ANALISIS EFISIENSI PROSES PASIEN RAWAT JALAN DENGAN MENGGUNAKAN VALUE STREAM MAPPING DI RSUD DAYAKU RAJA KOTA BANGUN

DENY WIHARJA SURYANI, Dr. dr. Andreasta Meliala, dipl.PH, M. Kes, MAS; Dr. Firman, SE, MPH

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Rumah sakit merupakan institusi pelayanan kesehatan dimana pelayanan yang efektif, efisien dan cepat merupakan penilaian mutu rumah sakit. Lamanya proses pelayanan rawat jalan menjadi salah satu masalah yang dilaporkan oleh Komite Mutu Rumah Sakit Umum Daerah Dayaku Raja Kota Bangun. Rerata waktu tunggu bulan Juni- November 2021 yaitu 91 menit mulai mendaftar sampai bertemu dokter, hal ini berpengaruh pada lamanya proses pelayanan rawat jalan. Penerapan Lean Healthcare guna mengukur efisiensi pada berbagai proses layanan di rumah sakit dengan menerapkan tools Value Stream Mapping (VSM) diharapkan dapat menciptakan nilai tambah (value added) dan meniadakan pemborosan (waste) Tujuan: Mengimplementasikan value stream mapping, mengukur dan mengidentifikasi waste sebelum dan sesudah implementasi serta memberikan pelayanan yang efisien di RSUD Dayaku Raja. Metode: Penelitian ini menggunakan metode Action Research dengan empat tahapan yaitu Diagnosing, Planning action, Taking action dan Evaluation. Pengumpulan data kualitatif dengan wawancara mendalam, focus group discussion dan telaah dokumen. Penerapan konsep lean dengan tools Value Stream Mapping dilakukan dengan mengobservasi langsung terhadap proses layanan pasien rawat jalan dan mengidentifikasi secara detail pemborosan/waste pada proses pelayanan rawat jalan di RSUD Dayaku Raja Kota Bangun untuk menghasilkan efisiensi pelayanan. Hasil: Pemborosan (waste) utama yang teridentifikasi dalam proses pelayanan rawat jalan di poli penyakit dalam, obgyn dan bedah di RSUD Dayaku Raja antara lain waste of motion, inventory, transportation, waiting, dan over processing. Penerapan VSM memberikan gambaran tentang aliran pasien dan waktu prosesnya. VSM dapat memetakan waktu proses pelayanan pasien rawat jalan yaitu waiting time, cycle time, lead time dan process cycle efficiency (PCE) serta mengidentifikasi waste yang terjadi dalam proses layanan tersebut. Efisiensi proses setelah dianalisa hasil penggunaan VSM semuanya menunjukkan peningkatan, dimana PCE pre implementasi adalah 33,6% dan 48,5% (post implementasi).

Background: Hospital is a health service institution where effective, efficient and fast service is an assessment of hospital quality. The length of the outpatient service process was one of the problems reported by the Quality Committee of the Dayaku Raja Kota Bangun Regional General Hospital. The average waiting time in June - November 2021 is 91 minutes from registering to seeing a doctor, this affects the length of the outpatient service process. The application of Lean Healthcare to measure efficiency in various service processes in hospitals by applying Value Stream Mapping (VSM) tools is expected to create value added and eliminate waste. Objectives: Implement value stream mapping, measure and identify waste before and after after implementation and provide efficient services at the Dayaku Raja Hospital. Methods: This study uses the Action Research method with four stages, namely Diagnosing, Planning action, Taking action and Evaluation. Collecting qualitative data with in-depth interviews, focus group discussions and document review. The application of the lean concept with Value Stream Mapping tools is carried out by observing directly the outpatient service process and identifying in detail the waste in the outpatient service process at Dayaku Raja Hospital, Kota Bangun to produce service efficiency. Result: The main waste identified in the outpatient service process at the internal medicine, obgyn and surgery polyclinic at Dayaku Raja Hospital include waste of motion, inventory, transportation, waiting, and over processing. The application of VSM provides an overview of patient flow and processing time. VSM can map outpatient service process time, namely waiting time, cycle time, lead time and process cycle efficiency (PCE) and identify waste that occurs in the service process. Process efficiency after analyzing the results of using VSM all showed an increase, where pre-implementation PCE was 33.6% and 48.5% (post-implementation).

Kata Kunci : Lean Healthcare, Value stream mapping, waste, rawat jalan, efisiensi, Lean healthcare, Value stream mapping, waste, outpatient, efficiency