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Waiting time for laboratory test results as a measure of service performance is an important requirement to prove the quality of laboratory services. The timing of the results of laboratory examinations affects the determination of the patient's diagnosis and therapy. The laboratory quality target indicator sets a target waiting time for the examination of chemical laboratory results of 120 minutes. The achievement of the quality indicator targets in 2020 is only 70% of the target set, there are also complaints about the slowness of the inspection results. Preliminary study from January to February 2021 showed 18% waiting time above 120 minutes.methods Lean six sigma focus on improvement by driving sharp improvements in speed, quality and profitability. This research is anoperational research to provide recommendations for improving waiting time for laboratory examinations using the DMAIC method approach consisting of a cycle of Define (defining), Measure (measure), Analyze (analyze), Improve (recommendation for improvement) and Control (Controlling). The results of the study get an overview of the occurrence of waste in the pre-analytical, analytical and post analytic stages which have an impact on the waiting time for laboratory results. The most dominant wastage occurred in the pre-analytic stage. The percentage of value added of laboratory inspection services before the implementation of Lean six sigma is 67.30% and non value added is 33.83%. After the implementation of Lean six sigma, the value added increased by 38.48% to 91.32% and the value added decreased by 28.42% to 8.68%. It was found that there were eight types of waste, most of which were defects, over processing, delays (waiting time), over production. A lot of waste occurs in the preanalytic and post-analytic stages. Sources of waste based on analysis results fishbone are man and method due to quantity of ATLM (Laboratory Medical Technical Analyst) and ineffective handling of laboratory specimens and handover methods. Improvement proposals are prepared using lean tools such as standardized work, visual management, error profiling, and the application of 5S(Short, Stabilize, Shine, Standardize, Sustain) Interventions carried out with the proposed flow of laboratory examinations, specimen handover methods, as well as re-education on handling laboratory specimens and proposed phlebotomy training
The Laboratory of Clinical Parasitology, FKUI is a special national referral laboratory for parasitic diseases in Indonesia and has been accredited A, it should be able to set a KPI target for the satisfaction of laboratory users every year greater than 82%. This is not in accordance with Permenpan No. 14 of 2017 concerning the Community Satisfaction Survey for service quality regarding service unit performance of at least 88.31%. This study aims to determine the conditions related to the quality of health services in the Clinical Parasitology Laboratory of FKUI based on 5 Servqual dimensions with a qualitative research method design using a case study design. The study was conducted in October and November 2020 at the Clinical Parasitology Laboratory of FKUI with a total of 13 informants, namely the head of the laboratory, laboratory staff and patients who carried out examinations in the laboratory. The results showed that from the dimension of reliability in terms of human resources, it was actually sufficient, but because the Clinical Parasitology Laboratory of FKUI, apart from accepting patients who came, also carried out research and education, causing double jobs for employees and resulting in one of the causes of the long waiting time for laboratory services. The guarantee dimension is that officers are still considered less skilled in performing actions compared to other laboratories. The dimensions of physical evidence in the laboratory still need to be repaired or considered so that customers can feel comfortable. Researchers suggest that monitoring of SOP implementation by the laboratory coordinator can streamline, the existence of a waiting time indicator to improve laboratory services and workload analysis and workforce adjustment according to workload.
Strategi penanggulangan TB melalui strategi DOTS (Directly Observed Trearmem Shorlcourse) memprioritaskan penemuan pasien melalui pemeriksaan mikroskopis, oleh karena itu mutu pemeriksaan mikroskopis perlu dipantau tems. Hasil pemeriksaan mikroskopis sputum BTA ,oleh 54 pemugas laboratorium puskesmas (Puskesmas Ruiukan Mikroskopis dan Puskesmas Pelaksana Mandiri) di Provinsi Jambi pada tahun 2004 ada 29 puskesmas yang hasil error rate 25%, sedangkan pada tahun 2005 mcnjndi 32 puskcsmas yang hasil error rare-nya 25%. Untuk itu pcrlu dilakukan penilaian terhadap faktor-faktor yang berhubungan dengan mutu pemeiiksaan mikroskopis sputum BTA. Penelitian ini bertuiuan untuk mengetahui gambaran dan faktor-faktor yang berhubungan dengan mutu pemeriksaan mikroskopis sputum BTA pada laboratorium puskesmas (PRM dan PPM) di Provinsi Jambi tahun 2006, dengan menggunakan metodologi kuantitatif yang bersifat deskriptif dengam desaiu” penelitian berupa pcndckatan cross sectional, terhadap 56 petugas laboratorium puskesmas di PRM dan PPM (total populasi). Hasil pemeriksaan mikroskopis sputum BTA yang bermutu baik masih rendah, hanya 35,7%. Adapun faktor yang berhubungan signiiikan dengan mutu pemeriksaan mikroskopis sputum BTA adalah pelatihan (tanpa dikontrol), dan faktor pengalaman kelfia, supervisi, kepuasan kerja, dan penerapan SOP (dengan dikontrol). Faktor yang paling dominan bcrhubungan dengan rnutu pemeriksaan mikroskopis sputum BTA aclalah pencmpan SOP. Disarankan kepada puskcsmas agar petugas laboratorium selalu menerapkan SOP, meqiaga keamanan bckclja di laboratorium, dan merawat mikroskop dcngan bai[c. Kepada Dinas Kesehatan K.abupatenfKota agar pembinaan petugas laboratodum dilakukan torus-mcncms melalui peiaksanaan supenkisi yang baik. Kepada Dinas Kesehatan Provinsi agar dapat rpelatih semua petugas laboratoriurn puskesmas, melaksanakan pertemuan untuk pembinaan dan pcrnbekalan pengetahuan terhadap petugas TB kabupatenfkota dan petugas laboratorium puskesmas, dan juga perlu bckcrjasama dengan Balai Laboratorium Kesehatan untuk melakukan pembinaan di puskesmas (PRM dan PPND.
TB prevention strategy with DOTS (Directly Observed Treatment Short course) give priority to patient’s invention by microscopic examination, therefore we must always control the microscopic examination. The result of BTA sputum microscopic examination by 54 government clinic laboratory assistant (Microscopic Reconciliation Government Clinic/PRM and Autonomy Execution Government Clinic/PPM) in Province of Jamb in year 2004, there was 29 local govemment clinic with error rate 25%, whereas in 2005 became 32 local government clinic with error rate 25%. Because of that, we need to evaluate about factors which related with quality of BTA sputum microscopic examination. The purpose of the research is to get the description and factors that related with quality of BTA sputum microscopic control, at PRM and PPM laboratories in Province of Jambi, in year 2006, by using quantitative methodology, which have descriptive characteristic with cross sectional approaching research design, toward 56 laboratory assistant at PRM and PPM (total population). The result of BTA sputum microscopic examination with good quality is still low, that is only 35.7% The factors that have a significant relation with quality of BTA sputum microscopic examination are training (without controlling), and work experience factor, supervision, work satisfaction, and SOP implementation (without controlling). The most dominant factor which related with quality of BTA sputum microscopic examination is SOP examination. We suggest to government clinic is laboratory assistant must implement SOP, maintain the security of laboratory, take good care of microscope. For public service in Regency, they must train laboratory assistant continually with good supervision. For public service in Province, they must train all laboratory assistant of local government clinic by meeting for founded and provided knowledge towards TB Regency officer and laboratory assistant of public government clinic, and also good cooperate with Health Laboratory Center to make founding at local government clinic (PRM and PPM).
Organizations that produce a product such as services, requires anevaluation of a self-assessment to improve service quality continuously to obtaina high quality of service and in accordance with the demands of the times. One ofthe assessment of an organization's success is the result of optimal performanceas measured by the target-the specified target organization itself. Researchers areusing seven (7) criteria contained in the Malcolm Baldrige Health Care Criteriafor Performance Excelence to determine the quality of the organization of theRefferal Health Directorate Building Effort, 2014. Research method is thesequential explanatory mixed method design. The results of the bivariate analysisshowed a strong association between positive and patterned organizationalperformance results with the six criteria of the Malcolm Baldrige. While theresults of the multivariate analysis showed four positive criteria and negativecriteria that one can explain the results of the organization's performance by65.7%, while the criteria are not included in the modeling. The results of theperformance of the Refferal Health Directorate Building Effort referencesincluded in the very low range. 3 problems that still stand out among otherorganizations have not set goals, objectives and performance measures (keyperfomance indicators) in the planning of the organization; has not set a vision,mission and values of organization and planning has not been prepared based ona period of long-term and short-term. These problems can be solved if the directorand the head of the organization immediately set the vision, mission and values ofthe organization, strategic planning in accordance with the duties and functionsof the organization as well as by long-term period and the short-term.
Pencapaian cakupan imunisasi hepatitis B1 pada bayi 0-7 han merupakan salah satu indikator mutu pelayanan yang dilakukan oleh penolong persaliman. (bidan), indikator tersebut menunjukan tamptlan kerja bidan apakah semua bayi yang persalinanya ditolong oleh bidan diberikan imunisasi hepatitis B1 atau tidak. Tampilan hasil kerja merapakan salah satu gambaran perilaku individu atau kelompok dari tingkat kepatuhannya terhadap standar pelayanan yang ada. Di Kabupaten Pandeglang angka pencapaian imunisasi hepatitis B1 pada bayi 0 - 7 hari masth sangat rendah (34.2%) tahun 2004, sementara angka cakupan persalinan yang ditolong oleh bidan sebesar 57,6 % . Dengan kondisi ini dapat diasumsikan adanya faktor -faktor yang berpengaruh terhadap pemberian imunisasi Hepatitis B1 pada bayi 0-7 hari oleh bidan pada pertolongan persalinan. Salah satu faktor yang berpengaruh adalah standar pelayanan imunisasi befum sepenuhnya dilaksanakan oleh bidan khususnya imunisasi hepatitis B1 pada bayi 0 - 7 hari. Penelitian ini dilakukan untuk melihat kepatuhan bidan dalam melaksanakan standar pelayanan imunisasi hepatitis B! pada bayi 0-7 hari. Penelitian ini menggunakan 2 (dua) pendekatan yaitu pertama kualitatif dilakukan dengan elaborasi kepustakaan dan elaborasi dikalangan pelaksana dengan wawancara mendalam. Hasil elaborasi ini menghasilkan kerangka empiris dan kuesioner final yang akan digunakan untuk tahap berikutnya. kedua tahap kuantitatif dengan menggunakan desain cross sectional. Hasil penelitian menggambarkan bahwa responden (bidan) yang menunjukan kepatuhan terhadap standar pelayanan imunisasi hepatitis B pada bayi 0-7 hari iebih banyak yang patuh dibandingkan dengan responden yang tidak patuh. Sedangkan variabel independent yang mempunyai hubungan bermakna terhadap kepatuhan responden (bidan) dalam melaksanakan standar pelayanan imunisasi hepatitis B pada bayi 0-7 hari adalah variabel pengetahuan, sarana, imbalan, supervisi, motivasi dan pandangan bidan terhadap tradisi masyarakat, Dart semua variabel yang berhubungan signifikan, variabel motivasi merupakan variabel yang paling dominan. Memang dalam kaitanya dengan pelaksanaan imunisasi, seorang petugas akan termotivasi untuk melaksanakan standar pelayanan imunisasi, bila diyakini benar bahwa tindakannya akan menghantarkan ke suatu penilaian kinerja, penilaian yang baik akan mendorong untuk mendapatkan kebutuhan yang diharapkan, dimana kebutuhan tersebut akan memuaskan pribadi petugas. Sehingga upaya peningkatan mutu pelayanan dalam penelitian ini, faktor yang paling penting dalam perbaikan adalah dengan pendekatan pada proses. Identifikasi, penentuan prioritas dan penentuan penyebab potensial masalah dalam penelitian ini difokuskan kepada motivast petugas yang akan mempengaruhi terhadap kepatuhanya dalam melaksanakan standar pelayanan imunisasi hepatitis B pada bayi 0-7 hari. Upaya perbaikan mutu pelayanan yang berkesinambungan ini menggunakan siklus PDCA(Plan-Do-Check-Action). Dalam penelitian ini penulis memberikan saran kepada Dinas Kesehatan dan Puskesmas di Kabupaten Pandeglang agar dalam meningkatkan mutu pelayanan kesehatan selalu berorientasi pada perbaikan yang terus-menerus dan berkesinambungan pada simpul proses, sehingga tidak memberikan dampak pemborosan. Dalam memenuhi semua Kebutuhan fasilitas, sarana dan dukungan sebaiknya lebih meningkatkan advokasi kepada semua pengambil kebijakan di setiap jenjang, schingga semua yang diperlukan dapat menunjang keberhasilan program imunisasi tersebut.
Attainment of Coverage immunize hepatitis BI at baby 0-7 day represent one of indicator quality of service conducted by birth helper (midwife), this indicator as performance of midwife work, whether all baby which helped by midwife given to by immunize hepatitis B1 or not. Appearance result of job represent one of behavioral picture of individual or group of people from level of his compliance to standard of existing service. In Pandeglang District the number of attainment immunize hepatitis Bi at baby 0 - 7 day still be very low ( 34,2%) year 2004, whereas number of coverage is copies with helped by midwife of equal to 57,6 . With this condition can be assumed by a factor existence factor having an effect on to gift immunize Hepatitis Bl at baby 0-7 day by midwife that help the birth. One of factor having an effect on standard of service immunize not yet full executed by midwife specially immunize hepatitis Bi at baby 0 - 7 day. This research is conducted to see compliance of midwife in executing standard of service immunize hepatitis B1 at baby 0-7 day. This research use 2 ( two) of phase that is first of phase is qualitative conducted by elaborasi is reference and elaborasi of among executor with circumstantial interview. result of this Elaborasi yield empirical framework and kuesioner of final to be used for the next phase. second of quantitative phase by using desain cross sectional. The result of research that responder (midwife) which compliance to service standard immunize hepatitis B at baby 0-7 day, proportional compliance responder more than which not compliance, While variable independent having relation have a meaning to responder compliance in executing service standard immunize hepatitis B at baby 0-7 day, is knowledge vanable, reward, supervise, midwife view and motivation to tradition socialize, From all coresponding variable of signifikan, variable motivate to represent most dominant variable. It is true that the relationship immunization activities, a worker will be motivated to do service standard immunize, 1f believed by correctness that his, action will send to a performance assessment, good assessment will push to get requirement expected, where the requirement will gratify worker person. So that, the improvement quality of service in research, the determinant this improvement factor in repair is with approach of process. Identify, potential cause determination and priority determination of internal issue this research is focussed to worker motivation to influence to compliance in service standard immunize hepatitis B at baby 0-7 day. Strive repair of quality of continual service use cycle PDCA (Plan-DoCheck-Action). In this reaserch, the writer suggest to health District office and public health service in Pandeglang District to increase the quality health service that focus to continous improvement ai processing, so that not extravagance impact. In fulfilling all facility requirement, support and medium better more improve advokasi to all policy taker in every ladder, so that all that is needed can support efficacy program to immunization