“Interaction with your staff is very important,” says Dr Fathema Djan Rachmat. “As a leader, your life is easier.”

Dr Fathema, who is settling into her new role as President Director of state-owned hospital group PT Pertamina Bina Medika, has a three-part vision for healthcare 4.0 – and people are central to it.

“You can ask for the wisdom of your employees and they can give you solutions,” she tells Hospital Insider. This creates a virtuous cycle – if hospital leaders respect their staff, their staff will respect the patients, she believes.

Empowered teams

Dr Fathema’s priorities lie in three key areas: empowering her staff; eliminating waste in processes; and creating better patient journeys and quality services. In her prior stint as President Director of Pelni Hospital, she frequently reached out to her employees on the lower levels for their opinions on how to improve the hospital’s processes. “You do not have to always ask consultants,” she notes.

It is a priority for her to make sure that her staff “can work easily”, and in “comfortable” environments. If staff are working in the right environment, they are able to keep providing quality services, she points out. A key priority for her is to upskill her doctors and staff too, she adds.

Going lean

Dr Fathema was the face of lean management at Pelni Hospital, where she sought to eliminate waste in processes. “We have indicators and standards for every process,” she remarks. “Usually, problems are in the process.”

Now, the billing for health insurance claims is more streamlined and takes up less time. “We can close the claims for 2,000 patients daily and send to BPJS (Indonesia’s Social Security Administration Agency for Health) in one day, using technology,” she explains. Before lean management was introduced, the hospital previously could only serve up to 300 patients a day.

The hospital has transformed the storage of medication as well. Through an online storage system, all staff and medication suppliers can view the available stocks. “We use them just in time, so we can reduce inventory cost,” Dr Fathema says.

She believes that with good standards and processes, it is possible to cut medication errors or get rid of them altogether. There is a system in place called the “Eight Rights”, she says – “Before the medication is released to the patient, through the system we can check that it is right about dose, frequency, pathway, everything”.

This system syncs up information from e-medical records, so that it is more convenient for doctors and staff. And the leadership team has patient safety meetings every week to discuss if there were lapses in safety or quality defects, and how to fix them, she adds.

These changes are partly possible thanks to the Pelni Hospital staff that built these solutions in-house, Dr Fathema continues – “50 percent of our employees are millennials”. They helped develop software to make the hospital operate more efficiently, she says.

Dr Fathema has been in her new role at the state-owned healthcare corporation for a month now, overseeing 13 hospitals. “It is a new and big playground,” she says, and “I started with standardising everything”.

Putting patients at the centre

Lean processes and empowered staff are key to creating a better patient journey. Hospitals in Indonesia need to also look at improving patient journeys and engagement, Dr Fathema believes. This means improving how doctors and nurses communicate between themselves; how they communicate with patients; and understanding what the patients’ expectations are.

It is crucial to focus on patient-centredness and patients’ needs in this way, she says. “How does the nurse communicate with patients? It is very important to ask the patient, what’s the right method for you?” she asserts.


“Leadership has to be more adaptive and enabling, it cannot be only administrative.”
Dr Fathema’s advice for other hospital leaders? “Leadership has to be more adaptive and enabling, it cannot be only administrative,” she emphasises. Hospitals need to find ways to develop new business models, processes and mindsets, because in the world of healthcare 4.0, “the smallest hospitals will disrupt even big hospital networks”, she notes.

Her vision for the future is simple: “I would like to improve access for every citizen so it is easier to get healthcare.” And despite the challenges in the healthcare space – for instance, stiff regulations, and the deficit faced by BPJS, as Dr Fathema points out – there are now opportunities to use technology to create new solutions and ways of working. E-clinics, e-prescriptions and integrated services are just some examples. “We have to find a way to create the future,” she concludes.