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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.

This study was motivated by the gap between employee performance evaluations and the quality of health services at Dr. Adnaan WD Payakumbuh Regional General Hospital. Although the majority of employees received a “Good” performance rating through the e-Kinerja system and SKP, the public still complained about slow service, long lines, a lack of empathy among staff, and poor coordination between units. This study aims to analyze the implementation of performance management in relation to improvements in employee performance and the quality of healthcare services. The research method employs a descriptive qualitative approach, utilizing data collection techniques such as in-depth interviews, observations, and documentation involving hospital management, medical and non-medical staff, as well as patients. Data analysis utilizes the Miles and Huberman model through data reduction, data presentation, and drawing conclusions. The results indicate that the implementation of performance management is not yet optimal because it remains administratively oriented and has not been integrated with service quality. Issues were identified in the areas of human resources, facilities, coordination, supervision, as well as low levels of empathy and service responsiveness. The study concludes that the performance management system does not yet fully support improvements in the quality of healthcare services; therefore, an evaluation based on service outcomes and patient satisfaction is required.

Digital transformation in hospitals through the Digital Hospital concept (HIMSS EMRAM) aims to improve efficiency and reduce the potential for human error. RS Panti Abdi Dharma Cirebon has initiated the implementation of digital systems since 2015; however, several technical obstacles remain in its execution. Nurses, as the primary care providers, frequently face challenges in using electronic nursing documentation, which can negatively impact the quality of service and the continuity of patient care. This community service activity aims to enhance nurses' proficiency in using digital nursing documentation systems to support the improvement of healthcare quality and patient safety. The activity is conducted through three main steps: 1) Situational analysis and identification of technical constraints via questionnaires; 2) Technical training and coaching regarding the standardized structure of electronic nursing care documentation; 3) Evaluation of results by comparing the results/values of digital document completeness observations. Through this activity, a significant increase in nurses' knowledge and skills in operating the hospital information system is expected. It is also anticipated that there will be an improvement in the completeness of nursing care documentation, thereby minimizing medical risks and strengthening RS Panti Abdi Dharma's position towards national accreditation standards.

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.

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.

The healthcare sector is increasingly confronted with a VUCA environment (Volatility, Uncertainty, Complexity, and Ambiguity), requiring hospitals to adopt adaptive, resilient, and innovative strategies. This study aims to systematically review the evidence on smart hospital strategies in responding to uncertainty, particularly in improving service quality, operational efficiency, and patient satisfaction. A systematic literature review was conducted using major academic databases, including Scopus-indexed sources, Google Scholar, and Semantic Scholar, covering publications from 2020 to 2026. Articles were selected based on predefined inclusion criteria focusing on hospital management strategies in dynamic and uncertain environments. A total of 10–15 relevant studies were included and analyzed using thematic synthesis. The findings indicate that key strategies in addressing VUCA challenges include digital transformation (e.g., electronic medical records and telemedicine), adaptive and transformational leadership, agile management approaches, and patient-centered care. Digital technologies significantly improve efficiency and decision-making processes, while agile and adaptive leadership enhances organizational responsiveness and resilience. However, several studies highlight that technological advancement alone is insufficient without integrating humanistic values such as empathy, communication, and trust. In conclusion, the most effective hospital strategies in a VUCA world are those that integrate technological innovation with human-centered care. Hospitals must develop flexible, data-driven, and patient-oriented systems to ensure sustainability and competitiveness in uncertain environments. Future research should focus on longitudinal and experimental designs to strengthen causal evidence and explore the integration of digital systems with humanistic healthcare values.

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.

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.

Chronic liver disease is a significant health problem and places a significant burden on healthcare services. Deaths from complications of chronic liver disease (cirrhosis and cancer) account for approximately 3.5% of all deaths worldwide each year. Hepatocellular carcinoma (HCC) is a primary liver tumor, accounting for 90% of all liver tumors. Due to limitations in liver transplantation, liver resection is considered the treatment of choice for HCC patients with a single tumor and sufficient liver function reserve. Liver resection and transplantation are the only curative treatment options available for HCC patients. Surgical procedures require anesthesia. General anesthesia is the preferred method for liver tumor resection. There are five main classes of anesthetic agents: intravenous (IV) anesthetics, inhalational anesthetics, IV sedatives, synthetic opioids, and neuromuscular blocking agents. Estimated health risks depend on the extent or severity of liver disease, the nature and timing of surgery, the type of anesthesia, and other comorbidities.

Ibnu Sina Yarsi Islamic Hospital Padang Panjang plays a crucial role in providing medical services to the community. However, challenges such as inadequate facilities, limited service space, and insufficient healthcare personnel have led to long queue times and schedule mismatches, adversely affecting patient satisfaction. This study analyzes strategies to improve service quality at the hospital using a qualitative descriptive approach with data collected through observation, interviews, and documentation involving management, medical staff, and patients. Data validity was ensured by triangulation, and analysis followed the Miles and Huberman interactive model. The findings reveal that strategies focusing on human resource development programs, performance-based budget management, and consistent application of standard operating procedures (SOP) have been implemented effectively. Despite this, limitations in human resources, budget, and physical infrastructure hinder optimal results. Strengthening internal capacity and resource optimization are necessary to achieve sustainable improvements in service quality.

Depression is one of the mental health problems that often arise in patients with chronic diseases, such as diabetes mellitus, hypertension, and chronic kidney failure. This condition not only impacts the patient's quality of life, but also affects the treatment process and the burden on the family. However, mental health literacy in the community is still low, so targeted preventive and curative efforts are needed. The Community Service Program (PKM) aims to improve people's mental health through educational interventions with scientific booklet media that are easy to understand and apply. The activity method is carried out in a participatory manner, including the preparation stage, socialization, educational implementation, and evaluation. Education is provided to the community with a focus on preventing depression through a healthy lifestyle, stress management skills, and early intervention efforts by seeking professional support. Evaluation is carried out through pre-post tests, observations, and group discussions. The results of the activity showed an increase in public knowledge about depression, a change in attitudes to be more open in expressing feelings, as well as practical skills in relaxation, maintaining sleep patterns, and building social support. Participants also better understand the importance of seeking professional help when depressive symptoms are getting worse. The conclusion of this PKM is that the scientific booklet has proven to be effective as a preventive and curative educational intervention medium, and can be an innovative strategy in improving the mental health of people affected by chronic diseases.

Hidayah Boyolali General Hospital (RSU) was established by the Yayasan Dua September Boyolali and began operating since September 2, 2011 as a medical center, then officially became a hospital in May 2012 through the Decree of the Head of the Investment and Integrated Licensing Service Agency of Boyolali Regency No. 503/002/30 of 2012. As a type D private hospital, RSU Hidayah Boyolali is committed to providing professional health services that are oriented towards customer satisfaction. In the face of fierce competition between hospitals, especially in the Boyolali area, RSU Hidayah seeks to develop an effective marketing strategy to increase the number of patient visits. This Community Service activity aims to improve the knowledge and skills of the hospital development team related to marketing strategies through the Hospital Corporate Social Responsibility (CSR) approach. The solutions offered include education on CSR concepts and methods in hospital marketing, CSR implementation training, and assistance in developing strategies and user interfaces for customer data collection. The output of this activity includes the publication of the results of service in scientific journals, videos of online activities, increasing the knowledge and skills of the hospital development team, and integrating the results of the activities into the Hospital Marketing Management course. This activity is expected to be able to strengthen the ability of Hidayah Boyolali Hospital to compete and increase patient satisfaction and loyalty.

This study aims to analyze the implementation of internal control in the receivables audit process and evaluate its effectiveness in minimizing the risk of bad debts in a health center environment. Receivables, especially those originating from health services to JKN participants and general patients, can cause problematic receivables if not managed effectively. This study uses a descriptive qualitative approach with data collection through observation, interviews and documentation review during the audit by a public accounting firm. The results of the study indicate that there are still weaknesses in the internal control structure such as suboptimal separation of duties, an unintegrated receivables information system and a weak bad debt reserve policy. In addition, late payments by third parties and poor patient administration knowledge are also external factors that influence the high risk of bad debts. Therefore, improving the internal control system, implementing information technology and strengthening coordination with the guarantor are very important to reduce the risk of bad debts and increase accountability for financial management in the health center environment.