GAMBARAN PENGELOLAAN DOKUMEN REKAM MEDIS DI PUSKESMAS X
DOI:
https://doi.org/10.32585/jmiak.v3i01.703Abstract
Penyelenggaraan rekam medis untuk mencapai tertib administrasi dan pelayanan kesehatan di rumah sakit maupun puskesmas. Penyelenggaraan rekam medis sangat dibutuhkan sebagai salah satu sarana pelayanan kesehatan. Penelitian ini dilakukan dengan menggunakan studi deskriptif. Tujuan dari penelitian deskriptif menggambarkan sistem pengelolaan dokumen rekam medis puskesmas. Hasil penelitian 1) Sistem penamaan menggunakan identitas asli pasien berupa KTP. 2) Sistem penomoran menggunakan satu nomor untuk pemeriksaan seterusnya. 3) Penjajaran dokumen rekam medis diurutkan berdasarkan kode wilayah pada masing-masing sub rak, dimana dokumen dijajarkan dari angka kecil ke besar. 4) Sistem penyimpanan secara sentralisasi. 5) Retensi dokumen dilakukan secara kondisional. 6) Sistem Pelaporan bersumber dari SP3. 7) Sistem Pengelolaan Dokumen Rekam Medis : assembling, coding, indexing, analysing and reporting, filing.
Kata kunci : puskesmas, dokumen, rekam medis
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References
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