Analisis Perbedaan Sebelum dan Sesudah Penerapan Aplikasi Lean Hospital Berdasarkan Lead Time Dan Volume Berkas Pelayanan Rekam Medis bagi Pasien Peserta Jaminan Kesehatan Nasional Kartu Indonesia Sehat di Rumah Sakit Keluarga Sehat Kebupaten Pati

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2017 ABSTRAK Ahmad Syaifuddin Analisis Perbedaan Sebelum dan Sesudah Penerapan Aplikasi Lean Hospital Berdasarkan Lead Time Dan Volume Berkas Pelayanan Rekam Medis bagi Pasien Peserta Jaminan Kesehatan Nasional Kartu Indonesia Sehat di Rumah Sakit Keluarga Sehat Kebupaten Pati xiv + halaman + 16 tabel + 8 gambar + 2 lampiran Peningkatan jumlah kunjungan pasien JKN-KIS membuat beban peningkatan jumlah pelayanan rekam medis yang berdampak pada keterlambatan dalam melakukan proses klaim ke BPJS Kesehatan. Upaya perbaikan layanan dengan mempercepat proses klaim dapat dilakukan dengan menggunakan metode lean hospital. Penelitian ini menggunakan metode mixed method berupa purposive sampling dan focus group discussion (FGD). Penelitian membandingkan lead time, value activity, non necessary value activity dan waste sebelum dan sesudah penerapan aplikasi lean hospital di instalasi rekam medis RS Keluarga Sehat Pati. Metode kuantitatif dibuat dengan membandingkan lead time setiap bagian dalam pengerjaan rekam medis berupa assembling, coding dan analyzing dan mencari perbedaan value activity, non necessary value activity dan waste disetiap bagian tersebut. Hasil penelitian menunjukan perbedaan rerata waktu penyelesain sesudah dilakukan aplikasi lean hospital dibagian assembling sebesar 123,86 detik, dibagian coding sebesar 14,79 detik, dan dibagian analyzing sebesar 201,35 detik. Uji Wilcoxon-signed ranks test didapatkan hasil Signifikansi sebesar 0.000 < 0.05, maka terdapat perbedaan lead time rekam medis pasien BPJS kesehatan antara sebelum dan sesudah penerapan aplikasi lean hospital pada pelayanan rekam medis. Hasil perhitungan VAA (Value activityAssesment) untuk alur proses asembling sebelum penerapan lean memperlihatkan komposisi value activitydibanding non necessary value activity dibanding waste sebesar 42% : 8%.: 50%. Setelah penerapan lean memperlihatkan sebesar 80% : 20% : 0%. Bagian coding didapatkan hasil sebelum penerapan lean memperlihatkan value activity dibanding non necessary value activity dibanding waste sebesar 40% : 20%.: 40%. Setelah penerapan lean memperlihatkan sebesar 67% : 33% : 0%. Bagian analyzing didapatkan hasil sebelum penerapan lean memperlihatkan value activity dibanding non necessary value activity dibanding waste sebesar 43% : 14%: 43%. Setelah penerapan lean memperlihatkan sebesar 75% : 25% : 0%. Aplikasi lean hospital dapat membantumeningkatkat lead time dan perubahan value pada pekerjaan di rekam medis. Kata kunci : Lean Hospital, Lead Time, JKN Kepustakaan : 34 (1996-2014)Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2017 ABSTRACT Ahmad Syaifuddin Analysis of the Difference between Before and After Applying Lean Hospital Application based on a Lead Time and Volume of Documents of Medical Record Services for Patients of National Health Insurance Members of Healthy Indonesia Card at Healthy Family Hospital in Pati Regency xiv + pages + 16 tables + 8 figures + 2 appendices The increase of visit number of patients of National Health Insurance (NHI) Members of Healthy Indonesia Card (HIC) led to increase a number of medical record services that affected to lateness in claiming to Health Social Insurance Agency (HSIA). The efforts of service improvements were made by expediting a claim process using a method of a lean hospital. This was a mixed method using purposive sampling and focus group discussion (FGD). This study compared a lead time, value activity, non-necessary value activity, and waste before and after applying lean hospital application at a medical record installation of a Healthy Family Hospital in Pati Regency. A qualitative method was used by comparing a lead time in each part of medical record service like assembling, coding, and analysing and by finding the differences between value activity, non-necessary value activity, and waste in these parts. The results of this research showed that mean time differences for accomplishing after applying the lean hospital application at the assembling, coding, and analysing departments respectively were 123.86 seconds, 14.79 seconds, and 201.35 seconds. The results of a Wilcoxon-signed ranks test demonstrated that there was any significant difference in the lead time of medical record between before and after applying the lean hospital application at medical record services (p=0.000 < 0.05). The results of calculating Value Activity Assessment (VAA) for the process flow of assembling before applying the lean hospital application showed comparisons of compositions between value activity, non-necessary value activity, and waste respectively were 42%: 8%: 50%. In contrast, after applying the application, these composition changed to be 80%: 20%: 0% respectively. At the coding department, comparisons of compositions between value activity, non-necessary value activity, and waste before applying the application respectively were 40%: 20%: 40%. In contrast, after applying the application, these composition changed to be 67%: 33%: 0%. At the analysing department, comparisons of compositions between value activity, non-necessary value activity, and waste before applying the application respectively were 43%: 14%: 43% whereas after applying the application, they changed to be 75%: 25%: 0%. The lean hospital application could improve the lead time and change values on the jobs at the medical record unit. Keywords : Lean Hospital, Lead Time, NHI Bibliography: 34 (1996-2014)