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Latar Belakang: Proses pre-registrasi pasien rawat inap di RS Mayapada Tangerang terdiri dari tiga fase utama, yaitu penerimaan berkas admission, review asuransi, serta konfirmasi jadwal dan persiapan pasien. Studi ini bertujuan untuk mengevaluasi proses pre-registrasi dan mengidentifikasi area yang perlu diperbaiki guna meningkatkan efisiensi pelayanan dengan.
Metode: Penelitian ini menggunakan pendekatan Lean six sigma dengan metode DMAIC (Define, Measure, Analyze, Improve, dan Control). Data dikumpulkan melalui observasi langsung, pencatatan waktu proses, dan diskusi kelompok terfokus (FGD) bersama tim terkait. Analisis dilakukan menggunakan Value Stream Mapping (VSM) untuk mengidentifikasi aktivitas bernilai tambah, serta Pareto Analysis dan Problem Tree Analysis untuk menemukan akar penyebab pemborosan dan keterlambatan.
Hasil: Analisis terhadap alur dan capaian waktu proses menunjukkan adanya ketidakefisienan, dengan total waktu mencapai 26 jam 1 menit 48 detik. Proporsi aktivitas bernilai tambah (Value added) tercatat sebesar 71%, sementara 29% lainnya tergolong Non-Value added, dengan pemborosan terbesar terjadi pada fase review asuransi akibat waktu tunggu yang panjang dan aktivitas berulang. Hasil penelitian menunjukkan bahwa intervensi berbasis Lean six sigma efektif dalam meningkatkan efisiensi, ditandai dengan penurunan lead time pada fase post-intervensi. Pada fase I dan II terjadi perbaikan signifikan, seperti penyederhanaan proses konfirmasi DPJP, percepatan verifikasi dokumen, serta pengurangan waktu tunggu pada proses review asuransi.
Kesimpulan: Penerapan Lean six sigma mampu memberikan dampak positif terhadap optimalisasi proses pre-registrasi pasien rawat inap di RS Mayapada Tangerang.
Background : The inpatient pre-registration process at Mayapada Hospital Tangerang consists of three main phases: admission document submission, insurance review, and confirmation of schedule and patient preparation. This study aims to evaluate the pre-registration process and identify areas that need improvement to enhance service efficiency. Method : This research uses the Lean six sigma approach with the DMAIC method (Define, Measure, Analyze, Improve, and Control). Data were collected through direct observation, process time tracking, and focus group discussions (FGDs) with relevant teams. The analysis was conducted using Value Stream Mapping (VSM) to identify value-added activities, along with Pareto Analysis and Problem Tree Analysis to determine the root causes of waste and delays. Results : Analysis of the process flow and time achievements revealed inefficiencies, with a total duration of 26 hours, 1 minute, and 48 seconds. The proportion of Value-Added (VA) activities was recorded at 71%, while the remaining 29% were classified as Non-Value added (NVA), with the most significant waste occurring during the insurance review phase due to long waiting times and repetitive tasks. The results showed that Lean six sigma-based interventions were effective in improving efficiency, as indicated by a reduction in lead time during the post-intervention phase. Significant improvements were observed in Phases I and II, including the simplification of DPJP (attending physician) confirmation, acceleration of document verification, and reduction in waiting time during the insurance review process. Conclusion : The implementation of Lean six sigma has a positive impact on optimizing the inpatient pre-registration process at Mayapada Hospital Tangerang
Latar Belakang : Length of stay (LOS) atau ideal time merupakan salah satu indikator penilaian key performance indicator (KPI) patient experience untuk menilai pelayanan IGD. Pencapaian LOS di IGD Mayapada Hospital Bogor baru tercapai 91% di bulan September dari target 100% dengan angka variasi waktu pelayanan yang cukup tinggi.
Metodologi : Penelitian ini menggunakan desain penelitian operational research dengan menggabungkan metode penelitian kuantitatif dan kualitatif (mix methode) dan teknik stratified random sampling untuk metode pengambilan sampel dengan jumlah sebanyak 240 pasien IGD. Penentuan sampel menggunakan rumus Slovin.
Hasil Pembahasan : Pada penelitian ini ditemukan waste waiting sebagai penyebab masalah berdasarkan analisa pareto adalah pada kegiatan menunggu hasil laboratorium sebesar 28% (00:36:20), menunggu hasil radiologi sebesar 21% (00:27:38), persiapan obat, alkes dan oplos obat sebesar 19% (00:24:42) dan menunggu keputusan rawat inap sebesar 23% (00:30:11) dengan total keseluruhan sebesar 91%. Intervensi dengan implementasi lean six sigma yang dilakukan mampu menurunkan angka lead time sebesar (↓ 27,7%) dari 3 jam 59 menit 20 detik menjadi 2 jam 53 menit 2 detik dengan menghilangkan kegiatan non value added sebesar (↓ 37%) dari 2 jam 7 menit 4 detik menjadi 1 jam 20 menit 23 detik. Pada fase kontrol LOS pasien IGD menunjukan penurunan angka lead time sebesar 18% yaitu 2 jam 21 menit 23 detik dan penurunan kegiatan non value added menjadi 51 menit 7 detik
Kesimpulan : Intervensi lean six sigma dengan menggunakan tools standardize work, heijunka, 5S dan brainstorming terbukti mampu menurunkan waktu length of stay pelayanan pasien IGD.
Background : Length of stay (LOS) or ideal time, is one of the key performance indicators (KPIs) used to assess patient experience in emergency department (ED) services. LOS achievement in the ED reached only 91% of the target 100% in September at Mayapada Hospital Bogor, with a high variation in service time. Methodology : This study uses an operational research design, combining quantitative and qualitative research methods (mixed methods), and employs stratified random sampling techniques. The sampel size consisted of 240 ED patients, determined using the Slovin formula. Results and Discussion: In this study, the identified cause of the problem based on pareto analysis was waste due to waiting, with the following breakdown : waiting for laboratory results accounted for 28% (00:36:20), waiting for radiology results 21% (00:27:38), preparation of medications, medical devices, and drug mixing 19% (00:24:42), and waiting for inpatient admission decisions 23% (00:30:11), comprising a total of 91%. The intervention through the implementation of lean six sigma successfully reduced lead time by 27.7%, from 3 hours 59 minutes 20 seconds to 2 hours 53 minutes 2 seconds, by eliminating non–value-added activities by 37%, from 2 hours 7 minutes 4 seconds to 1 hour 20 minutes 23 seconds. In the control phase, the Emergency Department patient length of stay (LOS) showed a lead time reduction of 18%, equivalent to 2 hours, 21 minutes, and 23 seconds, and a decrease in non-value-added activities to 51 minutes and 7 seconds. During the control phase, the length of stay (LOS) for emergency department (ED) patients showed a further lead time reduction of 18%, reaching 2 hours 21 minutes 23 seconds, with a reduction in non–value-added activities to 51 minutes 7 seconds. Conclusion : Lean Six Sigma interventions, utilizing tools such as standardized work, heijunka, 5S, and brainstorming, effectively reduced the length of stay for ED patients.
Digital marketing is currently widely used and sought after by business people. The development of increasingly sophisticated technology makes the marketing process easier. The need for digital marketing continues to increase, resulting in hospital businesses using online marketing strategies. Especially during the Corona Virus Disease-2019 (COVID-19) pandemic, many people avoid visiting hospitals and prefer to use digital-based medical applications. This study is to determine the evaluation acceptance of the use of Digital Marketing on Instagram media using the Technology Acceptance Model (TAM) approach at Bunda Hospital Palembang. TAM is a model that explains the behavior of information technology users based on beliefs, attitudes, intentions, and user behavior relationships. This study is a quantitative study with a cross-sectional survey design. The dimension of Perceived usefulness had an impact of 31.1% on the acceptance of the use of digital marketing on Instagram media. Meanwhile, perceived ease of use had an impact of 13.1% on the acceptance of the use of digital marketing on Instagram media, the attitude toward using had given 17% impact on acceptance of digital marketing use on Instagram media. Meanwhile, behavioral intention to use had given 17.5% impact on acceptance of digital marketing use on Instagram media at Bunda Hospital Palembang. The evaluation by using Technology Acceptance Model (TAM) approach from various dimensions. Perceived usefulness dimension was found significantly affected on the acceptance of the use of digital marketing on Instagram media at Bunda Hospital Palembang.
Hipertensi merupakan salah satu penyebab utama kematian dini global dan prevalensinya masih tinggi di Indonesia. Obesitas sentral diidentifikasi sebagai faktor risiko yang signifikan terhadap hipertensi, termasuk pada kelompok berisiko tinggi seperti jemaah haji. Analisis ini bertujuan mengetahui risiko obesitas sentral terhadap hipertensi derajat satu pada jemaah haji Provinsi Banten tahun 2024.
Penelitian ini menggunakan desain potong lintang (cros-sectional) pada data Siskohatkes hasil pemeriksaan kesehatan jemaah haji Provinsi Banten tahun 2024 berusia 20-70 tahun dan memenuhi kriteria inklusi dan eksklusi (N=4.650). Uji cox regression yang dimodifikasi dilakukan untuk memperoleh Prevalence Ratio (PR) dan 95% CI yang diestimasi dari nilai Hazard Ratio (HR).
Prevalensi hipertensi derajat satu pada jemaah haji provinsi Banten tahun 2024 sebesar 34,37%. Jemaah haji dengan hipertensi derajat satu pada kelompok obesitas sentral lebih tinggi (38,11%) dibandingkan yang tidak obesitas sentral. Setelah dikontrol IMT, obesitas sentral dapat meningkatkan risiko hipertensi derajat satu sebesar 1,12 kali (95% CI: 1,00–1,27). Risiko obesitas sentral terhadap kejadian hipertensi derajat satu pada subpopulasi umur dan jenis kelamin meningkat seiring bertambahnya usia. Dibandingkan laki-laki, risiko obesitas sentral terhadap hipertensi derajat satu pada perempuan terjadi lebih awal di usia muda pada 20-29 tahun, sedangkan pada laki-laki dimulai usia 40-59 lansia.
Obesitas sentral memiliki hubungan signifikan dan meningkatkan risiko hipertensi derajat satu pada jemaah haji Provinsi Banten tahun 2024. Hal ini menegaskan pentingnya deteksi dini dan intervensi obesitas sentral dalam upaya pencegahan hipertensi, khususnya pada populasi berisiko tinggi.
Background. Bogor regency is one of the regions in West Java with the highest reported TB burden in 2022, totaling 15,433 cases with a prevalence of 413 per 100,000 population. Indicating that TB prevalence reduction efforts in West Java remain suboptimal. Methods. This study employed Spearman correlation test and spatial overlay analysis on secondary data from 2022, covering 40 sub-districts in Bogor Regency. The analyzed variables included the proportion of healthcare workers, ratio of health facilities, BCG immunization coverage, proportion of poor population, low education levels, PHBS, malnourished children, population density, hygienic management of water and food, household waste management, and indoor air quality. Conclusion. The variable significantly associated with TB cases was the proportion of poor population (R = 0.492; P = 0.001) The spatial overlay analysis revealed that TB distribution tended to be higher in areas with a combination of high social and environmental vulnerability, such as Jonggol, Sukaraja, and Parung.
Obesitas merupakan masalah kesehatan global dengan prevalensi yang terus meningkat, termasuk di Indonesia. Pada anak dan remaja, obesitas dipengaruhi oleh berbagai faktor, seperti genetik, lingkungan, pola makan, dan status sosial ekonomi. Namun, penelitian yang secara khusus mengkaji obesitas pada kelompok usia ini masih terbatas. Penelitian ini bertujuan untuk mengetahui prevalensi dan determinan obesitas pada anak dan remaja di Indonesia menggunakan data Survei Kesehatan Indonesia (SKI) 2023. Desain penelitian ini adalah potong lintang, dengan sampel terdiri dari 115.053 anggota rumah tangga berusia 5–19 tahun yang memenuhi kriteria inklusi dan eksklusi. Hasil menunjukkan prevalensi obesitas sebesar 7,9% (95% CI 7,6–8,1). Faktor-faktor yang secara signifikan berhubungan dengan peningkatan risiko obesitas meliputi: jenis kelamin laki-laki [AOR 1,56; 95% CI 1,451–1,678], pendidikan ibu tinggi [AOR 1,197; 95% CI 1,106–1,296], ibu bekerja [AOR 1,14; 95% CI 1,063–1,223], tinggal di perkotaan [AOR 1,27; 95% CI 1,176–1,370], status ekonomi teratas [AOR 1,791; 95% CI 1,548–2,032], aktivitas fisik rendah [AOR 1,534; 95% CI 1,230–1,913], konsumsi makanan olahan lebih dari satu kali sehari [AOR 1,27; 95% CI 1,009–1,242], serta konsumsi buah dan sayur minimal satu porsi per hari [AOR 1,142; 95% CI 1,060–1,227]. Temuan ini menunjukkan bahwa intervensi promosi kesehatan yang menargetkan faktor-faktor tersebut penting untuk mencegah dan mengendalikan obesitas pada anak dan remaja di Indonesia.
Early life growth disorders, including stunting, have long-term negative impacts on many aspects of life. The birth of "4 Too" is thought to be at risk of disrupting early life growth. The purpose of this study was to provide new evidence of the association between the birth of "4 Too" and the risk of stunting according to SKI 2023. This research method is quantitative-analytical with a cross-sectional design. The data source is SKI 2023 with a population of toddler families; the number of samples is 61870 respondents. Data analysis using the chi-square test, simple logistic regression, and complex multiple samples. The results of the study showed that there was a relationship between "4 Too", including the birth of a mother who is too young (<20 years), too close (birth spacing <24 months), too many (parity >=4) to stunting and severe stunting. Furthermore, births from mothers who are too young (<20 years) have a higher risk of stunting [(AOR=1.24(95%CI=1.07 - 1.44)] after controlling for economic status, births from too young mothers (<20 years) have a higher risk of severe stunting [(AOR=1.65(95%CI=1.27 - 2.15)] after controlling for maternal height and MUAC and too many births [AOR=0.88 (95%CI=0.78 - 0.99)] lower risk of severe stunting after controlling for region. A pre-conception healthy pregnancy planning education campaign is needed for prospective brides and young women utilizing special peer educators in areas with high replacement rates and high stunting prevalence, increasing access to and quality of family planning services, and strengthening nutritional interventions by strengthening the implementation of makan bergizi gratis (MBG) program for pregnant and lactating women.
Research related to premature mortality, deaths aged 30-70 years due to NCDs in Indonesia, is still limited. This study aims to analyze the trend of premature mortality due to 4NCD, including CVD, cancer, diabetes, and CRD in DKI Jakarta in 2020-2024 using a cross-sectional design based on secondary data from DKI Jakarta Health Department. Univariate analysis examined 4NCD premature mortality trends based on age distribution, gender, domicile area, and health facility reports. The results showed 4NCD premature mortality was caused by CVD (78%), diabetes (17%), cancer (14%), and CRD (9%). CVD mortality due to other heart disease (47.4%) and cerebrovascular (19.4%). Site-specific primary malignant cancer (88.7%), type 2 DM (77%). CRD mortality by other respiratory system disease block (34%) and chronic lower respiratory disease (27.8%). Premature mortality was highest in middle-aged adults (49%), young elderly (46%), young adults (5%). Male mortality (58%) was higher than female mortality (42%). Domicile of death was highest in East Jakarta (30%), South Jakarta (19%), North Jakarta (17%), the highest source of report being puskesmas (56%). Unspecified death cases illustrate the challenges of accurate surveillance processes. This study emphasizes the vitality of data quality to support effective and targeted interventions and policies in reducing morbidity.