Leadership

di Era JKN dan Healthcare 4.0:

Andreasta Meliala
andremeliala@ugm.ac.id
Outline

 The Challenges
 Kepemimpinan sebagai jawaban
Memahami “Demand”
Penyakit Infeksi
TB Paru
Kanker di Indonesia
Stroke di Indonesia
Ginjal Kronis
Diabetes Melitus
Obesitas Sentral
Kekinian dalam manajemen
rumah sakit
 What is Industry 4.0 ?

Industries are demand to

The current industrial adapt and agile in :
transformation with data * Intelligent and self-learning
The Fourth Industrial exchanges, cloud, software robots
revolution in cyber-physical system, * Required multi-skilled,
manufacturing and big data, artificial multi-disciplined and multi-
industry intelligence (AI), jobs
Internet of Things (IOT) *ceasing of present with
and more unknown future job
Healthcare 4.0
Example
The future of “Anamnesis”:
Patient Data
The Future of Diagnostic
Precision Diagnostic: Nano-Tech & AI
The Future of Treatment: Kill The Source and Replace
Tele-Robotic-Medicine: The Link & Roles
(A. Roshdy / Trends in Anaesthesia and Critical Care 15 (2017) 8e11)

Human

Substitusi Substitusi

Robot Komputer
Kolaborasi
Bagaimana memanfaatkan Situasi
Hi-Demand dalam konteks
Healthcare 4.0?
The Balance
Product Development..
Contoh Sukses Kendali Mutu & Biaya dengan
Profit Luar Biasa…..
•Facebook •Kuncinya:
•Whatsapp • Volume/crowd
•Gmail & Google • Add on
content/multi-
•GoJek function
•Grab & Uber • Partnership
• Parameter klasik
Law of Large lainnya
Number
Terjemahannya di Rumah Sakit
• Paradigma: zero marginal revenue
• Price is given
• Creating crowd:
• Make it “free”
• Multi-function:
• Hospital & hospitality
• Partnership:
• Referral system
Namun faktanya untuk Rumah Sakit….
Crowd means headache….
 Service in Hospital Setting

 Work load in hospital  Over burden leads to task-

increases significantly, whilst Non delegation based on education
number of physician remains valuable program
crowd
 Non
valuable
activity
 Sources of variation in a
clinical system
Staff Process Patients
motivation unclear age motivation
skills disease
illness holiday guidelines
race education
shifts training differ
complicationssex
anaesthetics
Non
GP valuable
Machines/rooms transcription result
not the same transport
80% is under
suppliers applications our control
Information
Resource
It means….

• High Volume is Higher Resource Burning

• Higher Volume is Higher Burden (work load)
• Higher claims is lower revenue & margin
• Higher price creates lower revenue

• Makin banyak pasien, makin rugi….

Konsep Dasar
The Result Success
of Leadership
Without Leadership

L 10
E 9
A
D 8
E
R
7
S
H
I 6
P
5
A
B 4
I
L 3
I
T 2 Customer’s
Y 1 Expectation

1 2 3 4 5 6 7 8 9 10
Order, Result, Development John Macarthur, 2008
The Role

• An organization’s ability to learn and translate

learning into action rapidly is the ultimate
competitive advantage. It is CREATED BY LEADERS

• Jack Welch, Chairman, General Electric

Paradox in Paradigm: Change the Mindset

Current Strategy in-used Current Challenge in-front

Prinsip Balanced-Score Card

Financial Performance
Government

Customer Satisfaction Payor/BPJS

Business Process Patient

Donors
Learning & Growth
How to be a Good Leader
Leadership

• Leadership is the process through which an individual

attempts to intentionally influence another individual
or a group in order to accomplish a goal.

• International Management Basic, 2005

Strategic Leadership
A person’s ability to anticipate,
envision, maintain flexibility, think
strategically, and work with others to
initiate changes that will create a
viable future for the organization.

Ireland and Hitt (1999)

 The New Reality for Leadership
OLD Paradigm NEW Paradigm
• Stability • Change and crisis management
• Control • Empowerment
• Competition • Collaboration
• Uniformity • Diversity
• Self-centered • Higher purpose
• Hero • Humble

51
1. The Factors & Level of Leadership

Factors

Ordinary Genetic Behavior Contingency

Extra GB GC BC
Ordinary

Special Genetic + Behavior + Contingency

One
2. The Vision:
Linking the current achievement to the Future State

We cannot predict the future but we must be prepared for the future
(Sir Ken Robinson, educationalist)
Tugas Pemimpin
Bermimpi Menggalang Komitmen
• Melihat sesuatu di balik gunung • Menyebarkan “mimpi”
• Melihat benda berharga di • Meyakinkan orang lain tentang
“mimpi” itu
dalam lautan
• Mengajarkan teknik dan cara untuk
• Melihat tempat tinggal yang mencapai “mimpi” tersebut
nyaman di Bulan • Menjaga stamina agar komitmen
tetap terjaga konsisten
The Dream
• Staff development seperti Delnore
Hospital
• Clinical Performance seperti Mayo Clinic
• Customer Satisfaction seperti Mayo Clinic
• Financial Performance seperti
Bumrungrad Hospital
 Persepsi Image

Great leader adalah orang yang ahli dalam

menciptakan gambaran-gambaran positif,
optimis serta jelas dalam benak orang lain dan
terutama dalam benak sendiri.
-Schwartz-

Experience Internalisasi
3. Influencing capacity
Personal Characters

• Intelligent
• Credibility
• Humanity
• Discipline
SUN TZU
Idealism

Idealisme meningkat sebanding dengan

jarak seorang pemimpin dari masalahnya

-John Galsworthy-
Emotional Intelligence

• Emotional intelligence is the ability to

know and manage oneself along with
an awareness and ability to manage
one’s relationships with others.
 EI in Practice
• Gaya Bicara Saya Sesuai dengan:
• Bung Karno
• SBY
• Soeharto
• Sri Sultan HB IX
• Megawati
EI Competency

• Self Awareness
• Self Management
• Social Awareness
• Relationship Management
Be Decisive
PIKIR
banyak sedikit

banyak

ACTION
1 3
sedikit
2 4
Risk Taker
TAAT ATURAN
banyak sedikit

banyak

TEROBOSAN 1 3
sedikit

2 4
4. Dare to See & to Declare The Reality

Tanggung jawab seorang pemimpin adalah

mendefinisikan realita
-Max dePree-

Pelayanan
buruk Penghasilan
Biaya RS menurun
Isu Regulasi SDM
Mahal
berkelompok
Sign of Unsynchronized Behavior
 STRUKTURAL PERAWAT DOKTER

VIP

KI

K II

K III
New Payment Mechanism

Pembayar

Rumah Sakit

Dokter
5. Combining Leadership into Managing
Organization
Leaders Managers
• Innovate • Administer
• Develop • Maintain
• Inspire • Control
• Long-Term View • Short-Term View
• Ask What and Why • Ask How and When
• Originate • Initiate
• Challenge the Status • Accept the Status Quo
Quo • Do the Things Right
• Do the Right Things

Warren Bennis
Combination
L M
E A
A N
Managerial Function
D A
Planning
E Influence People Executing G
R Controlling E
S Evaluation
M
H E
I N
P T
6. Broad-Minded
• Do You Have a Clear Understanding of How the Industry May
Be Different Ten Years from Now?

• Having deep insights into trends in technology, demographics, regulations, and

lifestyles, which can be harnessed to rewrite industry rules and create new
competitive space (industry foresights).
• Understanding clearly customer needs, competitors, and industry rules of the
game in the future.

Hamel and Prahalad (1994)

Organizational Life Cycle & Leadership
 LEADERSHIP within System

CYCLES IN MANAGEMENT
IN THE FORM OF SYSTEM

INPUT PROCESS OUTPUT

IMPACT

INPUT FOR
OTHER SYSTEM
 7A. Style of Leadership: Creating Cadres

• Transactional Leadership
Concerned with changes and exchanges. Seeking to alter both the objective and
nature of leader-follower interactions, in a very rational way

• Charismatic Leadership
Distinct social relationship between the leader and follower, in which the leader
presents the revolutionary idea & Follower accepts the idea not by rationally, but
by believes
 Personhood

RESPECT:
People People follow because of
who you are &
Development what you represent

REPRODUCTION:
people follow because of what you have
production done for them

RESULT:
people follow because of what
Permission you have done for the organization

RELATIONSHIP: people follow because they want to

Position

RIGHTS: people follow because they have to

7B. Contextual Style of Leadership
1. Coercive leaders demand immediate
compliance: useful to lead people out of
sinking ship
2. Authoritative leaders mobilise people
towards a vision: useful when an
important change is required
3. Affiliative leaders create emotional
bonds and harmony: useful to bind team
in difficult time
Style of Leadership (2)
4. Democratic leaders build consensus through participation: useful
to encourage input from valuable team members
5. Pace setting leaders expect excellence and self direction: useful to
get quick results from a good team
6. Coaching leaders develop people for the future: useful for long
term development of key member team
8. Change Agent

•Leader is the first change-agent

Perubahan (2)

• Melakukan hal yang sama terus menerus tetapi

mengharapkan hasil yang berbeda adalah tindakan
ORANG GILA
• Einstein
Diagram

Restraining forces

Desire
Refreezing
State

Movement

Status
Quo
Unfreezing
Driving forces

Time
Reaksi Terhadap Perubahan

• Shock
• Denial
• Marah
• Terpaksa Menerima
• Perilaku baru
Response to Change
Focus on external world

Denial Commitment

Focus on future
Focus on past

Resistance Exploration

Focus on internal world

Mengapa Takut Berubah

• Takut akan hal baru

• Perbedaan perspektif
• Kepentingan pribadi yang terganggu
• Curiga (terutama kepada pemimpin)
• Konservatif & kemapanan
Tipe Orang
Menerima Tidak menerima

Mendukung
CHAMPION DOUBTERS
1
3

Tidak
mendukung BELIEVER TERRORIST
2 4
 Anda tidak bisa mengharuskan orang lain
untuk berpikir, tetapi anda dapat mendorong
mereka untuk berpikir
-Frank A. Dusch-

Implementasi
Avian Flu? Fungsi Regulasi
Are You Ready

Semua orang ingin mengubah dunia,

tetapi tidak seorangpun ingin mengubah
…………………….dirinya
-Leo Tolstoy-

Status Quo Keyakinan

Resistensi
9. Communication Expert

• Lobbying
• Negotiation
• Presentation
• Interpersonal
10. Have You Been Lucky in Your Life So Far?

• An effective leader needs good luck

• Having the ability to place oneself in a
position that favors being lucky

Hinterhuber and Popp (1992)

Result of Leadership
Indikator Ada Tidak

Keteraturan

Hasil

Improvement
Summary…
Translating the strategy to specific tactics with
measurable goals and timelines

Operation
Program Wadir &
Manajer
Dokter
Vision
• Visi
Mid • Tactic
• Policy • Strategy • Operation
• Program

Direktur Top Line

Thank You..