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Budi Anna Keliat ... [et al.]
MJI-Vol.18/No.1
Jakarta : Faculty of Medicine Universitas Indonesia, 2009
Indeks Artikel Jurnal-Majalah   Pusat Informasi Kesehatan Masyarakat
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Ristanti Karina; Pembimbing: Masyitoh; Penguji: Pujiyanto, Purnawan Junadi, Maria Linggar Pratiwi, Melani Vandauli Fabiola
Abstrak:

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.

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B-2549
Depok : FKM-UI, 2025
S2 - Tesis   Pusat Informasi Kesehatan Masyarakat
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Gustiane Adriani Dwisari; Pembimbing: Kurnia Sari; Penguji: Wachyu Sulistiadi, Novita Dwi Istanti
Abstrak:
Pelayanan di Instalasi Gawat Darurat (IGD) memegang peran penting dalam menentukan kualitas pelayanan dan keselamatan pasien di rumah sakit. Indikator kinerja IGD, seperti Length of Stay (LOS), yang mengukur lama pasien d IGD dari kedatangan hingga pemulangan atau pemindahan, dapat memengaruhi tingkat kepadatan di IGD. Penelitian ini bertujuan untuk mengidentifikasi alur pelayanan, hambatan, dan akar penyebab masalah terkait LOS di IGD. Pengumpulan data dilakukan pada bulan April-Mei 2024 dengan pendekatan kualitatif studi kasus, berupa observasi pada 30 pasien, wawancara, dan telaah dokumen. Analisis data menggunakan flowchart untuk mengidentifikasi alur pelayanan, Value Stream Mapping untuk mengenali kegiatan bernilai dan menemukan waste, serta The Five Whys untuk menganalisis akar penyebab hambatan. Metode Lean Thinking digunakan untuk menghasilkan alur dan Model BAS (Baseline, Assess, Suggest Solution) dari Model BASICS. Hasil penelitian menunjukkan bahwa alur pelayanan pasien IGD melibatkan lima tahapan; dengan 65,5% waktu pelayanan adalah kegiatan non-value added, 23,4% kegiatan necessary but non-value added, dan 11,1% kegiatan value added, dengan total Lead Time 7 jam 55 menit 29 detik. Dari sisi pasien, waste yang terjadi meliputi waste of waiting (94,9%) dan transportation (5,1%). Bottleneck terjadi pada aktivitas menunggu terdaftar di rawat inap (25,2%), menunggu advis DPJP (22,9%), menunggu hasil pemeriksaan penunjang (22,3%), dan menunggu kesiapan rawat inap (18,2%), dengan total 88,6%. Perbaikan LOS di IGD dapat menggunakan lean tools seperti standardized work, visual management, heijunka, kaizen, dan just in time agar waste dapat dikurangi.

Emergency Department (ED) services play a crucial role in determining the quality of care and patient safety in hospitals. Performance indicators in the ED, such as Length of Stay (LOS) which measures the duration from a patient's arrival to their discharge or transfer can significantly impact the congestion levels in the ED. This study aims to identify the service flow, obstacles, and root causes of issues related to LOS in the ED. Data collection was conducted from April to May 2024 using a qualitative case study approach, including observations of 30 patients, interviews, and document reviews. Data analysis involved using flowcharts to identify the service flow, Value Stream Mapping to recognize value-added activities and identify waste, and The Five Whys to analyze the root causes of obstacles. Lean Thinking methodology was applied to develop a service flow and the BAS (Baseline, Assess, Suggest Solution) model from the BASICS model. The study results show that the patient service flow in the ED involves five stages, with 65.5% of service time consisting of non-value-added activities, 23.4% of necessary but non-value-added activities, and 11.1% of value-added activities, resulting in a total lead time of 7 hours, 55 minutes, and 29 seconds. From the patient's perspective, the waste observed includes waiting (94.9%) and transportation (5.1%). Bottlenecks were identified in activities such as waiting to be registered for inpatient care (25.2%), waiting for specialist advice (22.9%), waiting for the results of supporting examinations (22.3%), and waiting for inpatient readiness (18.2%), totaling 88.6%. Improving LOS in the ED can utilize lean tools such as standardized work, visual management, heijunka, kaizen, and just-in-time to reduce waste.
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S-11692
Depok : FKM UI, 2024
S1 - Skripsi   Pusat Informasi Kesehatan Masyarakat
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The Indonesian J. of Public Health (IJPH), Vol.2, No.2, Nov. 2005, hal. 33-37. ( ket. ada di bendel 2005- 2007), dan ( ada di bendel 2005- 2006)
[s.l.] : [s.n.] : s.a.]
Indeks Artikel Jurnal-Majalah   Pusat Informasi Kesehatan Masyarakat
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The Am. J. Clin. Nutr. (AJCN), Vol. 87, No.6, June 2008, hal. 1656-1661
[s.l.] : [s.n.] : s.a.]
Indeks Artikel Jurnal-Majalah   Pusat Informasi Kesehatan Masyarakat
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The Am. Jour. of Clinical Nutrition ( AJCN), Vol.100, No.2, Augt. 2014, hal. 609-615
[s.l.] : [s.n.] : s.a.]
Indeks Artikel Jurnal-Majalah   Pusat Informasi Kesehatan Masyarakat
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616.8914 MEN M
[s.l.] : New Jersey John Eilley 2001, s.a.]
Kumpulan Daftar Isi Buku   Pusat Informasi Kesehatan Masyarakat
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616.8914 MEN M
[s.l.] : New Jersey John Eilley 2001, s.a.]
Kumpulan Daftar Isi Buku   Pusat Informasi Kesehatan Masyarakat
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Resna A.S., Zarni Amri, Mr. Russell Vogel
MKMI Vol.XX, No.4
Jakarta : IAKMI, 1992
Indeks Artikel Jurnal-Majalah   Pusat Informasi Kesehatan Masyarakat
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Wirda Murningtyas; Pembimbing: Masyitoh; Penguji: Atik Nurwahyuni, Ahmad Riza`i
S-10316
Depok : FKM UI, 2020
S1 - Skripsi   Pusat Informasi Kesehatan Masyarakat
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