The Quality of Prescription Service and Satisfaction Level at

Pharmaceutical Installation of X Hospital

Lutfiya and Budi Firdaus Darmasila

Faculty of Pharmacy, Universitas 17 Agustus 1945, Jakarta, Indonesia

Keywords: Quality of Prescription Service, Satisfaction Level, Hospital.

Abstract: The Pharmacy Installation is a place where pharmacy services are carried out, both management of pharmacy

preparations and clinical pharmacy services. Its main function is to administrate, coordinate, manage, and

supervise all forms of pharmacy service activities. The purpose of this study is to determine the quality of

prescription services and the level of satisfaction of outpatients at Hospital X and to determine the relationship

between the two variables. The research method is descriptive research conducted using a cross-sectional

research design with a sample of 156 prescriptions. Then, to assess the level of satisfaction, the data was

collected from the respondents. 156 patients who will redeem prescriptions using a questionnaire sheet. The

results of the prescription service quality category showed a score of 99.6, which was classified in the range

of 68-100 in the very good category. Then, for the results of patient satisfaction, showing a satisfied score of

142 respondents (91.0%), showing a very high satisfaction level.

1 INTRODUCTION

In Indonesia, health efforts are supported by several

facilities such as hospitals. To support good health

efforts, hospitals are required to have good pharmacy

services in accordance with existing qualification

standards. Standards in hospitals that are complete in

accordance with the demands of hospitals and

patients (The Health Ministry of the Republic of

Indonesia, Permenkes, 2016). At present, pharmacy

services are an integrated part of the health care

system in hospitals that have the orientation of

providing the best service for all patients, providing

quality pharmaceuticals, medical devices, and

disposable medical devices that can be reached by

various community groups, including pharmacy

services in clinics (The Health Ministry Regulation of

the Republic of Indonesia, Permenkes, 2016).

Providing medicines at the complex is required to pay

attention to that medicines are always available at the

pharmacy that have the best quality, efficacious, safe,

and certain based on the mandate of Law UU No. 44

of 2009 on Hospitals and implemented according to

the pharmacy service standards. Furthermore, in the

Minister of Health of the Republic of Indonesia No.

72, (2016) concerning Standards for Pharmacy

Services in Hospitals that are issued, including

management of medicine supplies and consumable

medical devices, clinical pharmacy devices, and

supervision of consumable medical devices and

medicines used by complex parties, Setting standards

in pharmacy services in hospitals is used to:

Encouraging improvements in pharmacy services in

hospitals Ensuring that pharmacy personnel get the

right license from the right agent Provide protection

and certainty for patients to get appropriate medicine

and pay attention to patient safety. Standards are used

for pharmacy services in hospitals, which include the

management of supplies of medicines, medical

consumables, and medical devices. Prescription

services are one of the various pharmacy services

provided by pharmacists to improve health services

for patients in hospitals. Pharmacy services are

services provided to patients and have direct

responsibility for patients directly related to the

provision of medicines and pharmacies in order to

obtain optimal results to improve the patient’s quality

of life. This service is supported by competent work

staff on their part, because patients must be treated by

the right staff. The quality of prescription services is

one indicator that correlates with the quality of health

services. In addition, there is also a study conducted

by Wiyono in 2016 which revealed that there is a

relationship between service quality and customer

satisfaction. The Hospital Pharmacy Service

Lutﬁya, . and Darmasila, B.

The Quality of Prescription Service and Satisfaction Level at Pharmaceutical Installation of X Hospital.

DOI: 10.5220/0011978900003582

In Proceedings of the 3rd International Seminar and Call for Paper (ISCP) UTA â

Z45 Jakarta (ISCP UTA’45 Jakarta 2022), pages 213-218

ISBN: 978-989-758-654-5; ISSN: 2828-853X

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

213

Standards as stated in the Hospital Service Standards

are within the basic scope. Therefore, in order to

support the hospital in implementing the Hospital

Service Standards, it is necessary to develop a

comprehensive Hospital Pharmacy Service Standard

based on the needs of patients and hospitals.

Management of pharmacy supplies and medical

devices is a stage and flow of activities that begins

with procurement planning, production, or

procurement, receipt, distribution, supervision,

storage, disposal supervision, reporting,

administration, and evaluation needed in carrying out

health service activities. The purpose is to ensure that

all medical devices and medicines are still available

and do not run out of stock, have sufficient quantities

in accordance with the specified specifications, and

have proper functions by the management of the

pharmacy department so that they can be used

efficiently and effectively in pharmacy services. A

satisfied score will be created if the expectations of a

patient can be met by the services provided by the

hospital. Therefore, it is necessary to observe and

periodically evaluate the satisfaction and expectations

of the patient. The word "satisfaction" comes from the

words "static," which means "quite good, adequate,"

and "facio," which means "does or makes. Consumer

satisfaction is the level of one individual's feelings

after making comparisons (results) obtained

compared to their expectations. The X Hospital is a

type C general hospital with 15 pharmacy staff,

meaning there are 15 pharmacy staff. 1 pharmacist as

the installation's head; 1 pharmacist in outpatient

assisted by 6 pharmacy technician; 1 pharmacist

inpatient assisted by 5 pharmacy technician; and 1

pharmacist as production coordinator. 6 supporting

staff exclude 15 pharmacy staff who have a high

school background, D3 Nursing, Bachelor of

Mathematics or physiotherapy for supporting

activities outside the pharmacy installation but still

have a relationship with the pharmacy installation.

Based on several explanations that have been

described in the background, the researcher makes the

title "Quality of Prescription Services and Patient

Satisfaction Levels" to find out whether the quality of

service at X hospital has a relationship with the level

of patient satisfaction.

2 METHODS

2.1 Research Method

This research method is a cross-sectional study. In

this study, data collection was carried out using a

completed questionnaire. The filling out of the

questionnaire is carried out offline by distributing the

questionnaire form directly to respondents at the

Pharmacy Installation of Hospital X.

2.2 Ethical Approval

The Ethics Committee has approved this research for

health research at the University of August 17, 1945,

Jakarta, based on the certificate of ethical feasibility

(Ethical Clearance) with the number: No.32/KEPK-

UTA45JKT/EC/EXE/05/2022.

2.3 Population and Sample

The population in this study was all patients who

visited for treatment at Hospital X. In this research,

there are 2 kinds of sample criteria, namely inclusion

and exclusion criteria. The data was taken using the

population from Hospital X, which was set for the

total sample in this study to be 156 samples. The

inclusion criteria are outpatients and their

prescriptions (male and female) aged > 17 years.

Inclusion criteria are criteria where the research

subject represents research samples that meet the

requirements as a sample. The respondent's age is at

least 17 years because, according to Hurlock's

statement, 17 years is an adult age and has been

considered a legal adult, and it is stated that at 17

years old, people have self-identity because, at that

age, society is considered responsible for itself (

Hurlock, 2006). Exclusion criteria are criteria where

the research subject cannot represent the sample

because it does not meet the requirements. Research

sample, as well as ethical obstacles, such as refusing

to be a respondent or a situation where it is not

possible to do research. As stated by Yuliani (2017),

some patients may have a high risk of being in the

study. So, for the exclusion criteria, there are

outpatients (male and female) aged <17 years,

pregnant patients, lupus, HIV/AIDS, and Covid-19,

and there were no exclusion criteria for prescriptions.

2.4 Variable Score Calculation

Calculation The quality of prescription service was

scored using a questionnaire. Questionnaire The

quality of prescription service is calculated from a

number of variables, and each variable has a score

calculation, and that variable are:

• Check the patient's name and identity. A

total score of 10 is taken when checking the

patient's name and identity. If not, the score is

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

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• Screening. A total score of 10 is taken when

screening is carried out. If not, the score is 5.

• Counseling. A total score of 10 is taken when

counseling is carried out. If not, the score is 5.

• Fulfillment of the number of medicines

submitted according to the prescription. A

total score of 10 is taken when the fulfillment

of the number of medicines submitted is in

accordance with the prescription given. If not,

the score is 5.

• Completeness of the type of medicine that is

submitted according to the prescription. A

total score of 10 will be obtained when the

completeness of the type of medicine

submitted is according to the prescription

given. If not, the score is 5.

• Is there a medicine substitute? A total score of

10 is taken when there is no change in

medicine. If not, the score is 5.

• Writing Complete Prescriptions Labels.

The total score here is determined by writing

the complete label. A score of 1 will be given

when specifying the instructions for use; a

score of 2 will be given when specifying the

instructions for use and the patient's name; a

score of 3 will be given when including the

patient's name, instructions for use, and other

precautions/warnings; a score of 4 will be

given when including the patient's name, rules

and regulations. Other cautions and the date A

score of 5 will be given when including the

patient's name, instructions for use, method of

use, other warnings, date, and serial number of

the prescription. Here, the value of 5 is a

perfect score because the writing of the label

is done in full.

• Medication preparation time: The total

score here is determined from the time of

medicine preparation. For finished medicine,

if the preparation is done right within 15

minutes, it will get a value of 2. If it takes >15

minutes, it will get a value of 1. For

compounding medicine, if the preparation is

done right within 30 minutes, it will get a

value of 3. If it takes >30 minutes, it will get a

value of 2. If in one prescription there is only

finished medicine, then if the preparation is

done right within 15 minutes, it will get a

value of 5. If it takes >15 minutes, it will get a

value of 4. Conversely, if in one recipe there is

only concoction medicine, then if the

preparation is done within 30 minutes, it will

get a value of 5, and if >30 minutes, it will get

a value of 4. The total perfect score is 5, and is

obtained when the time of medicine

preparation is in accordance with the specified

time.

• Final check. A total score of 10 is taken when

the final check is carried out. If not, the score

is 5.

• Documentation. A total score of 10 is taken

when the documentation is done. If not, the

score is 5.

• Recipe work is carried out according to the

protocol. A total score of 10 is taken when the

recipe is carried out according to the

applicable protocol. If not, the score is 5.

In these variables, it can be seen 1 result of the

calculation of the prescription service quality score,

where this questionnaire has been distributed to a

number of respondents. The Category of Prescription

Service Quality explained in table 1.

Table 1: Category of Prescription Service Quality.

Score Cate

(0-33) Poo

(34-67) Goo

(68-100) Excellen

A questionnaire was also used to assess the

satisfaction level at X Hospital's pharmacy

installation. The questionnaire that was distributed to

patients consisted of 11 questions, where the method

of assessment for each question was by assigning a

value to each answer choice based on the Lickert

scale. And the weight value given in one question has

been explained in table 2. The Satisfaction Level at

Pharmacy Installation has been explained in table 3.

Table 2: The way of measuring variables is based on the

lickert scale.

Reality weight value

Ver

satisfie

Quite satisfie

Less satisfie

ot satisfie

Table 3: The Satisfaction Level Category at Pharmacy

Installation.

Score Cate

1 (0-14)

ot satisfie

2 (15-29) Satisfie

3 (30-44) Ver

Satisfie

The results of these questionnaires that have been

obtained were processed with SPSS software using

the Chi Square test, and the relationship between the

The Quality of Prescription Service and Satisfaction Level at Pharmaceutical Installation of X Hospital

215

quality of prescription services and the level of

satisfaction at the Pharmacy Installation of X Hospital

was determined by running a correlation analysis test

with SPSS software.

3 RESULT AND DISCUSSION

The results of this study describe how the quality of

prescription services will be measured by filling out a

data collection table by a researcher based on a

predetermined assessment weight, including

checking the patient's name, identity of the patient

concerned, screening, counseling, fulfilling and

providing medicines according to the prescription

given, ensuring the completeness of medicine,

checking if needed for medicine substitution, writing

labels, when preparing medicine, final checks,

making documentation or notes, and prescriptions are

carried out in stages according to procedures and

provisions. When the 11 variables above are done

correctly, a value of 100 will be obtained for 1

medicine prescription. The percentage of patients

who have checked the names and identities of their

patients is 100%. These results show that checking

the patient's name and identity is a mandatory

procedure that has been implemented in the Pharmacy

Installation of X Hospital. The activity of checking

the patient's name and identity is an important part

that should not be ignored because the number of

patients is very large when paying for prescriptions

and there is a lot of risk that prescriptions can be

misrepresented by both the pharmacy and the patient.

The percentage of carried out screening activities is

100%. Prescription screening activities are carried out

by expert pharmacy staff to avoid medication errors.

The percentage of the number of medicines delivered

according to the prescription is 100%. X hospital has

a pharmacy installation with a fairly good

completeness of medicine. The stock of medicine in

the pharmacy installation of hospital x is quite

complete, because according to one of the reference

journals entitled Overview of the Causes of

Emptiness of Patent Medicine Stocks and Control of

Its Efforts in the Medical Warehouse of the Pharmacy

Installation of the Bekasi City Hospital in the First

Quarter of 2015 (Wulansari, 2015), the Bekasi City

Hospital gave many medicines that were not in

accordance with the prescription because the Bekasi

City Hospital Pharmacy installation had a limited

stock of medicine. The percentage stock of medicine

is 100%. This is because X Hospital has a pharmacy

installation with a sufficient amount of medicine;

therefore, the percentage of types of medicine given

is always in accordance with the prescription given

by the patient. The stock of medicine that was given

to patients according to prescriptions is 100%. The

percentage of the stock of medicine that has been

given is always in accordance with the prescription

given to the patient. The measurement of the

percentage of the label is to look at several parameters

of the label, such as the completeness of the

prescription number, the date, the name of the patient,

the administration, and, of course, how to use it. Like

the indication and the usage, the value of each

parameter item is a minimum of 1 and a maximum of

5. A value of 1 is obtained when only administration

is on the label. Score 2 is obtained when it includes

administration and the patient's name. Score 3 is

obtained when administration, as well as the name of

the patient and the usage of other warnings, are

included. Score 4 is obtained when the

administration, patient's name, the indications and

warnings, and date are included. Score 5 is obtained

when the instructions for use, patient's name, the

indications and warnings, date, and serial number of

the prescription are included. The total percentage of

label scores 1 is 0%, scores 2 and 3 are 0%, score 4 is

0% with a sample of 0 prescriptions, and score 5 is

100% with a sample of 156 medical prescriptions.

The Pharmacy Installation of X Hospital did the

writing of labels with fairly clear parameters, where

the number on the prescription was written, as well as

the date the prescription was made, the name of the

patient, as well as the method and time of medicine

use, as well as the use of medicine to reduce the

occurrence of errors in medicine administration. This

is also done to avoid the risk of medicine swapping

and/or patients not knowing what medicine they are

taking. In this case, the pharmacy installation of X

Hospital is excellent; they always carry out final

checks while actively providing labels.

Documentation must always be considered and made

because it is one of the important elements in

pharmacy (The Health Ministry Regulation of the

Republic of Indonesia Permenkes, 2016). From these

results, it was found that the compounding and

dispensing of medicines at the Pharmacy Installation

of X hospital was fully carried out according to the

Standard Operating Procedure, where all activities

were carried out according to the Standard Operating

Procedure. The service quality assessment of X

Hospital was carried out from the sum of each

question item. A different amount will be generated

by each item of the questionnaire question. The factor

is the level of difficulty and importance of the

research data. All scores will be added up and divided

by the average, and the result is 98.2, which is

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included in the score of 68-100, which means the

quality of prescription services is excellent, according

to what has been explained in table 1. By summing

the values in the questionnaire (Arikunto, 2002), a

total score will be obtained from the level of patient

satisfaction with prescription services at the

Pharmacy Installation of X Hospital. The Pharmacy

Installation of X Hospital got an excellent score. This

was evidenced by 142 respondents stating that they

were very satisfied with the percentage of 91.0%,

falling into the score range of 30-44. The result of the

satisfaction level at the pharmacy installation is

explained in table 4

. These results are taken from

a questionnaire that has been distributed to

respondents who are outpatients at the hospital

Table 4: Total patient score data based on variables that

affect the level of patient satisfaction with the quality of

prescription services at the Pharmacy Installation of X

hospital.

Total Score of Patient’s

Satisfaction

N (156)/%

(

0-14

)

0/0%

(

15-29

)

14/9.0%

3(30-44) 142/91.0%

The difference between the quality of prescription

services and the level of patient satisfaction, the

probability value is = 0.000 <0.05.

It can be seen that the value of t count =-316 and

sig. (2-tailed) for Prescription Service Quality of

0.000. The significance level is 0.000, so the data is

quite significant (0.000<0.05).

It can be seen that the value of t count =-316 and

the value of Sig. (2-tailed) for patient's satisfaction is

0.000. The significance level is 0.000, so the data is

quite significant (0.000<0.05),

It can be concluded that the probability value here is

0.000 (<0.5), which means that the two variables,

namely the Prescription Service Quality and the

Satisfaction Level at Pharmacy Installation, have a

significant relationship. This is indicated by the

quality of prescription services at X hospital, which is

categorized as very good and can provide a very high

satisfaction rate, namely 142 respondents with a

percentage of 91%, and also a satisfied rate, namely

14 respondents with a percentage of 9%. The

probability value here is 0.000 (<0.5), which means

that the second variable, namely Prescription Service

Quality and Patient Satisfaction, has a significant

relationship. This is indicated by the quality of

prescription services at X hospital, which is

categorized as very good and can provide a very high

satisfaction rate, namely 142 respondents with a

percentage of 91%, and also a satisfied rate, namely

14 respondents with a percentage of 9%. This is also

evidenced by a similar study that I found in the

journal Hana Mutiara et al. entitled The Relationship

of Service Quality with Patients Participating in BPJS

(Social Security Agency of Health) RSUD by Dr. H

Abdul Moeloek, (Hana, 2018). The journal proves

that there is a good service relationship between a

hospital and a patient because the probability value =

0.03 <0.05 which means there is a correlation value

between the quality of prescription services and the

level of patient satisfaction.

4 CONCLUSIONS

The value of patient satisfaction at hospital x is quite

good because the quality of prescription services

provided by hospital x is also quite good. which

means that the hospital pharmacy installation service

is satisfactory.

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