PENDEKATAN LEAN MANAGEMENT UNTUK MENINGKATKAN PENULISAN RESEP ELEKTRONIK DI INSTALASI RAWAT JALAN RS PERTAMINA CIREBON

FARAH ALKATIRI, Prof. DR. Dra. Erna Kristin Apt., M.Si; DR. Firman SE., MPH

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: RS Pertamina Cirebon memiliki aplikasi resep elektronik yang terhubung kedalam SIMRS sejak tahun 2016. Pada pelaksanaannya aplikasi belum dimanfaatkan. Penerapan kembali resep elektronik di instalasi rawat jalan tanggal 28 November 2021, dengan hasil penggunaan resep elektronik <50%, lead time obat non racikan >30 menit dan racikan >60 menit. Untuk meningkatkan mutu dan kinerja organisasi pelayanan kesehatan, IOM menyarankan penggunaan berbagai pendekatan, antaralain penggunaan lean management. Tujuan: Mengimplementasikan lean management untuk meningkatkan penggunaan resep elektronik di instalasi rawat jalan RSPC. Metode: Action Research dengan pendekatan Participatory Action Research. Analisis data kuantitatif menguji beda mean lead time, Value Added Ratio penggunaan resep elektronik sebelum dan sesudah intervensi. Analisis data kualitatif dari data primer berupa hasil wawancara. Hasil dan Pembahasan: Sistem resep elektronik terdiri dari obat non racikan dan racikan. Pengurangan waste of extraprocessing, waiting dan inventory. Dilakukan perbaikan resep elektronik obat racikan. Peningkatan penggunaan resep elektronik 92%, non racikan 98% dan racikan 29%. Perbaikan lead time sistem resep elektronik dan layanan obat non racikan 31 menit 40 detik, dan racikan 45 menit 15 detik. Persepsi dokter dan petugas farmasi terkait resep elektronik dapat mempersingkat waktu layanan, mengurangi medication error dan peningkatan patient safety. Kesimpulan: Fitur resep elektronik yang ada di RSPC dapat digunakan oleh dokter. Implementasi lean management berdampak terhadap perbaikan waste, perbaikan lead time sistem resep elektronik, layanan resep elektronik obat non racikan dan racikan, perbaikan sistem resep elektronik racikan serta peningkatan penggunaan resep elektronik. Persepsi dokter dan petugas farmasi dengan adanya resep elektronik memberikan perbaikan kualitas layanan.

Background: Cirebon Pertamina Hospital has an e-prescribing application in place that has been connected to SIMRS since 2016. In practice, the application has yet to be utilized. The application was reinstated at the outpatient ward on November 28, 2021, with e-prescriptions being used <50% of the time and with lead times for other prescription medicine being >30 minutes and for pulveres medicine >60 minutes. To improve the quality and performance of health care organizations, IOM recommends the use of various approaches, including lean management. Objective: To implement lean management to improve e-prescribing practices at RSPC's outpatient ward. Method: Action Research using the Participatory Action Research approach. Quantitative data analysis testing the difference in mean lead times, Value Added Ratios before and after the intervention. Analysis of qualitative data from primary data in the form of interviews Results and Discussion: The e-prescription system consists of other prescription and pulveres medicine. Reduction of waste of extraprocessing, waiting and inventory. Improvements to e-prescription drugs were made. An increase in the use of e-prescriptions by 92%, other prescription medicine 98%, and pulveres medicine 29%. Improvement of lead time for the e-prescription system and service for other prescription medicine of 31 minutes 40 seconds and pulveres medicine of 45 minutes 15 seconds. Physicians and pharmacists perceive the e-prescribing system to be able to shorten service time, reduce medication errors, and increase patient safety. Conclusion: The e-prescribing feature in the RSPC can be used by physicians. The implementation of lean management has an impact on improving waste, improving the e-prescription system's lead time, e-prescription services for other prescription and pulveres medicine, and increasing the use of e-prescriptions. Physicians and pharmacists alike perceive the e-prescribing system to having improved service quality.

Kata Kunci : Resep elektronik, Lean Management, Lead time, Persepsi, E-prescription, Lean Management, Lead time, Perception