Analisis Waste Pelayanan Farmasi Rawat Jalan dengan Model Lean Hospital Di RS.Panti Rahayu Purwodadi Grobogan

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2016 ABSTRAK Feri Sovia Ersani Analisis Waste Pelayanan Farmasi Rawat Jalan dengan Model Lean Hospital Di RS.Panti Rahayu Purwodadi Grobogan xviii + 112 halaman + 15 tabel + 11 gambar + 16 lampiran Instalasi Farmasi Rawat Jalan RS Panti Rahayu Purwodadi dalam pencapaian sasaran mutu pelayanan tentang respon time dan ketepatan pemberian obat berturut-turut dari tahun 2011 sampai 2014 tidak dapat mencapai target yang ditetapkan (77,9% dari 100% target). Hasil angket kepuasan pasien untuk kecepatan pelayanan hanya 9 % yang menyatakan pelayanan sudah cepat. Penelitian ini bertujuan menggunakan pendekatan lean hospital untuk mengidentifikasi waste dari proses pelayanan kepada customer serta menganalisis sebagai acuan pembenahan proses pelayanan yang difokuskan kepada farmasi rawat jalan RS Panti Rahayu Purwodadi. Penelitian ini menggunakan menggunakan 5 langkah dalam lean hospital yaitu identifikasi value customer, menentukan current state value stream mapping (CSVSM), eliminasi waste, menstandarisasi proses baru dengan future state value stream mapping (FSVSM) dan continuous improvement. Data CSVSM dengan observasi partisipatif dan wawancara serta penentuan waste kritis dengan scoring dan akar penyebab waste kritis dengan RCA melalui Focused Group Discussion (FGD) dengan peserta seluruh petugas farmasi rawat jalan. Analisis data dilakukan dengan analisis model interaktif yaitu dengan reduksi data, penyajian data dan menarik kesimpulan atau verifikasi. Hasil penelitian menunjukkan bahwa perbandingan aktivitas value added terhadap non value added(waste) di farmasi rawat jalan adalah 45% : 55% untuk pelayanan resep non racikan dan 46% : 54% untuk pelayanan resep racikan sehingga dapat dikatakan bahwa pelayanan farmasi rawat jalan belum dalam keadaan lean. Waste yang sering terjadi dalam pelayanan farmasi rawat jalan adalah waste motion dengan skor 8, waste transportation dengan skor 8 dan waste inventory dengan skor 4. Saran sesuai hasil FSVSM diberikan untuk memperbaiki pelayanan farmasi rawat jalan. Rekomendasi penelitian agar rumah sakit jika masih memungkinkan untuk mendesain ulang letak gudang farmasi dan ruang farmasi rawat jalan, mendesain ulang penataan prasarana penyimpanan obat, cara pembuatan etiket dengan komputer, pembuatan sistem antrian, perbaikan sistem persediaan obat dan yang paling utama adalah membentuk SDM agar mempunyai mental lean yaitu mempunyai karakter untuk selalu mendahulukan value pasien dalam setiap melakukan proses pelayanannya. Kata kunci : Waste, Lean hospital, Value Stream Mapping Kepustakaan : 41 (1996 -2014) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2016 ABSTRACT Feri Sovia Ersani Waste Analysis of Outpatient Pharmacy Service using a Model of Lean Hospital at Panti Rahayu Hospital of Purwodadi in Grobogan xviii + 112 pages + 15 tables + 11 figures + 16 appendices Installation of Outpatient Pharmacy at Panti Rahayu Hospital at Purwodadi had not achieved determined targets of response time (77.9%) and accurateness in providing medicine (100%) during the period of 2011 – 2014. A preliminary study showed that there was only 9% of patients felt satisfied with response time. The aim of this study was to identify and to analyse waste resulted from a service process to a customer using lean hospital approach as a reference to improve a service process focussing on outpatient pharmacy at Panti Rahayu Hospital at Purwodadi. This study used five steps of lean hospital namely identifying value customer, determining current state value stream mapping (CSVSM), eliminating waste, standardising a new process with future state value stream mapping (FSVSM) and continuous improvement. Data of CSVSM were collected using participative observation and interview. Determination of critical waste used a score. Meanwhile, determination of a cause of critical waste used RCA through conducting Focus Group Discussion (FGD) followed by all outpatient pharmacy officers. Data were analysed using an interactive model analysis, namely data reduction, data display, and conclusion drawing or verification. The results of this research showed that an activity comparison between value added and non-value added (waste) was 45%:55%. Meanwhile, an activity comparison between non-compounded and compounded prescriptions was 46%:54% respectively. It means that outpatient pharmacy service was not lean. Aspects of waste that often occurred in the outpatient pharmacy service were as follows: waste motion (score=8), waste transportation (score=8), and waste inventory (score=4). Provided suggestions were based on the results of FSVSM to improve the service. The hospital needs to redesign a location of a pharmacy warehouse, an outpatient pharmacy room, means of medicine storage, a method of making e-ticket using a computer, a method of queuing system, and improvement of medicine inventory system. The most important thing is development of human resource in order to have a mental of lean that has a character to prioritise patients’ value in each provided service. Keywords : Waste, Lean Hospital, Value Stream Mapping Bibliography : 41 (1996-2014)