Instalasi Gawat Darurat (IGD) memberikan pelayanan yang cepat dan tepat untuk mencegah kondisi kesehatan pasien memburuk dan mencegah kematian dan kecacatan. Penelitian ini bertujuan untuk melakukan analisa patient flow dengan menggunakan pendekatan Lean Six Sigma. Desain penelitian ini adalah analisa kualitatif dan kuantitatif dengan kerangka acuan DMAI (Define, Measure, Analyze, dan Improve). Observasi dilakukan dengan teknik Time Motion Studies mulai dari pasien datang sampai perawat melakukan serah terima pasien diruang rawat inap yang dibagi menjadi 4 cycle (respontime dokter, waktu observasi, boarding dan transfer pasien), wawancara mendalam, telaah dokumen. Hasil penelitian dari 30 pasien rata-rata respon time dokter pada pasien level II adalah 35 menit 5 detik, dan pada pasien level III selama 43 menit 4 detik. Total Lead time 6 Jam 56 menit 08 detik. Hasil identifikasi value stream mapping dari 4 cycle didapatkan respon time dokter membutuhkan waktu 00:46:38, Waktu Observasi 01:29:47, Waktu Boarding 04:17:02 dan transfer pasien 00:22:42. Proporsi Non value Added secara keseluruhan adalah 84.95 % dan Value added sebesar 15,05 %, dengan total waste selama 05:53:29 detik. Hasil analisis Five Whys menunjukan adanya bottleneck diboardingpada proses kegiatan pencarian dan penempatan kamar (2:45:04) dengan penyebab yaitu ketersediaan kamar, sistem waiting list (karena menunggu pasien pulang, pasien asuransi atau rencana pulang), kebijakan beset kamar, sistem pencarian kamar di Front Office dan kebijakan titip kamar. Upaya penerapan Lean Six Sigma diharapkan dapat memperbaiki kinerja di IGD, selain menghilangkan waste dan memaksimalkan nilai (valu-added), mengetahui akar masalah, perbaikan kualitas dan peningkatan efisiensi kinerja secara terus menerus.
Kata kunci: Patient flow,Instalasi Gawat Darurat, Lean Six Sigma

---

Emergency Departement provides fast and precise services to prevent the patient's deteriorating health condition and prevent death and disability. This study aimed to analyze patient flow by using Lean Six Sigma approach. The design of this research are qualitative and quantitative analysis with reference framework DMAI (Define, Measure, Analyze, and Improve). Observation was conducted with Time Motion Studies technique from patient arriving until nurse performed patient handover in inpatient room which was divided into 4 cycles (doctor respontime, observation time, boarding and patient transfer), in-depth interview, study document. Research result from 30 patients on average the physician's response time at patient level II was 35 minutes 5 seconds, and in the patient's level III for 43 minutes 4 seconds. Total Lead time 6 Hours 56 mins 08 sec. Identification result of value stream mapping from 4 cycle got doctor time response time 00:46:38, Observation Time 01:29:47, Boarding Time 04:17:02 and patient transfer 00: 22: 42. Proportion of Non value added as a whole is 84.95% and Value added of 15.05%, with total waste for 05:53:29 sec. Five Whys analysis results showed that there are a bottleneck in the process of searching and placing the room (2:45:04) with the cause of room availability, waiting list system (waiting for the patient to go home, insurance patient or return plan), room beset policy, in the Front Office and room-care policies. We suggest to apply Lean Six Sigma to improve performance in the ER, in addition to eliminating waste and maximizing the value (valu-added), knowing the root of the problem, quality improvement and continuous improvement in performance efficiency.
Key words: Patient Flow, Emergency Departement, Lean Six Sigma