Implementasi Manajemen Lean di IGD RS Akademik UGM

HUSNA YULIANINGSIH, 1. Dr. dr. Andreasta Meliala, DPH, M. Kes., MAS; 2. 2. DR. Firman SE., MPH

2021 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang : Permasalahan yang dihadapi dalam penerimaan pasien masuk rawat inap dari IGD yaitu lama waktu tunggu pasien yang akan masuk rawat inap rata-rata lebih dari 2 jam sebelum adanya pandemi covid-19. Terjadi peningkatan lama waktu tunggu 2-3 kali lipat sejak pandemi. Tujuan : Mendeskripsikan implementasi Manajemen Lean di IGD RS Akademik UGM, Mengukur efisiensi proses penerimaan pasien masuk di IGD RS Akademik UGM dan Mengimplementasikan solusi peningkatan efisiensi dalam proses penerimaan pasien masuk di IGD RS Akademik UGM. Metode : Disain penelitian ini Action Research. Penelitian ini memiliki empat siklus, yaitu perencanaan, implementasi (intervensi), dan evaluasi. Dalam tahap diagnosis, dilakukan pencatatan waktu dengan observasi yang dicatat dalam lembar pengamatan cycle time, lembar analisis value-added, waiting time dan lead time, lalu dimasukkan ke dalam Value Stream Mapping (VSM) sehingga didapatkan Value Added Ratio (VAR). Pada tahap perencanaan, usulan ide solusi untuk mengatasi waste dimasukkan dalam Diagram PICK. Kemudian dilakukan intervensi bersama stakeholder sesuai ide solusi terpilih dan dilakukan evaluasi. Hasil : Setelah Implementasi Manajemen Lean di IGD RS Akademik UGM , terjadi perubahan Lead Time Sub Proses 1 menurun (dari 121 menit menjadi 120 menit), Lead Time Sub Proses 2 meningkat (dari 278 menit menjadi 431 menit), Lead Time Sub Proses 3 menurun (dari 193 menit menjadi 159 menit). Terjadi peningkatan efisiensi dengan naiknya nilai VAR , Sub Proses 2 nilai VAR naik 8 % dari 23% menjadi 31 % dan Sub Proses 3 kenaikan efisiensi 2,2 % dari VAR 8,5 % menjadi 10,7%, penurunan sebesar 9 % dari 43 % menjadi 34 % pada sub proses 1. Kesimpulan : Implementasi Manajemen Lean di IGD RS Akademik UGM dilaksanakan dengan: (a) Penerapan 5 S dan Visual Management di IGD, (b) Pelatihan Implementasi Manajemen Lean bagi staf IGD, pendaftaran dan rawat inap, (c) Pengembangan Sistem Bed Reservation. Secara keseluruhan terjadi penurunan Lead Time dan peningkatan efisiensi setelah dilaksanakan Implementasi Manajemen Lean di RS Akademik UGM.

Background: The problem faced in receiving inpatients from the ER is the length of waiting time for patients who will be hospitalized on average more than 2 hours before the covid-19 pandemic. There has been an increase in waiting time of 2-3 times since the pandemic . Objectives : To describe the implementation of Lean Management in the ER of the UGM Academic Hospital, to measure the efficiency of the admission process at the UGM Academic Hospital and to implement solutions to increase efficiency in the admissions process of the UGM Academic Hospital. Methods: The design of this research is Action Research. This research has four cycles, diagnosis, planning, implementation (intervention), and evaluation. In the diagnosis stage, time is recorded with observations recorded in the cycle time observation sheet, value-added analysis sheet, waiting time and lead time, then entered into Value Stream Mapping (VSM) so that the Value Added Ratio (VAR) is obtained. At the planning stage, proposed solution ideas to overcome waste are included in the PICK Diagram. Then intervention with stakeholders is carried out according to the chosen solution idea and evaluation is carried out. Results: After the implementation of Lean Management in the ER of the UGM Academic Hospital, there was a change in the Lead Time of Sub Process 1 decreased (from 121 minutes to 120 minutes), Lead Time of Sub Process 2 increased (from 278 minutes to 431 minutes), Lead Time of Sub Process 3 decreased (from 193 minutes to 159 minutes). There was an increase in efficiency with an increase in the value of VAR, Sub Process 2 the value of VAR increased by 8% from 23% to 31% and Sub Process 3 increased in efficiency by 2.2% from VAR 8.5% to 10.7%, a decrease of 9% from 43 % to 34% in sub-process 1. Conclusion: Implementation of Lean Management in the Emergency Room at the UGM Academic Hospital is carried out by: (a) Implementation of 5S and Visual Management in the ER, (b) Training on Lean Management Implementation for ER staff, registration and hospitalization, (c) Development of the Bed Reservation System. Overall there was a decrease in Lead Time and an increase in efficiency after the implementation of Lean Management at the UGM Academic Hospital.

Kata Kunci : IGD, implementasi lean, waktu proses, VSM, efisiensi