PERAN LEADERSHIP DALAM KEBERHASILAN IMPLEMENTASI LEAN MANAGEMENT DI RUMAH SAKIT PELNI

IRENE TRISBIANTARA, dr. Andreasta Meliala M.Kes, MAS, Dr.

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Tantangan eksternal dalam sistem kesehatan di Indonesia saat ini mengharuskan rumah sakit untuk melakukan kendali mutu dan kendali biaya demi menjamin keberlangsungan kehidupan rumah sakit. Lean management merupakan salah satu solusi yang mulai diterapkan pada banyak rumah sakit, namun keberhasilannya sangat ditentukan oleh kehadiran leadership. Tujuan: Mengeksplanasi peranan leadership dalam keberhasilan implementasi lean management di rumah sakit. Metode: Penelitian ini menggunakan metode studi kasus eksplanatoris dengan desain kasus tunggal holistik pada rumah sakit Pelni di Jakarta. Informan penelitian dipilih secara purposive sampling sebanyak 1 direktur utama, 3 wakil direktur, 3 kepala divisi, 3 kepala instalasi dan 6 kepala urusan. Pengumpulan data dilakukan dengan observasi langsung, kuesioner kepada 50 orang staf, wawancara mendalam kepada para leader serta penelusuran dokumen rumah sakit. Hasil: Kehadiran transformational leadership dan transactional leadership berhasil menggerakkan implementasi lean management di rumah sakit dengan membentuk komitmen para staf melalui reward. Sebagai lean leadership disertai komitmen yang konstan dan standar tugas yang jelas pada setiap level leader, leader rumah sakit membentuk lingkungan continuous improvement dan target efisiensi pun selalu tercapai. Namun belum kuatnya keberadaan budaya berlandaskan filosofi lean di rumah sakit, serta komunikasi langsung yang belum terbangun dengan baik, minimnya pengembangan para pegawai dan sistem reward yang belum sesuai beban kerja, mengakibatkan munculnya sejumlah keluhan dari pegawai. Peningkatan beban kerja, tingkat stress dan kejenuhan sangat dirasakan oleh pegawai. Turn over pun menjadi tinggi, sementara kepuasan pasien rawat jalan tampak belum tercapai. Kesimpulan: Kombinasi transformational dan transactional leadership diperlukan pada awal implementasi lean management. Dalam proses selanjutnya, para leader rumah sakit harus memperluas peranan transformational leadership disertai komitmen dan standar tugas sebagai lean leadership. Keberadaan budaya organisasi yang kuat berlandaskan filosofi lean dan employee engagement sangat diperlukan untuk dapat mengatasi berbagai perubahan dan tantangan yang terus muncul dalam proses implementasi lean di rumah sakit.

Background: External challenges in the health system in Indonesia today require hospitals to perform quality control and cost control in order to ensure the survival of the hospital. Lean management is one solution that has begun to be applied in many hospitals, but its success is determined by the presence of leadership. Objective: Explain the role of leadership in the successful implementation of lean management at hospital. Method: This research is conducted using explanatory case study method with holistic singular case design at Pelni hospital, Jakarta. Resource persons of this research were selected through purposive sampling, comprising 1 chief director, 3 deputy directors, 3 chief division, 3 heads of installation and 6 chief of affairs. Data collection was conducted through direct observation, questionnaire to 50 staff persons, in-depth interview to leaders as well as examining hospitals documents. Result: The presence of transformational leadership and transactional leadership succeeded in driving the imple mentation of lean management in hospitals by establishing the comm itment of staff through rewards. As lean leadership is accompanied by constant commitment and clear standard of duties in every leader s level, hospital leaders form a continuous improvement environment and efficiency targets were always achieved. However, lack of strong culture based on lean philosophy in hospitals, inadequate direct communication, and lack of staff development and reward systems that did not fit the workload resulted in a number of complaints from employees. Increased workload, stress level and burnout were faced by employees. Turn over became too high, while out-patient satisfaction seemed to be not yet achieved. Conclusion: A combination of transformational and transactional leadership is required in early implementation of lean management. In the next process, the leaders of hospitals must expand the role of transformational leadership with commitment and standard of duties as lean leadership. The existence of a strong organizational culture based on lean philosophy and employee engagement is necessary to address many transformation and challenges that continue to appear in the process of lean implementation in hospitals.

Kata Kunci : Transformational leadership, lean management, hospital leader, lean leadership, lean philosophy, culture, employee engagement, Transformational leadership, lean management, hospital leader, lean leadership, lean philosophy, culture, employee engagement.