CHANGE MANAGEMENT IN GOVERNMENT AGENCY:

CASE STUDY OF THE IMPLEMENTATION OF PPK-BLUD POLICY

IN NTB PROVINCIAL MENTAL HOSPITAL

Julastri Rondonuwu1, Laksono Trisnantoro2

1 Mental Hospital of West Nusa Tenggara Province

2 Public Health Science Program, Faculty of Medicine,
University of Gadjah Mada, Yogyakarta.

ABSTRACT
Background: NTB Mental Hospital as the only major referral
center for mental health services in NTB was required to serve
the community, to develop and be self-sufficient, while at the
same time must be able to compete in providing quality and
affordable services to the community. In order to fulfill these
demands, since January 29, 2011 NTB Mental Hospital has
received full endorsement as a Mental Hospital with Financial
Management Patterns of Local Public Service Agency (PPKBLUD).
Therefore, indepth review of the implementation of
PPK-BLUD policy in NTB Provincial Mental Hospital (RSJP) is
required.
Objectives: To explore the transformation process and
implementation of PPK-BLUD policy in RSJP.
Methods: The design of this study is a qualitative research
case study to describe the dynamics of the change process
and implementation of PPK-BLUD policy in RSJP.
Results and Discussion: The phase of transformation
process was not running as expected. The implementation of
PPK-BLUD policy is not optimal because some flexibility as a
hospital privileges with BLUD financial pattern have not been
implemented yet. The f inance manager was hesitant to
implement the flexible financial management and still following
the local government financial management mechanisms. For
external stakeholders, the implementation of PPK-BLUD policy
implementation in RSJP did not harm local fiscal policy because
the revenue of RSJP was still counted as revenue for local
government, as opposed to independent PPK-BLUD. A survey
was conducted, consisting of community satisfaction towards
the services in RSJP, data of revenue and budgetting
management and distribution of fee services to employees in
RSJP. The survey result described that the implementation of
PPK-BLUD policy in RSJP gives positive impacts on financial,
services and benefits performances to RSJP. The positive
impacts were an increase in the number of income, increased
of service indicators measurement and increased incentive to
all employees.
Conclusion: Management changes in the transformation
process were not running optimal so that the PPK-BLUD policy
in RSJP is not fully implemented, although there were some
perceived positive results.
Keywords: Local Public Service Agency, policy, change

management.
INTRODUCTION
Hospitals as one of the service institutions
Public plays an important role for
Improvement of public health status. Home
Sick is required to serve the community, can
Developing and independent and must be able to compete
And provide a quality service and
Affordable for the community. The problems are
Emerged like a limited operational budget
Which is available, the bureaucracy is too deep
The process of disbursement of funds, the rules of financial management
Which inhibits the smooth service, the lack of
Support Human Resources (HR),
Need technology and capital very
Big1.
The form of public service is a form that
Most appropriate for public hospitals. Agency Services
General (BLU) is a government quasi body
Which is not aimed at making a profit, improving
Quality of public services, and providing autonomy
Or the flexibility of public hospital management, either
Owned by the central government as well as local governments2.
Fulfillment of the demand for quality of service
Quality then since 2008 Hospital
The soul of the Province of West Nusa Tenggara (NTB) seeks
To get approval as a service institution
Public with a Public Service Agency status
Regional (BLUD). A hospital change becomes
A public service agency is a form
Reforms mandated directly in the Law
Act no. 44/2010. Based on the Decree
Governor of West Nusa Tenggara 56/2011
Provincial Mental Hospital is designated as an Agency
Regional Public Service with full status since
January 29, 2011.
Since the status setting, various attempts have been made
By the BLUD Team of NTB Province Mental Hospital
For the Mental Hospital (RSJ) NTB Province can
Immediately operate according to the KDP-BLUD mechanism.
Implement On the Job Training to RSU
Moewardi Solo and to Surakarta Mental Hospital
And proposes a draft of technical guidelines / regulation
The technical implementation of KDP-BLUD is two activities
The main purpose is to accelerate implementation
Implementation policy of KDP-BLUD at RSJ
Province. Technical regulation is expected to
Legalized and further strengthened the management system
Implementation of KDP-BLUD at RSJ Provinsi.
This new management system is expected
Provincial hospitals able to improve the quality of service
To society and welfare for the people
The employee. Therefore, the purpose of this study
Is to explore the implementation of the process
Transformation of mental hospital and implementation
The implementation policy of KDP-BLUD at the Hospital
The soul of NTB Province.