| dc.description.abstract | Smoking is a leading cause of serious diseases such as lung cancer and heart
disease. In North Sumatra, the prevalence of smokers reaches 26.28%, indicating
a significant health challenge. Mitra Medika Amplas General Hospital, the only
hospital in Medan Amplas District, has established a Smoke-Free Area (SFA)
policy through Director’s Regulation Number 065/PER/DIR/RSMM/V/2022.
However, violations of this policy frequently occur, especially in outdoor areas.
This study utilizes the implementation theory by Ripley and Franklin to evaluate
the SFA policy implementation based on three indicators: implementer
compliance, routine smoothness and issues, and the desired performance and
impact. This study employs a descriptive qualitative design. Data were collected
through in-depth interviews with healthcare workers and visitors, observations of
smoking behavior within the hospital environment, and analysis of policy
documents. Informants included hospital staff responsible for overseeing the SFA
policy, as outlined in the Director’s Decision Number
003/SK/DIR/RSMM/IV/2023 regarding the Assignment of SFA Policy Supervisors.
Data were thematically analyzed using Ripley and Franklin’s theoretical
framework. The findings indicate that compliance with the SFA policy inside the
hospital building is relatively high, although violations are frequently observed in
outdoor areas. Observations revealed cigarette butts in public areas of the
hospital, indicating ineffective supervision. The hospital's operational routines
remain smooth; however, the main challenges are inconsistent supervision and
low awareness among visitors and staff. The impact of the policy on reducing the
number of smokers within the hospital environment is beginning to be seen,
though it is not yet significant. The implementation of the SFA policy at Mitra
Medika Amplas General Hospital has not yet reached optimal levels.
Strengthening supervision, increasing socialization efforts, and providing
facilities such as a Smoking Cessation Clinic are recommended to enhance policy
effectiveness. These steps are essential for achieving higher compliance and
establishing a smoke-free hospital environment. Enhanced supervision and more
intensive socialization efforts are needed to improve the effectiveness of the SFA
policy implementation at Mitra Medika Amplas General Hospital.
Keywords: General hospital, policy implementation, smoking | en_US |
