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Rama Garditya; Pembimbing:Masyitoh; Penguji: Amal Chalik Sjaaf, Pujiyanto, Adin Nulkhasanah, Andi Wahyuningsih Attas
Abstrak:
ABSTRAK Nama : Rama Garditya Program Studi : Kajian Administrasi Rumah Sakit Judul Tesis : Analisis Keterlambatan Pelayanan Ruang Operasi Kasus Bedah Saraf RS Pusat Otak Nasional Latar Belakang ; Pelayanan medis di instalasi bedah sentral membutuhkan biaya yang besar dan melibatkan sumber daya manusia (SDM) dari berbagai bidang ilmu meliputi SDM medis maupun SDM non medis. Adanya keterlambatan akan mengakibatkan peningkatan biaya dan mempengaruhi keselamatan pasien. Metode : Penelitian ini bertujuan menganalisa waktu pelayanan menggunakan metode metode kuantitatif dan kualitatif dengan desain retrospektif. Data kuantitatif didapatkan dari telaah dokumen dengan jumlah sampel 547 kasus operasi bedah saraf (358 kasus operasi kranial, 189 kasus operasi spinal), sedangkan data kualitatif didapatkan melalui wawancara mendalam dengan delapan informan penelitian. Analisis data dilakukan secara kuantitatif dengan uji Mann Whitney. Hasil : Didapatkan adanya keterlambatan dalam pelayanan ruang operasi bedah saraf operasi kranial 54 menit dan operasi spinal 48 menit. Didapatkan perbedaan waktu klinis, waktu non klinis dan waktu keterlambatan non klinis antara operasi kranial dan spinal. Keterlambatan dalam pelayanan ruang operasi disebabkan oleh faktor SDM, sarana prasarana dan kebijakan. Simpulan : Keterlambatan dalam pelayanan ruang operasi IBS RSPON terjadi dalam tahap proses anestesi, pemasangan monitoring saraf intraoperasi, positioning pasien, draping pasien, dan pembedahan. Keterlambatan dalam pelayanan ruang operasi IBS RSPON disebabkan oleh faktor SDM, sarana prasarana, dan kebijakan Kata kunci : keterlambatan, ruang operasi, waktu klinis, waktu non klinis, SDM, sarana prasarana, kebijakan
ABSTRACT Name : Rama Garditya Study Program : Hospital Administration Study Thesis : Analysis of Delays in Neurosurgery Operating Room Service at The National Brain Center Hospital Background : Medical services at a central surgical installation require a large amount of money and involve human resources (HR) from various fields of knowledge including medical and non-medical human resources. Delays in the operating room causes increased costs and impacts patient safety. Methods: This study aims to analyze the service time using quantitative and qualitative method with a retrospective design. Quantitative data was obtained from a document review with a sample of 547 cases of neurosurgery (358 cases of cranial surgery, 189 cases of spinal surgery), while qualitative data was obtained through in-depth interviews with eight research informants. Data analysis was carried out quantitatively with the Mann Whitney test. Result: Delays found in the neurosurgery operating room service for cranial surgery and spinal surgery was 54 minutes and 48 minutes respectively. There were differences in clinical time, non-clinical time, and non-clinical time delay between cranial and spinal surgery. Delays in the OR were caused by human resource factors, equipment, and hospital policies. Conclusion: Delays in RSPON IBS operating room services occur in the stages of the anesthesia process, installation of intraoperative nerve monitoring, patient positioning, patient draping, and surgery. Delays in RSPON IBS operating room services were caused by human resource factors, infrastructure, and policies Keywords: delay, operating room, clinical time, non-clinical time, HR, infrastructure, policy
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ABSTRACT Name : Rama Garditya Study Program : Hospital Administration Study Thesis : Analysis of Delays in Neurosurgery Operating Room Service at The National Brain Center Hospital Background : Medical services at a central surgical installation require a large amount of money and involve human resources (HR) from various fields of knowledge including medical and non-medical human resources. Delays in the operating room causes increased costs and impacts patient safety. Methods: This study aims to analyze the service time using quantitative and qualitative method with a retrospective design. Quantitative data was obtained from a document review with a sample of 547 cases of neurosurgery (358 cases of cranial surgery, 189 cases of spinal surgery), while qualitative data was obtained through in-depth interviews with eight research informants. Data analysis was carried out quantitatively with the Mann Whitney test. Result: Delays found in the neurosurgery operating room service for cranial surgery and spinal surgery was 54 minutes and 48 minutes respectively. There were differences in clinical time, non-clinical time, and non-clinical time delay between cranial and spinal surgery. Delays in the OR were caused by human resource factors, equipment, and hospital policies. Conclusion: Delays in RSPON IBS operating room services occur in the stages of the anesthesia process, installation of intraoperative nerve monitoring, patient positioning, patient draping, and surgery. Delays in RSPON IBS operating room services were caused by human resource factors, infrastructure, and policies Keywords: delay, operating room, clinical time, non-clinical time, HR, infrastructure, policy
B-2354
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Adi Sulistyanto; Pembimbing: Masyitoh; Penguji: Ede Surya Darmawan, Adin Nulkhasanah, Amal Chalik Sjaaf
Abstrak:
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Transformasi sumber daya manusia kesehatan di Indonesia didorong oleh keterbatasan jumlah serta ketidakmerataan distribusi dokter umum dan spesialis. Sebagai respons, Kementerian Kesehatan mengembangkan Program Pendidikan Dokter Spesialis berbasis rumah sakit melalui Rumah Sakit Penyelenggara Pendidikan Utama (PPDS RSPPU). RSPON ditunjuk sebagai penyelenggara PPDS Neurologi dan diproyeksikan menyelenggarakan PPDS Bedah Saraf sehingga memerlukan perubahan organisasi yang menyeluruh, termasuk kesiapan anggotanya dalam menerima dan menjalankan sistem baru. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus eksploratif. Data primer dikumpulkan melalui wawancara mendalam pada Mei – Juni 2025 terhadap delapan informan internal dan dua eksternal RSPON yang terlibat dalam persiapan penyelenggaraan PPDS RSPPU. Hasil penelitian menunjukkan bahwa PPDS RSPPU Bedah Saraf sudah memenuhi Standar Nasional Pendidikan sesuai Peraturan Menteri Pendidikan Tinggi, Sains, dan Teknologi Nomor 39 tahun 2025 serta memperoleh akreditasi dari Accreditation Council of Graduate Medical Education (ACGME). Komitmen perubahan anggota organisasi mengarah positif, dengan adanya komitmen afektif berupa keterikatan emosional dan kemauan terlibat, komitmen keberlanjutan melalui kesadaran potensi kerugian apabila tidak terlibat, serta komitmen normatif melalui pemahaman tanggung jawab peran baru. Efikasi perubahan cukup kuat ditunjukkan oleh didukung pemahaman tujuan dan kesiapan sumber daya. Faktor kontekstual dan valensi perubahan menunjukkan kecenderungan positif, sementara penilaian informasional belum sepenuhnya kuat akibat belum optimalnya pengelolaan beban kerja secara formal dan keterbatasan teknologi pendukung. Temuan ini mengindikasikan bahwa kesiapan perubahan RSPON berada pada kondisi yang relatif mendukung, meskipun masih diperlukan penguatan sistem dan sumber daya tertentu. Secara umum, kesiapan perubahan RSPON tergolong kondusif menuju penyelenggaraan PPDS RSPPU Bedah Saraf, dengan rekomendasi peningkatan pada aspek informasi dan sistem teknologi organisasi.
The insuf icient number and unequal distribution of general practitioners and medical specialists drive the transformation of the health workforce in Indonesia. To adress this issue, the Ministry of Health has implemented a hospital-based Specialist Medical Education Program through Main Teaching Hospitals (PDS RSPU). The National Brain Center Hospital (RSPON) has been designated to host the Neurology Residency Program and is projected to establish a Neurosurgery Residency Program. This initiative requires comprehensive organizational transformation, including member readiness to adopt and implement the new system. This study employed a qualitative approach using an exploratory case study design. Primary data were collected through in-depth interviews conducted between May and June 2025 with eight internal and two external informants involved in preparing the Neurosurgery Residency Program. The results indicate that the Neurosurgery Residency Program has met the National Education Standards as stipulated in the Minister of Higher Education, Science, and Technology Regulation No. 39 of 2025 and has been accredited by the Accreditation Council of Graduate Medical Education (ACGME). Organizational change commitment showed a positive direction through af ective commitment (emotional attachment and willingness to engage), continuance commitment (awareness of potential loss if disengaged), and normative commitment (recognition of new role responsibilities). Change ef icacy was relatively strong, supported by clear program objectives and resource readiness. However, informational assessment remains suboptimal due to unstructured workload management and limited technological support. Overall, RSPON’s readiness for change is relatively conducive to implementing the RSPU Neurosurgery Program, with recommendations to strengthen informational systems and organizational technology.
B-2577
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Maria Hotnida; Pembimbing: Wiku Bakti Bawono Adisasmito; Penguji: Vetty Yulianty Permanasari,
Abstrak:
Penelitian ini membahas tentang penangguhan klaim JKN di RS PON tahun 2015. Tujuan penelitian ini adalah untuk analisis permasalahan penangguhan klaim JKN yang belum terbayarkan di RS PON Jakarta pada tahun 2015. Penelitian ini merupakan penelitian dengan pendekatan studi kasus untuk menganalisis penyebab penangguhan pembayaran klaim jaminan kesehatan di RS Pusat Otak dan Analisis data dilakukan dengan melakukan penelaahan data yang diperoleh dari data primer dan data sekunder kemudian dianalisis berdasarkan teori yang ada. Analisis untuk melihat factor yang menyebabkan penangguhan klaim mulai dari Koder sampai ke Manajemen RS. Hasil penelitian didapatkan bahwa penangguhan klaim terjadi karena banyaknya berkas SEP, billing dan TXT yang hilang di bagian keuangan/piutang sehingga menghambat klaim. Kata kunci : Klaim; koder; verifikasi; kebijakan piutang
This study discusses the suspension of JKN claims in RS PON 2015. The purpose of this study is to analyze the problem of suspension of unpaid JKN claims in RS PON Jakarta in 2015. This study is a case study approach to analyze the causes of deferral payment of health insurance claims in RS Pusat Otak and data analysis done by doing study data obtained from primary data and secondary data then analyzed based on existing theory. Analysis to see the factors that led to the suspension of claims ranging from Coder to Management Hospital. The results showed that the suspension of claims occurred because of the large number of SEP, billing and TXT files lost in the financial / receivables thus inhibiting claims. Keywords: Claim; coder; verification; account receivable policy.
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This study discusses the suspension of JKN claims in RS PON 2015. The purpose of this study is to analyze the problem of suspension of unpaid JKN claims in RS PON Jakarta in 2015. This study is a case study approach to analyze the causes of deferral payment of health insurance claims in RS Pusat Otak and data analysis done by doing study data obtained from primary data and secondary data then analyzed based on existing theory. Analysis to see the factors that led to the suspension of claims ranging from Coder to Management Hospital. The results showed that the suspension of claims occurred because of the large number of SEP, billing and TXT files lost in the financial / receivables thus inhibiting claims. Keywords: Claim; coder; verification; account receivable policy.
B-1933
Depok : FKM-UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Weny Rinawati; Pembimbing: Adang Bachtiar; Penguji: Amal Chalik Sjaaf, Andi Basuki Prima B., Kemal Imran
Abstrak:
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ABSTRAK Nama : Weny Rinawati Program Studi : Kajian Administrasi Rumah Sakit Judul : Analisis biaya perawatan stroke berdasarkan Clinical Pathway di Rumah Sakit Pusat Otak Nasional Jakarta dalam pelayanan pasien Jaminan Kesehatan Nasional Latar belakang. Masalah yang sering dihadapi pada pelayanan pasien Jaminan Kesehatan Nasional adalah kesenjangan biaya perawatan pasien stroke dengan tarif INA-CBGs. Hal ini terkait dengan biaya perawatan dan Clinical Pathway. Tujuan. Mengetahui biaya perawatan pasien stroke di Rumah Sakit Pusat Otak Nasional. Metoda. Penelitian kuantitatif deskriptif mengikutsertakan 277 subjek penyakit stroke yang diperoleh di Rumah Sakit Pusat Otak Nasional Jakarta selama Januari – Juni 2015. Biaya perawatan stroke dihitung berdasarkan biaya satuan (unit cost) dengan menggunakan metode activity based costing dan Clinical Pathway. Hasil. Biaya satuan perawatan stroke iskemik dan stroke hemoragik berdasarkan Clinical Pathway, dengan memperhitungkan biaya investasi dan biaya gaji, tanpa memperhitungkan jasa medis berturut-turut adalah Rp 311,860,860.83 dan Rp 585,083,610.01; dengan memperhitungkan biaya investasi, biaya gaji, dan jasa medis berdasarkan tarif rumah sakit adalah Rp 321,682,940.73 dan Rp598,929,450.01; dengan memperhitungkan biaya investasi, biaya gaji, dan jasa medis berdasarkan tarif IDI adalah Rp 318,360,860.73 dan Rp 594,333,610.01; tanpa memperhitungkan biaya investasi, biaya gaji, dan jasa medis adalah Rp30,361,681.00 dan Rp25,698,199.46; tanpa memperhitungkan biaya investasi dan biaya gaji, tetapi memperhitungkan jasa medis berdasarkan tarif rumah sakit adalah Rp 40,183,761.00 dan Rp 39,544,199.46; tanpa memperhitungkan biaya investasi dan biaya gaji, tetapi memperhitungkan jasa medis berdasarkan IDI adalah Rp 36,861,681.00 dan Rp 34,948,199.46. Simpulan: Dijumpai selisih biaya perawatan berdasarkan biaya satuan dan Clinical Pathway, baik yang memperhitungkan biaya investasi, gaji, dan jasa medis, maupun tanpa memperhitungkan biaya investasi, gaji, dan jasa medis, dengan tarif layanan existing dan tarif INA-CBGs Kata kunci : biaya, Clinical Pathway, INA-CBGs, stroke
ABSTRACT Name : Weny Rinawati Study Program : Hospital Administration Title : Cost of stroke treatment based on Clinical Pathway in National Brain Center Hospital, Jakarta Background. Problem often encountered in patient care National Health Insurance is the gap between the cost of stroke treatment with INA-CBGs tariff. This is related to the cost of treatment and the Clinical Pathway. Aim. Knowing the cost of stroke treatment in the National Brain Center Hospital Jakarta. Methods. Descriptive quantitative study involving 277 subjects stroke obtained at the National Brain Center Hospital Jakarta during January - June 2015. The cost of stroke treatment are calculated based on the unit cost using activity-based costing method and Clinical Pathway. Results. The unit cost of ischemic stroke and hemorrhagic stroke treatment by Clinical Pathway, taking into account investment costs and salary costs, regardless of medical services is IDR 311,860,860.83 and IDR 585,083,610.01; taking into account investment cost, salary cost, and medical services tariff based hospital is IDR 321,682,940.73 and IDR 598,929,450.01; taking into account investment cost, salary cost, and medical services tariff based IDI is IDR 318,360,860.73 and IDR 594,333,610.01; without taking into account investment cost, salary cost, and medical services are IDR 30,361,681.00 and IDR 25,698,199.46; without taking into account the investment cost and salary cost, but taking into account medical services tariff based hospital is IDR 40,183,761.00 and IDR 39,544,199.46; without taking into account the investment cost and salary cost, but taking into account medical services tariff based IDI is IDR 36,861,681.00 and IDR 34,948,199.46. Conclusion. Found difference in the cost of stroke treatment is based on unit cost and Clinical Pathway, both of which take into account the investment, salaries, and medical services cost, and without taking into account investment, salaries, and medical services cost, with existing services and tariff rates INA-CBGs Keywords: Clinical Pathway, cost, INA-CBGs, stroke
B-1786
Depok : FKM-UI, 2016
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Fani Farhansyah; Pembimbing: Mieke Savitri; Penguji: Dumilah Ayuningtyas, Vetty Yuliyanty Permanasari, Heriyadi Manan, Budiman Wijaya
Abstrak:
Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan keterlambatan
operasi elektif di kamar bedah RS Awal Bros Pekanbaru. Variabel yang diteliti adalah
kedatangan tim operasi, kedatangan pasien, waktu persiapan pasien, operasi cito sebelumnya,
keterlambatan operasi sebelumnya, kelengkapan sarana operasi, kelengkapan administrasi dan
kondisi medis pasien. Penelitian ini adalah penelitian gabungan kuantitatif dan kualitatif,
menggunakan data retrospektif dengan desain penelitian cross sectional dilanjutkan dengan
metode concensus decision making grup (CDMG). Sampel dalam penelitian ini menggunakan
penghitungan rumus penelitian Slovin, dengan jumlah sampel 100 sampel. Pengumpulan data
menggunakan instrumen penelitian dan data sekunder dari laporan kinerja kamar bedah. Uji
statistik yang digunakan dalam penelitian ini adalah analisis univariat dan analisis bivariat
menggunakan uji chi square. Hasil penelitian pada uji statistic bivariat, dari semua variabel
yang diteliti ada 3 yang memiliki hubungan signifikan dengan keterlambatan operasi elektif,
yaitu kedatangan pasien, waktu persiapan pasien, dan keterlambatan operasi sebelumnya.
Kesimpulan pada penelitian ini didapatkan bahwa angka keterlambatan operasi elektif adalah
81,15 menit jauh diatas standar mutu RS yang ditetapkan yaitu <30 menit.
Kata kunci : keterlambatan operasi elektif, kedatangan pasien, waktu persiapan pasien,
keterlambatan operasi sebelumnya.
This study aims to determine the factors associated with the delay in elective surgery in the
operating room of Awal Bros Pekanbaru Hospital. The variables studied were the arrival of
the surgical team, the arrival of the patient, the patient's preparation time, the previous cito
surgery, the previous surgical delay, the completeness of the surgical means, the
administrative completeness and the patient's medical condition. This research is a
quantitative and qualitative combined research, using retrospective data with cross sectional
research design followed by concensus decision making grup (CDMG). The sample in this
study used Slovin formula calculation, with sample size of 100 samples. Data collection using
research instruments and secondary data from surgical room performance reports. The
statistical test used in this research is univariate and bivariate analysis using chi square test.
Result of the research on bivariate statistic test, from all variables studied there are 3 which
have significant relation with elective surgery delay, that is patient arrival, patient
preparation time, and previous operational delay. The conclusion of this research is that the
elective operation delay is 81.15 minutes far above the defined standard of hospital quality
<30 minutes.
Keywords: elective surgical delay, patient arrival, patient preparation time, previous surgery
delay.
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B-1925
Depok : FKM-UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Dewa Ngakan Gde Wahyu Mahatma Putra; Pembimbing: Jaslis Ilyas; Penguji: Adang Bachtiar, Bambang Dwipoyono, Chairulsjah Sjahruddin
Abstrak:
ABSTRAK Latar belakang dari penelitian ini adalah adanya waktu tunggu antrian pasien OK yang cukup lama hingga 21 hari dan angka utilisasi beberapa ruangan OK yang masih di bawah standar utilisasi. Waktu tunggu antrian OK yang lama dan angka utilisasi yang belum optimal salah satunya disebabkan oleh metode penjadwalan operasi yang belum akurat. Penelitian bertujuan untuk mengetahui utilisasi ruangan OK IBS dan mengetahui hubungannya dengan akurasi waktu mulai operasi, jumlah operasi, dan jenis operasi. Penelitian ini menggunakan pendekatan kuantitatif dengan metode telaah dokumen. Uji korelasi dilakukan dengan menggunakan metode Spearman. Berdasarkan 320 data sampel yang diteliti diperoleh rata-rata utilisasi ruangan OK IBS pada bulan Januari-Maret 2018 adalah 53,36%. Total pemakaian ruangan OK adalah 555 jam 24 menit. Terdapat dua faktor yang berhubungan dengan utilisasi kamar operasi yaitu akurasi waktu mulai operasi (p-value=0,012) dan jumlah operasi (p-value=0,015) dengan hubungan positif. Sedangkan jenis operasi (p-value = 0.373) tidak memiliki hubungan dengan utilisasi kamar operasi. Faktor lain yang mempengaruhi utilisasi kamar operasi adalah hari efektif jam buka ruangan OK setiap bulannya. Kata Kunci: Kamar Operasi, Operasi Elektif, Utilisasi, Akurasi Waktu Operasi, Jumlah Operasi, Jenis Operasi The background of this research is the high number of OK patients queue and delayed operation schedule due to the high utilization rate in the OK room in Central Surgery Installation Sanglah General Hospital. The study aims to find out the utilization of OK IBS room and to know its relation to the accuracy of the starting time of operation, the number of operation, and the type of operation. This research uses quantitative approach with document review method. The correlation test is done by using Spearman method. Based on the 320 sampled data obtained, the average utilization of OK IBS room in January-March 2018 is 53.36%. The total usage of OK room is 555 hours 24 minutes. There are two factors related to operating room utilization that is accuracy of starting time of operation (p-value = 0,012) and number of operation (p-value = 0,015) with positive relation. While the type of operation (p-value = 0.373) has no relationship with operating room utilization. Another factor affecting operating room utilization is the effective day open room hours OK in every month. Keywords: Operating Room, Elective Operation, Utilization, Accuracy of Starting Operation Time, Number of Operations, Type of Operation
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B-2014
Depok : FKM-UI, 2018
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Ita Mu'tiyah; Pembimbing: Puput Oktamianti; Penguji: Masyitoh, Lendy Delyanto
Abstrak:
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Utilisasi kamar operasi merupakan bagian yang penting dalam proses pelayanan di rumah sakit, oleh karena itu kinerja di kamar operasi yang memadai dapat berpengaruh terhadap kualitas mutu pelayanan Rumah Sakit. Keterlambatan pelayanan operasi elektif tentunya akan membuat kualitas mutu pelayanan di kamar operasi menjadi menurun, padahal kamar operasi sebagai salah satu unit di rumah sakit yang memiliki peran strategis dalam meningkatkan mutu pelayanan secara keseluruhan. Dengan menggunakan metode Lean Six Sigma dengan pendekatan DMAIC penelitian ini mempunyai tujuan untuk mengetahui alur prosedur pelayanan di kamar operasi RSUD Cilegon, selain itu teridentifikasi value added, non-value added dan waste yang terjadi pada pelayanan di kamar operasi sehingga didapatkan faktor penyebab waste yang terjadi melalui analisis kemudian ditemukan rekomendasi usulan perbaikan yang sesuai dengan masalah yang teridentifikasi. Penelitian ini merupakan penelitian kualitatif dengan metode pengumpulan data yang didapatkan melalui pengamatan dan pencatatan waktu keterlambatan operasi elektif di RSUD Cilegon, serta menggali informasi secara mendalam dan rinci kepada informan baik informan dalam maupun pasien penerima layanan operasi elektif di RSUD Cilegon dan melakukan telaah dokumen. Dilakukan observasi dan wawancara mendalam terhadap 20 pasien yang menjalani operasi elektif di RSUD Cilegon di shift yang berbeda – beda setiap harinya. Pemilihan informan dilakukan menggunakan teknik purposive sampling, dan kemudian dilakukan wawancara kepada pasien sehingga didapatkan value perspektif customer sesuai dengan prinsip metode Lean Six Sigma. Data yang diperoleh kemudian dianalisis untuk mendapat faktor penyebab adanya keterlambatan pelayanan operasi elektif menggunakan fishbone diagram yang dikelompokkan ke dalam kategori Man, Machine, Method, Money dan Environment sehingga penyebab masalah yang teridentifikasi dapat dirumuskan prioritas usulan perbaikan yang sesuai dan perlu dilakukan. Hasil penelitian yang dilakukan di bulan Mei – Juni 2023 didapatkan rata – rata total value added pada proses persiapan hingga pelayanan operasi elektif di RSUD Cilegon yaitu selama 40,8 menit atau sebesar 27,36% dari total waktu yang dihabisakan oleh pasien yang menjalani persiapan hingga dilakukan pembedahan. Sedangkan rata – rata total non-value-added yang didapatkan adalah selama 108,3 menit atau sebanyak 72,64% dari total waktu yang dihabiskan pasien sejak persiapan dan konsultasi hingga pasien mendapatkan pelayanan operasi. Beberapa faktor yang menjadi penyebab adanya non-value added dan waste yang terjadi adalah kegiatan menunggu pemanggilan dari kamar operasi, keterlambatan dokter operator dan anestesi yang masih melakukan praktik atau menangani pasien lain, serta menunggu jawaban konsul operator atau anestesi. Selain itu kemampuan petugas di kamar operasi yang belum merata juga menyebabkan terjadinya waste, selain itu ketersediaan alat, BHP dan fasilitas pendukung kegiatan operasi elektif yang terbatas turut mendukung adanya waste dan mengakibatkan banyaknya non-value-added yang teridentifikasi sehingga menyebabkan keterlambatan dimulainya operasi elektif. Peneliti mengharapkan strategi perbaikan yang telah diberikan dapat terus diterapkan untuk memperbaiki dan mengeliminasi kegiatan non value added yang terjadi yaitu dengan memberlakukan pengurangan indikator kinerja kepada petugas yang terlambat sehingga akan berdampak pada remunerasi petugas, selain itu diharapkan tersedia penanggung jawab akan jadwal kegiatan operasi sehingga dapat mengingatkan dokter operator maupun anestesi agar datang tepat waktu, penerapan diklat yang mempunyai target tercapainya kompetensi sehingga kompetensi petugas yang diperlukan terpenuhi, dan pengadaaan alat rutin yang dapat dilakukan secara berkala demi mencukupi kebutuhan di pelayanan operasi.
Operating room utilization is an important part of the hospital service process. Therefore, adequate performance in the operating room can affect the quality of hospital services. Delays in elective surgery services will certainly make the quality of service in the operating room decrease, even though the operating room as one of the units in the hospital has a strategic role in improving the overall quality of service. By using the Lean Six Sigma method and the Value Stream Mapping approach, this study aims to find out the flow of service procedures in the Cilegon Hospital operating room, in addition to identifying value added, non-value added and waste that occurs in services in the operating room so that the factors that cause waste are identified. This occurs through analysis which then finds recommendations for improvements that are in accordance with the problems identified. This research is a qualitative research with data collection methods obtained through observing and recording the delay in elective surgery at Cilegon Hospital, as well as digging in-depth and detailed information to informants both inside informants and patients receiving elective surgery services at Cilegon Hospital and conducting a document review. Observations and in-depth interviews were carried out with 20 patients undergoing elective surgery at Cilegon Hospital in different shifts every day. The selection of informants was carried out using a purposive sampling technique, and then conducted interviews with patients in order to obtain a customer perspective value in accordance with the principles of the Lean Six Sigma method. The data obtained is then analyzed to obtain the factors causing the delay in elective operating services using fishbone diagrams which are grouped into the Man, Machine, Method, Money and Environment categories so that the causes of the identified problems can be formulated priority recommendations for improvements that are suitable and need to be carried out. The results of research conducted in May - June 2023 obtained an average total value added in the preparation process to elective surgery services at Cilegon Hospital, namely for 40.8 minutes or 27.36% of the total time spent by patients undergoing preparation to surgery was performed. Meanwhile, the total non-value-added average obtained was 108.3 minutes or as much as 72.64% of the total time spent by patients from preparation and consultation to patients receiving surgical services. Some of the factors that cause non-value added and waste that occur are activities waiting to be called from the operating room, delays in operating doctors or anesthesiologists who are still practicing or treating other patients, and waiting for the operator or anesthesiologist's consult. In addition, the uneven ability of officers in the operating room also causes waste to occur, and the limited availability of tools, consumable part and supporting facilities for elective surgery also supports the presence of waste and results in many non-value-added being identified which causes delays in the beginning of elective operations. . The researcher hopes that the improvement strategies that have been provided can continue to be applied to improve and eliminate non-value-added activities that occur, namely by imposing a reduction in performance indicators for officers who are late so that it will have an impact on employee remuneration. reminding the operator and anesthetist to come on time, implementing training that has the target of achieving competence so that the necessary competence of officers is fulfilled, and procuring routine equipment that can be carried out periodically to meet the needs in operating services.
B-2396
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dennys Hermawati; Pemb. Peter Pattinama; Penguji: Dumilah Ayuningtyas, Anhari Achadi, Torang P. Batubara
B-1058
Depok : FKM UI, 2008
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Muhammad Askar; Pembimbing: Purnawan Junadi; Penguji: Sandi Iljanto, Mieke Savitri, Sumijatun, Prapanca Yuli Satar
Abstrak:
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Pelayanan kamar Operasi merupakan salah satu bentuk pelayanan yang sangat mempengaruhi tampilan dan merupakan salah satu indikator pelayanan Rumah Sakit.Instalasi Kamar Bedah Rumah Sakit Otorita Batam terdiri dari empat ( 4 ) buah kamar operasi yang melayani operasi cito, dan operasi bedah elektif. Komplain dari pasien dan dari survey awal pada saat residensi di bulan September 2010 dari data buku register instalasi kamar bedah didapatkan 95,79% (205 operasi terlambat dimulai dari 214 operasi elektif yang telah dijadwalkan sebelumnya). Penelitian ini bertujuan untuk menganalisa penyebab keterlambatan dimulainya operasi elektif di instalasi kamar bedah Rumah Sakit Otorita Batam,sehingga diharapkan menjadi masukan yang berarti bagi pihak manajemen Rumah sakit untuk mengelola Instalasi kamar bedah kedepannya. Penelitian ini adalah penelitian deskriptif dengan pendekatan kualitatif dan tidak bersifat intervensi. Hasil penelitian membuktikan bahwa 68% penyebab keterlambatan dimulainya operasi disebabkan oleh terlambatnya kedatangan operator.
Operating room service is one type of services that greatly affect the appearance and is one indicator Hospital appearance. Surgery Instalation Room Batam Authority Hospital consists of four (4) operating rooms that serve Cito surgery, and elective surgery. Complaints from patients and from the initial survey at the time of residency in September 2010 from the data register book installation of the operating room founded 95.79% (205 operations performed late in starting the operation of 214 elective operations previously scheduled). This study aims to analyze the causes of delay in the commencement of elective surgery in the operating room installation Batam Authority Hospital, which is expected to be input which means the part of hospital management to manage the Installation of the operating room in the future.The study was a descriptive research approach is qualitative and no intervention. The research proves that 68% of the causes of delay in the commencement of operations caused by the delay in the arrival of the operator.
B-1275
Depok : FKM-UI, 2011
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Nilandari; Pembimbing: Kurnia Sari; Penguji: Pujiyanto, Puput Oktamianti, Andi Basuki Prima Birawa
Abstrak:
Keterlambatan pengajuan klaim BPJS berakibat pada turunnya cashflow rumahsakit. Proses klaim saat ini berjalan tidak efisien dan efektif. Tujuan daripenelitian ini adalah mendapatkan hasil analisis dan usulan perbaikan alur prosesdokumen klaim BPJS pasien rawat jalan dengan menerapkan konsep LeanHospital. Penelitian dengan pendekatan kuantitatif dan kualitatif inimengobservasi waktu yang dibutuhkan untuk menyelesaikan dokumen klaimsebelum diberikan kepada verifikator BPJS serta melakukan wawancaramendalam, observasi proses, dan telaah dokumen. Hasil penelitian menunjukkanterjadi waste terbesar di unit mobilisasi dana yaitu selama 32,5 hari 18,8 menitdalam penyelesaian dokumen klaim. Jenis waste terbanyak adalah waiting dantransportation. Berdasarkan VSM diketahui Lead Time dari proses klaim saat iniadalah 33,9 hari. Usulan perbaikan yang diberikan dari penelitian ini adalahdengan optimalisasi tim Casemix yang baru saja dibentuk, sehingga lead timepengerjaan klaim yang dibutuhkan menjadi 6,44 menit. Standardisasi kerja danpenilaian kinerja berupa KPI, IKI, dan IKU dinilai perlu diterapkan agar kinerjapetugas menjadi optimal.
Kata Kunci: Lean Thinking, BPJS, klaim, value added activity, non value addedactivity, waste
Delay in the submission of BPJS claims resulted in decreasing hospital cash flow. The currentclaim process is not efficient and effective.The objective of this reseach is to analize and proposeimprovement in the claim process by applying Lean Hospital concept. This research usedquantitative and qualitative approaches to observed the time required to complete the claimprocess before submitted to the BPJS verificator and also have an in-depth interview, observe theprocess, and document review. The result showed most waste happened in mobilisasi dana unitfor 32.5 days 18.8 minutes in the settlement BPJS document claims. Based on Value StreamMapping, Lead Time of the claim process at this time is 33.9 day. Most types of waste arewaiting and transportation. Proposed improvement provided from the study is to optimizing thecasemix team which newly formed. By optimizing the casemix team, Lead Time required tocomplete the claims process is 6.44 minutes. Standardize work and performance appraisal (KPI,IKI, and IKU) consider to apply to reach employee best performance.
Keywords: Lean Thinking, BPJS, claim, value added activity, non value added activity, waste
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Kata Kunci: Lean Thinking, BPJS, klaim, value added activity, non value addedactivity, waste
Delay in the submission of BPJS claims resulted in decreasing hospital cash flow. The currentclaim process is not efficient and effective.The objective of this reseach is to analize and proposeimprovement in the claim process by applying Lean Hospital concept. This research usedquantitative and qualitative approaches to observed the time required to complete the claimprocess before submitted to the BPJS verificator and also have an in-depth interview, observe theprocess, and document review. The result showed most waste happened in mobilisasi dana unitfor 32.5 days 18.8 minutes in the settlement BPJS document claims. Based on Value StreamMapping, Lead Time of the claim process at this time is 33.9 day. Most types of waste arewaiting and transportation. Proposed improvement provided from the study is to optimizing thecasemix team which newly formed. By optimizing the casemix team, Lead Time required tocomplete the claims process is 6.44 minutes. Standardize work and performance appraisal (KPI,IKI, and IKU) consider to apply to reach employee best performance.
Keywords: Lean Thinking, BPJS, claim, value added activity, non value added activity, waste
B-1795
Depok : FKM UI, 2016
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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