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Rumah Sakit Atma Jaya tidak mempunyai suatu bentuk penilaian kinerja yang komprehensif dan data Rumah Sakit Atma Jaya menunjukkan bahwa 75% pasien Inslalasi Rawat Inap berasal dari Instalasi Gawat Darurat, untuk menjadikan Instalasi Gawat Darurat sebagai andalan Rumah Sakit Atma Jaya maka Instalasi Gawat Darurat Rumah Sakit Atma Jaya perlu dievaluasi kinerjanya yang selanjutnya menjadi bahan masukan bagi Rumah Sakit Atma Jaya dengan memakai pendekatan balance scorecard maka kinerja Instalasi Gawat Darurat dapat dievaluasi dari komitmen dan kepuasan kerja sumber daya manusia di Instalasi Gawat Darurat, pelayanan pasien di Instalasi Gawat Darurat, kepuasan pasien di Instalasi Gawat Darurat dan kinerja keuangan Instalasi Gawat Darurat.Penelititan ini dilakukan secara deskriptif kualitatif dan kuantitatif dengan responden sebanyak 23 orang sumber daya manusia di Instalasi Gawat Darurat, 288 orang pasien yang datang berobat di Instalasi Gawat Darurat selama bulan Mel tahun 2002 yang dipilih secara random. Alat penelititan yang digunakan yaitu : wawancara mendalam, kuesioner, dan check list. Data yang dikumpulkan dianalisa secara deskriptif kualitatif dan kuantitatif.Hasil penelitian menunjukkan bahwa indikator sumber daya manusia di Instalasi Gawat Darurat belum baik yaitu mereka tidak puas dan tidak komitmen terhadap Instalasi Gawat Darurat. Akibat dari indikator sumber daya manusia yang belum baik tersebut mempengaruhi proses pelayanan pasien di Instalasi Gawat Darurat. Indikator proses pelayanan yang belum baik tersebut mempengaruhi proses kepuasan pasien Instalasi Gawat Darurat terutama terhadap waktu tunggu rawat dan pelayanan dokter. Pasien yang tidak puas terhadap pelayanan yang diterima di Instalasi Gawat Darurat memberi dampak kurang baik terhadap pemasukan keuangan Instalasi Gawat Darurat ke rumah sakit sehingga rumah sakit tidak mampu memberi subsidi sebesar yang diharapkan sumber daya manusia di Instalasi Gawat Darurat. Hendaknya Direktur Rumah Sakit Atma Jaya menggunakan hasil penelitian ini sebagai dasar penilaian kinerja selanjutnya dan meninjau ulang kebijakan yang ada untuk meningkatkan kinerja di rumah sakit.
Performance Evaluation of Emergency Department at Atma Jaya Hospital in May 2002 Atma Jaya hospital doesn't have the comprehensive performance evaluation. There are 75% patients of in patient department come from emergency department, therefore emergency department need to become Atma Jaya hospital priority for performance evaluation then it will become an input in Atma Jaya hospital strategic planning. By using balanced scorecard approach, the performance of emergency department can be evaluated through its commitment and the work satisfaction of human resource in the emergency department, the process of patient service in the emergency department, the satisfaction of the emergency department?s patient, and the performance of the financial of the emergency department.This research was carried out by qualitative and quantitative descriptive, by using 23 respondents? human resources of emergency department, 288 patients who came to be cared in the emergency department during May 2002. The research was done by in depth interview, questioner, and checklist. The collected data were analyzed by qualitative and quantitative descriptive.The result of the research shows that human resource indicator in emergency department is not so good i.e. they are not satisfied and they do not commit to emergency department. The effect of that not so good human resource indicator influences the patient?s service process to the patient in emergency department. That not so good service process indicator influences the satisfaction of the emergency department's patient. The unsatisfaction of emergency department's patients especially about waiting time of care and the doctor's services. The unsatisfied patients to the service in emergency department causes not so good effects to the emergency department's earning to the hospital, so the hospital can not give subsidy as much as subsidy hoped by the human resource of emergency department. Atma Jaya Hospital can uses this research to be hospital foundation for next becoming performance evaluation, and Board of Director must observe at a distance about Atma Jaya Hospital policy that uses to raise performance of emergency department.
Waiting time is one indicator of health services. The increase in waiting time in the Emergency Department (ED) has an impact on longer treatment days, increased mortality and reduced patient satisfaction. The purpose of this study was to determine the length of stay for services at the emergency department of the Tangerang General Hospital using lean method to determine waste at each stage of activity. This research method is operational research with qualitative and quantitative approaches, primary data sources taken from direct observation using time motion study techniques and in-depth interviews. The waiting time at the ER at the Tangerang Regency General Hospital is 852.92 minutes for inpatients and 564.24 minutes for outpatients. The length of time for each service is as follows: triage is 11.83 minutes, waiting time for an emergency room doctor examination is 32.25 minutes, drug administration time and action is 22.33 minutes, waiting time for laboratory examination is 106.07 minutes, waiting time for examination radiology 140.15 minutes, waiting time for specialist doctor consultation 146.54 minutes, waiting time for inpatient registration 164.8 minutes, waiting time for inpatient admission 58.5 minutes, patient administration time going home 89.6 minutes. The largest nonvalued added activity is waiting for specialist consultations. Found 2 types of waste, namely waiting (93.3%) and motion (6.7%). After conducting an analysis using the 5 why method, the root of the problem was found in the number of nurses, not yet maximally carrying out tupoksi, hospital information system applications that are less user friendly, specialist doctors are not standby and consultation SOPs are not optimally run, lack of clinical experience of doctors ER, as well as the unavailability of the ward. The conclusion, t the waiting time in the ER at the Tangerang General Hospital exceeds the standard time (4 hours). The lean approach is appropriate to look for waste in health service activities so that problem solving efforts can be obtained to improve service waiting times in the IGD RSU Tangerang Gneral Hospital
Rumah Sakit Umum Daerah Tarakan merupakan salah satu RSUD yang mempunyai potensi untuk berkembang dalam menghadapi era globalisasi, lnstalasi Gawat Darurat sebagi pintu masuk pasien yang paling besar di Rumah Sakit Daerah Tarakan. Oleh sebab itu perlu adanya pengukuran kinerja secara komprehensif IGD di RSUD Tarakan Tahun 2008. Untuk mengukur kinerja secara komprehensif dapat menggunakan pendekatan Balanced Scorecard. Mengukur kinerja dengan menggunakan Balanced Scorecard dapat memberikan informasi secara menyeluruh terhadap kinerja program yang dijalankan., baik itu keberhasilan program maupun kendala-kendala yang dihadapi dalam kegiatan. Dimana terdapat empat perspektif Balanced Scorecard yang dikaitkan dengan visi dan misi organisasiyaitu perspektif fmansial, perspektif pelanggan, perspektif proses bisnis internal dan perspektif pembelajaran dan pertumbuhan karyawan, manajemen dan organisasi. Penelitian ini dilakukan di Instalasi Gawat Darurat Rumah Sakit Umum Daerah Tarakan pada bulan April sampai Juni 2008. Penelitian ini menggunakan metode studi kasus dengan pendekatan kualitatif dan kuantitatif untuk mengetahui gambaran kinerja IGD RSUD Tarakan berdasarkan empat perspektif dalam Balanced Scorecard yaitu perspektif keuangan, perpektif pelanggan, perspektif proses bisnis internal dan perspektif pembelajaran dan pertumbuhan. Populasi adalah seluruh pasien yang berkunjung ke RSUD Tarakan pada bulan April dan Juni 2008, sampel diambil decara random sampling terhadap pasien yang berkunjung ke IGD RSUD Tarakan dengan menggunakan alat ukur kuesioner. Pendekatan kualitatif dilakukan dengan metode In-depth interview, telaah dokumen dan observasi.In-depth interview dilakukan dengan Kepala IGD, Kepala Perawat IGD, Dokter jaga IGd dan perawat IGD sebagai infonnannya, telaah dokumen terbadap data keuangan IGD sedangkan metode observasi terbadap respon time pelayanan oleh petugas IGD. Dari hasil penelitian diperoleh gambaran bahwa perspektif pernbelajaran dan pertumbuban masih kurang baik karena masih kurangnya komitmen petugas IGD terhadap pelayanan yang dilakukan di IGD di sebabkan kurangnya sosialisasi Standar Pelayanan Minimal di IGD, masih ada ketidak puasan karyawan IGD terhadap reward gaji yang diterima dan ketidak puasan terhadap sistem pengembangan karier di IGD, perspektif proses bisnis internal tentang respon time belum memenuhi standar Depkes, perspektif pelanggan tentang kepuasan pelanggan masih dibawah standar Depkes yaitu < 70 % sedangkan perspektif keuangan tingkat pertumbuhan pendapatan seeara keseluruhan terjadi peningkatan sebesar 9,43 % dari tahun 2006 ke tahun 2007. Untuk itu diharapkan kepada pihak manajer RSUD Tarakan serta Kepala IGD untuk melakukan sosialisasi Standar Pelayanan Minimal (SPM) kepada seluruh tenaga yang bertugas di IGD serta meningkatkan komitmen tenaga di IGD dalam memberikan pelayanan yang bermutu terhadap pasien dengan menjalankan SPM yang telah ditetapkan oleh Depkes Rl, dan menggunakan hasil penelitian yang didapat sebagai dasar untuk melakukan evaluasi kinerja selanjutnya di lnstalasi Gawat Darurat dan menerapkannya ke dalam manajemen rumah sakit demi tercapai Visi dan Misi rumah sakit yang baru.
Tarakan District General Hospital (TDGH) is one of a district general hospital which has a potency to expand and develop in order to deal with the globalization era. It has widely known that the ER is the main entrance of receiving patients at the hospital. Therefore, there is a need for a comprehensive measurement on the perfonnance of the ER at TDGH in 2008, using the Balanced Scoreboani approach. This approach will give the entire intbnnation of the perfonnance of program conducting at the ER, whether its successful or problems found as the program has applied. There are four perspectives that included at the Balanced Scorecard related to the vision and mission of the organization, they are perspective of finance, perspective of client, perspective of internal business process, and perspective of employee, management and organization experience and development. The study is conducted at the ER of TDGH in the period of April to June 2008, using a study case design with a qualitative and quantitative approach, in order to know the description of performance at the ER of Tarakan DGH, based on four perspecti ves of Balanced Scorecard. The population is all patients who visit to the Tarakan DGH in the month of April to June 2008. Sample is taken by a simple random sampling and interviwed with a structured questionnaire. For qualitative approach, an in-depth interview is condocted, as well as a documents exploration and observation toward the ER. The in-depth interview is carried out toward informants, i.e. the Head of the ER, Head of nurse of the ER. doctor in charge of the ER and the nurse of the ER. Finance data is obtained from the documents explonttion, and observation is taken toward service response time by the ER providers. The study found that the perspective on the experience and development is poor, as the commitment of the ER providers in giving the services is still low. This because of the socialization of the Minimum Service Standard at the ER is not so good. Some employee still dissatisfy with the reward they have and also with the development career system at the ER. The perspective of the internal business process on the response time is not fulfilling the MoH criteria of standards. Perspective of client on service satisfuction is still below MoH standard, less than 70%. Of the perspective of finance, the income growth rate in overall is increase 9.43% from the year 2006 to 2007. Therefore, it is expected that the management of the Tarakan DGH and the Head of the ER will carried out the socialization of the Minimum Service Standard (MSS/ SPM) to all health providers of the ER, and increasing the commitment among providers at the ER to address a good services by applying SPM determined by the MoH. !t is also expected that the resuit of the study will be using fur the base of the advance performance eva1uation at the ER and implemented in to the hospital management board, and hoped that the new visions and missions of the hospital are reached.
Kata kunci : Metode lean, rawat jalan, waktu tunggu, kegiatan value added, kegiatan non value added
The length of waiting time in the hospital outpatient service is important for efficient hospital service. Long waiting time leads to accumulating queue and inefficient service. This study was aimed to analyze the application of lean method on outpatient BPJS services at Hermina Depok Hospital in 2017. This qualitative research method investigated the time spent by BPJS outpatient patient by applying lean method and observing the outpatient service flow condition. The first result, the value stream mapping (VSM) of patients without any adjunctive examinations (i.e., laboratory or radiology), the fastest cycle time was observed at the reception desk (2.2 minutes) and the longest at the doctor examination room (12.6 minutes). The longest waiting time was at drug prescription process at pharmaceutical unit (96.2 minutes or 1 hour,36 minutes) and checkout was the fastest (4.4 minutes). Second result, the VSM with laboratory examination, the fastest time-cycle was at the reception desk (4.2 minutes), and the longest was observed at the doctor examination (12.6 minutes). The longest waiting time at the doctor waiting room (2 hours 6 minutes) and checkout was the fastest (2.2 minutes). Third result, the VSM with radiologic examination, the fastest cycle time was observed at the reception desk (4.8 minutes), the longest cycle time was at the radiology examination process (67.2 minutes or 1 hour, 7 minutes). The longest waiting time was observed at the doctor examination room (95.6 minutes or 1 hour, 35 minutes) and checkout was the fastest (4.4 minutes). The results showed that 90% service time was non value added activity and only 10% of value added activity. The wastes were defect, over production, waiting, transportation, inventory, motion, and over processing. After conducting future state analysis with the proposed improvement with simulative lean method (5S, Kanban Inventory, visual management), it was found that non value added activity became 78,30% and value added activity became 21,70%. Future recommendation is important to organize short-, medium- and long-term improvements through implementation of sustainable lean method program.
Keywords: Lean method, outpatient waiting time, value added activity, non-value added activity
Penelitian ini dilakukan dengan tujuan menganalisa beban kerja instalasi farmasi rumah sakit Hermina Depok dan menemukan metode yang tepat untuk penghitungan kebutuhan tenaga. Penelitian ini adalah gabungan antara kuantitatif dan kualitatif. Penelitian kuantitatif dilakukan dengan pengukuran waktu transaksi pelayanan resep sebagai dasar pengukuran beban kerja dan kebutuhan tenaga, sementara kualitatif dilakukan dengan wawancara mendalam pada manajer penunjang medis, kepala instalasi, asisten apoteker junior dan senior serta juru racik untuk mengetahui faktor yang menjadi hambatan dalam pencapaian standar pelayanan minimum. Penelitian kuantitatif dilakukan pada 120 sampel resep racikan dan 181 sampel resep non racikan, diambil menggunakan metode simple random sampling. Dari penelitian kuantitatif didapatkan waktu transaksi (WT) 44 menit untuk racikan dan 21 menit non racikan, dan dari angka trsebut didapatkan beban kerja 299 jam orang/hari, kebutuhan tenaga 65 orang dan jumlah penambahan tenaga 39 orang. Dari waktu tersebut dilakukan penyesuaian dengan dua cara, pertama dengan konstanta waktu antrian berbanding waktu transaksi dan kedua dengan mengurangi waktu antrian. Didapatkan WT 21 menit racikan dan 9 menit non racikan serta 22 menit racikan dan 8 menit non racikan untuk masing-masing cara konstanta dan pengurangan waktu antrian. Hasil ini mendekati waktu transaksi minimal yaitu 23 menit untuk racikan dan 8 menit non racikan. Beban kerja 130, 137 dan 139 jam orang/hari untuk konstanta, pengurangan waktu antrian dan waktu minimum, serta bagi ketiganya kebutuhan tenaga 30 orang dengan jumlah penambahan tenaga 4 orang. Dari penelitian kualitatif didapatkan bahwa kekurangan tenaga merupakan hambatan terbesar dalam pelayanan resep, dengan hambatan lainnya yang memerlukan penanganan adalah mengenai pengalaman dan keterampilan personel, proses rekrutmen, serta manajemen dan perencanaan obat. Hambatan lainnya dalam pelaksanaan solusi atau dirasakan tidak terlalu mengganggu. Kata kunci: Farmasi, Beban kerja, Kebutuhan Tenaga
The aim of this study is to analyze the workload of pharmacy installation, Hermina Depok Hospital and to find appropriate method for calculating workforce need. This study combines quantitative and qualitative method. Quantitative research is carried out by measuring the transaction time of prescription services as the basis of workload and workforce need measurement, while in-depth qualitative interviews is conducted by interviewing manager of medical support, head of pharmacy installation, junior and senior assistant pharmacist and juru racik to determine the factors contributing to the low achievement of minimum service standards. Quantitative research conducted on 120 samples of pulveres prescription and 181 samples of non pulveres prescription, using simple random sampling method. From quantitative study we found transaction time (TT) of 44 minutes for pulveres prescription and 21 minutes for non pulveres prescription, resulted in workload of 299 man hours/day, 65 people of workforce need, resulting in the need of additional 39 people. Adjustment is made to TT in two ways, first by finding a constant from the ratio of queuing time and TT, second by reducing TT with queuing time. TT obtained from this adjustment are 21 minutes for pulveres prescription and 9 minutes for non pulveres for constant adjustment, and 22 minutes for pulvres prescription and 8 minutes for non pulveres prescription for the reduction in queuing time. These results resemble the minimum TT, 23 minutes for pulveres pescription and 8 minutes for non pulveres prescription. Workload measurement relusted in 130, 137 and 139 man hours/day for constant adjustment, reducing queuing time and minimum time, all three resulted in workforce need of 30 people, with the additional requirement of 4 people. From the qualitative research it is found that the shortage of man is the biggest obstacle in prescription service, other obstacles requiring immediate handling are issues of the experience and skills of personnel, the recruitment process, and drugs management and planning. Other obstacle in prescription service is thought to be less significant or undergoing process to solution. Keywords: pharmacy, workload, workforce need
