IMPLEMENTASI MANAJEMEN LEAN PADA OPERASI SOFT TISSUE TUMOR DI INSTALASI BEDAH SENTRAL RSUD PATUT PATUH PATJU KABUPATEN LOMBOK BARAT

NANANG WIDODO, Dr. dr. Hanevi Djasri, MARS FISQua; Dr. Firman, SE, MPH

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Kamar operasi adalah salah satu instalasi yang sangat vital di rumah sakit. Beberapa indikator pelayanan di kamar Operasi RSUD Patut Patuh Patju masih belum memenuhi stadart. Tujuan: Mengimplementasikan manajemen lean, mengidentifikasi dan mengukur waste sebelum dan sesudah, mengidentifikasi perilaku petugas untuk penandaan area operasi sebelum dan sesudah implementasi lean, mengukur outcome dari implementasi manajemen lean pada operasi soft tissue tumor di Instalasi Bedah Sentral RSUD Patut Patuh Patju Kabupaten Lombok Barat. Metode: Desain penelitian adalah Action Research. Pendekatan yang dilakukan adalah Participatory Action Research (PAR). Pengumpulan data dengan menggunakan wawancara, observasi, diskusi dan dokumen. Analisis data untuk menguji hipotesa dilakukan dengan menguji beda rerata (mean) lead time menggunakan student t-test. Hasil dan Pembahasan: Value pelanggan operasi cepat dan tidak nyeri, sedangkan value petugas kepastian atau ketepatan waktu. Waste yang dominan pada penelitian ini adalah waste of motion, waiting dan defect dan extra processing. Solusi pada prinsipnya betujuan mengurangi motion petugas dan mengatasi waste lainnya. Tools diusulkan dan disepakati oleh staf 5S, Visual Management, Standarisasi, hingga penggunaan Teknologi Informasi. Setelah Implementasi tools waktu proses berkurang. Nilai Value Added Rasio (VAR) mengalami peningkatan. Site marking meningkat dan tingkat nyeri yang dipersepsikan pasien mengalami penurunan signifikan. Efisiensi pengolahan sampah medis sebanyak juga signifikan baik untuk Tindakan operasi STT maupun tindakan operasi yang lainnya. Setelah implementasi lean staf di kamar operasi mempersepsikan implementasi lean sebagai hal positif dan memberikan manfaat untuk kecepatan, kemudahan, keteraturan, ketepatan, efisiensi dan safety dalam melaksanakan operasi. Kesimpulan: Implementasi Manajemen Lean terbukti meningkatkan value added ratio dan menurunkan lead time proses operasi soft tissue tumor. Tools utama yang dipergunakan untuk mengimplementasikan lean adalah 5S, Visual management, standarisasi dan penggunaan teknologi informasi. Ouput implementasi lean pada proses operasi STT menurunkan waktu proses, mengurangi persepsi nyeri, mengurangi sampah medis, mengurangi pemborosan pemakaian benang. serta meningkatkan perilaku kepatuhan site marking pasien.

Background: The operating room is one of the very vital installations in the hospital. Some indicators of service in the Operating room of the Patju Compliant Hospital still do not meet the stadart. Objectives: Implementing lean management, identifying and measuring waste before and after, identifying officer behavior for marking operation areas before and after lean implementation, measuring the outcomes of lean management implementation on tumor soft tissue operations in the Operating Room Installation of Rsud Patut Patuh Patju, West Lombok Regency. Method: The research design is Action Research. The approach taken is Participatory Action Research (PAR). Data collection using interviews, observations, discussions and documents. Data analysis to test hypotheses was carried out by testing the mean difference in lead time using a student t-test. Result and Discussion: The customer value of fast and painless operation, while the value of the officer is certainty or punctuality. The dominant waste in this study is waste of motion, waiting and defect and extra processing. The solution in principle aims to reduce officer motion and overcome other waste. Tools are proposed and agreed upon by 5S staff, Visual Management, Standardization, to the use of Information Technology. After the implementation of the tools the process time is reduced. The Value Added Ratio (VAR) value has increased. Site markings increased and the patient's perceived pain level decreased significantly. The efficiency of medical waste processing is also significant for both STT surgery and other surgical procedures. After the implementation of lean staff in the operating room perceives lean implementation as a positive thing and provides benefits for speed, convenience, regularity, accuracy, efficiency and safety in carrying out operations. Conclusion: The implementation of Lean Management has been proven to increase the value added ratio and reduce the lead time of the tumor soft tissue surgery process. The main tools used to implement lean are 5S, Visual management, standardization and use of information technology. The output of lean implementation in the STT surgery process also decreases process time, reduces pain perception, reduces medical waste, reduces thread wastage. and improve patient site marking compliance behavior.

Kata Kunci : Manajemen Lean , Waste, Efisiensi, Soft tissue tumor, Kamar operasi, Lean Management, Waste, Efficiency, Soft tumor tissue, Operating Room