Analisis Proses Pengadaan, Penerimaan dan Penyimpanan dengan Pendekatan Lean Hospital di Rumah Sakit Universitas Gadjah Mada

LUTHFI HIMAWAN, Prof. Dr. Marchaban, DESS., Apt. ; Dr. Satibi, M.Si.,Apt.

2020 | Tesis | MAGISTER ILMU FARMASI

Instalasi Farmasi jika dikelola dengan baik memberikan pendapatan terbesar terhadap rumah sakit, jika sebaliknya akan menjadi sumber pengeluaran yang besar bagi rumah sakit karena instalasi farmasi menggunakan anggaran terbesar. Berdasarkan laporan akhir tahun 2019, terdapat persoalan mengenai pengelolaan obat di IFRS UGM diantaranya adalah Nilai ITOR 6,6 kali, tingginya nilai kadaluwarsa dan rusaknya obat yaitu 3,27%, persentase kesesuaian barang dengan kartu stok yaitu 82,8%. Oleh karena itu dilakukan analisis aliran proses pengadaan, penerimaan dan penyimpanan serta menganalisis akar penyebab (root cause analysis) dari waste dan apakah ada dampak pada pasien di RS UGM. Penelitian ini bersifat deskriptif kualitatif. Pengambilan data diperoleh melalui wawancara, dokumen pengelolaan obat, standar prosedur operasional dan perhitungan cycle time melalui observasi pada proses pengelolaan obat. Identifikasi waste menggunakan Big Picture Mapping yang bertujuan untuk mengetahui dan menghitung presentase aktivitas yang termasuk kategori aktivitas yang memberikan nilai tambah, aktivitas yang penting namun tidak memberikan nilai tambah, dan aktivitas yang tidak memberikan nilai tambah. Fishbone Diagram digunakan untuk menganalisis sebab dan akibat suatu permasalahan sehingga ditemukan akar permasalahan dari waste kritis yang terjadi. Hasil penelitian menunjukkan persentase value added pada proses pengadaan 48,27%, proses penerimaan 20,5% dan proses penyimpanan 12,83%. Persentase necessarry but non value added pada proses pengadaan yaitu 51,72%, proses penerimaan 59% dan proses penyimpanan 5,3%. sedangkan non value added pada proses pengadaan yaitu 0,005%, proses penerimaan 20,5% dan proses penyimpanan 81,87%. Proses pengadaan, penerimaan dan penyimpanan dapat diidentifikasi dengan lean thinking, waste yang banyak terjadi diantaranya waste of overproduction, waste of waiting, waste of defect, waste of motion, waste of transportation., akar masalah sebagian besar terjadi pada pihak distributor/kurir, jika dibiarkan akan berdampak pada kekosongan obat pada pasien. Rumah sakit masih dapat melakukan perbaikan misalnya pada Sistem Informasi Manajemen Rumah Sakit.

Pharmacy Departement if managed properly provides the biggest revenue to the hospital, otherwise it will be a large source of expenditure for the hospital because the pharmaceutical departement uses the largest budget. Based on the final report in 2019, there were problems regarding drug management at IFRS UGM including ITOR value of 6.6 times, high expiry value and damage to drugs that was 3.27%, percentage of conformity of goods with stock cards was 82.8%. Therefore, it will be carried out an analysis of the process flow of procurement, acceptance and storage as well as analyzing the root causes (root cause analysis) of waste and whether there is an impact on patients at UGM Hospital. This research was descriptive qualitative. Retrieval of data obtained through interviews, drug management documents, standard operating procedures and calculation of cycle time through observation in the process of drug management. Waste identification used Big Picture Mapping which aims to find out and calculate the percentage of activities that are categorized as activities that provide added value, activities that are important but do not provide added value, and activities that do not provide added value. Fishbone Diagrams were used to analyze the causes and effects of a problem so that the root causes of critical waste are found. The results showed the percentage of value added in the procurement process was 48.27%, the acceptance process was 20.5% and the storage process was 12.83%. The percentage of necessity but non value added in the procurement process was 51.72%, the acceptance process was 59% and the storage process was 5.3%. while the non value added in the procurement process was 0.005%, the acceptance process was 20.5% and the storage process was 81.87%. The process of procurement, acceptance and storage can be identified by lean thinking, a lot of waste occurs among them were waste of overproduction, waste of waiting, waste of defect, waste of motion, waste of transportation. if left unchecked will have an impact on the vacancy of the drug in the patient. Hospitals could still be improved, for example in Hospital Management Information Systems.

Kata Kunci : Pengadaan Obat, Penerimaan Obat, Penyimpanan Obat, Big Picture Mapping, Lean Hospital.