Redesain Struktur Organisasi untuk Efektivitas Layanan Kesehatan Mental: Studi Kualitatif di Rumah Sakit Jiwa Provinsi Bali. (Indonesian)

This study aims to provide an in-depth analysis of the application of organizational structure theory within the context of public organizations, using a case study of the Provincial Mental Hospital of Bali. The research focuses on how organizational design, authority distribution systems, and both formal and informal power dynamics influence coordination effectiveness and the quality of mental health services. A qualitative descriptive approach with an intrinsic case study method was employed. Data were collected through document analysis, non-participant observation, and semi-structured interviews with five key informants from various managerial levels. The findings reveal that the organization’s classical bureaucratic structure, characterized by five hierarchical layers, tends to hinder decision-making processes and cause fragmentation in inter-unit collaboration. Moreover, informal power dynamics were found to often override formal command lines, thereby disrupting organizational cohesion and reducing operational effectiveness. Based on these findings, the study recommends a redesign of the organizational structure to be more adaptive, decentralized, and collaborative, in order to improve service performance—particularly in the mental health sector, which demands rapid response and a holistic approach. These results not only offer theoretical contributions to the development of public organization theory but also serve as a practical reference for institutional reform in mental health services at both local and national levels. [ABSTRACT FROM AUTHOR]

Penelitian ini bertujuan untuk menganalisis secara mendalam penerapan teori struktur organisasi dalam konteks organisasi publik, dengan studi kasus yang difokuskan pada Rumah Sakit Jiwa Provinsi Bali. Kajian ini menitikberatkan pada bagaimana desain struktur organisasi, sistem distribusi wewenang, serta kekuasaan formal dan informal membentuk dinamika koordinasi dan memengaruhi efektivitas pelayanan kesehatan jiwa. Pendekatan yang digunakan adalah kualitatif deskriptif dengan metode studi kasus intrinsik. Data dikumpulkan melalui studi dokumentasi, observasi non-partisipatif, dan wawancara semistruktural terhadap lima informan kunci yang mewakili berbagai tingkatan manajerial. Hasil penelitian menunjukkan bahwa struktur organisasi yang masih bercorak birokrasi klasik dengan lima lapisan hierarki cenderung menghambat proses pengambilan keputusan dan menciptakan fragmentasi sistem kerja antarunit. Selain itu, temuan penting lainnya adalah dominasi kekuasaan informal yang kerap melemahkan jalur komando formal, sehingga mengganggu kohesi dan efektivitas organisasi. Berdasarkan temuan tersebut, penelitian ini merekomendasikan redesain struktur organisasi yang lebih adaptif, desentralistik, dan kolaboratif untuk meningkatkan kinerja pelayanan, khususnya dalam sektor kesehatan mental yang menuntut respons cepat dan pendekatan holistik. Temuan ini tidak hanya memberikan kontribusi teoretis terhadap pengembangan teori organisasi publik, tetapi juga menjadi rujukan praktis dalam upaya reformasi kelembagaan di sektor layanan kesehatan jiwa di tingkat daerah maupun nasional. [ABSTRACT FROM AUTHOR]

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