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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.
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
Analisis penerapan Penganggaran berbasis Kinerja untuk Standar Pelayanan Minimal (SPM) Orang dengan Gangguan Jiwa (ODGJ) Berat di Dinas Kesehatan Kota Depok Tahun 2025, Penelitian ini menganalisis pelaksanaan penganggaran berbasis kinerja (PBK) terhadap Standar Pelayanan Minimal (SPM) ODGJ Berat di Dinas Kesehatan Kota Depok telah mencerminkan kebutuhan riil di lapangan. Meskipun capaian SPM tercatat mencapai 100% pada tahun 2023 dan 2024, alokasi anggaran justru mengalami penurunan signifikan: dari (0,06%) pada 2023 menjadi hanya (0,02%) pada 2024 dari total anggaran Dinas Kesehatan. Kontradiksi ini mencolok, terutama ketika prevalensi gangguan jiwa di Kota Depok masih sangat tinggi 9,1% di kalangan pegawai pemerintah dan 15,3% di masyarakat umum, angka provinsi (4,4%) dan nasional (2%). Kondisi ini menunjukkan adanya tantangan serius dalam penerapan PBK yang seharusnya mengedepankan prinsip efektivitas, efisiensi, dan evidence-based. Penelitian ini menggunakan pendekatan komprehensif terhadap komponen struktur, proses, dan komitmen daerah, untuk menilai apakah kebijakan penganggaran yang diterapkan sudah mendukung keberlanjutan layanan kesehatan jiwa secara substantif, bukan sekadar administratif.
Analysis of the Implementation of Performance-Based Budgeting for Minimum Service Standards (SPM) for People with Severe Mental Disorders (ODGJ) at the Depok City Health Office in 2025,This study analyzes whether the implementation of performance-based budgeting (PBB) for the Minimum Service Standards (SPM) for People with Severe Mental Disorders (ODGJ) at the Depok City Health Office reflects the actual needs in the field. Although SPM achievements reached 100% in 2023 and 2024, the allocated budget experienced a significant decline—from 0.06% in 2023 to only 0.02% in 2024 of the total Health Office budget. This contradiction is striking, especially considering the high prevalence of mental disorders in Depok: 9.1% among government employees and 15.3% in the general population, far exceeding the provincial average (4.4%) and the national rate (2%). This situation highlights serious challenges in the application of PBB, which should prioritize effectiveness, efficiency, and evidence-based principles. This study adopts a comprehensive approach by examining structural components, processes, and regional commitment to assess whether the current budgeting policy supports the sustainability of mental health services in a substantive, rather than merely administrative, manner.
Latar belakang: Hipertensi merupakan penyakit tidak menular dengan prevalensi tertinggi Indonesia. Berdasarkan data Survei Kesehatan Indonesia (SKI) 2023, 30,8% penduduk usia ≥18 tahun mengalami hipertensi berdasarkan pengukuran, sedangkan prevalensi hipertensi berdasarkan diagnosis dokter adalah 8,6%. Selain itu, laporan SKI 2023 menekankan adanya kesenjangan antara perilaku pencarian pengobatan hipertensi dengan proporsi masyarakat yang terdiagnosis. Saat ini, sebesar 53,3% penyandang hipertensi tidak teratur minum obat atau tidak minum obat antihipertensi, dan 56,9% tidak teratur atau sama sekali tidak melakukan pemeriksaan ulang ke tenaga kesehatan.
Tujuan: Mengetahui faktor-faktor yang berhubungan dengan perilaku pencarian pengobatan hipertensi pada penyandang hipertensi usia ≥18 tahun di Indonesia.
Metode: Sebanyak 53.648 penyandang hipertensi usia ≥18 tahun berdasarkan data SKI 2023 diteliti dalam penelitian cross-sectional ini. Uji chi-square dan regresi logistik sederhana dilakukan untuk melihat hubungan antar variabel. Variabel luaran adalah perilaku pencarian pengobatan hipertensi. Variabel prediktor adalah jenis kelamin, usia, status pernikahan, tingkat pendidikan, status pekerjaan, pengetahuan terkait hipertensi, tempat tinggal, wilayah geografis, status sosial ekonomi, kepemilikan jaminan kesehatan, akses ke fasilitas kesehatan, multimorbiditas, dan perilaku cek kesehatan berkala.
Hasil: Proporsi perilaku pencarian pengobatan hipertensi yang aktif pada penyandang hipertensi usia ≥18 tahun di Indonesia tahun 2023 adalah 76,2%. Faktor-faktor yang berhubungan dengan perilaku pencarian pengobatan hipertensi adalah berjenis kelamin perempuan (OR = 1,24; 95% CI: 1,15-1,33), berusia 65-74 tahun (ref. 18-24 tahun; OR = 6,60; 95% CI: 4,35-10,04), sedang menikah (OR = 0,92; 95% CI: 0,85-0,99), memiliki tingkat pendidikan tersier (ref. Tidak sekolah; OR = 1,28; 95% CI: 1,12-1,47), tidak bekerja (OR = 1,15; 95% CI: 1,08-1,23), pernah mendapat informasi pengobatan hipertensi (OR = 3,98; 95% CI: 3,70-4,28), berasal dari Kepulauan Maluku (ref. Papua; OR = 1,97; 95% CI: 1,51-2,58), memiliki status sosial ekonomi teratas (OR = 1,36; 95% CI: 1,17-1,59), memiliki jaminan kesehatan (OR = 1,48; 95% CI: 1,36-1,61), memiliki multimorbiditas (OR = 1,77; 95% CI: 1,63-1,92), dan melakukan cek kesehatan minimal 1 bulan sekali (ref. Tidak pernah; OR = 6,16; 95% CI: 5,54-6,84).
Kesimpulan: Studi ini menunjukkan dibutuhkannya program untuk meningkatkan kesadaran dan partisipasi aktif masyarakat, khususnya kelompok usia produktif, dalam melakukan pengobatan hipertensi.
Kata kunci: Perilaku pencarian pengobatan, penyandang hipertensi, hipertensi
Background: Hypertension is a non-communicable disease with the highest prevalence in Indonesia. According to the Indonesian Health Survey (SKI) in 2023, 30.8% of people aged ≥18 experienced hypertension based on blood pressure measurement, while the prevalence of hypertension based on a doctor’s diagnosis was 8.6%. In addition, the SKI 2023 report emphasised the gap between hypertension health-seeking behaviour and the proportion of diagnosed patients. Currently, 53.3% of hypertensive patients do not regularly or do not take anti-hypertensive medication, and 56.9% do not regularly or do not have re-examinations with health professionals. Objective: This study aims to determine the factors associated with hypertension health-seeking behaviour in hypertensive patients aged ≥18 years in Indonesia. Methods: A total of 53.648 hypertensive patients aged ≥18 years based on SKI 2023 were analysed in this cross-sectional study. Chi-square test and simple logistic regression were used to determine the associations between variables. The outcome variable is hypertension health-seeking behaviour. The independent variables are gender, age, marital status, education level, employment status, hypertension-related knowledge, place of residence, geographic area, socioeconomic status, health insurance ownership, access to health facility, multimorbidity, and regular health check-up. Results: The proportion of active hypertension health-seeking behaviour in hypertensive patients aged ≥18 years in Indonesia in 2023 was 76.2%. Factors associated with hypertension health-seeking behaviour were female (OR = 1.24; 95% CI: 1.15-1.33), aged 65-74 years (ref. 18-44 years; OR = 6.60; 95% CI: 4.35-10.04), married (OR = 0.92; 95% CI: 0.85-0.99), having tertiary education (ref. no formal education; OR = 1.28; 95% CI: 1.12-1.47), not working (OR = 1.15; 95% CI: 1.08-1.23), having received information on hypertension treatment (OR = 3.98; 95% CI: 3.70-4.28), living in the Maluku Islands (ref. Papua; OR = 1.97; 95% CI: 1.51-2.58), having the highest socioeconomic status (OR = 1.36; 95% CI: 1.17-1.59), insured (OR = 1.48; 95% CI: 1.36-1.61), having multimorbidity (OR = 1.77; 95% CI: 1.63-1.92), and doing a health check-up at least once a month (ref. never; OR = 6.16; 95% CI: 5.54-6.84). Conclusion: This study indicates the need for a program to raise awareness and the active participation of the public, particularly the productive age population, in seeking hypertension treatment. Key words: Health-seeking behaviour, hypertensive patients, hypertension
