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"[ABSTRAKLangkah awal memperbaiki mutu dan meningkatkan pelayanan laboratorium RS.Masmitra adalah melalui metode Lean yang bertujuan meciptakan value dengancara mengurangi kesalahan dan waktu tungguPenelitian analitik dengan metode kualitatif dengan cara observasi, wawancaradan telaah data bertujuan menganalisis alur proses pelayanan laboratorium pasienUGD RS. Masmitra dan membuat usulan rancangan perbaikan setelahmenerapkan konsep Lean ThinkingPada Current State Value Stream Map didapati 39% kegiatan non value-addedserta 7 jenis waste dalam proses pelayanan laboratorium pasien UGD sertamelalui penerapan Lean Tools diciptakan ide-ide perbaikan dalam bentuk FutureState Value Stream Map dimana hanya terdapat 9% kegiatan non value-addedpada proses tersebut. Oleh karena itu, penerapan konsep lean thinking sangatlahtepat untuk meningkatkan kualitas pelayanan laboratorium RS.Masmitra.

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ABSTRACTInitial steps to improve the quality and enhance the hospital laboratory service atMasmitra Hospital is through Lean methods which aimed then to create value byreducing errors and waiting time.Analytical Study with qualitative methods by taking observation, interviews anddocuments analysis which aims to analyze the process flow of the ED patientlaboratory service at Masmitra Hospital and creating the improvement afterapplying the concept of Lean ThinkingOn the Current State Value Stream Map found 39 % of non value-added activitiesas well as 7 different types of waste in the process of ER patients and laboratoryservices through the application of Lean Tools which has created improvementideas in the form of Future State Value Stream Map where there are only 9 % ofnon value- added activities to the process. Therefore , the application of theconcept of lean thinking is appropriate to improve the quality of laboratoryservices at Masmitra Hospital.;Initial steps to improve the quality and enhance the hospital laboratory service atMasmitra Hospital is through Lean methods which aimed then to create value byreducing errors and waiting time.Analytical Study with qualitative methods by taking observation, interviews anddocuments analysis which aims to analyze the process flow of the ED patientlaboratory service at Masmitra Hospital and creating the improvement afterapplying the concept of Lean ThinkingOn the Current State Value Stream Map found 39 % of non value-added activitiesas well as 7 different types of waste in the process of ER patients and laboratoryservices through the application of Lean Tools which has created improvementideas in the form of Future State Value Stream Map where there are only 9 % ofnon value- added activities to the process. Therefore , the application of theconcept of lean thinking is appropriate to improve the quality of laboratoryservices at Masmitra Hospital., Initial steps to improve the quality and enhance the hospital laboratory service atMasmitra Hospital is through Lean methods which aimed then to create value byreducing errors and waiting time.Analytical Study with qualitative methods by taking observation, interviews anddocuments analysis which aims to analyze the process flow of the ED patientlaboratory service at Masmitra Hospital and creating the improvement afterapplying the concept of Lean ThinkingOn the Current State Value Stream Map found 39 % of non value-added activitiesas well as 7 different types of waste in the process of ER patients and laboratoryservices through the application of Lean Tools which has created improvementideas in the form of Future State Value Stream Map where there are only 9 % ofnon value- added activities to the process. Therefore , the application of theconcept of lean thinking is appropriate to improve the quality of laboratoryservices at Masmitra Hospital.]"

"Proses pemulangan pasien di Rumah Sakit Masmitra saat ini masih belum optimal, oleh karena belum ada alur yang menggambarkan proses pemulangan pasien secara menyeluruh. Dengan mengaplikasikan Konsep Lean, dilakukan pemetaan aliran nilai kondisi sekarang (Value Stream Map) yang menunjukkan bahwa pada proses pemulangan pasien terdapat 41 kegiatan dan hanya 51 % bersifat Value Added, dan tentu saja mempunyai implikasi adanya pemborosan. Dari hasil analisis akar masalah diperoleh ide-ide perbaikan, kemudian dilakukan desain ulang kedalam alur proses baru yang dianggap ideal menghasilkan total hanya 17 kegiatan, 83 % diantaranya bersifat Value Added. Dengan diterapkannya Konsep Lean di RS Masmitra, diharapkan efisiensi juga akan terjadi bila pekerjaan dilakukan sesuai dengan apa yang dibutuhkan oleh pasien, tepat waktu, tepat ukuran dan tepat sasaran.

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The process discharge of patients in hospital Masmitra is still not optimal, because there is no groove that describes the process of returning the patient as a whole. By applying the concept of Lean, value stream mapping current conditions which shows that the process of returning patients there were 41 activities and only 51% are value added, and of course has implications for wastage. From the analysis of the root causes of acquired ideas repair, and then carried into the re-design of the new process flow is considered ideal to produce a total of only 17 activities, 83% of which is value added. With the implementation of Lean Concept in RS Masmitra, expected efficiency will also occur when the work is done in accordance with what is required by the patient, right time, the right size and right on target."

"Economics is one of social subjects learnt by vocational high school students.Therefore , cooperative integrated reading and composition (CJRC) could improve the students learning result at the second grade TN 1 SMK negeri 1 Padang panjang."

"Penundaan pada proses pemulangan pasien berkaitan dengan ketersediaan jumlah tempat tidur pada pasien yang akan masuk dirawat inap. Hal ini mengakibatkan pelayanan menjadi tidak efisien. Metode Lean merupakan suatu metode yang diharapkan dapat meningkatkan efisiensi pada proses pemulangan pasien rawat inap. Penelitian kualitatif dengan menggunakan prinsip Lean thinking untuk menggambarkan alur proses pemulangan pasien, menghitung Lead time dan Cycle Time, dan menganalisis waste yang terjadi. Hasil penelitian menunjukkan waktu rata-rata yang diperlukan untuk pasien metode pembayaran BPJS sebesar 153,5 menit, Cash sebesar 127 menit , dan asuransi sebesar 264 menit. Total persentase non value added activity pada proses pemulangan pasien dengan metode pembayaran BPJS sebesar 76,4%, cash sebesar 72,4%, dan asuransi sebesar 84,1%. Usulan perbaikan dengan metode Lean dapat menurunka persentase non value added activity menjadi sebesar 56,6% untuk pasien BPJS, 46,6% untuk pasien cash, dan 56,8% untuk pasien asuransi.

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Delays in the process of discharge related to the availability of the number of beds for patients who are going to be hospitalized. This resulted inefficiency of services. Lean method is a method that is expected to improve efficiency in the process of discharge process. A qualitative study using the principles of lean thinking to describe the process of discharge flow, calculate the lead time and cycle time, and analyze the waste that occurs.

The results show the average time required for patient used BPJS payment method is 153.5 minutes, cash is 127 minutes, and insurance is 264 minutes. The total percentage of non-value added activity in the process of discharge process with BPJS payment method is 76.4%, cash is 72.4%, and insurance is 84.1%. Suggestions for improvements with lean methods can reduce the percentage of non-value added activity by 56.6% for BPJS patients, 46.6% for cash patients, and 56.8% for insured patients."

"[ABSTRAKRumah Sakit Ibu dan Anak Ummi (RSIA Ummi) memiliki pelayanan unggulan pada poliklinik kandungan. Jumlah kunjungan pada poliklinik kandungan RSIA Ummi terus meningkat setiap tahunnya. Peningkatan jumlah pasien menyebabkan waktu tunggu pelayanan menjadi semakin lama, ditambah alur proses pelayanan yang kompleks menimbulkan kebingungan pada pasien. Penelitian ini menganalisis pelayanan poliklinik kandungan di Instalasi Rawat Jalan RSIA Ummi dengan Konsep Lean Thinking. Dengan menggunakan metode Lean Thinking memperlihatkan adanya non value added activity sebesar 86% dan value added activity sebesar 14%. Hal ini menunjukkan bahwa terdapat cukup banyak waste (pemborosan). Selain itu dari analisis fishbone diagram menunjukkan delapan akar masalah. Usulan ide perbaikan dibagi menjadi 3 tahap, yaitu jangka pendek, jangka menengah, dan jangka panjang, yang di dalamnya terdapat juga ide perbaikan untuk mengurangi waste (pemborosan) dan membuat aliran proses menjadi lebih efektif dan efisien.ABSTRACTMother and Child Hospital (RSIA) Ummi has a superior service at the obstetric and Gynecology polyclinic. The visitation number of the obstetric and Gynecology polyclinic in RSIA Ummi keep increasing every year. The increasing number of patients makes the waiting time services become longer. Beside that, the complex service flowchart causes confusion for patients. This research analyzes the content of polyclinic service at the Outpatient Installation RSIA Ummi with Lean Thinking Concept. By using Lean Thinking showed non-value added activity by 86% and value added activity by 14%. This shows that there are quite a lot of wastes. Addition of fishbone diagram analysis showed that there are eight roots of the problem. The writer proposed ideas for improvement that are divided into three stages, namely short term, medium term and long term, in which there is also the idea to reduce waste and to make the service flowchart becomes more effective and efficient.;Mother and Child Hospital (RSIA) Ummi has a superior service at the obstetric and Gynecology polyclinic. The visitation number of the obstetric and Gynecology polyclinic in RSIA Ummi keep increasing every year. The increasing number of patients makes the waiting time services become longer. Beside that, the complex service flowchart causes confusion for patients. This research analyzes the content of polyclinic service at the Outpatient Installation RSIA Ummi with Lean Thinking Concept. By using Lean Thinking showed non-value added activity by 86% and value added activity by 14%. This shows that there are quite a lot of wastes. Addition of fishbone diagram analysis showed that there are eight roots of the problem. The writer proposed ideas for improvement that are divided into three stages, namely short term, medium term and long term, in which there is also the idea to reduce waste and to make the service flowchart becomes more effective and efficient., Mother and Child Hospital (RSIA) Ummi has a superior service at the obstetric and Gynecology polyclinic. The visitation number of the obstetric and Gynecology polyclinic in RSIA Ummi keep increasing every year. The increasing number of patients makes the waiting time services become longer. Beside that, the complex service flowchart causes confusion for patients. This research analyzes the content of polyclinic service at the Outpatient Installation RSIA Ummi with Lean Thinking Concept. By using Lean Thinking showed non-value added activity by 86% and value added activity by 14%. This shows that there are quite a lot of wastes. Addition of fishbone diagram analysis showed that there are eight roots of the problem. The writer proposed ideas for improvement that are divided into three stages, namely short term, medium term and long term, in which there is also the idea to reduce waste and to make the service flowchart becomes more effective and efficient.]"

"Penelitian ini menggunakan metode Narrative Review tentang analisis konsep Lean Thinking terhadap perbaikan waktu tunggu pelayanan pasien Instalasi Rawat Jalan Rumah Sakit di Indonesia. Tujuan penelitian ini adalah untuk mengetahui gambaran implementasi konsep Lean Thinking dalam mengatasi waktu tunggu pelayanan pasien Instalasi Rawat Jalan Rumah Sakit. Agar memperoleh literatur layak uji, peneliti menggunakan pedoman PRISMA. Peneliti mendapatkan 12 literatur dengan metode penelitian kualitatif dan kuantitatif. Hasil penelitian menyimpulkan bahwa konsep Lean dapat membuktikan proses pelayanan rawat jalan Rumah Sakit di Indonesia masih belum Lean. Terdapat 7 literatur yang menunjukkan bahwa Lean efektif mengurangi lama waktu tunggu pelayanan pasien rawat jalan di Rumah Sakit dibuktikan dengan mengadopsi prinsip utama Lean, yaitu Standardize work dan Heijunka. Agar tercapai kondisi Lean, Rumah Sakit harus menyelaraskan implementasi antara 5 prinsip Lean (Customer value, value stream, flow, pull, perfection) dengan budaya organisasi, pola pikir, metode Lean, membudayakan 5 S, dengan melibatkan seluruh pihak di Rumah Sakit untuk menyelesaikan masalah secara konsisten dan berkesinambungan.

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This study uses the Narrative Review method concerning the analysis of the Lean Thinking concept towards improving the waiting time for patient services in the Outpatient Hospital in Indonesia. The purpose of this study was to describe the implementation of the Lean Thinking concept in overcoming the waiting time for patient services in the Hospital Outpatient Installation. In order to obtain test-worthy literature, researchers used the PRISMA guidelines. The researcher obtained 12 literatures using qualitative and quantitative research methods. The results of the study conclude that the Lean concept can prove that the outpatient service process of hospitals in Indonesia is still not Lean. There are 7 literatures that show that Lean is effective in reducing the waiting time of outpatient services at the hospital as evidenced by adopting Lean's main principles, namely Standardize work and Heijunka. In order to achieve the Lean condition, the Hospital must align the implementation of the 5 Lean principles (customer value, value stream, flow, pull, perfection) with organizational culture, mindset, Lean method, cultivate the 5 S, by involving all parties in the hospital to solve problems consistently and continuously."

"Penelitian ini membahas pengaruh konsep diri mahasiswa reguler angkatan 2008 Universitas Indonesia terhadap kecemasan yang dirasakan ketika berbicara di depan umum selama mereka belajar di UI. UI sedang menerapkan program pengembangan proses pembeIajaran berorientasi learner centered yang dikenal dengan nama Program Dasar Pendidikan Tinggi (PDPT). Program ini menginisiasi mahasiswa belajar secara aktif dan mandiri, salah satunya dengan sering menyampaikan pendapat atau presentasi di depart kelas. Penelitian ini adalah penelitian kuantitatif dengan desain deskripfif koreIasi pada 96 responden mahasiswa. Hasil penelitian ini menunjukkan adanya hubungan antara konsep diri dengan kecemasan berbicara di depan urnum pada mahasiswa reguler angkatan 2008 Universitas Indonesia (p value = 0,045 dan α = 0,05). Peneliti secara khusus menyarankan mahasiswa agar lebih mernperhatikan kualitas konsep dirinya dalarn upaya mengurangi kecemasan demi tercapainya tujuan utama berbicara di depan umum.

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The focus of this research is self concept of regular college students in University of Indonesia that affect public speaking anxiety during they study in university. University of Indonesia is applying development program of study process orientate to learner centered or 'Program Dasar Pendidikan Tinggi (PDPT)'. This program initiates students to team actively and autonomous, one of the strategies is by explaining an opinion or taking presentation in front of class.

This research shows the positive correlation between self concept and public speaking anxiety at regular college student 2008 in University of Indonesia (p value = 0,045 and α = 0,05). The researcher suggests especially for the college students that they should pay attention to the quality of their self concept in order to decrease the anxiety and to achieve the main goal of their public speaking."

"Konsep diri merupakan cara pandang seseorang mengenai dirinya sendiri. Motivasi untuk rneraih rnasa depan merupakan suatu dorongan dari dalam atau luar dirinya sendiri yang mengarahkan seseorang untuk bertingkah laku dengan tujuan meraih impian. Penelitian ini bertujuan untuk mengetahui hubungan antara konsep diri anak jalanan usia remaja dan motivasi untuk meraih masa depan. Metodologi yang digunakan dalam penelitian ini adalah deskriptif korelasi. Sampel penelitian ini benjumlah 134 responden yang merupakan anak jalanan di Terminal Depok yang berusia 15-18 tahun dan bersekolah di Sekolah Masjid Terminal Depok yang dipilih secara random sampling. Pengumpulan data dilakukan dengan menggunakan lembar kuesioner mengenai konsep diri dan motivasi untuk meraih masa depan. Untuk mengukur konsep diri digunakan Tennessee Self Concept Scale yang telah dimodiiikasi, sedangkan untuk rnengukur motivasi untuk meraih masa depan digunakan kuesioner yang telah dibuat sendiri oleh peneliti. Data yang terkumpul dianalisis dengan menggunakan uji Chi-Square. Hasil penelitian menunjukkan bahwa ada hubungan yang bermakna antara konsep diri dan motivasi untuk meraih masa depan pada anak jalanan usia remaja di Terminal Depok (alpha = 0,05; p value = 0,000; dan OR = 9,646).

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Self-concept is the individual perspective to describe their own self. Motivation to achieve the fiiture is a force either from the outside or inside of individual itself leading them to behave and its purpose is to fulfill their dreams. The purpose of this research is to know the correlation between self-concept and motivation to achieve the future on adolescence street children at Terminal Depok. The methodology that being used in this research is descriptive correlation. The total amount of the sample of this research is 134 respondents that are adolescence street children at Tenninal Depok which age around 15 through 18 years old and they go to school at Sekolah Masjid Terminal Depok, they were being chosen by random sampling. The data was collected by using a questionnaire sheet about self concept and motivation to achieve the future. To measure self concept, researchers used Tennessee Self Concept Scale that has been modified. Besides that, to measure motivation to achieve the future, researchers used the questionnaire that made by ourselves. The collected data is being analyzed by using Chi-Square test. The results of this research showed that there was a significant correlation between self-concept and motivation to achieve the future on adolescence street children at Tenninal Depok (alpha = 0,05; p value = 0,000; and OR = 9,646)."

"Self-esteem merupakan keseluruhan cara yang digunakan untuk menilai diri atau penilaian pribadi mengenai kelayakan yang diungkapkan dalam sikap individu terhadap diri sendiri. Ketika individu memiliki nilai self-esteem yang rendah, ini menunjukkan bahwa individu memiliki perasaan tidak berharga dan rendah diri yang biasa disebut dengan harga diri rendah kronik. Penulisan karya ilmiah akhir ners ini bertujuan untuk mengetahui efektivitas penerapan expressive writing dalam meningkatkan self-esteem pada Ny. I (37 tahun) dengan masalah keperawatan harga diri rendah kronik dan diagnosis medis skizofrenia. Terapi yang diberikan adalah terapi generalis dengan memasukkan latihan expressive writing kedalam kegiatan yang dapat dilatih sehari-hari. Expressive writing merupakan salah satu teknik intervensi yang digunakan dalam dunia kesehatan jiwa. Dengan latihan expressive writing individu dapat mengeksplorasi pemikiran melalui tulisan, kemudian menerjemahkan peristiwa yang terjadi disekitar dalam kata-kata yang dirangkai sendiri sehingga individu tersebut dapat memahami pemikiran aslinya mengenai kejadian yang traumatis dan emosional dalam hidupnya. Hasil dari karya ilmiah ini menunjukkan bahwa klien mengalami penurunan tanda gejala harga diri rendah dan meningkatkan nilai self-esteem dirinya setelah mencapai semua kriteria evaluasi pada expressive writing. Terapi expressive writing diharapkan dapat menjadi intervensi pada asuhan keperawatan jiwa khususnya pada pasien dengan harga diri rendah kronik dan dapat meningkatkan mutu pelayanan asuhan keperawatan.

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Self-esteem is the overall way used to assess oneself or personal judgments about the worthiness expressed in an individual's attitude towards oneself. When the individual has a low self-esteem value, this indicates that the individual has feelings of worthlessness and low self-esteem which is commonly referred to as chronic low self-esteem. The purpose of writing this final scientific paper for nurses is to determine the effectiveness of implementing expressive writing in increasing self-esteem in Ny. I (37 years old) with chronic low self-esteem nursing problems and a medical diagnosis of schizophrenia. The therapy given is generalist therapy by incorporating expressive writing exercises into activities that can be trained daily. Expressive writing is one of the intervention techniques used in mental health. With expressive writing exercises, individuals can explore thoughts through writing, then translate events that occur around them in their own words so that the individual can understand his original thoughts about traumatic and emotional events in his life. The results of this scientific work indicate that the client experiences a decrease in symptoms of low self-esteem and increases his self- esteem value after achieving all the evaluation criteria in expressive writing. Expressive writing therapy is expected to be an intervention in mental nursing care, especially in patients with chronic low self-esteem and can improve the quality of nursing care services."