A Workload and job performance among medical record professionals in an Indonesian specialised hospital

Annisa Wahyuni, Nurhasanah Nasution, Kesha Tilla Adzkia, Tosi Rahmaddian

Objective: To examine the association between workload and job performance among medical record professionals in a specialised hospital in Indonesia, and to consider the implications for workforce planning in health information services.

Design: Cross-sectional study using structured, self-administered questionnaires, with total sampling of the eligible population. Reporting follows the STROBE statement for cross-sectional studies.

Setting: The medical record unit of a specialised (national brain centre) hospital in Bukittinggi, West Sumatra, Indonesia, between March and August 2026.

Main outcome measures: Self-reported workload (11 items) and job performance (13 items), each rated on a five-point Likert scale (Cronbach's alpha 0.849 and 0.891 respectively). The association was assessed using Spearman's rank correlation, with a partial correlation adjusted for length of service as a sensitivity analysis.

Results: All 18 eligible staff participated (100% response rate). Workload was moderate (mean per item 2.87) while performance was high (3.44). Workload was inversely associated with performance (r = −0.520; 95% CI −0.81 to −0.04; p = 0.027), and the association persisted after adjustment for length of service (partial r = −0.498; p = 0.042). The highest-rated workload item concerned the need for better distribution of work, whereas overtime pressure was the least endorsed item; the lowest-rated performance items concerned the effect of workload on concentration.

Conclusions: Higher workload was associated with lower job performance, although performance remained high overall — a pattern consistent with a threshold effect in which staff sustain output until demands exceed available resources. For managers, the actionable levers are equitable task redistribution and staffing adequacy informed by systematic workload analysis, rather than reliance on overtime. Aligning electronic medical record implementation with realistic workflows forms part of the same task. Findings from a single small unit require confirmation in larger, multi-site studies.

Implementation Of Collaborative Governance Through Hexahelic Actor Synergy In Tuberculosis Combat Efforts In Makassar City

Riska Nuraisyah

Tuberculosis (TB) remains a public health problem in Makassar City and requires cross-sectoral collaborative governance. This study aims to analyze the hexahelic collaborative governance in TB control in Makassar City, involving government, academics, the business/philanthropic sector, the media, civil society, TB patient organizations, and donors. The study used a descriptive qualitative approach with a case study method. Data were obtained through in-depth interviews, observation, and documentation, then analyzed thematically using NVivo. The results show that collaboration has an initial foundation through the MoU, the Multisector Forum Decree, informal networks, and interdependence between actors. However, coordination still predominantly relies on the Health Office, while the Multisector Forum does not yet have a definitive chair and the Regional TB Action Plan has not been ratified. In terms of program achievements, the coverage of TB detection and treatment increased from 5,863 cases in 2022 to 7,314 cases in 2024, reaching 93%. The coverage of suspected TB screenings also exceeded the target, reaching 52,778 out of 43,119, or 122%. However, the success rate for drug-sensitive TB treatment declined to 73%, while the success rate for drug-resistant TB treatment decreased from 61% in 2022 to 39% in 2024. This study underscores the need for institutional strengthening, role allocation, funding, and capacity building of hexahelic actors.

Asia Pacific Journal of Health Management

A Workload and job performance among medical record professionals in an Indonesian specialised hospital

Implementation Of Collaborative Governance Through Hexahelic Actor Synergy In Tuberculosis Combat Efforts In Makassar City