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Rosinta Magdalena; Pembimbing: Adang Bachtiar; Penguji: Dumilah Ayuningtyas, Amal Chalik Sjaaf, Amila Megraini, Rahma Indira Wardani
Abstrak:
Tahun 2017 rata-rata waktu tunggu penyelesaian administrasi pasien pulang rawat inap di RS Eka Pekanbaru 246 menit (> 2 jam), yang meyebabkan ketidakpuasan pasien sehingga perlu dilakukan analisa terkait penyebab lamanya waktu tunggu tersebut dengan pendekatan Lean-Six Sigma untuk dapat melihat pemborosan yang terjadi. Penelitian ini adalah operational research, dengan desain penelitian kuantitatif dan kualitatif. Hasil penelitian memperlihatkan proses diawali dengan instruksi dokter bahwa pasien boleh pulang sampai pasien menerima bukti pembayaran administrasi. Hasil penelitian digambarkan dengan value stream mapping yang memperlihatkan lead time proses pengurusan administrasi pasien pulang selama 356,42 menit dengan value added 70,49 menit (22,58%), dan aktivitas yang tergolong non value added sebesar 285,93 menit (77,42%). Proses paling lama terjadi di keperawatan karena menunggu obat pasien, dan kasir (administrasi rawat inap) karena menunggu finalize dari farmasi dan jawaban asuransi / perusahaan penanggung biaya pasien. Waste paling besar yaitu waiting sebesar 193,33 menit (69,44%) dari total seluruh waste yang ada. Berdasarkan analisis fishbone diagram diketahui bahwa akar penyebab masalah paling banyak berasal dari kategori man. Usulan perbaikan berupa pembuatan standarisasi kerja, rapat koordinasi, meningkatkan pengawasan, dan menerapkan heijunka.
Kata Kunci: Pengurusan Administrasi pasien pulang, Lean Six Sigma, Rawat Inap
In 2017 the average waiting time for the process of Discharged Patients Administration at Eka Pekanbaru Hospital is 246 minutes (> 2 hours), it causes patient complaint so it is necessary to analyze the causes of the long waiting time with the Lean-Six Sigma approach to be able to see the waste that occurs. This is operational research that uses quantitative and qualitative design. The result of this research showed that the Discharged Patients Administration in hospital begins from the instruction of the doctor that the patient can go home until the patient receives an administrative payment receipt. The results of this research were also described with the value stream mapping that showed lead time of discharged patients administration process is 356,42 minutes, with value added 70,49 minutes (22,58%), and non value added 285,93 minutes (77,42%). The longest process occurs on nursing unit and inpatient administration unit. The longest waste is waiting waste of 193,33 minutes (69,44%) of the total waste that found. Based on fishbone diagram analysis it is known that most of the root cause of discharged patients administration process problem come from man category. Based on that analysis, improvements proposed are work standardization, coordination meeting, increase of supervision, and implementation of heijunka
Key words: Discharged Patients Administration, Lean Six Sigma, Inpatient.
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Kata Kunci: Pengurusan Administrasi pasien pulang, Lean Six Sigma, Rawat Inap
In 2017 the average waiting time for the process of Discharged Patients Administration at Eka Pekanbaru Hospital is 246 minutes (> 2 hours), it causes patient complaint so it is necessary to analyze the causes of the long waiting time with the Lean-Six Sigma approach to be able to see the waste that occurs. This is operational research that uses quantitative and qualitative design. The result of this research showed that the Discharged Patients Administration in hospital begins from the instruction of the doctor that the patient can go home until the patient receives an administrative payment receipt. The results of this research were also described with the value stream mapping that showed lead time of discharged patients administration process is 356,42 minutes, with value added 70,49 minutes (22,58%), and non value added 285,93 minutes (77,42%). The longest process occurs on nursing unit and inpatient administration unit. The longest waste is waiting waste of 193,33 minutes (69,44%) of the total waste that found. Based on fishbone diagram analysis it is known that most of the root cause of discharged patients administration process problem come from man category. Based on that analysis, improvements proposed are work standardization, coordination meeting, increase of supervision, and implementation of heijunka
Key words: Discharged Patients Administration, Lean Six Sigma, Inpatient.
B-2051
Depok : FKM-UI, 2019
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Doris Lumban Tobing; Pembimbing: Pujiyanto; Penguji: Suprijanto Rijadi, Puput Oktamianti, Yuli Prapancha Enny Satar, Ekasari
Abstrak:
Berdasarkan UBA pasien di RS Siloam Kebon Jeruk, didapat komentar mengenaipemulangan pasien, yaitu : waktu tunggu penyelesaian administrasi pulang pasienmasih cukup lama, terutama menggunakan asuransi. Dari uji petik didapatkanrata-rata waktu tunggu yang menggunakan jaminan perusahaan/asuransi 5 jam 45menit dan non jaminan 3 jam 4 menit. Penelitian bertujuan mengetahui faktor-faktor yang mempengaruhi waktu tunggu pelayanan administrasi pulang pasienrawat inap dengan jaminan perusahaan/asuransi di RS Siloam Kebon Jeruk.Desain penelitian menggunakan kuantitatif dan kualitatif. Data primer didapat dariwawancara dan observasi dan data sekunder didapat dari telaah dokumen danlaporan pasien pulang. Dari hasil penelitian didapatkan faktor-faktor yangmempengaruhi adalah pengisian resume medis, jumlah sumber daya manusia,kebijakan dan alur proses rumah sakit yang sudah ada perubahan dengan prosesyang dilaksanakan di lapangan.Dapat disimpulkan dengan efisiensi waktu padatahap admin, tahap farmasi dan tahap gudang satelit dapat memperpendek waktuproses di rumah sakit. Efisiensi proses mempersingkat penyelesaian administrasipulang pasien rawat inap dengan jaminan perusahaan/asuransi menjadi 2 jam.Saran peneliti yaitu sosialisasi mengenai pentingnya peran dokter spesialis,pengkajian ulan tenaga staf admin ruangan, revisi kebijakan dan alur prosesadministrasi pulang pasien dengan jaminan perusahaan/asuransi dan uraian tugasstaf yang berperan, revisi MoU dengan pihak penjamin untuk masalah konfirmasi.Kata kunci : waktu tunggu penyelesaian administrasi pulang pasien rawat inap,pasien jaminan perusahaan/asuransi
Based UBA hospital inpatients in Siloam Kebon Jeruk , gained criticism andsuggestions regarding the discharge of patients, namely: the waiting time ofpatients still settling administrative home long enough, especially the use ofinsurance. From the test results obtained quotes the average waiting time ofpatients who use the guarantee is 5 hours 45 minutes and non warranty is 3 hours4 minutes. The study aims to determine the factors that influence waiting timesadministrative services to inpatients home insurance in Siloam Kebon JerukHospital. Design using both quantitative and qualitative research. The primarydata obtained from interviews and observations and secondary data obtainedfrom the study of documents and reports patient's home.From the results, the factors that affect the length of time patients wait forcompletion of home administration is charging inpatient medical resume, theamount of human resources, policies and workflow processes existing hospitalswith process changes implemented in the field.It can be concluded in less time on admin stage, stage pharmaceutical andsatellite warehouses stage can shorten the processing time in the hospital. Theefficiency of the process beyond the administrative processes to shorten hospitalinpatients with insurance to 2 hours. Suggestions researchers that thesocialization of medical importance to specialist resume, review of workforce,policy revisions and return patient administration process flow with insuranceand job descriptions of staff whose role, revised MoU with an insurer to issue aconfirmation.Keywords: waiting time home administrative settlement inpatients, corporateguarantee patient / insurance
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Based UBA hospital inpatients in Siloam Kebon Jeruk , gained criticism andsuggestions regarding the discharge of patients, namely: the waiting time ofpatients still settling administrative home long enough, especially the use ofinsurance. From the test results obtained quotes the average waiting time ofpatients who use the guarantee is 5 hours 45 minutes and non warranty is 3 hours4 minutes. The study aims to determine the factors that influence waiting timesadministrative services to inpatients home insurance in Siloam Kebon JerukHospital. Design using both quantitative and qualitative research. The primarydata obtained from interviews and observations and secondary data obtainedfrom the study of documents and reports patient's home.From the results, the factors that affect the length of time patients wait forcompletion of home administration is charging inpatient medical resume, theamount of human resources, policies and workflow processes existing hospitalswith process changes implemented in the field.It can be concluded in less time on admin stage, stage pharmaceutical andsatellite warehouses stage can shorten the processing time in the hospital. Theefficiency of the process beyond the administrative processes to shorten hospitalinpatients with insurance to 2 hours. Suggestions researchers that thesocialization of medical importance to specialist resume, review of workforce,policy revisions and return patient administration process flow with insuranceand job descriptions of staff whose role, revised MoU with an insurer to issue aconfirmation.Keywords: waiting time home administrative settlement inpatients, corporateguarantee patient / insurance
B-1618
Depok : FKM-UI, 2014
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Jesslyn Bernadette; Pembimbing: Masyitoh; Penguji: Wachyu Sulistiadi, Irene Girsang, Dini Handayani
Abstrak:
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Latar Belakang : Waktu tunggu sering kali dijadikan indikator untuk menilai kualitas pelayanan rumah sakit oleh pasien. Salah satu aspek yang menjadi perhatian adalah waktu tunggu untuk pemulangan pasien. Data RS Mitra Keluarga Bintaro tahun 2023 menunjukkan rata-rata waktu tunggu pasien adalah 87 menit dengan perbedaan yang cukup signifikan antara pasien dengan penjaminan pribadi (66 menit) dan penjaminan asuransi (121 menit). Data rata-rata waktu tunggu tersebut terhitung sejak dokter memberikan instruksi pulang hingga pasien melakukan billing akhir. Data tersebut belum terhitung hingga pasien meninggalkan ruang rawat inap. Standar pelayanan minimal waktu tunggu pemulangan pasien rawat inap yang ditetapkan oleh Kemenkes yaitu kurang dari 120 menit. Pencapaian waktu tunggu pasien yang keluar dalam waktu ≤ 2 jam tercatat sebesar 88%, meskipun masih belum memenuhi target korporat yang ditetapkan sebesar 100%.
Metode : Penelitian ini mengadopsi desain operational research yang mengintegrasikan metode kuantitatif dan kualitatif. Teknik pengambilan sampel yang digunakan adalah simple random sampling, dengan total sampel sebanyak 38 pasien yang pulang setelah menjalani rawat inap. Pemilihan sampel didasarkan pada distribusi hari, jam kepulangan, dan jenis metode penjaminan yang telah ditetapkan.
Hasil : Hasil penelitian dengan pendekatan lean six sigma berhasil mengidentifikasi lead time pemulangan pasien rawat inap di RS Mitra Keluarga Bintaro sebesar 5 jam 10 menit 54 detik dimana 69% merupakan kegiatan non value added yang didominasi oleh waste tipe waiting sebesar 3 jam 14 menit 23 detik. Akar masalah dari memanjangnya waktu tunggu pemulangan pasien rawat inap berada di fase III pada kegiatan menunggu pasien meninggalkan ruang rawat inap. Penerapan lean six sigma dalam proses pemulangan pasien rawat inap di RS Mitra Keluarga Bintaro berhasil mengurangi lead time sebesar 16%, dari 5 jam 10 menit 54 detik menjadi 4 jam 21 menit 25 detik. Pengurangan lead time ini diikuti dengan penurunan waste di seluruh tahapan pemulangan pasien, dengan penurunan waste terbesar terjadi pada fase I, yaitu sebesar 44%, dari 1 jam 3 menit 27 detik menjadi 35 menit 46 detik.
Kesimpulan : Terdapat penurunan waktu tunggu pemulangan pasien rawat inap di RS Mitra Keluarga Bintaro setelah penerapan lean six sigma. Penurunan waktu tunggu pemulangan pasien rawat inap masih diatas target standar pelayanan minimal yang ditetapkan oleh Kemenkes.
Background : Waiting time is often used as an indicator to assess the quality of hospital services by patients. One aspect of concern is the waiting time for patient discharge. Data from Mitra Keluarga Bintaro Hospital in 2023 showed that the average patient waiting time was 87 minutes with a significant difference between patients with personal guarantees (66 minutes) and insurance guarantees (121 minutes). The average waiting time data is calculated from when the doctor gives instructions to go home until the patient makes the final billing. The data does not include until the patient leaves the inpatient room. The minimum service standard for inpatient discharge waiting time set by the Ministry of Health is less than 120 minutes. The achievement of waiting time for patients who leave within ≤ 2 hours was recorded at 88%, although it still does not meet the corporate target set at 100%. Method : This study adopted an operational research design that integrates quantitative and qualitative methods. The sampling technique used was simple random sampling, with a total sample of 38 patients who returned home after undergoing inpatient care. Sample selection was based on the distribution of days, hours of discharge, and types of guarantee methods that had been determined. Hasil : The results of the study using the lean six sigma approach successfully identified the lead time for inpatient discharge at Mitra Keluarga Bintaro Hospital of 5 hours 10 minutes 54 seconds, where 69% were non-value added activities dominated by waiting type waste of 3 hours 14 minutes 23 seconds. The root of the problem of the long waiting time for inpatient discharge is in phase III in the activity of waiting for the patient to leave the inpatient room. The application of lean six sigma in the inpatient discharge process at Mitra Keluarga Bintaro Hospital successfully reduced the lead time by 16%, from 5 hours 10 minutes 54 seconds to 4 hours 21 minutes 25 seconds. This reduction in lead time was followed by a decrease in waste in all stages of patient discharge, with the largest decrease in waste occurring in phase I, which was 44%, from 1 hour 3 minutes 27 seconds to 35 minutes 46 seconds. Kesimpulan : There is a decrease in the waiting time for discharge of inpatients at Mitra Keluarga Bintaro Hospital after the implementation of lean six sigma. The decrease in the waiting time for discharge of inpatients is still above the minimum service standard target set by the Ministry of Health.
B-2507
Depok : FKM UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Ietje Susantin; Pembimbing: Kurnia Sari; Penguji: Mieke Savitri, Retno Wulanjari, Wirda Saleh
Abstrak:
Instalasi farmasi merupakan salah satu bagian di rumah sakit yang diharapkan dapat meningkatkan mutu pelayanan secara berkesinambungan dan bersinggungan langsung dengan kesehatan pasien. Penelitian ini bertujuan untuk melakukan analisa pelayanan farmasi rawat jalan dengan menggunakan pendekatan Lean Six Sigma. Desain penelitian ini adalah analisa kualitatif dengan kerangka acuan DMAI (Define, Measure, Analyzedan Improve). Observasi mulai dari pasien menyerahkan resep sampai petugas memberikan obat yang dibagi menjadi 4 cycle (penerimaan resep, persiapan obat pemberian etiket dan penyerahan obat), wawancara mendalam, telaah dokumen. Hasil identifikasi value stream mapping dari 4 cycle di dapatkan penerimaan resep membutuhkan waktu 15 menit 13 detik, persiapan obat 5 menit 10 detik untuk obat non racikan dan 30 menit 14 detik untuk obat racikan, penyerahan obat 6 menit 28 detik. Proporsi non-value added untuk obat non racikan adalah 54% dan value added sebesar 46%, sedangkan non-value added untuk obat racikan adalah 39,4% dan value addedsebesar 60,6% dengan total waste selama 20 menit 50 detik. Hasil analisis Five Whys menunjukkan adanya bottleneck di penerimaan resep (15 menit 13 detik) dengan penyebab yaitu stok obat yang tidak sesuai dengan sistem komputer, sehingga bila ada stok yang kosong maka petugas perlu konfirmasi ke dokter dan menunggu kuitansi/bukti pembayaran dari kasir . Upaya penerapan lean six sigmadiharapkan dapat memperbaiki kinerja di instalasi farmasi, selain menghilangkan wastedan memaksimalkan nilai (value added), mengetahui akar masalah, perbaikan kualitas dan peningkatan efisiensi kinerja secara terus menerus
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B-2137
Depok : FKM-UI, 2020
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Retno Arimby; Pembimbing: Wiku Bakti Bawono Adisasmito; Penguji: Masyitoh, A. Heri Iswanto
Abstrak:
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Waktu tunggu merupakan salah satu indikator dari mutu pelayanan di rawat jalan. Penelitian ini bertujuan untuk menganalisis proses pelayanan rawat jalan poli penyakit dalam di RS Simpangan Depok melalui pendekatan Lean Six Sigma (LSS). Desain penelitian ini adalah kualitatif dengan pengumpulan data yang didapatkan melalui pengamatan dan pencatatan waktu (time motion) dalam setiap tahapan proses rawat jalan, penggalian informasi secara mendalam kepada informan dan pertanyaan terbuka kepada tiga puluh enam responden serta telaah dokumen. Pemilihan informan dilakukan menggunakan teknik purposive sampling dan dilakukan wawancara terbuka kepada pasien untuk mendapatkan value dari perspektif customer. Data yang didapatkan kemudian dianalisis untuk mendapatkan faktor penyebab lamanya waktu tunggu pelayanan di rawat jalan dengan menggunakan fishbone diagram sehingga dapat diberikan rekomendasi perbaikan yang dapat dilakukan oleh rumah sakit. Hasil penelitian yang dilakukan pada bulan Juni-Juli 2023 didapatkan rata-rata waktu tunggu pelayanan di rawat jalan adalah 03:05:23 (dengan nilai VAR 10%) yang berarti masih kurang dari 30% dan dikategorikan sebagai Un-Lean. Beberapa faktor penyebab terjadinya waste adalah keterlambatan dokter, keterbatasan SDM, prosedur rawat jalan kurang praktis, belum ada penerapan e-resep, dan keterbatasan sarana prasarana. Kata kunci : mutu pelayanan, Lean Six Sigma, waktu tunggu rawat jalan
Waiting time is one indicator of the quality of outpatient services. This study aims to analyze the process of outpatient internal medicine services at Simpang Depok Hospital through the Lean Six Sigma (LSS) approach. The design of this study was qualitative with data collection obtained through observation and recording of time (time motion) in each stage of the outpatient process, in-depth exploration of informants and open-ended questions to thirty-six respondents as well as document review. Informants were selected using a purposive sampling technique and open interviews were conducted with patients to obtain value from a customer perspective. The data obtained is then analyzed to obtain the factors causing the long waiting time for outpatient services using a fishbone diagram so that recommendations for improvements can be given by the hospital. The results of research conducted in June-July 2023 found that the average waiting time for outpatient services was 03:05:23 (with a VAR value of 10%), which means that it is still less than 30% and is categorized as Un-Lean. Some of the factors that cause waste are delays in doctors, limited human resources, less practical outpatient procedures, no e-prescription implementation, and limited infrastructure. Keywords: service quality, Lean Six Sigma, outpatient waiting time
B-2389
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Radhica El Shalawa; Pembimbing: Masyitoh; Penguji: Purnawan Junadi, Rakhmad Hidayat, Melanie Husna
Abstrak:
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Waktu pemulangan pasien rawat inap merupakan indikator mutu penting dalam pelayanan rumah sakit. Di RS Universitas Indonesia (RSUI), target check-out time sebelum pukul 12 siang belum tercapai selama empat tahun terakhir, berdampak pada keterlambatan alur rawat inap dari IGD dan menurunnya efisiensi pemanfaatan tempat tidur. Proses discharge yang kompleks, melibatkan banyak unit, serta dominasi aktivitas non-value-added menjadi penyebab utama rendahnya capaian indicator mutu tersebut. Penelitian ini menggunakan pendekatan Lean Six Sigma dengan desain DMAIC (Define, Measure, Analyze, Improve, Control). Pengumpulan data dilakukan melalui observasi proses discharge dan wawancara mendalam terhadap tujuh informan kunci lintas profesi. Sampel terdiri atas 40 pasien jaminan BPJS Kesehatan. Analisis dilakukan untuk mengidentifikasi aktivitas value-added, non-value-added, waste, dan variasi proses. Rata-rata lead time discharge sebelum intervensi adalah 20 jam 35 menit dengan 86% aktivitas tergolong NVA. Empat aktivitas prioritas dengan waste tertinggi adalah discharge billing (43,75%), penyusunan resume keperawatan dan surat kontrol (13,62%), pengorderan resep obat pulang (9,95%), dan penyusunan resume medis (9,86%). Intervensi dilakukan melalui penempatan tenaga administrasi ruangan (ADRU), surat edaran kebijakan peresepan oleh DPJP, serta pelatihan Kaizen. Setelah intervensi, capaian check-out sebelum pukul 12.00 meningkat dari 45% menjadi 53%, meskipun total lead time meningkat menjadi 22 jam 40 menit. Namun, beberapa subprocess mengalami perbaikan signifikan, seperti edukasi dan pemberian obat (turun 29%), pasien keluar ruang (turun 40%), dan discharge billing (turun 40%). Intervensi Lean Six Sigma berhasil meningkatkan capaian check-out time <12.00 meskipun belum menurunkan total lead time secara keseluruhan. Perbaikan cenderung parsial dan menunjukkan perlunya intervensi lebih menyeluruh terhadap tahapan proses discharge yang belum optimal.
Inpatient discharge time is a key quality indicator in hospital services. At Universitas Indonesia Hospital (RSUI), the target check-out time before 12:00 PM has not been achieved over the past four years. This delay negatively impacts the inpatient admission flow from the emergency department and reduces the efficiency of bed utilization. The complexity of the discharge process, which involves multiple units and is dominated by non-value-added (NVA) activities, is a primary factor contributing to the low performance of this indicator. This study applied a Lean Six Sigma approach using the DMAIC (Define, Measure, Analyze, Improve, Control) framework. Data collection was conducted through direct observation of the discharge process and in-depth interviews with seven key informants from different professional backgrounds. The sample consisted of 40 inpatients covered by the national health insurance scheme (BPJS Kesehatan). The analysis focused on identifying value-added (VA) and non-value-added (NVA) activities, waste, and process variation. The average pre-intervention discharge lead time was 20 hours and 35 minutes, with 86% of activities categorized as NVA. Four priority activities contributing the most waste were: system-based discharge billing (43.75%), preparation of nursing discharge summaries and follow-up letters (13.62%), prescription of discharge medications (9.95%), and preparation of medical summaries (9.86%). Interventions included the deployment of room-based administrative staff (ADRU), a policy circular mandating discharge prescriptions by the attending physician, and Kaizen training for process owners. Post-intervention, the proportion of patients discharged before 12:00 PM increased from 45% to 53%, although the total lead time rose to 22 hours and 40 minutes. However, several subprocesses showed significant improvements, such as patient education and medication handover (reduced by 29%), patient exit from the ward (reduced by 40%), and discharge billing (reduced by 40%). The Lean Six Sigma intervention succeeded in improving the achievement of the <12:00 PM discharge time indicator, although it did not reduce the overall discharge lead time. The improvements were partial, indicating a need for more comprehensive interventions targeting other suboptimal discharge process components.
B-2559
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Gina Adriana; Pembimbing: Purnawan Junadi; Penguji: Suprijanto Rijadi, Pujiyanto, Puput Oktamianti, Prima Yunika D. Ruswanti
Abstrak:
Selama satu setengah tahun, pengajuan penagihan klaim rawat inap oleh RS AwalBros Pekanbaru kepada BPJS Kesehatan menemui berbagai kendala yaitulamanya menyerahkan berkas penagihan klaim RS yang berdampak terlambatnyaRS menerima pembayaran. Penelitian dengan metode preeksperimental pre testpost test ini mengobservasi waktu proses dan waktu antar proses, mengidentifikasiwaste pada proses penagihan klaim serta melakukan perbaikan jangka pendek danjangka menengah menggunakan metode Lean Six Sigma. Hasil penelitian padabulan April 2015 menunjukkan 98% waktu proses penagihan klaim merupakankegiatan Non Value Added dengan waktu terlama melakukan serah terima berkaspenagihan kepada verifikator BPJS kesehatan adalah 26 hari dan waktu tercepatadalah 12 hari dengan nilai sigma level adalah -3,85 dan defect per million adalah999,943. Setelah dilakukan proses perbaikan dengan metode Lean Six Sigma padabulan September 2015, kegiatan Non Value Added menurun menjadi 92% denganwaktu terlama melakukan serah terima berkas penagihan kepada verifikator BPJSkesehatan adalah 11 hari dan waktu tercepat adalah 3 hari dengan nilai sigma leveladalah 1,48 dan defect per million adalah 68,976 dengan menghasilkan kualitasklaim yang lebih baik terlihat dari hasil rekapitulasi berkas tidak ada berkas yangtidak layak klaim.Kata kunci : Lean Six Sigma, waste, klaim, non value added, defect per million,sigma level
During one and a half years, the insurance claim life cycle filling by Awal BrosPekanbaru to BPJS Kesehatan faced many obstacles, such as: longer time tosubmit the billing claims documents that impact to delay on receives payment.This Research using pretest posttest experimental method to observe total time ofinsurance claim life cycle and time between processes, identify the waste, andperform short term and medium-term improvement plan by using Lean Six Sigmamethod. The results of the research in April 2015 showed 98% of billing claimsprocessing time was a Non Value Added activity with the longest time to submitbilling document to BPJS verificator was 26 days, and the fastest time was 12days. The sigma value was -3,85 and defect levels was 999.943 per million. Afterimprovement process by using Lean Six Sigma in September 2015, there weresignificant changes that show non value added acitivity of billing claimprocessing time becomes 92% with the longest time to submit billing document toBPJS verificator was 11 days, and the fastest time was 3 days which values ofsigma level was 1.48 and defect per million was 68.976 with better quality claims.Key words : Lean Six Sigma, waste, Claim, non-value add, defect per million,sigma level
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During one and a half years, the insurance claim life cycle filling by Awal BrosPekanbaru to BPJS Kesehatan faced many obstacles, such as: longer time tosubmit the billing claims documents that impact to delay on receives payment.This Research using pretest posttest experimental method to observe total time ofinsurance claim life cycle and time between processes, identify the waste, andperform short term and medium-term improvement plan by using Lean Six Sigmamethod. The results of the research in April 2015 showed 98% of billing claimsprocessing time was a Non Value Added activity with the longest time to submitbilling document to BPJS verificator was 26 days, and the fastest time was 12days. The sigma value was -3,85 and defect levels was 999.943 per million. Afterimprovement process by using Lean Six Sigma in September 2015, there weresignificant changes that show non value added acitivity of billing claimprocessing time becomes 92% with the longest time to submit billing document toBPJS verificator was 11 days, and the fastest time was 3 days which values ofsigma level was 1.48 and defect per million was 68.976 with better quality claims.Key words : Lean Six Sigma, waste, Claim, non-value add, defect per million,sigma level
B-1784
Depok : FKM-UI, 2016
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Rheine Indira Putrie Sesunan; Pembimbing: Pujiyanto; Penguji: Masyitoh Basabih, Dumilah Ayuningtyas, Elga Ria Vinensa, Adryansyah
Abstrak:
Lamanya waktu tunggu pemulangan pasien di rumah sakit Mitra Husada Pringsewu menyebabkan belum tersedia kamar perawatan pada saat pasien membutuhkan rawat inap. Hal ini memacu untuk menjadikan percepatan pemulangan pasien rawat inap sebagai salah satu program kerja tahun 2022. Tujuan penelitian adalah mengetahui gambaran proses pemulangan rawat inap, mengukur tahapan proses, menganalisis faktor yang memengaruhi waktu tunggu pemulangan pasien rawat inap, dan memberikan usulan perbaikan dengan pendekatan Lean Six Sigma yang berfokus menciptakan aliran lancar produk sepanjang proses, menghilangkan semua jenis pemborosan, mencapai nol kesalahan, dan menghilangkan variasi. Jenis penelitian ini adalah observasional deskriptif, desain studi cross sectional dengan pendekatan kuantitatif dan kualitatif terhadap 284 sampel. Hasil penelitian diperoleh total waktu adalah 441,6 menit (7,36 jam) dengan waktu proses administrasi rumah sakit 385,8 menit (6,43 jam) dan waktu pasien menunggu dijemput 55,8 menit. Aktivitas value added sebesar 282 menit (4,7 jam) atau 63,9% dan aktivitas non-value added sebesar 159,6 menit (2,66 jam) atau 36,1%. Ditemukan waste sebesar 157,9 menit (2,63 jam) yang apabila dihilangkan akan memotong lead time menjadi 283,7 menit (4,73 jam). Faktor-faktor yang memengaruhi lama waktu pemulangan pasien rawat inap adalah jumlah, uraian tugas , budaya kerja sumber daya manusia, metode atau alur proses berupa kebijakan atau SPO, sistem manual atau berbasis IT, sistem komunikasi internal RS dan kepada pasien, mesin, dan desain ruangan. Methode dan man adalah faktor yang paling berpengaruh. Diperlukan upaya perbaikan dengan standarisasi kerja, pemerataan aktifitas petugas, manajemen visual, bed management system, penyediaan ruang tunggu, dan pembaruan SIMRS dengan teknik error proofing
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B-2272
Depok : FKM-UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Erna Maria; Pembimbing: Vetty Yulianty Permanasari; Penguji: Dumilah Ayuningtyas, Jaslis Ilyas, Ati Nirwanawati, Hariyadi Wibowo
Abstrak:
Latar Belakang : Rumah sakit sebagai institusi pemberi layanan kesehatan, bertanggungjawab terhadap penyediaan layanan yang ada di masyarakat yang dapat memberikan rasa aman, efektif, memiliki mutu dan tidak bersifat diskriminatif dengan mengutamakan kepentingan pasien. Peresepan obat oleh dokter dan pemenuhannya oleh bagian farmasi secara tepat mencerminkan pelayanan berkualitas di tempat tersebut. Keterlambatan penerimaan obat menimbulkan ketidakpuasan dari pasien dan menurunkan kepercayaan terhadap RS. Pada tahun 2015 hingga 2016, waktu tunggu obat pasien unit rawat jalan RS Eka Pekanbaru masih berkisar 1 jam 4 menit untuk obat non racikan dan 1 jam untuk obat racikan. Tahun 2017 terjadi perbaikan namun angka kepuasan pasien masih belum dapat mencapai 95% dari ketetapan rumah sakit. Tentunya hal ini dapat mengakibatkan keenganan pasien untuk kembali untuk berobat yang menurunkan pendapatan RS.
Tujuan : Mengetahui hubungan waktu tunggu pasien dan karakteristik pasien terhadap tingkat kepuasan pasien pada pelayanan unit farmasi rawat jalan RS Eka Pekanbaru.
Metode : Penelitian ini memakai desain penelitian kuantitatif dengan desain potong lintang, yang dilengkapi dengan penelitian kualitatif. Dilaksanakan pada bulan Maret 2019 di unit Farmasi Rawat Jalan RS Eka Pekanbaru. Data primer diambil dengan melakukan pengamatan langsung di farmasi unit rawat jalan dan wawancara kepada Direktur serta Kepala Instalasi Farmasi RS. Data sekunder didapat dari data resep racikan maupun resep non racikan RS Eka Pekanbaru. Semua data kemudian diolah menggunakan sistem dan dianalisa menggunakan pendekatan PLS-SEM.
Hasil : Ratarata pelayanan farmasi unit rawat jalan RS. Eka Pekanbaru memiliki waktu 17.13 menit obat non racikan dan 33.48 menit obat racikan. Usia tua puas dengan responsiveness, pasien yang bekerja puas dengan tangible. Namun secara umum karakteristik pasien tidak mempengaruhi dari keseluruhan kualitas layanan.
Kesimpulan : Manajemen masih pelu melakukan perbaikan terhadap waktu tunggu terhadap resep racikan. Adanya waktu tunggu penyelesaian resep obat semakin cepat akan meningkatkan kepuasan, yang didukung dengan kualitas layanan yang baik
Background : The hospital as an institution providing health services, is responsible for providing services in the community that can provide a sense of security, effectiveness, quality and non-discrimination by prioritizing the interests of patients. Doctors prescriptions and their fulfillment by the pharmacy department reflect the quality service in Hospital. The delay in receiving drug caused dissatisfaction from the patient and reduced trust. In 2015 to 2016, the waiting time prescription for outpatient patients at Eka Pekanbaru Hospital was still around 1 hour 4 minutes for nonconcoction drugs and 1 hour for concoction drugs. In 2017 there was an improvement but the patient satisfaction rate still could not reach 95% of hospital provisions. This can lead to patient reluctance to return to treatment which reduces hospital income.
Objective: To determine the correlation between patient waiting time and patient characteristics to the level of patient satisfaction at the outpatient pharmacy unit in the Eka Pekanbaru hospital.
Method: This study uses a quantitative research design with cross-sectional design, which is supplemented by qualitative research. Performed in March 2019 in the outpatient pharmacy department of the Eka Pekanbaru hospital. Primary data was taken by conducting direct observation in the outpatient pharmacy unit and interviewing the Director and Head of the Pharmacy Installation. Secondary data was obtained from data on recipe concoctions and recipes for non-concoction of Eka Pekanbaru Hospital. All data were then processed using an analyzed system using PLS-SEM approach.
Results: The average time for outpatient pharmacy units in RS Pekanbaru takes 17.13 minutes for non-concoction medicine and 33.48 minutes for concoction medicine Old age has satisfied with the responsiveness, patients who work was satisfied with tangible. But in general the characteristics of patients did not influence the overall quality of the service.
Conclusion: management still needs to improve the waiting time for concoction recepies. The waiting time for drug prescription completion will increase satisfaction, which is supported by good service quality
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Tujuan : Mengetahui hubungan waktu tunggu pasien dan karakteristik pasien terhadap tingkat kepuasan pasien pada pelayanan unit farmasi rawat jalan RS Eka Pekanbaru.
Metode : Penelitian ini memakai desain penelitian kuantitatif dengan desain potong lintang, yang dilengkapi dengan penelitian kualitatif. Dilaksanakan pada bulan Maret 2019 di unit Farmasi Rawat Jalan RS Eka Pekanbaru. Data primer diambil dengan melakukan pengamatan langsung di farmasi unit rawat jalan dan wawancara kepada Direktur serta Kepala Instalasi Farmasi RS. Data sekunder didapat dari data resep racikan maupun resep non racikan RS Eka Pekanbaru. Semua data kemudian diolah menggunakan sistem dan dianalisa menggunakan pendekatan PLS-SEM.
Hasil : Ratarata pelayanan farmasi unit rawat jalan RS. Eka Pekanbaru memiliki waktu 17.13 menit obat non racikan dan 33.48 menit obat racikan. Usia tua puas dengan responsiveness, pasien yang bekerja puas dengan tangible. Namun secara umum karakteristik pasien tidak mempengaruhi dari keseluruhan kualitas layanan.
Kesimpulan : Manajemen masih pelu melakukan perbaikan terhadap waktu tunggu terhadap resep racikan. Adanya waktu tunggu penyelesaian resep obat semakin cepat akan meningkatkan kepuasan, yang didukung dengan kualitas layanan yang baik
Background : The hospital as an institution providing health services, is responsible for providing services in the community that can provide a sense of security, effectiveness, quality and non-discrimination by prioritizing the interests of patients. Doctors prescriptions and their fulfillment by the pharmacy department reflect the quality service in Hospital. The delay in receiving drug caused dissatisfaction from the patient and reduced trust. In 2015 to 2016, the waiting time prescription for outpatient patients at Eka Pekanbaru Hospital was still around 1 hour 4 minutes for nonconcoction drugs and 1 hour for concoction drugs. In 2017 there was an improvement but the patient satisfaction rate still could not reach 95% of hospital provisions. This can lead to patient reluctance to return to treatment which reduces hospital income.
Objective: To determine the correlation between patient waiting time and patient characteristics to the level of patient satisfaction at the outpatient pharmacy unit in the Eka Pekanbaru hospital.
Method: This study uses a quantitative research design with cross-sectional design, which is supplemented by qualitative research. Performed in March 2019 in the outpatient pharmacy department of the Eka Pekanbaru hospital. Primary data was taken by conducting direct observation in the outpatient pharmacy unit and interviewing the Director and Head of the Pharmacy Installation. Secondary data was obtained from data on recipe concoctions and recipes for non-concoction of Eka Pekanbaru Hospital. All data were then processed using an analyzed system using PLS-SEM approach.
Results: The average time for outpatient pharmacy units in RS Pekanbaru takes 17.13 minutes for non-concoction medicine and 33.48 minutes for concoction medicine Old age has satisfied with the responsiveness, patients who work was satisfied with tangible. But in general the characteristics of patients did not influence the overall quality of the service.
Conclusion: management still needs to improve the waiting time for concoction recepies. The waiting time for drug prescription completion will increase satisfaction, which is supported by good service quality
B-2112
Depok : FKM UI, 2019
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nisle Purada Sihombing; Pembimbing: Adik Wibowo; Penguji: Suprijanto Rijadi, Mardiati Nadjib, F.X. Santoso Soemidjo
Abstrak:
Penelitian ini bertujuan menganalisis proses discharge pasien rawat inap di RS St. ElisabethBekasi dengan menggunakan pendekatan Lean Six Sigma melalui metode kualitatif denganpengamatan pada 6 unit yang terlibat. Pendekatan Six Sigma mencoba mengurangi variasiwaktu pada setiap tahapan discharge di masing-masing unit tersebut, pendekatan Leanmengidentifikasi aktifitas yang tidak menambah nilai dan berusaha menguranginya. Hasilpenelitian diperoleh, rat-rata waktu proses discharge pasien rawat inap adalah 238 menit danfaktor yang paling berperan untuk menurunkan waktu tersebut adalah disiapkannya instruksipemulangan pasien oleh dokter, sehari sebelum pasien dipulangkan.
With the aim of streamlining the inpatient's discharge process at the Elizabeth HospitalBekasi, this study analyzed the efficiency of discharge process using the Lean Six Sigmamethod. Six Sigma method tries to reduce time variation in each step of the discharge processfollowed by identifying the appropriate time. The Lean method identifies the non valuesactivities (waste) to be reduced. For that, qualitative approach using observation wasimplied. The study resulted with 238 minute as average total timing of discharge and thegreatest impact to reduce it will be the one day earlier written discharge instruction preparedby the physician.
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With the aim of streamlining the inpatient's discharge process at the Elizabeth HospitalBekasi, this study analyzed the efficiency of discharge process using the Lean Six Sigmamethod. Six Sigma method tries to reduce time variation in each step of the discharge processfollowed by identifying the appropriate time. The Lean method identifies the non valuesactivities (waste) to be reduced. For that, qualitative approach using observation wasimplied. The study resulted with 238 minute as average total timing of discharge and thegreatest impact to reduce it will be the one day earlier written discharge instruction preparedby the physician.
B-1631
Depok : FKM UI, 2014
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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