154  Jurnal Manajemen Pelayanan Kesehatan, Vol. 13, No. 3 September 2010 Felix Kasim, dkk.: Roles of The Stakeholder ... ROLES OF THE STAKE HOLDER AND PROVIDER OF BATAM CITY IN AN ATTEMPT TO ENHANCE CLINICAL GOVERNANCE OF HEALTH SERVICES IN CONNECTION WITH DOCTOR PRACTICE LAWS PERAN STAKE HOLDER DAN PROVIDER KOTA BATAM DALAM UPAYA MENINGKATKAN CLINICAL GOVERNANCE PELAYANAN KESEHATAN DIHUBUNGKAN DENGAN UNDANG UNDANG PRAKTIK KEDOKTERAN Felix Kasim, Tiara Indah Putrawi Siahaan Fakultas Kedokteran Universitas Kristen Maranatha Bandung ABSTRACT Background: Deming (1984), Crosby (1979, 1985), and Juran (1988), all found that more than 85% of errors are related to a system; whereas, only 15% of them constitute human error, or an employee’s. According to NGO coordinator, Iskandar Sitorus, 2000 victims of malpractice have been recorded throughout Kepulauan Riau. This malpractice occurs when a system does not have a proper policy, standard procedure, and equipment needed. Objective: The purpose of this research is to find out the management, obstacles, and expectations with regards to clinical governance management from the point of view of the stakeholder and provider of Batam City. Method: The method used in this research was a qualitative method with a grounded theory. The primary data are derived from in-depth interview. The respondents involved are the commission IV chairperson of Batam City local Parliament, Kepulauan Riau, chairperson of Medical Committee of Batu Aji Local Public Hospital Kepulauan Riau using a purposive sampling with an extreme case sampling approach. Result and conclusion: The research shows that clinical governance by the stakeholder and provider still needs further improvement. There are still obstacles in terms of regulations and implementation of clinical governance. Based on the Minimum Service Standard, some indicators of Batam City in 2008 did not meet the performance target and national standard. Therefore, the clinical governance system has not been implemented throughout health services in Batam City. Suggestions: For IV Legislative Commission for People’s Welfare and Human Resources Batam Riau Islands are expected to lack of regulation and appropriate systems in improving health services. And then for Hospital Medical Committee Batu Aji, Batam Riau Islands is expected to implement Clinical Governance. It is expected that the recording and reporting systems as well as obtaining accurate data in making the next Batam health profile based on the quality of evidence-based. Keywords: Clinical Governance, stakeholder, provider ABSTRAK Latar belakang: Deming (1984), Crosby (1979, 1985), maupun Juran (1988), semuanya menemukan bahwa lebih dari 85% kesalahan terkait dengan sistem, sedangkan hanya 15% yang memang benar kesalahan manusia atau pekerja. Menurut opini Koordinator LSM Kesehatan, Iskandar Sitorus, mereka mencatat sekitar 2.000 korban malpraktik di seluruh Kepulauan Riau. Kesalahan terjadi ketika sistem tidak memiliki kebijakan yang tepat, prosedur standar, dan perlengakapan yang dibutuhkan. Tujuan: penelitian ini bertujuan untuk mengetahui penatalaksanaan, hambatan serta harapan yang berkaitan dengan penatalaksanaan clinical governance ditinjau dari peran stakeholder dan provider kota Batam. Metode: Penelitian ini menggunakan metode kualitatif dengan rancangan penelitian grounded theory. Data primer didapatkan dari wawancara mendalam. Responden yang diambil adalah Ketua Komisi IV DPRD kota Batam Kepulauan Riau, Ketua Komite Medik RSUD Batu Aji kota Batam Kepulauan Riau dengan metode pengambilan sampel Purposive sampling dengan pendekatan extreme case sampling. Hasil dan kesimpulan: Berdasarkan hasil penelitan didapatkan bahwa pelaksanaan Clinical Governance oleh stakeholder dan provider masih belum cukup baik. Masih banyaknya kendala dalam regulasi dan implementasi Clinical Governance. Berdasarkan Standar Pelayanan Minimal (SPM) kota Batam 2008 beberapa indikator masih belum memenuhi target kinerja dan standar nasional. Dengan demikian, sistem Clinical Governance belum dilakukan secara menyeluruh pada pelayanan kesehatan di kota Batam. Saran: Penerapan clinical governance yang baik adalah dengan melakukan pencatatan dan pelaporan yang transparan serta akurat sebagai dasar dari pengambilan kebijakan di bidang kesehatan dengan melibatkan semua unsur mulai dari stake holder, pelaksana dan masyarakat. Kata kunci: clinical governance, stakeholder, provider BACKGROUND According to Deming in Out of the Crisis in the year 1948 - 1949, Japan attempted to recover from the defeat of World War II and finding ways to rebuild its economy. Some Japanese engineer observed that quality improvement is almost always resulted in increased productivity. 1 Indonesia has been using strong policies and institutions dealing with quality of health services and have recently implemented these policies through a strategy that can be accepted at various levels. 2 Duties and functions of health services in the initial understanding is that health care is to relieve JURNAL MANAJEMEN PELAYANAN KESEHATAN VOLUME 13 No. 03 September  2010 Halaman 154 - 161 Artikel Penelitian