PSYCHIATRIC INPATIENT INSTALLATION BUSINESS STRATEGY AT THE PSYCHIATRIC HOSPITAL DR. H. MARZOEKI MAHDI

The problem that is the object of research is the number of people experiencing mental health disorders due to the Covid 19 pandemic becomes a new source of stress for the global community today. This research is qualitative with an analytical descriptive problem analysis approach using strategy formulation tools in the form of IFE matrix, EFE matrix, TOWS matrix, IE matrix.). Based on the results of the study. Total EFE Matrix score of 2.90. Ife Matrix total score of 2.41. With the merger of TOWS Matrix and IE Matrix, the right strategy for Dr. H. Marzoeki Mahdi's Mental Hospital is product development. With QSPM the strategy is to develop services that are adaptive to pandemic conditions but still refer to the strategic and business plans that have been established, strengthening the competence of nurses in Psychiatric Hospitalization Installations, utilization of IT in the service process, the preparation of guidelines for psychiatric inpatient installation infrastructure facilities, increasing partnership efforts across programs and across sectors.


INTRODUCTION
Health development is the main investment for the development of Indonesian human resources and to achieve this, a systematic, targeted, integrated and comprehensive health development plan is needed, and it requires the involvement of various sectors and all components of the nation in its implementation. According to (Law Number 36, 2009) Health is a healthy state, both physically, mentally, spiritually, and socially that allows everyone to live socially and economically productive. Health according to (WHO, 1984) is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity or disability. The COVID-19 pandemic in Indonesia since March 2020 has had many impacts on a person's psyche. The survey results (pdskji, 2020) show that 63% of respondents experience anxiety and 66% of respondents experience depression due to the Covid19 pandemic. Symptoms of anxiety are worries about something bad that will happen, excessive worry, irritability, and difficulty relaxing, while the main symptoms of depression that occur are difficulty sleeping, lack of confidence, fatigue, lack of energy, and loss of consciousness and interest. The difficult situation in the midst of a pandemic is getting worse due to the lack of access to quality mental health services. In the United States, efforts to standardize measures of mental health care quality have been slow. Only a third of health services receive adequate mental health care. Quality of care has been slow to improve compared to general medical care. The gap in the quality of mental health care is also partly due to the lack of systematic methods for measuring the quality of mental health services (Kilbourne et al., 2018). According to (Ridlo, 2020)If the government does not give the necessary attention to mental health issues, especially in the implementation of integrated policies related to the handling of the COVID-19 pandemic, the potential post-pandemic losses will be even greater. Governments should integrate mental health services into community-based services as a way to ensure universal coverage of mental health services.
Mental health problems is a matter that gets special attention from the Government as stated in its strategic goal, namely improving the degree of public health through a life cycle approach (Renstra Kemkes, 2020-2024. The realization of quality mental health services through improving the quality of hospital services is a challenge for RSJMM which is derived from the vision of the RSJMM to be achieved, namely the Realization of Personal Development Care Services Towards a Healthy, Productive and Independent Society (RSB RSJMM, 2020-2024. The condition of the COVID-19 pandemic has caused changes in services and needs that are not in accordance with the plan. One of these conditions was seen in psychiatric inpatient services during the covid 19 pandemic. People with Mental Disorders (ODGJ) who visited RSJMM decreased by 4299. The BOR value of the Hospital also decreased by 57.51 in 2020. While the LOS value from 2015 2017 -2020 average under 23 days. In research conducted (Iskandar, 2012) this management has difficulty anticipating the increasing number of patient visits every year, so that future planning cannot be done properly. One of the reasons is that the hospital does not have a strategic plan that can be agreed upon by all parties involved in the decision-making process.
Quality and patient safety is currently one of the main demands of hospital service users. It even becomes one of the elements of hospital accreditation assessment. RSJMM with International Accreditation predicate must serve in accordance with Accreditation standards for customer satisfaction. By monitoring the evaluation of all programs and services on time, it is expected to increase service growth. To achieve quality mental health services in the Covid-19 Pandemic conditions by prioritizing the quality and safety of psychiatric patients, the authors will analyze and identify external and internal factors in the Psychiatric Inpatient Installation. From the empirical findings of the previous research above, the author sees the need for further research on business strategic planning in the Psychiatric Inpatient Installation in 2020 -2024 which is expected to be a strategy for management in developing quality mental health services.
Problem Identification are the number of people experiencing mental health problems due to the Covid-19 pandemic has become a new source of stress for the global community today in the face of the Covid-19 pandemic, Cases of People with Mental Disorders Increase during the Covid Pandemic 19 but in RSJMM there was a decrease in the value of BOR and Visits Psychiatric Inpatients at RSJMM in 2020, Mental health problems must be the government's attention achieve an increase in public health status. 2020 marks the beginning of the first implementation of the Strategic Plan Business Year 2020-2024, it is necessary to identify in-depth and empirical measurements to realize development quality mental health services.
General Objectives are knowing the Overview of Strategic Planning Business Psychiatry Inpatient Installation in RSJ. Dr. H. Marzoeki Mahdi Bogor. Specific Objectives are Analyze which external factors influence in determining strategy based on financial perspective, customer perspective, internal business process perspective, growth and learning perspective, Analyze which internal factors influence in determining strategy based on financial perspective, customer perspective, internal business process perspective, growth and learning perspective, Analyze and explain the positioning of Ranap Installation RSJMM psychiatry according to the situation analysis in 2020, Knowledge of alternative strategy recommendations and selected strategies appropriate for the development of the RSJMM Psychiatric Installation.

LITERATURE REVIEW
Strategic management is the art and science of formulating, implementing, and evaluating cross-functional and sectoral decisions that enable an organization to achieve its goals. The term strategic management is used synonymously with the term strategic planning. The goal of strategic management is to discover and create new and different opportunities for the future. Long-term planning, on the other hand, tries to optimize future trends based on current trends . Strategy presents the results of actions taken to meet long-term goals. The time frame for goals and strategies should be consistent, usually two to five years  Strategic planning is the process of deciding what to do and how to do it in the future. Meanwhile, according to Kotler and Andreas, strategic planning is a management process to develop and maintain a strategic fit between organizational goals and resources and changing opportunities in the market. Strategic planning includes defining the overall vision, mission, goals, identification of the external environment and the internal environment. The concept of a generic strategy and its main strategy proposed by other strategists are used according to (Duncan et al., 2018), different clustering strategies, which are grouped into adaptive strategies, market entry strategies and positioning strategies. Adaptive strategy is a strategy that determines whether the state of the organization will develop, shrink, or stabilize. Market entry strategy is a strategy that determines how to enter the market. In general, in the shrinking strategy, the company does not need a market entry strategy. Positioning strategy is a strategy to deal with other companies in the market. This strategy is market oriented and aims to create a competitive advantage Situation analysis involves looking at the organization both internally in terms of its strengths and weaknesses, and externally in terms of its opportunities and threats. Situational analysis can yield a large amount of information, but much of it is not particularly relevant to strategy formulation. To make information more manageable, it can sometimes be useful to categorize internal factors as strengths and weaknesses, and external environmental factors as opportunities and challenges. This analysis is often referred to as a SWOT (Strengths, Weakness, Opportunities, Threats) analysis (Ayuningtyas, 2013). The external environment has two aspects: (1) Macro Environment which affects all companies, and (2) Macro Environment which only affects certain industrial companies. Macro-environmental analysts cover certain political, economic, social, and technological factors. And sometimes referred to as a PEST (Political, Economic, Social, Technological) analyst. An important aspect of the microenvironmental analyst is the industry in which the Company operates or in which it operates. Michael Porter presents a useful Five Forces Framework for industry analysts. Porter's five strengths include barriers to entry, customers, suppliers, substitute products, and rivals among the company's competencies (Ayuningtyas, 2013). Regulation

RESEARCH METHOD
This research was conducted at the Inpatient Installation of RSJMM which is located on Jl. Dr. Sumeru No.114 Bogor. Research Time is 2020. This type of research is a qualitative research with a descriptive analytical problem analysis approach using strategy formulation tools in the form of IFE matrix, EFE matrix, TOWS matrix, IE matrix. Non-probability sampling technique with purposive sampling. According to (Sugiyono, 2018) Purposive Sampling is a technique for sampling data sources with certain considerations. Samples of Nurses in the Psychiatric Installation were taken as many as 96 people. To anticipate samples whose data is not valid, approximately 102 nurses are taken at the Psychiatric Development Unit. Sampling using the slovin method.Samples as key informants are represented from each Directorate according to his perspective.
Financial Perspective as many as 2 people represented by the Sub Coordinator Accounting and BMN, Ka. Installation of Guarantee and Receivable Verification, Customer Perspective as many as 2 people represented by the Coordinator Organization and General, Head of Psychiatry Inpatient Installation, Internal Business Process Perspective as many as 5 people represented by Coordinator of Medical and Nursing Services, Sub coordinator Nursing, Chair of the KMKP Committee, Head of PKRS Installation, Ka. Installation Medical record, Growth and Learning Perspective as many as 2 people are represented by the Sub Coordinator of Personnel Administration, Ka. Hospital Information System Installation (SIRS). In this study, qualitative researchers as Human Instruments, whose functions are to determine the focus of research, have informants as data sources, collect data, assess data quality, analyze data, interpret data and draw conclusions from their findings. Triangulation data collection (a combination of observation, in-depth interviews and documentation) (Sugiyono, 2018). .

RESULT AND DISCUSSION
At this stage the formulation tools used are Matrix IE and TOWS Matrix. This formulation depends on the information obtained from the input stage stage. Matching Critical Succes External and Internal Factors is the key to effectively arranging strategies that are worth implementing. The total score of EFE Matrix 2.90 indicates that the Psychiatric Inpatient Unit responds well to existing opportunities and avoids threats from the environment outside the hospital. The use of mental drugs should not be interrupted so that if the provider is constrained in the supply of drugs, it will have a direct impact on services The tiered referral policy from BPJS  Based on the results of the calculation of the QSPM (Quantitative Strategic Planning Matrix) method, the results of the selected strategy sequence are as follows I) Develop services that are adaptive to pandemic conditions but still refer to Strategic and business plans that have been set (Priority 1), II) Utilization of IT (Information Technology) in the service process (Priority ), III) .Increasing cross-program and crosssector partnership efforts (Priority 3), IV) Strengthening the competence of nurses in the Psychiatric Inpatient Installation (Priority 4), V) Preparation of guidelines for Psychiatric Inpatient Installation (Priority 5).

CONCLUSION
Analysis of opportunities and threats from the Psychiatric Inpatient Installation is an analysis of the External Environment. Psychiatric Inpatient Installations have good opportunities in terms of achieving customer satisfaction according to standards, sophisticated medical devices for psychiatric examinations (TMS, Neurofeedback), Puskesmas that have ODGJ fostered in districts and municipalities, The existence of providers who have registered with LPSE either contractually or operational cooperation because the availability of drugs for ODGJ must always be continuous. While the High Threat is the existence of a Tiered Referral Policy from BPJS. The total score of EFE Matrix 2.90 indicates that the Psychiatric Inpatient Unit responds well to existing opportunities and avoids threats from the environment outside the hospital.
Analysis of the strengths and weaknesses of the Psychiatric Inpatient Installation is an analysis of the Internal Environment. The Psychiatric Inpatient Installation has good strength in terms of the availability of the BLU budget for expenditure on goods and personnel, the Minimum Service Standard of 9 (nine) variables has 4 (four) variables that meet the standard, the RSJMM-assisted health center has 16 health centers. While the high weakness is that the training for employee competency skills has problems with the online training model.The IFE Matrix total score of 2.41 indicates that internal Psychiatric Inpatient Installation still weak.
In the IE Matrix, the strategies that can be developed if they are in cell V (Hold and Maintain) are Product Development (Product Development) and Market Penetration (Market Penetration). From the results of the TOWS Matrix illustrates that the Mental Hospital Dr. H. Marzoeki Mahdi is in quadrant 2, namely the Fix-it Internal Quadrant where management must minimize internal weaknesses and maximize external opportunities.By combining the TOWS Matrix and IE Matrix, the right strategy was obtained for the Mental Hospital Dr. H. Marzoeki Mahdi, namely product development. Based on the results of the calculation of the QSPM (Quantitative Strategic Planning Matrix) method, the results of the selected strategy sequence are as follows: Develop services that are adaptive to pandemic conditions but still refer to the strategic and business plans that have been set (Priority 1), Utilization of IT (Information Technology) in the service process (Priority 2), Increasing cross-program and crosssector partnership efforts (Priority 3), Strengthening the competence of nurses in the Psychiatric Inpatient Installation (Priority 4), Ppreparation of guidelines for Psychiatric Inpatient Installation facilities (Priority 5).
The Recommendation are it needs to be further developed into a program or activity that adjust to the five selected strategies including risk management, It is necessary to carry out a strong advocacy process using justification academic and smart strategy by the Hospital management to maximize Cooperation or Operational Agreements with Hospitals others, the Department of Health, the Department of Social Affairs, the Health Center, Optimization SIMRS applications that are not in accordance with the RS flow and perform rebuild databases, It takes a strong commitment from all employees of Dr. Mental Hospital. H. Marzoeki Mahdi to implement the inpatient installation strategic planning psychiatry.