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ABSTRAK Sistem pelaporan kegiatan rutin di Rumah Sakit Metropolitan Medical Center yang masih manual atau belum terintegrasi secara online, sehingga menyebabkan beberapa masalah seperti tidak standarnya laporan-laporan yang diberikan oleh masing-masing unit, dan terjadinya kesalahan dalam input dan rekapitulasi laporan oleh petugas rekam medis. Tujuan penelitian ini adalah untuk memberikan gambaran dan identifikasi sistem pelaporan rutin rumah sakit Metropolitan Medical Center sehingga dapat memberikan saran guna meminimalkan kesalahan dalam pembuatan laporan rutin rumah sakit. Rumah sakit metropolitan medical center memiliki 162 tempat tidur, dimana unit rekam medis bertanggung jawab dalam pembuatan dua laporan wajib rumah sakit, yakni laporan eksternal, yaitu laporan kepada departemen kesehatan, dan laporan internal, yaitu laporan kepada seluruh direksi rumah sakit. Jenis penelitian yang dilakukan adalah penelitian kualitatif yang bersifat deskriptif, terbatas pada laporan internal rumah sakit. Informan penelitian berjumlah 14 orang. Dari penelitian didapatkan hasil mengenai sumber daya dan fasilitas yang berhubungan dengan pembuatan laporan kegiatan, dan diketahui bahwa belum semua unit yang terkomputerisasi dan memiliki sistem online, serta tidak standarnya format formulir laporan di setiap unit. Selain itu juga ditemukan adanya kesulitan dari unit rekam medis dalam memproses laporan yang diterima. Dari penelitian dapat disimpulkan bahwa perlunya suatu formulir standar sehingga dapat memudahkan unit rekam medis dalam melakukan rekapitulasi di setiap unit pelaksana sehingga dapat mengurangi kemungkinan timbulnya kesalahan dalam pembuatan laporan rutin rumah sakit. ABSTRACT Report activities in Metropolitan Medical Center are done manually and has not yet adopted an online integration. This causes a number of problems such that the report are not collected in one unified standard and that input mistakes are often made in the reports by the medica record staffs. The purpose of this research is to describe and analyze the daily and monthly report activities at the hospital therefore to advice which could be use to overcome the problems. The Metropolitan Medical Center has 162 beds, and its medical record unit responsible to produce essential reports that are external and internal reports. The external reports are to be submitted to the Ministry of Health Department while the internal reports to the board of directors. The type of research conducted will be qualitatif-descriptive and limited to only internal reports. The research is held the interview of fourteen informants and observations. The informations result from the interview are type of resources and facilities needed to produce the reports as well as evidence that not all the units has the computerized system or online system, and also the format of the form reports is not standard for each unit. It is also known that there is some difficulties to process the reports in medical record unit. The conclusion of the research is standar form is needed to facilitate the medical record unit in order to process the reports for each unit in hospital, so that can minimalized the chance of mistakes in the process of reporting the hospital reports.
ABSTRAK
Lean Thinking, filosofi manajemen yang berfokus pada proses usaha, merupakan metode yang tepat untuk menganalisis alur proses pengadaan obat kemoterapi di RS MMC Jakarta. Penelitian ini mengaplikasikan prinsip Lean dalam menggambarkan alur proses yang terjadi saat ini, menganalisis masalah, serta mendesain alur proses yang lebih ideal. Metode yang dilakukan adalah penelitian kualitatif, dengan observasi langsung proses yang terjadi, wawancara mendalam dengan staf terkait, serta telaah dokumen. Hasil penelitian menunjukkan bahwa pada saat ini sebagian besar pengadaan obat kemoterapi di RS MMC saat ini berlangsung secara cito tanpa standar yang khusus, sehingga polanya tidak jelas. Masalah utama yang ditemukan adalah seringnya obat tidak ada di distributor utamanya dan proses koordinasi antar-unit yang rumit apabila hal ini terjadi. Alur proses terdiri dari 48 kegiatan pada proses pengadaan obat kemoterapi di RS MMC dan hanya 18% dari waktu prosesnya yang bersifat value-added. Analisis masalah dilakukan dengan menggunakan Lean Tools Value Stream Mapping (VSM), identifikasi 8 wastes, analisis akar masalah dengan metode 5 Whys, Kanban, serta konsep error-proofing. Setelah analisis akar masalah dan perumusan ide perbaikan, dilakukan desain ulang yang menghasilkan alur proses baru, terdiri dari 16 kegiatan, dengan persentase waktu value added mencapai 83%.
ABSTRACT
Lean Thinking, a management philosophy focusing on business processes, is the right method to analysis the chemotherapy drugs purchasing process at MMC Hospital Jakarta. This study applied Lean principles in mapping the current work process, analyzing problems, and redesigining a more ideal work flow. Research method used in this study is qualitative approach, by doing direct observation of the actual process, in-depth interview with staffs involved, and document study. This research showed that the current chemotherapy drugs purchasing process are done cito with no specific standard, therefore there was no clear pattern. The main problems were often not found at the main distributors, and that it would demand a very complicated coordination process. The current work process consisted of 48 activities, and only 18% of the total process time was value-added. Analysis were done with the use of Lean Tools Value Stream Mapping (VSM), 8 wastes identification, root cause analysis with 5 Whys method, Kanban, and error-proofing concept. After conducting root-cause analysis and comprising improvement ideas, a new work process was designed, consisted of 16 activites, with 83% value added time.
Kata Kunci : Kelengkapan Berkas Rekam Medis, Retrospective Review, Concurrent Review
One of the parameters to determine the quality of health services in the hospital is the quality of medical record services that is about the completeness of recording medical records. A good medical record quality indicator is the completeness of its content, accurate, punctual, and legal aspects fulfillment. A complete medical record will provide convenience for the provision of information in the hospital. The medical record services at Kasih Ibu General Hospital Denpasar in the implementation are still facing some problems, to wit the return of medical record file that is more than the deadline specified and the completeness of the medical record file. The evaluation results for the third quarter report in 2017 showed that the average length of medical record file returns from July to September 2017 which is more than 1x24 hours is 22% while less than 1x24 hours was 78%. On average incompleteness charging inpatient medical record file at the General Hospital Kasih Ibu Denpasar in July to September 2017 was 73%. The purpose of this study was to determine differences in the completeness of the document review is based on a retrospective review and concurrent review of the patient's complete medical record file Sectio Caesaria (inpasif action) and pneumonia (by conventional measures) Kasih Ibu Hospital in Denpasar. The type of research used in this research is using quantitative approach method by comparing two (2) population that is Retrospecttive Review and Concurrent Review. The study was conducted on the medical records of Sectio Caesaria patients and on the medical records of patients with Pneumonia. Determination of population is done based on clinical pathways in Kasih Ibu Hospital Denpasar. There is a difference to the completeness of the medical record file between the retrospective review and the concurrent review. The data obtained shows that the number of medical record completeness with concurrent review method is higher than in the retrospective review method. This is because the medical recorder to check the completeness of the file when the patient is still inpatient and provide a sign or note on the file that is not complete so that when the doctor visits it is easier to complete the medical records file
Keywords: Medical File Recordings, Retrospective Review, Concurrent Review
