphasize that hospitals should strengthen strategies to enhance motivation and career development in a targeted manner while ensuring key sources of job satisfaction so that nurses’ performance improves sustainably.

The purpose of this study was to analyze the significance of the influence of work motivation, workload and work discipline on the performance of inpatient room nurses at Karanganyar Regency Hospital. This research is a quantitative study at Karanganyar Regency Hospital with a population of 239 inpatient room nurses. The sample was 71 people with proportional cluster random sampling technique. Data collection techniques using questionnaires and observation. Data analysis techniques using multiple linear regression analysis, t test, F test, and coefficient of determination (R2) test. The t test results show that work motivation, workload, work discipline have a significant partial effect on the performance of inpatient room nurses at Karanganyar Regency Hospital. The results of the F test obtained the right model in predicting the effect of work motivation (X1), workload (X2) and work discipline (X3) on nurse performance (Y) in the hospital room of Karanganyar Regency Hospital.  Based on the results of the study, it is hoped that the Director will provide opportunities for nurses to participate in education and training and provide rewards proportional to workload, namely medical services according to the number of patients served.

Economic and demographic developments in the past few decades have increased the pressure on efficiency in the healthcare industry. Modern management accounting and cost accounting techniques are a critical component in improving the efficiency and quality of care in urology. With the ever-increasing costs of healthcare, the need for a sophisticated accounting system that can provide accurate data on costs and revenues is more important than ever. The aim of this research was to investigate the role of modern techniques in management accounting and cost accounting as a means of enhancing cost efficiency and quality of care in urology. The research highlights the importance of training medical staff in these techniques, as this can improve overall performance and reduce costs without compromising the quality of care provided to patients. These techniques have been shown to help physicians and administrators make informed decisions, which helps improve the efficiency and quality of care. They also contribute to improving communication between medical teams, enabling better patient care. By focusing on improving resource and cost management, these techniques can play a pivotal role in achieving superior and effective health outcomes.

Dental and oral health is a vital aspect of overall health that supports functions such as digestion, speech, chewing, and enhancing an individual's self-esteem and quality of life. Currently, the rate of follow-up visits by elementary school students in the Lawanggintung Health Center area remains low, leading to unmet indicators for dental services. The main issue is that students do not adhere to their scheduled dental care appointments and are permitted to seek treatment at other healthcare facilities. This study aims to analyze the role of the health center in addressing dental health issues among children in schools and to investigate the efforts made by the health center for elementary school students who have not received dental treatment. The research method employed is qualitative with a descriptive approach, utilizing interviews, observations, and documentation. The findings indicate that the health center's role in managing children's dental health issues at schools is reasonably effective through promotive, preventive, and curative efforts. The initiatives for elementary school students who have not received dental treatment mainly include referrals, providing feedback to parents and school authorities, as well as health education.    

Nowadays, the utilization of a Web-based Hospital Management Information System has been implemented in Raja Ahmad Tabib Hospital of Pulau Riau Province, which not only has an impact on patient services but can also have an impact on the effectiveness of employee work in serving patients in the hospital, in order of study aims to determine the effectiveness of work through Web-based HMIS (SIMRS) by determining the Quality of Information, Organizational Culture and Digital Competence. This study will conduct data analysis through SEM-PLS (Structural Equation Modeling-Partial Least Square) software, which the test conducted by the researcher uses path analysis to test the pattern of relationships that can reveal the influence of variables or a set of variables on other variables, both direct and indirect influences. Based on the results of the research that has been conducted, the researcher found that there is a positive influence between Organizational Culture both on HMIS and on work effectiveness and organizational culture has a significant determination of work effectiveness through the utilization of Web-based HMIS. On the other hand, the quality of information and digital competence are not significant to Web-Based HMIS, although both are significant to work effectiveness. However, the determination of information quality and digital competence does not have an indirect relationship to work effectiveness through Web-based HMIS.    

This study examines the impact of information systems, facilities, and competence on inpatient satisfaction with service quality as an intervening variable at Raja Ahmad Thabib Hospital, Riau Islands Province. The sample for this study consists of 100 individuals who either received healthcare services or are family members of patients. The research method employed is an associative method with a quantitative approach, utilizing Partial Least Square (PLS) analysis techniques through the SmartPLS Version 4.0 program. The results of the study indicate that the information system has a positive and significant effect on the satisfaction variable, facilities have a positive and significant effect on the satisfaction variable, competence does not significantly affect the satisfaction variable, service quality significantly affects the satisfaction variable, competence does not significantly affect the service quality variable, the information system has a positive and significant effect on the service quality variable, facilities have a positive and significant effect on the service quality variable, the information system positively and significantly affects the satisfaction variable with service quality as an intervening variable, facilities positively and significantly affect the satisfaction variable with service quality as an intervening variable, and competence does not significantly affect the satisfaction variable with service quality as an intervening variable at Raja Ahmad Thabib Hospital, Riau Islands Province.

This study aims to examine: about the function of Human Resource Management (HRM) in a company in increasing customer satisfaction, especially for patients at Sultan Agung Islamic Hospital Banjarbaru. The research design is a qualitative research which is a type of field survey research and a type of research whose findings are not obtained through statistical procedures or other forms of calculation. The results showed that human resource management is very influential on the satisfaction of visitors or patients at the Islamic Hospital Sultan Agung Banjarbaru, the results of the study obtained from several dimensions, namely: reliability, responsiveness, assurance, empathy, physical appearance. And from these results indicate that the informants are not satisfied with the dimensions of reliability, responsiveness, empathy and physical appearance due to queuing problems, health workers do not provide good explanations and understanding, doctors pay less attention when providing services. Meanwhile, informants who are satisfied only with the guarantee variable because the service they get is very good and the doctor is able to assure the patient's recovery, provides a sense of security, is friendly, polite and gentle.      

The problems faced in this study include (1) How does the quality of nurse services affect patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital? (2) How do paramedic facilities affect patient satisfaction in the Inpatient Room of the Regional Public Service Agency of Banjar City General Hospital? (3) How does the quality of nurse services and paramedic facilities affect patient satisfaction in the Inpatient Room of the Regional Public Service Agency of Banjar City General Hospital? This study aims to study, know, and analyze (1) The effect of nurse service quality on patient satisfaction in the Inpatient Room of the Regional Public Service Agency of Banjar City General Hospital. (2) The effect of paramedic facilities on patient satisfaction in the Inpatient Room of the Regional Public Service Agency of Banjar City General Hospital. (3) The effect of the quality of nurse services and paramedic facilities on patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital.The method used in this study is an explanatory survey, while the data analysis techniques, namely validity tests, reliability tests, descriptive statistics, Inferential Statistical Analysis with Multiple Regression. The results of the study inform that (1) The quality of nurse services has a positive effect on patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital. This means that if the quality of service is improved, then patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital will also increase. (2) Paramedic facilities have a positive effect on patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital. This means that if paramedic facilities are improved, patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital will also increase. (3) The quality of nurse services and paramedic facilities has a positive effect on patient satisfaction in the Inpatient Room of the Regional Public Service Agency of Banjar City General Hospital. This means that if the quality of nurse services and paramedic facilities is improved, patient satisfaction in the Inpatient Room of the Regional Public Service Agency of the Banjar City General Hospital will also increase.