Internal Quality Assurance Model at Samarinda Midwifery Academy

The objectives to be achieved through this research are describe the Quality Assurance Model, Formulate the Quality Assurance Model, Describe the inhibiting factors and solution of the Quality assurance system at the Husada Flower Midwifery Academy, the Mahakam Pearl Midwifery Academy and the East Kalimantan Health Polytechnic. This study uses a qualitative approach to the type. Data collection techniques are carried out through in-depth interviews, participant observation and documentation. Establish procedures for preparation of implementation and required resources. Prepare human resources through the process of training, workshops and discussions. Samarinda Mahakam Pearl Midwifery Academy Samarinda. Conducted based on: Academic documents: quality standards that have been set. Quality document: as an instrument to achieve predetermined standards. Poltekkes Kemenkes East Kalimantan, The implementation of improving the quality assurance system is guided by: quality assurance principles oriented to inputs, processes and outputs. Formulation of Quality Assurance, preparation of quality improvement strategy plans is carried out systematically and structured in each midwifery academy which is oriented towards improving the quality of inputs, processes and outputs, with different strategies. Inhibiting factors and quality assurance system solutions implemented by carrying out: self-evaluation, internal academic quality audits, solutions carried out to determine the achievement of quality standards that have been set and evaluation findings used as material to improve the quality assurance improvement, which is planned, implemented and evaluated carried out implementation control and improvement in accordance with midwifery vocational education standards properly.


Introduction
The quality assurance of tertiary institutions in Indonesia was only officially begun in 2003 when the emergence of guidelines for higher education quality assurance was issued by the Higher Education Ministry of National Education, but actually the quality assurance movement had existed long before that. One significant factor driving the quality assurance movement within the tertiary institution is the establishment of the 2003-2010 helts which hopes that national tertiary education can contribute to the improvement of the nation's competitiveness and the creation of a healthy tertiary organization. In its implementation there are several Government policies in the Development of Higher Education Quality Assurance Systems), including: Law Number 20 of 2003 concerning the National Education System (national education system law). System has been improved from time to time. And of course it will be more perfect. To support the Ministerial Regulation socialization, workshops, guidance, books on the internal quality assurance system of Higher Education have been aimed at inspiring Universities to run education quality assurance.
Quality assurance of education is a must in the midwifery academy. Internally this quality assurance is usually carried out by an agency or unit that is domiciled under the leadership of a tertiary institution or the leader of a study program, integrated into the management of the tertiary institution or organizing a combination of the two. To see the quality of a tertiary institution, every year the Directorate General of tertiary education requires all tertiary institutions to fill in a Study Program Evaluation Report. Based on the results of this selfevaluation can be seen directly by stakeholders so that they can see for themselves the quality at the midwifery academy. Quality assurance that is born on its own initiative based on the needs and desires of institutions to continue to improve sustainable quality, will form a healthy and quality midwifery academy.
Every midwifery academy is expected to be responsive to the needs of stakeholders and be able to civilize internal quality assurance and improve quality on an ongoing basis, so that stakeholders get satisfaction as characterized by quality midwifery academy institutions Autonomy in the midwifery academy as described above, the Internal Quality Assurance System (SPMI) which is an internal system in the midwifery academy must be an autonomous (independent) system established by the midwifery academy itself.
The Government (Directorate of Quality Assurance, Directorate General of Learning and Student Affairs, Ministry of Research, Technology and Higher Education) is tasked with inspiring the pillars and good practices of the internal quality assurance system in midwifery academies. The higher education strengthens the integration of Higher Education Quality Assurance in a system with the change of name from the Higher Education Quality Assurance System to the Higher Education Quality Assurance System (SPM) higher education, which consists of the Internal Quality Assurance System (SPMI), External Quality Assurance System (SPME) or accreditation, and the Higher Education Database (Higher education database). Terry & Franklin (1972) explained that management is a typical process that consists of the actions of planning, organizing and controlling mobilization undertaken to determine and achieve the goals that have determined other resource utilization. Meanwhile, according to Koontz et al (1980) it provides a limitation that management is an effort to achieve a certain goal through the activities of others through planning, organizing, placement, mobilization and control. The researcher concludes that management contains an understanding of a social process with regard to the overall human endeavor with the help of humans and resources carried out jointly to obtain results in order to achieve the objectives through specified activities. managers / leaders include: planning (planning), For the planning category, as follows: (1) physical planning related to the properties and regulations of building materials and tools, (2) functional planning related to certain functions or tasks, (3) broad planning that covers the overall activities of the institution, (4) preparation of strategies, policies and programs, (5) combined planning which includes elements the above planning elements are combined and combined to become a complete pattern. Planning includes a variety of activities determining the need for determining strategies to achieve goals determining the contents of educational programs and others (Hämäläinen & Jakku-Sihvonen, 2000). The meaning of quality in an absolute concept level arises because of various views which cause confusion. The reason is that quality is used as a concept that is absolutely absolute and relative together. In the context of application, the concept of integrated quality management to education is emphasized (Sallis, 2014).
Total Quality Management is a philosophy of improvement, which can provide any educational institution with a set of practical tools for meeting and exceeding present and future customers' needs, wants and ecxpectations" The most important emphasis is that quality in the program can change the culture of education. In the world of education, total quality improvement is applied by various names and terms. For example, Total Quality Education which was developed also from Total Quality Management (TQM) which was originally applied in the business world (Sun, 2000;Walsh et al., 2002).
In Indonesia, TQM was first introduced in the 1980s and is now quite popular in the private sector especially with the ISO 9000 program. The strategy developed in the use of integrated quality management in the world of education is an educational institution that positions itself as a service institution or in other words a service industry, namely institutions that provide services in accordance with what is desired by the customer. So that's when it takes a management system that is able to empower higher quality educational institutions. The quality assurance model developed by Elton is very demanding of the commitment of all members (academics) of the relevant tertiary institution. In the development of quality assurance, a professional attitude is needed, namely those who want to be fully responsible for their work towards quality excellence (Elton, 1993). The quality assurance model developed by Elton in its scheme must first require: agreement on what needs to be met by its satisfaction requirements, identify activities that must be measured about its quality and establish procedures used to ensure that quality can be met and maintained. The Elton Model begins with demands coming from the public for the professionalism of the organizers of learning that must be carried out in tertiary institutions.
The specificity of the quality assurance model in the tertiary environment, can be influenced by the demands of the graduates or it can be influenced and formed because the relevant tertiary institution tries to adapt to the demands made by the world of work formulated in the job description. The objectives to be achieved through this research are describe the Quality Assurance Model, Formulate the Quality Assurance Model, Describe the inhibiting factors and solution of the Quality assurance system at the Husada Flower Midwifery Academy, the Mahakam Pearl Midwifery Academy and the East Kalimantan Health Polytechnic.

Methods
This study uses a qualitative approach to the type. Data collection techniques are carried out through in-depth interviews, participant observation, photography and documentation. Data were analyzed using Miless and Huberman, interactive transformations consisting of data collection, data reduction, data display and conclusion. Checking the validity of the data is done by testing the credibility, transferability, dependability, and confirmability.

Implementation of the Quality Assurance System at the Samarinda Midwifery Academy
Husada Flower Midwifery Academy Samarinda: (1) Establish procedures for the preparation of implementation and resources needed; (2) Preparing human resources through the process of training, workshops and discussions; (3) Human resources are trained and qualified so as to realize the implementation of thirteen components of quality standards that have been set.
Mutiara Mahakam Samarinda Midwifery Academy Implemented based on: (1) Academic documents: a predetermined quality standard plan; (2) Quality documents: as instruments to achieve predetermined standards; (3) Quality documents consist of: quality manuals, procedure manuals, work instructions, supporting documents and forms.
Poltekkes Kemenkes East Kalimantan. Implementation of quality improvement based on: (1) Implementing quality principles that are oriented to inputs, processes and outputs; (2) In improving its quality, pay attention to four factors that affect the quality of higher education: the quality of students, the quality of lecturers, the quality of researchers and the quality of community service. Conducted by carrying out self-evaluations, internal academic quality audits, to determine the achievement of predetermined quality standards and evaluation findings used as material for improvement of quality assurance improvements, which are planned, implemented and evaluated properly, thus having a good impact on inputs, processes and outputs. Mutiara Mahakam Samarinda Midwifery Academy has a positive impact making graduates skilled and ready to work the positive impact of strengthening accreditation produces quality graduates.

Model of Quality Assurance System at the Husada Bunga Midwifery Academy
Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan. The preparation of a quality improvement strategy plan at three midwifery academies is carried out systematically and structurally, each midwifery academy is oriented towards improving the quality of inputs, processes and outputs, with different strategies: Akbid Bunga Husada sets effective and efficient standards set out in 13 standards quality, Mutiara Mahakam Midwifery Academy is outlined in SPMI compiled in 3 books (policies, manuals and standards), while the Health Ministry of Health Polytechnic of East Kalimantan is a need analysis that aims to increase input and output.

Inhibiting Factors and Solutions to the Internal Quality Assurance System at the Husada Bunga Midwifery Academy
The Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan. Obstacle factor: STRENGTH: Leadership commitment, Status as the Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and Polytechnic of the Ministry of Health, East Kalimantan, Study programs that have accreditation, Application of an industry competency-based curriculum that produces soft skills character, adequate infrastructure, additional training programs for students before entering the world of work, learning material which includes theory (45 percent) and practice (55 percent), high absorption of the region against graduates. WEAKNESS: Unequal interest ratios for each study program, the number of teaching staff in some study programs, administrative and operating systems not yet fully based on information technology, there is no grand strategy for the implementation of the Law on Educational Law, the welfare of the internal community The solution carried out in the Three Midwifery Academies based on the Midwifery Academy Strategic Planningdocument in Samarinda 2008-2020, it is known that in order to realize the strategic goals and objectives that have been formulated and by taking into account the position of the Husada Flower Midwifery Academy, the Pearl Mahakam Midwifery Academy and the Polytechnic of the Ministry of Health of East Kalimantan from the results of the environmental analysis, the three Midwifery Academies formulated three programs and 13 policies as the strategies that had been formulated. The three programs are: (1) Program for equalization and expansion of university access; (2) Program for improving the quality of relevance and competitiveness; (3) Program for strengthening governance, accountability and public imaging. The three programs are a form of strategy formulation conducted by Bunga Husada Midwifery Academy, Mutiara Mahakam Midwifery Academy and Polytechnic of the Ministry of Health of East Kalimantan. Unlike Steiss's (2003) formulation of strategies and programs, the two concepts seem to be one in the strategic planning that has been carried out by the Husada Flower Midwifery Academy, the Pearl Mahakam Midwifery Academy and the Polytechnic of the Ministry of Health of East Kalimantan. These alternative policy and strategy resource recommendations selected by the three midwifery academies were then developed through 13 policies. These policies are further elaborated into activities that are carried out annually. The details of the policies referred to are as follows: (1) Policy for strengthening midwifery academies; (2) The policy to establish a motto of order, time, materials, meetings and records; (3) Policies implement curriculum revisions to keep abreast of industry developments; 4) Policy to prepare study programs to obtain an ISO 9001: 2000 certificate; (5) Policies to prepare study programs to obtain the BAN accreditation certificate for institution A; (6) Clean Friday policy; (7) HR strengthening policy; (8) Policy for conducting socialization to schools in 13 districts / cities; (9) Policy for accelerating student entry into industry; (10) Policies to increase the competitiveness of graduates; (11) Scholarship donor search policy; (12) Organizational strengthening policy; (13) Policy to search for third party funding sources through mutually beneficial cooperation.
Empirical Model of Strategic Planning of the Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and Polytechnic of the Ministry of Health of East Kalimantan, after reviewing and analyzing the strategic planning process carried out by the three midwifery academies, it came to a research finding that the strategic planning undertaken had fulfilled the five planning components strategic as Steiss's (1993) formulation. However, there is an overlap in the use of the concept of strategy with programs and policies in the strategy formulation stage, which results in the fourth and fifth strategic planning components, as if they were the same component. Based on the ten streams of strategy proposed by Mintzberg et al (2005), the Husada Flower Midwifery Academy, the Pearl Mahakam Midwifery Academy and the Polytechnic of the Ministry of Health in East Kalimantan in formulating a competitive strategy oriented to the flow flow configuration group, as indicated by the existence of efforts in the efforts of Mutiara Mahakam Midwifery and Poltekkes of the Ministry of Health in East Kalimantan. development of organizational management that focuses on consumers and products or services produced with special specifications. The competitive strategy used by the three midwifery academies in this study then seeks to be analyzed through the structural components of organizationaldesign, which includes the main objectives of the organization, the organizational strategy used, the understanding of the environment in which the organization operates and the selection of configurations used (Burton & Obel, 2018).
In the end, the positions of Bunga Husada Midwifery Academy, Mutiara Mahakam Midwifery Academy and Poltekkes Kemenkes East Kalimantan in the process of organizational transformation could also be identified. The strategic planning process carried out by the Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and the Health Ministry of Health Ministry of East Kalimantan begins with stage (1) system readiness analysis which involves identifying strategic issues, gathering rules and forming a planning team, then preparing the polytechnic profile and presenting information finance. Followed by step (2) the formulation of the vision and mission, goals and objectives, which generally emphasizes excellence at the national level then at the international level. Then next is stage (3)  (1) Establish procedures for the preparation of implementation and the resources needed; (2) Preparing human resources through the process of training, workshops and discussions; Human resources are trained and qualified so as to realize the implementation of thirteen components of quality standards that have been set. Mutiara Mahakam Samarinda Midwifery Academy; Implemented based on: (1) Academic documents: a planned quality standard; (2) Quality documents: as instruments to achieve predetermined standards; (3) Quality documents consist of: quality manuals, procedure manuals, work instructions, supporting documents and forms. Poltekkes Kemenkes East Kalimantan; Implementation of quality improvement is based on quality principles that are oriented to inputs, processes and outputs. In improving its quality, pay attention to four factors that affect the quality of tertiary institutions: student quality, lecturer quality, researcher quality and community service quality. Conducting self-evaluation, internal academic quality audits, to determine the achievement of established quality standards and evaluation findings used as material for improving quality assurance improvement, which is planned, implemented and evaluated properly, thus having a good impact on inputs, processes and outputs.
Model of Quality Assurance System at the Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan. Formulation of the Internal Quality Assurance System at the Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan. The midwifery academy is professionally managed by empowering human resources optimally, effective and efficient learning. By improving human resources Midwifery academy quality is better, the academic climate of facilities and infrastructure services, accreditation produces quality quality. Inhibiting Factors and Solutions to the Internal Quality Assurance System at the Husada Bunga Midwifery Academy, the Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan.
Obstacle factor at the Husada Flower Midwifery Academy, the Pearl Mahakam Midwifery Academy and the Polytechnic of the Ministry of Health, East Kalimantan, study programs that have been accredited, the application of an industry competency-based curriculum that produces soft skills, adequate infrastructure, the existence of additional training programs for students before entering the workforce, materials learning which includes theory (45 percent) and practice (55 percent), high absorption of the region towards graduates. The unequal interest ratio for each study program, the number of teaching staff in some study programs, administration systems and operations that are not yet fully based on Information Technology, there is no grand strategy for implementing the Law on Education Law, the welfare of the internal community has not been reached optimally. Commitment from the Central Government and Local Governments to increase the education budget, Formation of various other midwifery academies in the Regency / City areas in East Kalimantan, The need for information and technological development is very high, Increasing competition in the world of work among graduates, both within country and abroad in the era of globalization.
Solution to the Internal Quality Assurance System at the Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan. Based on the Midwifery Academy Strategic Planning document in Samarinda 2008-2020, it is known that in order to realize the strategic goals and objectives that have been formulated and by taking into account the position of the Midwifery Husada Academy, the Pearl Mahakam Midwifery Academy and the Polytechnic of the Ministry of Health of East Kalimantan from the results of environmental analysis, the three Midwifery Academies formulated three programs including: (1) Program equity and expansion of access to tertiary institutions; (2) Programs to improve the quality of relevance and competitiveness; (3) Programs for strengthening governance, accountability and public imaging.
Alternative Policies and Recommendations Resources The Husada Bunga Midwifery Academy, Mutiara Mahakam Midwifery Academy and the Health Ministry of Health, East Kalimantan. The strategies chosen by the three midwifery academies were then developed through the following policies: Policy for strengthening midwifery academies. The policy sets out an orderly motto of time, material, meeting and recording. Policies implement curriculum revisions to keep abreast of industry developments. Policy to prepare study programs to obtain accreditation certificates from National accreditation bodies of institutions A. Policy on strengthening human resources. Policy implementation of the socialization to schools. Policies to increase competitiveness of graduates. Scholarship donor search policy. Organizational strengthening policy. Policy to find third-party funding sources through mutually beneficial cooperation.

Conclusion
The implementation of improving the quality assurance system is guided quality assurance principles oriented to inputs, processes and outputs. Formulation of Quality Assurance, preparation of quality improvement strategy plans is carried out systematically and structured in each midwifery academy which is oriented towards improving the quality of inputs, processes and outputs, with different strategies. Inhibiting factors and quality assurance system solutions implemented by carrying out: self-evaluation, internal academic quality audits, solutions carried out to determine the achievement of quality standards that have been set and evaluation findings used as material to improve the quality assurance improvement, which is planned, implemented and evaluated carried out implementation control and improvement in accordance with midwifery vocational education standards properly. By improving human resources Midwifery academy quality is better, the academic climate of facilities and infrastructure services, accreditation produces quality quality. Policy to prepare study programs