KESIAPAN DAN PENERIMAAN KARYAWAN TERHADAP PENERAPAN LEAN MANAGEMENT DI RS BETHESDA

KATHERINA ADISAPUTRO, Dr. dr. Andreasta Meliala, Dipl.PH., MKes, MAS

2020 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Efisiensi pelayanan kesehatan di rumah sakit dapat menjadi salah satu solusi di era JKN saat ini. Salah satu metode yang dapat digunakan adalah lean management. Rumah sakit Bethesda mulai menerapkan lean management pada tahun 2019 dengan fokus eliminasi waste, sedangkan organisasi yang hanya berfokus pada lean tools dan lean technique serta kurang fokus pada kesiapan dapat menurunkan tingkat sustainable dan hanya menjadi kegiatan jangka pendek (Radnor, 2011). Belum pernah dilakukan penilaian tingkat kesiapan dan penerimaan karyawan terhadap penerapan lean management yang telah dilakukan oleh RS Bethesda. Karena itu agar dapat berhasil melakukan penerapan lean diperlukan data-data mengenai kesiapan lean dan penerimaan lean dari rumah sakit. Tujuan: Mengukur kesiapan dan penerimaan karyawan terhadap penerapan lean management Metode: Metode penelitian ini menggunakan explanatory case study, dengan teknik pengumpulan data kuantitatif berupa survey dan kualitatif menggunakan in depth interview. Hasil dan Pembahasan: Kesiapan lean RS Bethesda yang dianalisis menggunakan fuzzy dan Euclidean didapatkan hasil 6.08, dengan jarak HLR 4 pada nilai 2.113 yang bermakna“close to ready”, yang bermakna bahwa RS Bethesda siap untuk memulai lean journey, namun belum sampai tahap siap sepenuhnya dan belum memiliki continuous improvement yang baik. Aspek-aspek kesiapan yang masih kurang perlu ditingkatkan, antara lain keterlibatan supplier dan customer dalam lean, lean sensei dalam institusi, resistensi karyawan , dan sistem reward. Dalam sub elemen kesiapan lean, indikator tertinggi pada elemen 6.4 yaitu keselamatan pasien dan karyawan, sedangkan indikator terendah pada elemen 5.2 yaitu keterlibatan supplier dan kesesuaian dengan institusi. Penerimaan lean RS Bethesda yang dinilai melalui lean maturity berada pada rerata level 3, namun dalam kondisi operasional di RS lean maturity berada pada level 2 dimana kesadaran terhadap lean sudah terjadi secara garis besar, namun pendekatan lean masih terjadi di sebagian area dengan efektivitas yang berbeda-beda. Hasil dengan penerimaan yang kurang antara lain belum adanya fondasi filosofi lean yang kuat serta sistem monitoring evaluasi yang belum terstandarisasi untuk semua bagian. Kesimpulan: Penerapan lean yang telah dilakukan memberikan output yang baik dalam segi finansial dan non-finansial. RS Bethesda dinilai memiliki kemampuan untuk memulai lean journey, namun aspek-aspek kesiapan yang kurang harus ditingkatkan. RS Bethesda memiliki tingkat penerimaan yang cukup untuk melakukan pengembangan lebih lanjut mengenai penerapan lean.

Introductions: Efficiency of health care services at a hospital became one of the solutions amid national health insurance era. Particular method offering the solution is lean management. Bethesda Hospital began implementing lean management in 2019. During the course of the program, readiness and acceptance evaluation at the level of employee never been accomplished. Organizations focused mainly on lean tools and lean techniques tend to allocate minimal measurement on readiness lead to reduced level of sustainability and last for short-term activities. Successful lean management require both preparation and implementation combining on lean readiness and lean acceptance data from the organization. Aim: This study aimed to measure employee readiness and acceptance toward implementation of lean management. Methods: An explanatory research took place in Bethesda Hospital, Yogyakarta. Survey were used to collect quantitative data while the qualitative approach performed through in-depth interviews. Results and Discussion: Lean readiness at Bethesda Hospital were analyzed using fuzzy and Euclidean. The analysis indicate value of 6.08 with HLR 4 distance 2.016 interpreted as "close to ready", therefore Bethesda Hospital is ready to start the lean journey, but is not yet fully ready , as well as continuous improvement. The aspects of readiness that still lack of improvement include supplier and customer involvement in lean, lean sensei in institutions, employee resistance, and reward systems. The highest indicator identified from element 6.4, patient and employee safety, while the lowest indicator originated from element 5.2, supplier involvement and conformity to the institution. Lean acceptance Bethesda Hospital measured through lean maturity present average score level 3, but in operational conditions at the hospital lean maturity is at level 2 where awareness of lean has occurred in general, but the lean approach only occurs in some areas with variability of effectiveness. The aspects of lean that still lack of improvement is the foundation of lean philosophy and a monitoring evaluation system that has not been standardized in all of sections. Conclusion: The lean implementation that has been carried out has provided good output in both financial and non-financial term. Bethesda hospital is considered to have the ability to start a lean journey, but the aspects of readiness that are lacking need to be improved. Bethesda hospital has sufficient level of acceptance to undertake further development of lean implementation.

Kata Kunci : Lean management, lean readiness, lean acceptance, Lean management, lean readiness, lean acceptance