Clinical pathway is a significant administration document to achieve the good clinical governance in the hospital. In Indonesia, this document is one of the very critical requirements that should be provided by the hospital to fulfil the KARS 2012 policy. As the center of referral teaching hospital of East Indonesia, Professor Dr. R. D. Kandou General Hospital has committed to fulfil the international standard of care, inter alia implementation of the clinical pathways based on the main cause of death, high risk, and high cost. There are several obstacles concerning this implementation, such as the irresponsibility of the doctors due to overloaded work, lack of concentration in filling the formation of clinical pathway, and uncertainity in the usage of clinical pathway. This study was aimed to evaluate the implementation of the clinical pathway and its limitation in the hospital above. The results showed that the administrative policy of the clinical pathway had been provided by the top management leader with the specialization in dengue shock syndrome (DSS), chronic kidney disease (CKD), eclampsia, benign prostatic hypertrophy (BPH), and myocardial infarction (MCI) without complication. Conclusion: Clinical pathway was implemented at Prof. Dr. R. D. Kandou General Hospital according to the Minister Health Regulation No. 012 Year 2012 about Standard Accreditation for Hospital.Keywords: clinical pathway, hospitalAbstrak: Clinical pathway merupakan bagian penting dari dokumen dan alat dalam mewujudkan good clinical governance di rumah sakit. Di Indonesia, dokumen ini juga menjadi salah satu syarat yang harus dipenuhi dalam Standar Akreditasi Rumah Sakit versi KARS 2012. Rumah Sakit Prof. Dr. R. D. Kandou merupakan rumah sakit pendidikan dan pusat rujukan untuk wilayah Indonesia Timur, berkomitmen untuk meningkatkan pelayanan berstandar internasional; salah satu upayanya dengan mengimplementasikan clinical pathway. Pemilihan clinical pathway ditujukan pada penyakit-penyakit yang merupakan penyebab utama kematian, berisiko tinggi, dan biaya tinggi. Kendala penggunaan clinical pathway antara lain kurangnya kepatuhan dokter penanggung jawab pasien terhadap clinical pathway, kurangnya konsentrasi dalam pengisian pembentukan clinical pathway, serta kesulitan kepastian penggunaan clinical pathway. Penelitian ini bertujuan untuk mengetahui pelaksanaan clinical pathway dan analisis terhadap kendala-kendalanya di RSUP Prof. Dr. R. D. Kandou Manado. Hasil studi menunjukkan bahwa pada tingkat manajerial telah tersedia kebijakan clinical pathway dan spesialisasinya yaitu dengue shock syndrome (DSS), penyakit ginjal kronik (PGK), preeklamsia berat, benign prostat hypertrophy (BPH), dan miokard cardiac infark (MCI) tanpa komplikasi. Simpulan: Clinical pathway telah diterapkan di RSUP Prof. Dr. R. D. Kandou berdasarkan Permenkes Nomor 012 tahun 2012 tentang Standar Akreditasi Rumah Sakit.Kata kunci: clinical pathway, rumah sakit

AbstrakThe purpose of this research is to know of the implication of coastal and seareclamation towards coastal peaple and to know the available efforts ofprotection as well as protection that should be pel/ormed. By benefitingprimary legal materials such as legislation regulations and internationalconventions as well as secondary legal materials such as text books, courtdecisions, experts' opinion, research results, journals, internet sources andnon-legal materials, it can be concluded that coastal and sea reclamationpossessed urgent implication on the coastal people's rights so protection isnecessary towards the coastal people through the establishment of specialact concerning coastal and sea reclamation, arranging the reclamationcomprehensively, comprising the adat law community, local as well as urbancommunity rights, also regulating the requirements, planning, performing,protection and/or compensation of the people as well as ordering conservingthe function of the environment.

Bangka Island in North Sulawesi is home to several endemics and endangered terrestrial and marine wildlife and at the same time a wellknown tourist destination is facing a serious threat to irreversible environmental destruction due to mining activities. Although finally ordered closure by Indonesian Supreme Court, the initial mining activities have greatly impacted the highly critical environment of Bangka Island. This study aims to examine the documents (including government-issued permits as well as related laws and regulations) and interviewed key respondents as to their knowledge of the supposed mining activity and their perceived impacts. Results revealed that there were lapses in the Indonesian government's side in issuing permits. The respondents (N = 34) were fully aware of the natural resources (including mineral resources being mined) and identified mining as the major threat to the sustainability of the livelihood (tourism and fishery) that highly depend on the fragile island ecosystem of Bangka Island. We showed using a multivariate non-metric multidimensional scaling based on the respondents' attitude or perception towards the mining activities in Bangka Island. Regardless of their educational status, age, and occupation, it appears that the respondents have negative perceptions towards mining and openly suggest that mining be stopped. We identified major failures on the side of the government and the mining operators, including lack of proper consultation among stakeholders as well as failure to recognize the fragile condition (i.e. as a small island ecosystem) of Bangka Island as indicated in Indonesian laws and regulations related to zoning and utilization.

Four urban villages in the administrative area of Tuminting District, i.e. Sindulang Satu, Sindulang Dua, Bitung Karangria and Maasing based on North Sulawesi Provincial Regulation Number 1 of 2017 concerning Coastal Zone Zoning Plans and Small Islands (RZWP-3-K) of Prov. North Sulawesi 2017-2037, will be used as a location to establish tourism supporting infrastructures. The purpose of this study is to determine the key factors for the success of the strategy for public facilities zone construction in Manado Bay, by taking into account the environmental, economic and social aspects. The study was conducted from September 2018 to March 2019. Data collection was carried out through in-depth interviewing techniques to 15 key people selected based on pentahelix. Data analysis employed SWOT and Strategic Analysis and Choice (SAC) to determine the alternative strategy. The results found six priority strategies as follows: (1) synchronizing the regulations for Coastal Zone spatial planning, (2) evaluating the coastal spatial planning regulations with regional development planning documents, (3) conducting socialization for coastal communities, (4) increasing the prosperity through small-scaled fishermen empowerment ( 5) developing 3A (increase, accessibility, and amenity) to support the tourism by increasing tourists’ visit, and (6) Improving the quality of human resources.Key words: RZWP-3-K, Public Facilities Zone, Pentahelix, SWOT. ABSTRAKEmpat kelurahan yang masuk dalam wilayah administrasi Kecamatan Tuminting yaitu: Sindulang Satu, Sindulang Dua, Bitung Karangria, dan Maasing berdasarkan Peraturan Daerah Provinsi Sulawesi Utara Nomor 1 Tahun 2017 tentang Rencana Zonasi Wilayah Pesisir dan Pulau-pulau Kecil (RZWP-3-K) Prov. Sulut Tahun 2017-2037, akan dimanfaatkan sebagai lokasi pembangunan infrastruktur penunjang pariwisata. Tujuan penelitian ini untuk menentukan faktor-faktor kunci keberhasilan sebagai strategi prioritas untuk pembangunan zona fasilitas umum penunjang pariwisata di Teluk Manado, dengan memperhatikan aspek lingkungan, aspek ekonomi dan aspek sosial. Penelitian dilakukan dari bulan September 2018 sampai Maret 2019. Pengumpulan data dilakukan dengan teknik wawancara secara mendalam (in depth interview) kepada 15 key persons dipilih berdasarkan pentahelix. Metode analisis data untuk menentukan strategi alternatif dengan menggunakan SWOT dan Strategic Analysis and Choice (SAC). Hasil penelitian menunjukan ada enam strategi prioritas yaitu: (1) melakukan sinkronisasi peraturan perundang-undangan bidang penataan ruang daerah pesisir, (2) melakukan sinkronisasi peraturan penataan ruang daerah pesisir dengan dokumen perencanaan pembangunan daerah, (3) melakukan sosialisasi kepada masyarakat pesisir, (4) meningkatan kesejahteraan melalui pemberdayaan nelayan kecil, (5) meningkatkan 3A (atraksi, aksesibilitas, dan amenitas) sebagai penunjang pariwisata untuk meningkatkan kunjungan wisatawan, (6) peningkatan kualitas sumber daya manusia.      Kata Kunci: RZWP-3-K, Zona Fasilitas Umum, Pentahelix, SWOT.

The environmental laws provide protection, good management, and conservation for the nature. The enforcement of said law does not mean stopping or negating development activities in the area. Progress must go on in accordance to agreed-upon development programs. Such developments, which in this case take place in Manado, need to take into account the impact towards the environment, in accordance to Environmental Protection and Management Act No. 32 of 2009 so as to not contaminate or compromise the life-supporting nature, both short-term and long term. For that purpose, developments in Manado must be executed with respect to sustainable, environmentally friendly development concepts, so development and natural conservation efforts can progress alongside each other.