Lamanya waktu tunggu di pelayanan di instalasi farmasi rawat jalan Rumah Sakit Ari Canti masih belum sesuai target Standar Pelayanan Minimal, dimana standar pelayanan minimal (SPM) mewajibkan waktu tunggu obat non racikan ≤30 menit dan obat racikan ≤60 menit. Penelitian ini bertujuan untuk menganalisis waktu tunggu pelayanan obat rawat jalan JKN dengan lean hospital di RS Ari Canti Tahun 2023. Desain penelitian ini adalah operational research (OR). Tempat dari penelitian adalah Depo Farmasi Rawat Jalan di RS Ari Canti saat hari kerja pada bulan Mei – Juni 2023. Sampel dalam penelitian ini diambil sebanyak 98 resep obat yang dibagi ke dalam beberapa poliklinik di RS Ari Canti. Pengamatan langsung menggunakan lembar observasi VSM dan lembar waste, wawancara mendalam dengan infoman menggunakan lembar wawancara. Hasil penelitian menunjukkan bahwa total waktu dalam pelayanan kefarmasian pada kondisi current state adalah 53 menit 12 detik. Lead time untuk obat racikan selama 1 jam 2 menit 28 detik sedangkan pada resep obat non-recikan selama 51 menit 41 detik. Setelah dilakukan pengkajian ditemukan 10 aktivitas waste yang terdiri dari 56,89% waste waiting, 20,75% waste defect, 15,53% waste motion, dan 6,83%waste overprocessing. Setelah dilakukannya intervensi lean hospital berupa 5S, visual management, heijunka borda pareto dan PDCA terjadi penurunan lead time dari 53 menit 12 detik menjadi 19 menit 47 detik dengan persentase penurunan sebesar 62,80%. Kemudian lead time berdasarkan resep obat racikan pasca intervensi selama 42 menit 7 detik, sedangkan lead time resep obat non racikan selama 18 menit 47 detik. Nilai value to waste ratio juga terjadi peningkatan dari sebelumnya pre intervensi sebesar 40,90% menjadi 88,32% pasca intervensi. Kesimpulan penelitian ini alalah Lean Hospital merupakan metode atau tool yang tepat untuk meningkatkan value to waste ratio dengan mengurangi pemborosan dan meningkatkan nilai tambah untuk pasien. Manajemen dapat melakukan langkah awal continuous improvement seperti menghitung kebutuhan obat secara berkala untuk dapat memproyeksikan persiapan obat sesuai dengan permintaan.
The length of time waiting for service at the outpatient pharmacy installation at Ari Canti Hospital is still not in accordance with the Minimum Service Standard target, where the minimum service standard (SPM) requires waiting time for non-concoction drugs ≤30 minutes and for mixed drugs ≤60 minutes. This study aims to analyze the waiting time for JKN outpatient drug services with lean hospital at Ari Canti Hospital in 2023. The design of this research is operational research (OR). The location of the research was the Outpatient Pharmacy Depot at Ari Canti Hospital during weekdays from May to June 2023. The sample in this study was taken as many as 98 drug prescriptions which were divided into several polyclinics at Ari Canti Hospital. Direct observation using VSM observation sheets and waste sheets, in-depth interviews with informants using interview sheets. The results showed that the total time in pharmaceutical services in the current state was 53 minutes 12 seconds. The lead time for concoction drugs is 1 hour 2 minutes 28 seconds while for non-recipe drug prescriptions it is 51 minutes 12 seconds. After conducting the study, it was found that 9 waste activities consisted of 56,89% waste waiting, 20,75% waste defects, 15,53% waste motion, and 6,83% waste overprocessing. After the lean hospital intervention in the form of 5S, visual management, heijunka borda pareto and PDCA, the lead time decreased from 53 minutes 12 seconds to 19 minutes 47 seconds with a decrease percentage of 62.80%. Then the lead time based on post-intervention concoction drug prescription was 42 minutes 7 seconds, while the non-concoction drug prescription lead time was 18 minutes 47 seconds. The value to waste ratio also increased from the previous pre-intervention of 40.90% to 88.32% post-intervention. The conclusion of this study is that Lean Hospital is the right method or tool to increase the value to waste ratio by reducing waste and increasing added value for patients. Management can take initial steps for continuous improvement, such as calculating drug needs on a regular basis to be able to project drug preparations according to demand.
Ni Wayan Ari Anindita Sari-Tesis-FKM-Full Text-2023.pdf ::