Analisis Pelayanan Rawat Jalan RSUD Prambanan Dengan Pendekatan Lean Hospital

ROFI'ATUN SURYANI, Wakhid Slamet Ciptono, MBA., MPM., Ph.D.; Dr. Satibi, M.Si., Apt.

2017 | Tesis | S2 Ilmu Farmasi

Standar Pelayanan Minimal waktu tunggu pelayanan rawat jalan RSUD Prambanan belum sesuai target yaitu >30 menit. Konsep Lean Hospital yang sukses diterapkan di beberapa rumah sakit diharapkan dapat menghilangkan waste dan menambah value added activity yang pada akhirnya dapat memberikan rekomendasi perbaikan berkelanjutan khusunya masukan bagi pengembangan rumah sakit. Penelitian ini bertujuan untuk mengidentifikasi aliran pelayanan rawat jalan, letak bottleneck dan penyebabnya, serta memberikan usulan perbaikan terus-menerus dengan pendekatan Lean Hospital. Penelitian dilakukan selama bulan November 2016 hingga April 2017. Jenis penelitian adalah deskriptif kualitatif. Sampel diambil dengan teknik purposive dengan menggunakan sampel pasien hingga tercapai keadaan jenuh yaitu 61 responden. Analisis data menggunakan Value Stream Mapping dalam mengidentifikasi aliran pelayanan dan menemukan waste serta letak bottleneck dan Fishbone Diagram untuk menganalisis penyebab bottleneck. Penelitian ini menerapkan Metode BAS yaitu Baseline, Assess, dan Sugest Solution dari Metode BASICS. Hasil penelitian, Total Cycle Time 4,79 jam; Total Lead Time 9,31 jam; Total Waiting Time 4,52 jam. Waste yang terjadi antara lain waste of waiting, inventory, transportation, motion, overproduction, overprocessing, defect, dan waste of human potential. Bottleneck terletak pada pelayanan Poliklinik Dokter Spesialis, Farmasi Rawat Jalan, Laboratorium dan Radiologi. Dari Fishbone Diagram didapatkan akar penyebab masalah dan usulan solusi untuk meningkatkan kinerja layanan rawat jalan dalam hal: (1) Petugas; (2) Material, sarana prasarana penunjang pelayanan rawat jalan; (3) Metode (Standar Prosedur Operasional); (4) Peralatan dan (5) Lingkungan.

Outpatient services are a reflection of hospital-provided services. RSUD Prambanan is going to a new development by adding new facilities and buildings. The problem is that the current waiting time had not met the required standard which is >30 minutes. The successful concept of Lean Hospital applied in some hospitals is expected to eliminate waste and add value added activity which will ultimately increase patient satisfaction. This research objectives are to identify the outpatient service flow, the location of the bottleneck and its causes, and provide some suggestions of continuous improvement with Lean Hospital approach. This study was conducted on outpatient service department during November 2016 until April 2017. This research is a qualitative descriptive study which samples were taken by purposive technique until it reached the saturation condition that is 61 patients. Value Stream Mapping was used in data analysis to identify outpatient servise flow, waste and the location of the bottleneck. Fishbone Diagram was used to analyze the root cause of the bottleneck. This research applied Baseline, Assess, and Suggest Solution from BASICS Method. Results : Total Cycle Time 4,79 hours; Total Lead Time 9,31 hours; Total Waiting Time 4,52 hours. This research discover waste as list : waste of waiting, inventory, transportation, motion, overproduction, overprocessing, defect and waste of human potential. Bottleneck located at the Outpatient Clinic, Outpatient Pharmacy, Laboratory, and Radiology. From the Fishbone Diagram the root causes of the problem are found and solutions are proposed to improve the performance of outpatient services in terms of : (1) Manpower; (2) Material; (3) Method, in this case include method and management of service (Standard Operational Procedure), (4) Equipment and (5) Environtment

Kata Kunci : Lean Hospital, waste, VSM, bottleneck