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The Emergency Department (ED) has already known as the gateway and the reflection of services given by the hospital which is suppose to be fast accurate and qualified without neglecting the pntient's safety. As the problem is more and more complicated regarding to services at the ED, therefore, a study is needed in order to explore how the quality of the service management is, as well as the input and process factors influenced at the ED of RK Charitas Hospital of Palembang. The research is a qualitative study with the Problem Solving Approach as the strategy of the study. The study is carried out at the ED of RK Charitas Hospital from March to April 2008 with an in-depth interview, direct observation and documents assessment (secondary data exploration), as the method of infonnation eolleetion. The study is using the Problem Priority Matrix in order to find the problem solving prioritizing base on the magnitude of benefit yielded from effort required. There are five problems in the three first order, namely ; time for picking-up inpatient care at the ED still too long, inadequate quality of doctor and nurse at the ED, in adequate amount of nurses, and inadequancy on triase implementation at the ED of RK Charitas Hospital of Palembang. It was suggested the existence of coordination between medical directorates and nursing to minimize time of patient?s transfer from ED to inpatient care unit, giving education and training for doctor and nurse at ED, adding nurse worker at ED, assuring triase implementation and opening an incidental unit near ED at the time of outpatient unit is closed.
Health program development needs support from government as well as society which includes a sufficient budget from private sector. The cost from private sector, mainly society’s budgeting has resulted in the biggest portion from the health expenses. The contribution from private sector and society is around 65 percent and the rest about 35 percent comes from public sector. From this 65 percentage, the majority of society is still using one mean of payment by paying for each service (fee for service), only 14 percent of the society is covered by health insurance. Prepaid payment sistem on the side of health provider either in hospitals and clinics (doctors) in the recommended state before certain treatment being given, one way is using Diagnosis Related Group’s (DRG’s). On the whole this study aims to get the descriptive picture as cost variation in making the DRG’s for Diarrhea/GastroEnteritis illness in Tangerang Public Hospital. The focus us on the diarrhea disease, since it is still one of the major disease for babbies and children in Indonesia. It is predicted that the number of these patients will be around 150-430 every 1000 people annually. According to WHO (1999), 12 millions children below the age of five all over the world died because of this disease. From the mortality rate, 70% died of ISPA (upper respiratory tract), diarrhea, malaria, measles, and malnutrition and oftentimes is the complication of all diseases. And also in Tangerang Public Hospital, diarrhea/GE cases between 2000 until 2004 ranked at number one of the the tenth most diseases in in-patient installation, Tangerang Public Hospital. The methode is quantitative, descriptive, using all patients as the population with the indication of diarrhea with or without difficulties and complications from January 2004 to December 2004. The sample is children. The data is taken from the medical record department and for the unit cost on dirrhea treatment is gathered from the accounting department and from other related departments in Tangerang Pubilc Hospital. The study reveals that LOS (length of stay) of diarrhea/GE with no complications is two days with the total cost Rp. 454.401, LOS (length of stay) of diarrhea/GE with complications is for days with the total cost Rp. 827.195. LOS (length of stay) of diarrhea/GE with difficulties is six days with the total cost Rp. 1.310.088, LOS (length of stay) of diarrhea/GE with complications and difficulties is for nine days with the total cost Rp. 1.727.192. So, the group of diarrhea disease/GastroEnteritis based on Tangerang Public Hospital’s DRG can be done, that is by grouping diarrhea disease, into MDC 6 with DRG G68A dan DRG G68B. Based on the results, it is recommended that the hospital should make a concise, clear diagnosis report before undergoing DRG’s and a complete DRG’s standard operating procedure. Indexing : 35 (1986 – 2005)
Penelitian ini menggunakan metode penelitian kualitatif (analitik observasional) untuk melihat alur pelayanan resep obat dan mengidentifikasi pemborosan pelayanan resep obat. Dan didukung oleh penelitian kuantitatif (analisis deskriptif) untuk memperoleh data perhitungan waktu setiap tahapan proses pelayanan resep obat.
Berdasarkan hasil penelitian diketahui rata-rata waktu tunggu pelayanan resep obat non racikan selama 89.6 menit (88.17% kegiatan menunggu) dan 124.70 menit (82.10% kegiatan menunggu) pada pelayanan resep obat racikan.
Hasil penelitian mengidentifikasi bahwa terdapat 8 jenis pemborosan (DOWNTIME) pada pelayanan resep obat. Usulan perbaikan dengan metode lean diharapkan dapat menurunkan waktu tunggu menjadi 66.67% pada pelayanan resep obat non racikan dan 56.67% pada pelayanan resep obat racikan.
Kata kunci : farmasi; metode lean; pemborosan; waktu tunggu
Long waiting times on prescription services will reduce patient satisfaction and lead to inefficient services. Lean is one of the methodologies that can be used to deal with inefficiencies in health services. This study aims to analyze the application of lean method in reducing waiting time of outpatient prescription services at Pasar Minggu public hospital in 2017.
This study used qualitative research methods (observational analytics) to examine the flow and identify waste of prescription drug services. And also supported by quantitative research (descriptive analysis) to get the exact calculation of every step of prescription drug services.
Based on the result of the research, it is known that the average waiting time of medicine prescription services is 89.6 minutes (88.17% waiting activity) and 124.70 minutes (82.10% waiting activity) of personalized medicine prescription services.
The study identified that there were 8 types of waste (DOWNTIME) in prescription services. The future improvement by lean method is expected to reduce waiting time to 66.67% on medicine prescription services and 56.67% on personalized medicine prescription services.
Keywords : pharmacy; lean methode; waste; waiting times
ABSTRAK Nama : Ainurinsan Amaludin Program Studi : Kajian Administrasi Rumah Sakit Judul : Efisiensi Pengadaan dan Penyimpanan Obat dalam Penyusunan Rencana Pengadaan Obat di RSUD Pasar Minggu Masalah terkait pengadaan obat di rumah sakit kerapkali terjadi, tidak terkecuali di RSUD Pasar Minggu. Masalah pengadaan obat yang sering terjadi di RSUD Pasar Minggu adalah peningkatan anggaran obat, seringnya terjadi kekosongan stok obat, dan lead time pengadaan obat yang relatif lama. Oleh karena itu, diperlukan upaya efisiensi pengadaan dan penyimpanan obat dalam penyusunan rencana kebutuhan obat untuk memperlancar kegiatan operasional dan meningkatkan mutu pelayanan kesehatan. Bentuk penelitian ini adalah riset operasional dengan metode kualitatif dan kuantitatif untuk menyusun upaya efisiensi baik dari pendekatan farmasi dan non farmasi. Pendekatan farmasi dilakukan dengan mengelompokkan obat menurut Analisis ABC nilai investasi kemudian membandingkan beberapa model inventori demi mendapatkan model dengan total biaya pengadaan dan penyimpanan obat terkecil, sementara pendekatan non farmasi melalui upaya manajemen formularium. Hasil Analisis ABC nilai investasi menunjukkan bahwa terdapat 34 jumlah obat kelompok A yang menjadi fokus utama efisiensi pengendalian biaya obat. Obat kelompok A tersebut kemudian dihitung perencanaan kebutuhannya dengan menggunakan model inventori Economic Order Quantity (EOQ) untuk menghasilkan perhitungan total biaya pengadaan dan penyimpanan obat (TIC) terkecil. Untuk mengantisipasi kejadian kekosongan stok obat dilakukan dengen menentukan nilai safety stock yang mempertimbangkan jumlah pemakaian dan lead time masing – masing obat. Kata kunci: Analisis ABC; Efisiensi; EOQ; TIC.
ABSTRACT Name : Ainurinsan Amaludin Program of Study : Hospital Administration Study Title : Medication Procurement and Inventory Efficiency in Planning Medication Procurement in RSUD Pasar Minggu Problems related to procuring medication often occur in hospital, including in RSUD Pasar Minggu. The problems involved are increased medication budget, the frequent occurrence of out of stock medication, and relatively long medication procurement lead time. Therefore, it is necessary to determine efforts to maximize efficiency in medication procurement and inventory in planning medication needs so that operational activities can be reinforced and the quality of health service can be improved. This is an operational research with qualitative and quantitative method to establish efficiency efforts both from pharmaceutical and nonpharmaceutical approaches. Pharmaceutical approach involves doing ABC Analysis to group the medication based on its investment values. Then, three inventory models will be compared to get the model with the lowest total inventory cost (TIC). Meanwhile, nonpharmaceutical approach is done by formulary management efforts. ABC Analysis of investment value indicates that group A medication consist of 34 items. Those items become the main focus of medication cost containment. The medication needs for group A are then calculated by Economic Order Quantity (EOQ) model to generate the lowest TIC. In addition, safety stock calculation that determines not only the demand of the medication but also the procurement lead time of each drug is vital to anticipate the occurrence of out of stock medication. Keywords: ABC Analysis; Efficiency; EOQ; TIC.
