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I Gusti Agung Putu Yudihartini; Pembimbing: Wachyu Sulistiadi; Penguji: Mieke Savitri, Pujiyanto, Endang Adriyani, Puji Triastuti
Abstrak:
ABSTRAK Pasien membayar pelayanan yang telah diberikan dengan value atau manfaat yang sesuai tanpa membayar lebih terhadap waste atau pemborosan yang ada dalam proses pelayanan di rumah sakit. Menghilangkan waste dalam proses pelayanan merupakan tantangan setiap rumah sakit. Tantangan rumah sakit semakin besar saat menjadi provider BPJS dan wajib memberikan pelayanan kepada pasien JKN.Sediaan farmasi merupakan pelayanan penunjang yang sangat penting dalam pelayanan pasien dan menghabiskan biaya yang sangat besar, maka rumah sakit perlu lebih efisien dalam mengelola sediaan farmasi mulai dari perencanaan, penganggaran dan pegadaan dengan tanpa mengabaikan mutu pelayanan. Tujuan umum penelitian ini adalah untuk mendapatkan gambaran tentang proses perencanaan, penganggaran dan pengadaan obat di unit farmasi RSIA Puri Bunda dan memberikan masukan dalam perbaikan proses siklus logistik farmasi sehingga menjadi lebih efisien. Penelitian dilaksanakan dengan melakukan wawancara, observasi dan Focus Discussion Group (FGD) pada proses perencanaan dan pengadaan dengan membuat value stream mapping dari seluruh proses yang ada. Pada penelitian ini didapatkan pemborosan berupa waste defect, waste inventory, waste motion, waste human potential dalam proses perencanaan, penganggaran dan pengadaan sediaan farmasi. Perbaikan berupa kaizen dilaksanakan oleh seluruh level karyawan mulai dari staf, jajaran manajemen, dan direksi rumah sakit, maupun pemilik rumah sakit. Pelaksanan kaizen tersebut dapat meningkatkan efisiensi waktu, biaya, maupun SDM dalam proses perencanaan, penganggaran dan pengadaan sediaan farmasi. Katakunci: Lean, farmasi,rumah sakit Patients will pay for services that have been provided with the appropriate value or benefit without paying more or wasting that is in the process of service in the hospital. Eliminating waste in the service process is the challenge of every hospital. Nowadays the hospital challenge is getting bigger when becoming provider of BPJS and obliged to give service to JKN patient. Pharmacy is a very important support services in patient care and costly. Hospitals need to be more efficient in managing pharmaceuticals from planning, budgeting, and procurement without neglecting service quality. Aim of this research is to get an overview of the planning, budgeting, and procurement process of medicines at pharmacy Puri Bunda Hospital and provide inputs to improve the pharmaceutical logistics cycle process. The study was conducted by interviewing, and observatian made with planning and procurement process by creating a value stream of the entire process. In this research, there was of waste defect, waste inventory, waste motion, waste human potential in planning process, budgeting, and procurement of pharmaceutical preparation. Kaizen improvements are performed by all levels of staff, management, and hospital directors, as well as to hospital owners. The implementation of kaizen can improve the efficiency of time, cost, and human resources in the process of planning, budgeting, and procurement of pharmaceutical preparations. Keyword : Lean, Pharmacy, Hospital
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B-1989
Depok : FKM-UI, 2018
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Raden Chandra Meydia Kundrawan; Pembimbing: Jaslis Ilyas; Penguji: Vetty Yulianty Permanasari, Diah Anggraini, Pita Aprilia
Abstrak:
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Pelayanan farmasi merupakan pelayanan penunjang yang berfungsi dalam pengelolaan obat, bahan medis habis pakai dan alat kesehatan di rumah sakit. Ketersediaan obat merupakan faktor yang sangat penting dalam pelayanan rumah sakit dan dapat menentukan mutu pelayanan rumah sakit. RSUD Kalideres melakukan peminjaman obat kepada beberapa instansi untuk mengatasi kekosongan obat pada tahun 2024. Penelitian ini bertujuan untuk mengetahui penerapan metode Lean dan ABC-VEN dalam meningkatkan pengelolaan dan perencanaan obat. Penelitian ini menggunakan metode Lean dalam menganalisis proses pengelolaan dan perencanaan obat untuk mengetahui Current State Stream Map, mengidentifikasi Value Added, Non Value Added dan Waste serta mengimplementasikan Future Stream Map. Metode ABC-VEN digunakan untuk mengklasifikasikan obat sebagai acuan dalam pembuatan kebijakan pengelolaan dan perencanaan obat. Hasil penelitian ditemukan waste overprocessing, overproduction dan waiting dalam proses pengelolaan dan perencanaan obat sehingga dilakukan intervensi dengan pembaruan Standar Prosedur Operasional dan penerapan spreadsheet inventory. Pada ABC Pemakaian, Klasifikasi A sebanyak 11,7%, Klasifikasi B 20,1%, Klasifikasi C 68,2%. Pada ABC Investasi didapatkan Obat Klasifikasi A 17,2%, Klasifikasi B 29,9%, Klasifikasi C 52,9%. Obat Klasifikasi V 13,6%, Klasifikasi E 80,2%, Klasifikasi N 6,2%. Kesimpulan pengelolaan dan perencanaan obat masih termasuk ke dalam proses un-LEAN dan belum mampu merespon terjadinya peningkatan kebutuhan pelayanan pasien. Penerapan metode Lean dapat mempersingkat proses pengelolaan dan perencanaan obat. Hasil penerapan metode ABC dapat menjadi acuan dalam proses pengelolaan dan perencanaan obat selanjutnya.
Pharmaceutical services are supporting services that function in the management of drugs, disposable medical materials and medical devices in hospitals. The availability of drugs is a very important factor in hospital services and can determine the quality of hospital services. Kalideres Regional Hospital borrows drugs from several agencies to overcome drug shortages in 2024. This study aims to determine the application of the Lean and ABC-VEN methods in improving drug management and planning. This study uses the Lean method in analyzing the drug management and planning process to determine the Current State Stream Map, identify Value Added, Non Value Added and Waste and implement the Future Stream Map. The ABC-VEN method is used to classify drugs as a reference in making drug management and planning policies. The results of the study found waste overprocessing, overproduction and waiting in the drug management and planning process so that interventions were carried out by updating Standard Operating Procedures and implementing spreadsheet inventory. In ABC Usage, Classification A was 11.7%, Classification B 20.1%, Classification C 68.2%. In ABC Investment, Classification A Drugs were 17.2%, Classification B 29.9%, Classification C 52.9%. Classification V Drugs 13.6%, Classification E 80.2%, Classification N 6.2%. The conclusion is that drug management and planning are still included in the un-LEAN process and have not been able to respond to the increasing need for patient services. The application of the Lean method can shorten the process of drug management and planning. The results of the application of the ABC method can be a reference in the process of further drug management and planning.
Pharmaceutical services are supporting services that function in the management of drugs, disposable medical materials and medical devices in hospitals. The availability of drugs is a very important factor in hospital services and can determine the quality of hospital services. Kalideres Regional Hospital borrows drugs from several agencies to overcome drug shortages in 2024. This study aims to determine the application of the Lean and ABC-VEN methods in improving drug management and planning. This study uses the Lean method in analyzing the drug management and planning process to determine the Current State Stream Map, identify Value Added, Non Value Added and Waste and implement the Future Stream Map. The ABC-VEN method is used to classify drugs as a reference in making drug management and planning policies. The results of the study found waste overprocessing, overproduction and waiting in the drug management and planning process so that interventions were carried out by updating Standard Operating Procedures and implementing spreadsheet inventory. In ABC Usage, Classification A was 11.7%, Classification B 20.1%, Classification C 68.2%. In ABC Investment, Classification A Drugs were 17.2%, Classification B 29.9%, Classification C 52.9%. Classification V Drugs 13.6%, Classification E 80.2%, Classification N 6.2%. The conclusion is that drug management and planning are still included in the un-LEAN process and have not been able to respond to the increasing need for patient services. The application of the Lean method can shorten the process of drug management and planning. The results of the application of the ABC method can be a reference in the process of further drug management and planning.
B-2552
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dani Indrawan; Pembimbing: Prastuti Soewondo; Penguji: Helen Andriani, Etty Yulianty Permanasari, Ediansyah, Vitrie Winastri
Abstrak:
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Berdasarkan laporan dari World Health Organisation (WHO), dampak pandemi COVID-19 dirasakan pada pelayanan kesehatan esensial di 90% negara. Hal ini terlihat pada kombinasi kondisi pelik dari menurunnya kunjungan akibat pembatasan kegiatan masyarakat, rantai distribusi alat kesehatan dan obat-obatan yang terhambat, sehingga kapasitas finansial fasilitas layanan kesehatan menurun. Tekanan yang terjadi mendorong rumah sakit beradaptasi dengan cepat serta memiliki strategi bertahan (resilience) dari berbagai guncangan yang dihadapi. Rumah Sakit Metropolitan Medical Center (RS MMC) sebagai salah satu rujukan COVID-19 turut merasakan dampak perubahan terhadap sistem pengelolaan logistik farmasi rumah sakit. Penelitian ini bertujuan untuk mengevaluasi pola perencanaan sediaan farmasi, menentukan pola perencanaan farmasi yang paling tepat, serta melakukan penerapan strategi Sales & Operations Planning (S&OP) dalam upaya membangun ketahanan sediaan farmasi Rumah Sakit Metropolitan Medical Center. Penelitian ini menggunakan metode kualitatif berupa studi kasus untuk melihat pengelolaan sediaan farmasi dengan menggunakan analisis deskriptif dari beberapa data sekunder yakni; data persediaan, data kunjungan pasien, serta data pendapatan dan pengeluaran rumah sakit selama masa pandemi COVID-19 pada periode Februari tahun 2020 - Desember tahun 2021 yang dikolaborasikan dengan wawancara mendalam. RS MMC melakukan berbagai upaya perbaikan pola perencanaan sediaan farmasi, mulai dari menggunakan metode konsumsi, pola morbiditas berdasarkan penyakit terbanyak, kombinasi pola konsumsi dan pola morbiditas, forecasting serta pendekatan S&OP. Hasil perhitungan tingkat Inventory Turnover (ITO) berada pada titik terendah di tahun 2020 yaitu sebesar 8,84% dan persentase ketersediaan di bulan Juni 2020 sebesar 51,80%. Pada titik ini terjadi kondisi yang tidak ideal sehingga manajemen didorong untuk merespon cepat serta adaptif terhadap pola perencanaan sediaan farmasi. Berdasarkan berbagai rangkaian metode yang digunakan RS MMC selama periode 2019-2021 serta data hasil wawancara mendalam, menunjukan bahwa pola perencanaan farmasi yang paling tepat di RS MMC ialah merujuk pada metode konsumsi yang dikombinasikan dengan pola morbiditas penyakit, hal tersebut dikarenakan dapat meningkatkan keakuratan manajemen perencanaan persediaan. Pengembangan dari metode konsumsi yang dikolaborasikan dengan pola morbiditas tersebut, dilakukan melalui penerapan forecast planning system menggunakan S&OP dan integrated demand supply yang sedang dibangun dalam sebuah sistem teknologi informasi rumah sakit yang diharapkan akan membuat pengambilan keputusan menjadi lebih mudah dan akurat. Dengan menggunakan pendekatan S&OP basis perencanaan kebutuhan logistik menjadi tidak hanya bergantung pada pemanfaatan data historis saja, baik yang terkait dengan pola konsumsi dan atau morbiditas saja. Pola pendekatan S&OP memodifikasi pola perencanaan kebutuhan sediaan sebelumnya yang merupakan gabungan pola konsumsi dan morbiditas. Pendekatan S&OP turut memperhatikan dinamika perkembangan kebutuhan terkini organisasi yang berkenaan dengan: adaptasi rencana strategi bisnis rumah sakit, ketersediaan finansial dan kegiatan operasional Rumah Sakit.
Based on a report from the World Health Organization (WHO), the impact of the COVID-19 pandemic was felt on essential health services in 90% of countries. This can be seen in the complicated combination of decreased visits due to restrictions on community activities, hampered distribution chain of medical devices and medicines, resulting in decreased financial capacity of health care facilities. The pressures that occur encourage hospitals to adapt quickly and have resilience strategies from the various shocks they face. The Metropolitan Medical Center Hospital (MMC Hospital) as one of the COVID-19 referrals also felt the impact of changes to the hospital pharmacy logistics management system. This study aims to evaluate the pattern of pharmaceutical preparation planning, determine the most appropriate pharmaceutical planning pattern, and implement the Sales & Operations Planning (S&OP) strategy in an effort to build the resilience of pharmaceutical preparations at Metropolitan Medical Center Hospital. This study uses a qualitative method in the form of a case study to see the management of pharmaceutical preparations using descriptive analysis of several secondary data, namely; inventory data, patient visit data, as well as hospital income and expenditure data during the COVID-19 pandemic in the period February 2020 - December 2021 in collaboration with in-depth interviews. MMC Hospital made various efforts to improve the planning pattern of pharmaceutical preparations, starting from using the consumption method, the pattern of morbidity based on the most disease, a combination of consumption patterns and morbidity patterns, forecasting and the S&OP approach. The results of the calculation of the Inventory Turnover (ITO) level are at their lowest point in 2020, which is 8.84% and the percentage of availability in June 2020 is 51.80%. At this point, conditions that are not ideal occur so that management is encouraged to respond quickly and be adaptive to the pattern of planning pharmaceutical preparations. Based on the various series of methods used by MMC Hospital during the 2019-2021 period as well as data from in-depth interviews, it shows that the most appropriate pharmaceutical planning pattern at MMC Hospital is referring to the consumption method combined with disease morbidity patterns, this is because it can improve the accuracy of planning management. supply. The development of the consumption method in collaboration with the morbidity pattern is carried out through the application of a forecast planning system using S&OP and integrated demand supply which is being built in a hospital information technology system which is expected to make decision making easier and more accurate. By using the S&OP approach, the basis for planning logistics needs is not only dependent on the use of historical data, both related to consumption patterns and or morbidity. The pattern of the S&OP approach modifies the previous pattern of planning requirements for preparations which is a combination of consumption patterns and morbidity. The S&OP approach also takes into account the dynamics of the latest development needs of the organization with regard to: adaptation of the hospital's business strategy plan, financial availability and hospital operational activities.
B-2300
Depok : FKM-UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Ulfia Mutiara Supatmanto; Pembimbing: Amal Chalik Sjaaf; Penguji: Helen Andriani, Purnawan Junadi, Wellya Hartati, Endang Adriyani
Abstrak:
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Proses bisnis yang penting dalam organisasi rumah sakit salah satunya adalah manajemen pengelolaan perbekalan farmasi. Manajemen pengelolaan perbekalan farmasi di RSPG Cisarua Bogor melibatkan tim dimulai dari tahapan perencanaan, pengadaan, penyimpanan dan distribusi. Hambatan internal dalam proses perencanaan dan pengadaan perbekalan farmasi merupakan hambatan yang bisa dikendalikan dengan intervensi secara internal dalam proses bisnis di dalam rumah sakit. Penelitian ini fokus pada usulan perubahan sistem manajemen pengelolaan perbekalan farmasi khususnya perencanaan dan pengadaan di internal RSPG Cisarua Bogor. Intervensi dalam proses pengadaan menggunakan lean six sigma sebagai alat bantu evaluasi untuk menentukan titik-titik lemah dalam penelitian ini hanya sampai pada tahap improve. Pengumpulan data menggunakan wawancara mendalam dengan informan yang terkait proses perencanaan dan pengadaan perbekalan farmasi, observasi dan penelusuran dokumen kemudian diakhiri dengan diskusi kelompok untuk menentukan kesepakatan bersama. Hasil penelitian menunjukkan bahwa ketiadaan prosedur tetap dalam proses pengadaan perbekalan farmasi membuat lamanya prosedur berjalan dan tidak ada tolak ukur efisiensi dalam sistem. Alat bantu dalam proses pengadaan perbekalan farmasi juga tidak ada sehingga komunikasi internal antar bagian walaupun dalam satu tim yang sama menjadi rendah. Pada tahapan improve dari lean six sigma menghasilkan usulan perubahan standar operasional prosedur untuk proses pengadaan perbekalan farmasi rutin, penggunaan indikator efisiensi pengadaan dan pemanfaatan ABC VEN sebagai alat bantu dalam proses pengadaan perbekalan farmasi. Usulan perbaikan penggunaan ABC VEN dan indikator efisiensi perencanaan untuk mengatasi waste over production yang teridentifikasi selama proses perencanaan perbekalan farmasi. Usulan penetapan standar operasional prosedur baru yang memuat timeline, alat bantu pengelompokan perbekalan farmasi berdasarkan ABC VEN dan indikator efisiensi pengadaan untuk mengatasi waste waiting dalam proses pengadaan perbekalan farmasi.
One of the important business processes in hospital organizations is the management of pharmaceutical supplies. The management of pharmaceutical supplies management at RSPG Cisarua Bogor involves teams starting from the stages of planning, procurement, storage and distribution. Internal obstacles in the process of planning and procuring pharmaceutical supplies are obstacles that can be controlled by internal intervention in business processes within the hospital. This research focuses on proposed changes in the management system of pharmaceutical supply management, especially planning and procurement within RSPG Cisarua Bogor. Intervention in the procurement process using lean six sigma as an evaluation tool to determine weak points in this study only reached the improvement stage. Data collection used in-depth interviews with informants related to the process of planning and procuring pharmaceutical supplies, observation and document tracing then ended with group discussions to determine mutual agreement. The results showed that the absence of fixed procedures in the process of procuring pharmaceutical supplies made the procedure run longer and there was no benchmark of efficiency in the system. Tools in the process of procuring pharmaceutical supplies are also absent so that internal communication between departments even in the same team is low. At the improve stage of lean six sigma produced proposals for changes to standard operating procedures for routine pharmaceutical supply procurement processes, the use of procurement efficiency indicators and the use of ABC VEN as a tool in the pharmaceutical supply procurement process. Proposed improvements in the use of ABC VEN and planning efficiency indicators to address waste over production identified during the pharmaceutical supply planning process. Proposed establishment of new standard operating procedures containing timelines, tools for grouping pharmaceutical supplies based on ABC VEN and procurement efficiency indicators to overcome waste waiting in the pharmaceutical supply procurement process.
One of the important business processes in hospital organizations is the management of pharmaceutical supplies. The management of pharmaceutical supplies management at RSPG Cisarua Bogor involves teams starting from the stages of planning, procurement, storage and distribution. Internal obstacles in the process of planning and procuring pharmaceutical supplies are obstacles that can be controlled by internal intervention in business processes within the hospital. This research focuses on proposed changes in the management system of pharmaceutical supply management, especially planning and procurement within RSPG Cisarua Bogor. Intervention in the procurement process using lean six sigma as an evaluation tool to determine weak points in this study only reached the improvement stage. Data collection used in-depth interviews with informants related to the process of planning and procuring pharmaceutical supplies, observation and document tracing then ended with group discussions to determine mutual agreement. The results showed that the absence of fixed procedures in the process of procuring pharmaceutical supplies made the procedure run longer and there was no benchmark of efficiency in the system. Tools in the process of procuring pharmaceutical supplies are also absent so that internal communication between departments even in the same team is low. At the improve stage of lean six sigma produced proposals for changes to standard operating procedures for routine pharmaceutical supply procurement processes, the use of procurement efficiency indicators and the use of ABC VEN as a tool in the pharmaceutical supply procurement process. Proposed improvements in the use of ABC VEN and planning efficiency indicators to address waste over production identified during the pharmaceutical supply planning process. Proposed establishment of new standard operating procedures containing timelines, tools for grouping pharmaceutical supplies based on ABC VEN and procurement efficiency indicators to overcome waste waiting in the pharmaceutical supply procurement process.
B-2339
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Tulus Kurnia Indah; Pembimbing: Ede Surya Darmawan; Penguji: Helen Andriani, Rakhmat Hidayat, Nugraharti, Erwien Sri Ujianto
Abstrak:
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Latar Belakang: Proses perawatan di rumah sakit didukung oleh berbagai aktivitas operasional diantaranya pengelolaan logistik dan distribusi perbekalan farmasi. Biaya perbekalan kesehatan merupakan pengeluaran terbesar kedua di rumah sakit setelah belanja pegawai, oleh sebab itu pimpinan rumah sakit perlu mengidentifikasi peluang untuk meningkatkan proses logistik untuk menurunkan biaya dan meningkatkan kualitas pelayanan kesehatan. Untuk meningkatan proses logistik diperlukan pemahaman terkait kinerja rantai pasokan yang saat ini berjalan, sehingga melakukan analisa kinerja rantai pasokan merupakan hal mendasar untuk mengatasi kekurangan dalam aktivitas logistik. Tujuan: Studi ini bertujuan melakukan analisa terkait waste yang ada pada proses perencanaan dan pengadaan obat di RSUPN Dr. Cipto Mangunkusumo, kemudian mencari penyebab dan akar masalah timbulnya pemborosan. Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Lokasi penelitian di RSUPN Dr. Cipto Mangunkumo bulan April-Mei 2024. Data primer diperoleh melalui wawancara dengan key specialist informan yang terkait dengan kegiatan perencanaan dan pengadaan dan observasi lapangan. Data sekunder diperoleh dari telaah data realisasi pemakaian obat tahun 2022, data usulan perencanaan dari unit kerja dan hasil rekapitulasi instalasi farmasi tahun 2023, data daftar barang dalam kontrak tahun 2023, datapenerimaan dan data pemakaian obat tahun 2023. Tahapan penelitian disusun berdasarkan lean six sigma dari mulai define, measure, analyze dan improve. Hasil: Jenis waste yang terjadi diantaranya penyedia tidak mengirimkan obat terhadap item perencanaan yang telah memiliki kontrak, obat yang dipesan dan dikirim tetapi tidak memiliki realisasi penggunaan, penyedia bersedia mengirimkan obat tetapi tidak mau berkontrak dengan rumah sakit, penyedia tidak bersedia mengirimkan obat dan tidak mau berkontrak dengan rumah sakit dan adanya pengadaan lain di luar jalur kontrak utama. Dari seluruh waste yang ada terjadinya pengadaan di luar jalur kontrak utama merupakan jumlah waste yang paling sering terjadi sehingga menjadi area improvement pada penelitian ini. Penyebab dari pemborosan yang masih dapat dikontrol oleh internal rumah sakit adalah keterlambatan penerbitan kontrak. Akar masalahnya karena tiap unit kerja yang terkait dengan kegiatan perencanaan dan pengadaan menyelesaikan proses kerja tanpa mempertimbangkan waktu penyelesaian proses sesudahnya, sehingga tujuan dari perencanaan dan pengadaan yang berupa penerbitan kontrak sebelum tahun anggaran menjadi tidak terlaksana. Kesimpulan: Dalam proses yang berjalan secara berkelanjutan diperlukan proses kerja yang terintegrasi berdasarkan komitmen setiap anggota rantai agar tujuan proses tersebut dapat tercapai.
Introduction: The hospital care process is supported by various operational activities including logistics management and distribution of pharmaceutical supplies. The cost of health supplies is the second largest expenditure in hospitals after personnel expenditure, therefore hospital leaders need to identify opportunities to improve logistics processes to reduce costs and improve the quality of health services. To improve logistics processes, an understanding of current supply chain performance is required, so analyzing supply chain performance is fundamental to overcoming deficiencies in logistics activities. Objective: This study aims to analyze waste in the drug planning and procurement at RSUPN Dr. Cipto Mangunkusumo, then looked for the causes and root causes of waste. Method: This research uses qualitative methods with a case study approach. The research location is at RSUPN Dr. Cipto Mangunkumo on April-May 2024. Primary data was obtained through interviews with key specialist informants related to planning and procurement activities and field observations. Secondary data was obtained from a review of drug use in 2022, drug planning proposals from units and results of drug planning recapitulation by pharmaceutical installations in 2023, list of drugs in contracts 2023, drug receive order and drug use in 2023. The research stages were arranged based on lean six sigma method from define, measure, analyze and improve. Results: Types of waste that occur include supplier not sending drugs from planning items that already have a contract, drugs ordered and sent but not having actual use, suppliers willing to send drugs but refusev to contract with the hospital, suppliers refuse to send drugss and refuse to contracts with hospitals and procurements that come from another its main contracts. The procurements that come from another its main contract occurs most frequently, so it is an area of improvement in this research. The cause of waste that can still be internally controlled by the hospital is delays in issuing contracts. The root of the problem is because each unit related to planning and procurement activities completes the process without considering the completion time of the process afterwards, so that the aim of planning and procurement to complete all the procurement contract before end of the year do not achieved. Conclusion: In a process that runs continuously, an integrated work process is needed based on the commitment of each member of the chain so that the process objectives can be achieved.
B-2469
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Mamat Nurahmat; Pembimbing: Pujiyanto; Penguji: Dumilah Ayuningtyas, Peter A.W. Pattinama, Yuli Prapancha Satar
Abstrak:
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Hasil observasi di Rumah Sakit Umum Daerah Cideres Kabupatcn Majalengka, menunjukkan bahwa ada masalah-masalah yang mengganggu pelayanan diantaranya masalah pengadaan penyimpanan dan penyaluran barang farmasi berupa obat dan alai kesehatan habis pakai. Hal itu menggambarkan masih lernahnya pelaksanaan pengadaan penyimpanan dan penyaluran barang farmasi di Rumah Sakit Umum Daerah Cideres Majalengka. Tujuan penelitian ini adalah untuk mcngetahui faktor kebijakan, faktor organisasi. faktor perencanaan. faktor prosedur. faktor sumberdaya manusia, faktor pencatatan pelaporan dan faktor evaluasi terhadap pengadaan, penerimaan penyimpanan dan penyaluran barang farmasi. Penelitian dilaksanakan tanggal 6 Maret sampai dengan tanggal 10 Mei 2006. penelitian ini adalah penelitian kualitatif dengan sumber data dari informan, telaah dokumen dan pengamatan langsung. Hasil penelitian adalah perlama Variabel Kebijakan. kebijakan yang ditetapkan telah sesuai dengan peraturan perundangan yang berlaku. Kedua Variabel Organisasi, hasilnya adalah bagian-bagian yang terkait dalam pengelolaan persediaan barang farmasi telah mempunyai tugas wewenang yang berbeda dengan bagian unit lain dan tidak terjadi duplikasi tugas dan wewenang. Ketiga Variabel Perencanaan. hasil yang didapat bahwa perencanaan rutin dan perencanaan tahunan kebutuhan barang farmasi tidak dilaksanakan sesuai kebijakan yang telah ditetapkan dan peraturan yang berlaku, tidak membuat Rencana Tahunan Barang Unit (RTBU) dan ada dokter yang tidak mematuhi formularium obat. Keempat Variabel prosedur. hasilnya sccara umum setiap bagian yang terkait dalam pengelolaan persediaan barang farmasi telah mempunyai prosedur tetap. Kelima Variabel Sumber Daya Manusia. Instalasi Farmasi masih membutuhkan tiga orang pegawai sedangkan personil Panitia Pengadaan Pekerjaan Unit merangkap tugas dengan tugas pokok lainnya dan belum memiliki ruang sekretariat khusus. Keenam Variabel Pencatatan Pelaporan hasil yang didapat adalah buku penerimaan barang, kartu barang dan pencatatan pendapatan obat tidak dicatat secara akurat. Pelaporan eksternal tidak dilaksanakan sesuai dengan peraturan yang berlaku. Ketujuh Variabel Evaluasi, Pelaksanaan evaluasi belum optimal, tidak dilaksanakan sesuai dengan tugas kewenangannya. Kedelupan Variable Pengadaan, Obat atas kesehatan habis pakai yang dipesan ke Perusahaan belum semuanya dikirim sesuai dengan pesanan, seluruh penerimaan barang ke rumah sakit diterima pemegang barang dan diperiksa Panitia perneriksa barang. Kesembilan Variabel Penyimpanan, Secara umum penyimpanan telah sesuai dengan peraturan namun sistim penyimpanan di Gudang induk dikelompokan berdasarkan pemasok. Kesepuluh Variabel Penyaluran, diketahui bahwa masih terdapat pennintaan obat alai kesehatan habis pakai dan atau resep yang tidak dipenuhi sesuai permintaan. Saran dari peneliti adalah buat dokumen kebutuhan barang unit yang mengakomodir kebutuhan pengguna. Optimalisasi pencatatan administrasi dan pendapatan barang farmasi rumah sakit. Tingkatkan kerjasama dengan pemasok tentang pembayaran dan pengiriman barang. Tetapkan buffer stock barang farmasi di gudang induk dan di instalasi farmasi. Perlu penambahan tiga pegawai di instalasi farmasi. sekretaris panitia pengadaan barang tidak dibebani tugas lain dan adanya ruang khusus panitia pengadaan barang. Serta perlunya aplikasi inventory yang teritegrasi dengan aplikasi billing system.
The result of an observation during a residency in Cideres country General Hospital some problem reveal on a pharmacies inventory supply and storage system. Those problems have a major impact on hospital service quality. The impact on hospital services quality will lead to a negative perception from the public and in a long run has a potential distortion on a hospital income thereby a good pharmacies good inventory controlling system in Cideres country General Hospital is a must. The aim of this research was to reveal and analyze the policy factor, organizational factor, planning factor, procedural factor, human resource factor, and data entry and reporting factor on pharmacies goods inventory contolling system. This research held from Maret 6 to May 10- of 2006, performed with qualitative analyzing that used informant data, secondary data and observation data. This research reveal that ; first, policy variable, the Cideres County General Hospital inventory policy has been established according to a general rules set by the government. Second, Organizational variable, every departement that co-op with pharmacies inevntory management already has a different task and a different authority, therefore, task and authority duplication were not found. Third, Planning variable, both daily and annually planning for pharmacies goods supplies were not held according to procedure and the rules, even a units stock annually planning was not made. Fourth, proccedure variable, generally every section that co-op with inventory management had a well astablish procedure. Fifth, human resource variable, pharmacies unit still sort of personnel therefore need an addition personnel as much as three personnel; Furthermore it required a secretary room. Sixth, Data Entry and reporting variable, stock card were not accurately update and externals reporting were not condurated according to the rules. Seventh, Evaluation variable, not optimalize of evaluation and improperly of the duty of authorities. Eight Supllies variable, drugs and expendable medical tools that has been ordered were not delivered as much as an order stated. Ninth, acceptance and storage variable all goods that goes in to the hospital accept by a goods holder after run in to check by the comitte. Tenth, expandite variable, this research reveral that there were some demands on a certain drugs and medical kit or recipe that were not fulfilled as demand. Base on the result of this research, making of the inventory unit necessity document for accomodate user needs. Optimalization of administration report and the income of hospital pharmacies stuff Increasing cooperation with the distributor about payment and distribution. Determined the buffer stock at pharmacy main strorage and fharmacy instalation. It needs three additional employees at fharmation unit, the officer of fharmacy inventory can not have another jobs and it needs special room. Integrated inventory application with a billing system is also a recomandation that has an urgency to fulfill imadietly.
B-969
Depok : FKM UI, 2006
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Goklian Paraduan Haposan; Pembimbing: Pujiyanto; Penguji: Atik Nurwahyuni, Vetty Yulianty Permanasari, Sri Diana Ginting Suka, Deriani Simatupang
Abstrak:
Instalasi Farmasi Rumah Sakit merupakan salah satu unit Revenue Center di rumah sakit. Banyaknya bagian terkait unit tersebut dalam proses kegiatannya, baik secara internal maupun eksternal rumah sakit, membuat manajemen rumah sakit sebaiknya memikirkan sistem pengelolaan yang tepat dan terintegrasi pada siklus manajemennya. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif analitik. Hasil penelitian ini memperlihatkan bahwa implementasi pengelolaan sediaan farmasi, alat kesehatan dan bahan medis habis pakai di IFRS Provita Jayapura pada tahun 2020 berdasarkan Permenkes No. 72 Tahun 2016, adalah terimplementasi sebagian dengan rata-rata capaian skoringnya adalah 73%. Hal yang paling baik terimplementasi adalah proses pada kegiatan penyimpanan dan sarana prasarana yang dimiliki oleh IFRS Provita. Sedangkan yang tidak terimplementasi adalah proses perencanaan baik perencanaan anggaran ataupun perencanaan kebutuhan obat tahunan. Hasil penelitian menyarankan bahwa manajemen sebaiknya segera membuat regulasi tentang perencanaan anggaran dan kebutuhan obat tahunan yang terintegrasi dengan pihak-pihak terkait dan dapat dievaluasi pelaksanaannya pada tahun berjalan saat operasional rumah sakit berjalan
Hospital Pharmacy Installation is one of the units in the hospital which is often categorized as a Revenue Center unit. The large number of related parts, both internal and external to the hospital, in the process of activities at the Hospital Pharmacy Installation, makes management better think about a good and integrated management system in the management cycle. This research is a qualitative research with analytical descriptive design. The results of this study show that the implementation of the management of pharmaceutical preparations, medical devices and medical consumables at IFRS Provita Jayapura based on Permenkes No. 72 of 2016 is partially implemented with an average score of 72%. The best thing to implement is the process of storage activities and infrastructure owned by IFRS Provita, while what is not implemented is the planning process, either budget planning or annual drug demand planning. The results of this study suggest that management should immediately make regulations regarding budget planning and annual drug needs that are integrated with related parties and can be evaluated for their implementation in the current year when hospital operations are running.
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Hospital Pharmacy Installation is one of the units in the hospital which is often categorized as a Revenue Center unit. The large number of related parts, both internal and external to the hospital, in the process of activities at the Hospital Pharmacy Installation, makes management better think about a good and integrated management system in the management cycle. This research is a qualitative research with analytical descriptive design. The results of this study show that the implementation of the management of pharmaceutical preparations, medical devices and medical consumables at IFRS Provita Jayapura based on Permenkes No. 72 of 2016 is partially implemented with an average score of 72%. The best thing to implement is the process of storage activities and infrastructure owned by IFRS Provita, while what is not implemented is the planning process, either budget planning or annual drug demand planning. The results of this study suggest that management should immediately make regulations regarding budget planning and annual drug needs that are integrated with related parties and can be evaluated for their implementation in the current year when hospital operations are running.
B-2236
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Angga Perdana Kusumah; Pembimbing: Anhari Achadi; Penguji: Masyitoh, Adik Wibowo, Dedi Wahyudi, Muhammad Bascharul Asana
Abstrak:
Rumah sakit memiliki kewajiban untuk memberikan pelayanan kesehatan yang aman, bermutu, anti diskriminatif dan efektif. Salah satunya adalah pelayanan kefarmasian yang merupakan bagian integral sistem pelayanan RS yang bertanggung jawab memastikan ketersediaan obat yang aman, bermutu dan berkhasiat. KMK 129/Menkes/SK/II/2008 menyebutkan bahwa RS wajib memenuhi Standar Pelayanan Minimal (SPM) yang salah satunya adalah Waktu Tunggu Pelayanan Obat. RS Jantung Hasna Medika Cirebon melayani 4000-5000 kunjungan rawat jalan setiap bulan dengan 92% diantaranya pasien BPJS Kesehatan. Rerata pencapaian waktu tunggu obat racikan hanya tercapai ≤ 72% dan obat jadi ≤40%. Tujuan penelitian ini adalah untuk meningkatkan kecepatan pelayanan resep rawat jalan pasien BPJS Kesehatan di instalasi farmasi RS Jantung Hasna Medika Cirebon menggunakan Lean Hospital. Metode penelitian ini adalah operational research dengan pendekatan kualitatif dengan sumber data primer diambil melalui observasi langsung dengan teknik time and motion study, telaah dokumen, wawancara mendalam dan Focus Group Discussion (FGD). Hasil penelitian ditemukan 2 jenis waste yaitu 99,31% waste waiting dan 0,69% waste motion, setelah dilakukan intervensi berupa optimalisasi e-resep, 5S dan visual management serta continuous flow dan process balancing terjadi penurunan lead time dari 01:24:47 menjadi 00:25:30 detik atau menurun sebesar 59 menit 17 detik (69,93%). Kesimpulan penelitian ini bahwa Lean Hospital merupakan metode atau tool yang tepat untuk meningkatkan value to waste ratio dengan mengurangi pemborosan dan meningkatkan nilai tambah untuk pasien. Penelitian ini belum maksimal dikarenakan pilihan lean hospital tools sangat terbatas mengingat waktu yang juga terbatas. Sehingga saran peneliti adalah meminta manajemen RS untuk menjadikan penelitian ini sebagai langkah awal continuous improvement untuk dapat dilanjutkan menggunakan tools lain dan di unit pelayanan yang berbeda
Hospitals have an obligation to provide safe, high quality, anti-discriminatory and effective services. One of them is pharmacy services as an integral part of the hospital service system that is responsible for ensuring the availability of safe, high quality and efficacious drugs. KMK 129/Menkes/SK/II/2008 states that hospitals are required to meet the Standards of Minimum Services (SPM), one of which is the Waiting Time for Drug Services. RS Jantung Hasna Medika Cirebon serves 4000-5000 outpatient visits every month with 92% of them being BPJS Kesehatan patients. The average waiting time for concoction drugs was only achieved by 72% and non-concoction drugs achieved by 40%. The purpose of this study was to increase the speed of outpatient prescription services for BPJS Kesehatan patients at the pharmacy installation of the RS Jantung Hasna Medika Cirebon using Lean Hospital. This research method is operational research with a qualitative approach. Primary data sources taken through direct observation with time and motion study techniques, in-depth interviews and Focus Group Discussion (FGD). The results of the study found 2 types of waste, namely 99.31% waiting waste and 0.69% motion waste, after intervention in the form of optimizing e-prescription, 5S and visual management as well as continuous flow and process balancing there was a decrease in lead time from 01:24:47 to 00:25:30 or decreased by 59 minutes 17 seconds (69.93%). The conclusion of this study is that Lean Hospital is the right method or tool to increase the value to waste ratio by reducing wasting time and increasing additional value for patients. This research has not been maximized because the choice of lean hospital tools is very limited considering the time is short. The researcher's suggestion is to encourage the hospital management to use this research as the first step of continuous improvement by using other tools in another service units
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Hospitals have an obligation to provide safe, high quality, anti-discriminatory and effective services. One of them is pharmacy services as an integral part of the hospital service system that is responsible for ensuring the availability of safe, high quality and efficacious drugs. KMK 129/Menkes/SK/II/2008 states that hospitals are required to meet the Standards of Minimum Services (SPM), one of which is the Waiting Time for Drug Services. RS Jantung Hasna Medika Cirebon serves 4000-5000 outpatient visits every month with 92% of them being BPJS Kesehatan patients. The average waiting time for concoction drugs was only achieved by 72% and non-concoction drugs achieved by 40%. The purpose of this study was to increase the speed of outpatient prescription services for BPJS Kesehatan patients at the pharmacy installation of the RS Jantung Hasna Medika Cirebon using Lean Hospital. This research method is operational research with a qualitative approach. Primary data sources taken through direct observation with time and motion study techniques, in-depth interviews and Focus Group Discussion (FGD). The results of the study found 2 types of waste, namely 99.31% waiting waste and 0.69% motion waste, after intervention in the form of optimizing e-prescription, 5S and visual management as well as continuous flow and process balancing there was a decrease in lead time from 01:24:47 to 00:25:30 or decreased by 59 minutes 17 seconds (69.93%). The conclusion of this study is that Lean Hospital is the right method or tool to increase the value to waste ratio by reducing wasting time and increasing additional value for patients. This research has not been maximized because the choice of lean hospital tools is very limited considering the time is short. The researcher's suggestion is to encourage the hospital management to use this research as the first step of continuous improvement by using other tools in another service units
B-2224
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dwi Dharmaningsih; Pembimbing: Helen Andriani; Penguji: Masyitoh, Pujiyanto, Hadijah Tahir, Endang Adriyani
Abstrak:
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Waktu tunggu pelayanan resep termasuk salah satu indikator dalam menjaga mutu pelayanan rumah sakit, waktu tunggu yang terlalu lama akan menimbulkan keluhan dari pasien yang dapat mengakibatkan penilaian negatif bagi rumah sakit. Waktu tunggu pelayanan resep obat jadi dan obat racikan di depo Farmasi Rawat Jalan Reguler RSPON Jakarta belum mencapai SPM yang ditetapkan dalam Kepmenkes Nomor 128 Tahun 2009 yaitu ≤30 menit untuk obat jadi dan ≤60 menit untuk obat racikan. Penelitian ini bertujuan mengurangi waktu tunggu pelayanan resep rawat jalan di depo farmasi rawat jalan reguler RSPON Jakarta dengan menggunakan pendekatan Lean Hospital. Penelitian ini menggunakan metode operational research dengan pendekatan kualitatif, pengambilan data dilakukan pada Mei-Juli 20223 di depo farmasi rawat jalan reguler, dengan jumlah sampel 25 resep obat jadi dan 5 resep obat racikan. Observasi langsung dilakukan dengan metode time motion study menggunakan lembar observasi VSM, wawancara dengan informan terpilih dan telaah dokumen. Pada kondisi current state waktu yang dibutuhkan untuk pelayanan setiap 1 resep (lead time) untuk resep obat jadi adalah 46,7 menit, dengan perbandingan aktivitas value added terhadap total waktu pelayanan 25%:75%, sedangkan lead time untuk resep racikan adalah 98,9 menit dengan perbandingan aktivitas value added terhadap total waktu pelayanan 27%:73%. Pada analisis kegiatan non value added, waste tertinggi pada kategori waste waiting dan waste overprocessing. Beberapa faktor penyebab terjadinya waste adalah inefisiensi SDM, jadwal praktek dokter yang bersamaan, belum adanya sistem pemisahan petugas pelayanan resep rawat jalan reguler dan rawat jalan eksekutif, perlunya optimalisasi e-resep, jaringan sistem informasi yang terkadang lambat di jam sibuk dan seringnya interupsi dari pasien yang bertanya di loket farmasi. Intervensi lean hospital yang dicoba untuk diterapkan adalah proses balancing, Heijunka dengan modifikasi shift petugas farmasi dan 5S. Pada kondisi future state terjadi penurunan lead time sebesar 28% untuk resep obat jadi menjadi 33,3 menit, sedangkan untuk resep racikan lead time turun sebesar 32% menjadi 67,1 menit. Kesimpulan penelitian ini Lean Hospital merupakan metode atau tool yang dapat digunakan untuk menurunkan lead time dengan mengurangi waste dan meningkatkan nilai tambah untuk pasien. Saran peneliti mendorong rumah sakit meneruskan sebagai langkah awal continuous improvement diiringi dengan pemenuhan kebutuhan SDM serta fasilitas pendukung.
Waiting time for prescription services is one of the indicators in maintaining the quality of hospital services, waiting times that are too long will cause complaints from patients which can result in a negative assessment of the hospital. The waiting time for ready-made and concocted drug prescription services at the Jakarta RSPON Regular Outpatient Pharmacy depot has not reached the SPM stipulated in Kepmenkes Number 128 of 2009, namely ≤30 minutes for finished drugs and ≤60 minutes for concocted drugs. This study aims to decrease the waiting time of outpatient prescription services at the regular outpatient pharmacy depots at RSPON Jakarta using Lean Hospital. This study used the operational research method with a qualitative approach, data collection was carried out in May-July 20223 at a regular outpatient pharmacy depot, a sample of 25 prescription drugs and 5 prescription drug concoctions. Direct observation was carried out using the time motion study method using VSM observation sheets, interviews with selected informants and document review. Under current state conditions, the lead time for each prescription (lead time) for finished drug prescription is 46.7 minutes, with a ratio of value added activity to total service time of 25%:75%, while the lead time for concoction recipes is 98.9 minutes with a ratio of value added activity to total service time of 27%:73%. In the analysis of non-value added activities, the highest waste is in the waste waiting and overprocessing waste. Some of the factors that cause waste are HR inefficiency, doctors' practice schedules that coincide, there is no separate system for regular outpatient prescription service officers and executive outpatient care, the need for optimizing e-prescriptions, information system networks that are sometimes slow during rush hours and frequent interruptions from patients asking questions at the pharmacy counter. The lean hospital intervention that was tried to be implemented was the balancing process, Heijunka with modifications to pharmacy staff shifts and 5S. In the future state, the lead time decreased by 28% for finished drug prescriptions to 33.3 minutes, while for mixed prescriptions the lead time decreased by 32% to 67.1 minutes. The conclusion of this study is that Lean Hospital is the right method or tool to reduce lead time by reducing waste and increasing added value for patients. The researcher's suggestion encourages the hospital to continue as the first step of continuous improvement accompanied by meeting the needs of human resources and supporting facilities.
B-2381
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Elizabeth Indah PSP; Pembimbing: Purnawan Junadi; Penguji: Mieke Savitri, Vetty Yulianty Permanasari, Endang Andriyani
Abstrak:
Studi pelayanan farmasi di rumah sakit dilaksanakan di Rumah Sakit PMI Bogor dengan indikasi awal masih rendahnya nilai inventory turn over. Pendekatan action research dengan fokus pada pendistribusian dan penyimpanan perbekalan farmasi dipilih sebagai jenis penelitian yang digunakan. Metodologi yang digunakan untuk melakukan perbaikan adalah kombinasi Lean dan Six Sigma. Studi dilakukan terhadap proses pendistribusian, periode permintaan barang, buffer stock, besaran permintaan, kondisi-kondisi permintaan barang, ROP, indikator farmasi, kesesuaian jumlah stok barang, barang dan obat kadaluwarsa, penanganan kadaluwarsa, penanganan barang di gudang. Rendahnya nilai inventory turnover dapat disebabkan belum dipahaminya dengan baik makna persediaan perbekalan farmasi bagi pengelola perbekalan farmasi. Data pendukung menunjukkan besarnya jumlah permintaan barang farmasi pada setiap kali periode permintaan barang yaitu data standar deviasi kelipatan permintaan barang farmasi sebesar 54.8 dan standar deviasi kelipatan pemenuhan barang farmasi adalah 50.4. Nilai Six Sigma Deffect Per Million Opportunities untuk ketepatan pemenuhan permintaan barang farmasi sesuai perkiraan permintaan barang yang tertera di dokumen surat permintaan barang farmasi adalah 0.09. Pada proses pendistribusian barang farmasi terdapat 47.6% merupakan proses tidak mempunyai nilai tambah dan menimbulkan variasi dalam langkah proses tersebut. Faktor yang mendukung terjadinya hal ini adalah waktu permintaan barang yang panjang, belum tepatnya peramalan yang dilakukan oleh ruang perawatan, tidak dipahaminya standar perkiraan permintaan yang tertera di surat permintaan barang farmasi, pemakaian barang farmasi yang belum terdata dengan akurat, bottleneck proses distribusi terdapat pada Instalasi Farmasi belum melakukan secara optimal pengendalian permintaan barang farmasi dari ruang perawatan, belum dilakukan pemantauan terhadap perputaran, persediaan, belum rincinya prosedur. Belum optimalnya pemanfaatan teknologi sistem inventori. Belum memiliki standar maksimum dan minimum setiap jenis barang farmasi dan belum menerapkan standar penyimpanan dan manajemen pergudangan. Untuk meningkatkan produktivitas dan profitabilitas Rumah Sakit PMI Bogor perlu dilakukan beberapa perbaikan pendistribusian dan penyimpanan perbekalan farmasi antara lain: Perbaikan kebijakan dan prosedur secara rinci dan operasional. Mengembangkan otomasi sistem inventori untuk mengurangi kesalahan. Meningkatkan pengetahuan dan keterampilan SDM pengelola melalui pelatihan. Mengembangkan Key Performance Indicator seperti Inventory Turn Over, kesesuaian jumlah barang, penataan 5-S.
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B-1579
Depok : FKM-UI, 2014
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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