PENDEKATAN LEAN HEALTHCARE UNTUK MEMINIMASI WASTE DI PELAYANAN UNIT LABORATORIUM RS PANTI NUGROHO SLEMAN

MUHAMMAD ALDAFIKIN, Dr. dr. Hanevi Djasri, MARS, FISQua; Dr. Firman, SE., MPH.

2020 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Laboratorium merupakan organisasi yang kompleks dan dinamis yang sehingga perlu meningkatkan kualitas pengujian dan memenuhi pedoman yang ketat. Pelayanan laboratorium pemeriksaan kima darah RS Panti Nugroho membutuhkan waktu 60-90 menit mulai dari penerimaan memo pengantar pemeriksaan laboratorium hingga hasil pemeriksaan selesai dengan prosentase 65,42% dari total pada triwulan ketiga tahun 2019, namun belum terdapat upaya untuk menurunkan waktu pelayanan laboratorium. Lean healthcare menjadi salah satu alternatif yang mudah, murah dan baik dalam meningkatkan efisiensi waktu pelayanan dengan meminimasi waste dalam proses pelayanan. Tujuan: Mengimplementasikan lean healthcare dan dampaknya untuk meminimasi waste di pelayanan laboratorium RS Panti Nugroho. Metode: Desain penelitian ini adalah action research, yang terdiri dari: a) Tahap diagnosis, melibatkan partisipan dalam identifikasi dan pengelompokkan waste serta mengidentifikasi penyebab waste, b) Tahap planning, melibatkan partisipan dalam mengidentifikasi alternatif perbaikan dan penetapan intervensi solusi, c) Tahap action, melibatkan partisipan dalam mengimplementasikan intervensi solusi yang telah ditetapkan bersama dan d) Tahap evaluation, membandingkan beda rerata lead time dan value added ratio. Hasil: Secara statistik tidak terdapat perbedaan rerata lead time sebelum dan sesudah intervensi lean healthcare dalam pelayanan laboratorum pemeriksaan kimia darah. Namun terjadi pengurangan waste of waiting yaitu penurunan lead time sesudah intervensi lean healthcare dan peningkatan value added ratio 1,64%. Tools yang dipergunakan adalah 5S (Sort, Set in order, Shine, Standardize dan Sustain), visual management dan standard work. Simpulan: Pendekatan lean healthcare pada pelayanan laboratorium pemeriksaan kimia darah dapat meminimasi 5 dari 9 waste yang ditemukan saat observasi sebelum intervensi.

Background: The laboratory is a complex and dynamic organization that needs to improve its quality of testing and fulfill strict guidelines. Laboratory services for blood climax examination at Panti Nugroho Hospital require 60-90 minutes starting from the receipt of a laboratory examination introduction note until the results of the examination are completed with a percentage of 65.81% of the total in the third quarter of 2019, but there has been no attempt to reduce laboratory service time. Lean healthcare is one of the easy, inexpensive and good alternatives in increasing service time efficiency by minimizing waste in the service process. Objective: Implement lean healthcare and its impact to minimize waste in laboratory services at Panti Nugroho Hospital. Methods: The design of this study was action research, which consists of: a) the diagnosis stage, involving participants in the identification and grouping of waste and identifying the causes of waste, b) the planning stage, involving participants in identifying alternative improvements and setting solution interventions, c) the action phase, involving participants in implementing the solution interventions that have been set together and d) the evaluation phase, comparing the different lead time averages and the value added ratio. Results: Statistically, there is no difference in the average lead time before and after lean healthcare interventions in the service of blood chemistry examination laboratories. However, there was a reduction in waste of waiting, which was a decrease in lead time after lean healthcare intervention and an increase in value added ratio of 1.64%. The tools used are 5S (Sort, Set in order, Shine, Standardize and Sustain), visual management and standard work Conclusion: The lean healthcare approach to blood chemistry laboratory testing services can minimize 5 out of 9 waste found during observation prior to intervention.

Kata Kunci : Lean healthcare, waste, unit laboratorium