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Pelayanan kesehatan yang berkualitas salah satunya dapat dinilai dari lamanya waktu tunggu pelayanan. Waktu tunggu yang lama di rawat jalan akan menghambat pelayanan dan menyebabkan penumpukan pasien serta inefisiensi pelayanan. Penelitian ini bertujuan melakukan analisis alur pelayanan online untuk mengurangi waktu tunggu pasien di Poliklinik Kebidanan RSUPN Dr. Cipto Mangunkusumo dengan pendekatan metode lean. Penelitian ini menggunakan penelitian kuantitatif dan kualitatif. Variabel yang dianalisis meliputi alur pelayanan pasien, cycle time, lead time, takt time, current state, value added activity, non value added activity, waste, fishbone diagram, dan future state. Teknik pengumpulan data dengan menggunakan observasi, wawancara mendalam, dan telaah dokumen. Hasil penelitian didapatkan rata-rata total lead time adalah 109,6 menit. Waktu tunggu paling cepat di pendaftaran 23,3 menit dan paling lama di farmasi 121,3 menit. Value added activities sebesar 13,2 % dan non value added activities sebesar 86,8%. Nilai value-to-waste ratio 15,2%. Hal ini menunjukan bahwa pelayanan belum dalam kondisi lean. Waste yang ditemukan adalah defect, transportation, motion, waiting dan over processing. Analisis future state dengan penerapan metode lean dapat menurunkan non value added menjadi 75% dan jika ditambah digitalisasi pengiriman obat akan menurunkan non value added menjadi 66 %. Usulan peneliti adalah dengan melakukan perbaikan jangka pendek, menengah dan panjang melalui program pelaksanaan metode lean yang berkelanjutan.
Quality health services can be assessed by the length of waiting time. Long waiting times in outpatient care will hamper services and cause patient accumulation and service inefficiencies. This study aims to analyze the flow of online services to reduce patient waiting time at the Obstetric and Gynecology Polyclinic of Dr. Cipto Mangunkusumo Hospital using the lean method approach. This study used quantitative and qualitative research. The variables analyzed include patient service flow, cycle time, lead time, takt time, current state, value added activity, non-value added activity, waste, fishbone diagram, and future state. Data collection techniques using observation, in-depth interviews, and document review. The results showed that thevaverage total lead time was 109,6 minutes. The fastest waiting time in registration is 23,3 minutes and the longest in pharmacy is 121,3 minutes. Value added activities amounted to 13,5 % and non-value added activities amounted to 86,5%. The value-to-waste ratio is 15.2%. This shows that the service is not yet in a lean condition. Waste found is defect, transportation, motion, waiting and over processing. Future state analysis with the application of lean methods can reduce non-value added to 75% and if digitalization of drug delivery is added, non-value added will decrease to 66%. The researcher's proposal is to make short, medium and long term improvements through a sustainable lean method implementation program.
To increase community affordability towards basic health services, several Public Health Center (PHC) in Indonesia have been upgraded to inpatient PHC, including in Bogor Regency. The number of inpatient visits during the last few years did not increase significantly, even during the last 2 years decreased. Even though during that period there were two new inpatient PHC unit. It is still unknown whether the low level of patient visits is related to the performance of that inpatient PHC unit. The purpose of this study was to determine the performance description and organizational factors related to the performance of inpatient PHC unit at the Bogor Regency in 2020 based on Malcolm Baldrige's criteria: leadership; strategic planning; patient focus; measurement, analysis and knowledge management; workforce focus, and process management. The design of this research is sequential explanatory by using mixed methods between quantitative and qualitative. The study involved 168 respondents from 13 inpatient PHC in Bogor Regency. Data analized with Chi Square Test and multiple logistic regression. In-depth interviews were conducted with 8 informants from selected PHC and 1 informant from Bogor Public Health Office. The results showed that the proportion of respondents who rated the performance of the inpatient PHC unit as good (54.2%) was greater than the proportion of respondents who rated the performance of the inpatient PHC unit as not good (48.2%). Based on Malcolm Baldrige's score, nine PHC are in the benchmark leader criteria while four other PHC are in the industry leader criteria. The results also show that there is a relationship between strategic planning (p-value=0.011), measurement analysis and knowledge management (p-value=0.003) and process management (p-value=0.011) with the results of the performance of inpatient services. The most dominant variable related to performance in this research is measurement, analysis and knowledge management (OR = 7.678). Recommendations for this study are the acceleration of BLUD legal protection making by the local government of Bogor Regency, increasing the frequency of scientific update activities and training for health workers and data management personnel at the PHC, better management of patient voices by the PHC, and a better reward system by the chief of PHC.
Ditinjau dengan pendekatan Malcolm Baldrige, FKTP percontohan dapat dianalisis faktor-faktor yang menghantarkannya sebagai pemenang, hasilmenunjukkan bahwa enam variabel independen dari tujuh kriteria Malcolm Baldrige,yaitu kepemimpinan, perencanaan strategis, fokus pada pelanggan dan pasar, sisteminformasi manajemen, fokus pada staf dan fokus pada proses, memiliki hubungan denganvariabel dependen yaitu hasil kinerja organisasi.
Studi kualitatif penelitian inimenunjukkan bahwa masing-masing kategori FKTP yaitu Klinik Pratama, Dokter PraktekPerorangan, Puskesmas dan klinik TNI/POLRI memiliki keunggulannya masing-masingditinjau dari Kriteria Malcolm Baldrige, hal ini merupakan sebuah bahan rekomendasisekaligus evaluasi bagi penyelenggara Jaminan Kesehatan (BPJS-Kesehatan) danregulator sistem kesehatan (Kemkes) agar membenahi FKTP yang ada dan menciptakanFKTP yang ideal di seluruh Indonesia.
Kata Kunci: FKTP, BPJS-Kesehatan, Pelayanan Kesehatan Primer, Dokter LayananPrimer, Malcolm Baldrige
Fasilitas Kesehatan Tingkat Pertama (FKTP), ideally be the gatekeepers on healthsystems in all states, including in Indonesia. effective efforts to quality control and costcontrol should be done since patients do the first contact with health services in PrimaryHealth care. BPJS- Kesehatan strives to maximize the quality and function of the primaryservice on the whole FKTP of various categories, as well as motivate FKTP for a race tobe the best, therefore the BPJS-Kesehatan Primary Care Award 2014 was held. BPJS-Kesehatan Primary Care Award 2014 held since April to October 2014, the best FKTP selection process conducted with a selection of tiered approaches starts from the level ofbranch offices, regional division offices to the national level, producing five best nationallevel FKTP, FKTP election results are interesting for research, FKTP as for the examinedFKTP throughout Indonesia.
Reviewed by Malcolm Baldrige approximation, Bestpractices of FKTP can be analyzed by factors that passed it as the winner, the resultsshowed that six of the seven independent variables Malcolm Baldrige, leadership,strategic planning, customer and market focus, information systems management,focusing on staff and focus on the process, have a correlation to the dependent variablei.e. performance results of the organization.
Study of the qualitative research indicatesthat each category of FKTP i.e. the Clinic Pratama, individuals Practice Doctor,PUSKESMAS and clinics TNI/POLRI have respective advantages in terms of MalcolmBaldrige Criteria, this Result is a recommendation and evaluation materials forHealthcare providers (BPJS-Kesehatan) and regulators of health systems (Kemkes) inorder to restructure the existing FKTP and create the ideal FKTP throughout Indonesia.
Key Words : Primary Health Care, BPJS-Kesehatan, Health Practitioner, medical doctor,FKTP, DLP, Malcolm Baldrige
Tujuan: Penelitian bertujuan untuk mengetahui faktor-faktor apa saja yang berhubungan dengan kepatuhan kontrol pasien glaukoma di Poliklinik Mata RSUP. Dr. Cipto Mangunkusumo tahun 2017.
Metode: Penelitian menggunakan rancangan crossectional. Populasi adalah pasien glaukoma yang berkunjung di Poliklinik Mata RSUP Dr. Cipto Mangunkusumo bulan Juli-September 2017. Instrumen yang digunakan adalah kuesioner dengan skala sikap.
Hasil: Kepatuhan kontrol pasien glaukoma di Poliklinik Mata RSUP Dr. Cipto Mangunkusumo bulan Juli-September 2017 adalah 74%. Berdasarkan analisis bivariat didapatkan variabel yang berhubungan dengan kepatuhan kontrol pasien glaukoma adalah lama menderita (0,000), tingkat pengetahuan (0,000), motivasi berobat (0,000), dukungan keluarga (0,000) dan peran tenaga kesehatan (0,000). Berdasarkan analisis multivariat, motivasi berobat mempunyai pengruh terbesar dalam kepatuhan kontrol pasien glaukoma (OR =12.015).
Kesimpulan: Perlunya peran serta keluarga, tenaga kesehatan dalam memberikan dukungan terhadap pasien glaukoma supaya timbul motivasi untuk disiplin dalam program pengobatan dan patuh untuk kontrol sesuai jadwal.
Kata kunci: Kepatuhan kontrol, glaukoma, rumah sakit
Background: Glaucoma is the second largest cause of blindness in the world after cataracts. It is estimated that there will be 79.4 million glaucoma patients by 2020 worldwide, the prevalence of glaucoma in Indonesia is 0.5%. Symptoms of glaucoma are often unrecognized because they resemble other symptoms of the disease so that the late glaucoma diagnosis results in total blindness. From the research of glaucoma seminar in 2013-2014 in RSCM, 64 patients with open-angle glaucoma were 51,4% advanced condition, 13,5% were totally blind, 76 patients with closed angle glaucoma 41,4% advanced condition, 26, 4% total blindness.
Objective: The objective of this research is to know what factors are related to compliance control of glaucoma patients in Poliklinik Mata RSUP. Dr. Cipto Mangunkusumo in 2017.
Methods: The study used crossectional design. The population is glaucoma patients who visit the Eye Poliklinik Mata RSUP. Dr. Cipto Mangunkusumo from July- September 2017. The instrument used is questionnaire with attitude scale.
Results: Compliance of control of glaucoma patients at Eye Polyclinic of Dr. Cipto Mangunkusumo from July to September 2017 is 74%. Based on the bivariate analysis, the variables related to the control compliance of glaucoma patients were long suffering (0,000), knowledge level (0,000), treatment motivation (0,000), family support (0,000) and the role of health workers (0.000). Based on multivariate analysis, motivation of medication has the biggest influence in compliance control of glaucoma patients (OR = 12.015).
Conclusion: The need for family participation, health personnel in providing support to glaucoma patients to generate motivation for discipline in treatment programs and adherence to controls on schedule.
Keywords: Compliance control, glaucoma, hospital
