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"Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) yang cepat dan tepat sesuai standar waktu response time yang ditetapkan Kementerian Kesehatan Republik Indonesia, diharapkan dapat menurunkan angka kematian ibu dan angka kematian bayi. Dengan menggunakan metode lean, dapat dirumuskan upaya perbaikan untuk memperpendek waktu response time pada tindakan Seksio sesarea emergensi di RSUD dr. Doris Sylvanus Palangkaraya. Tujuan dari penelitian ini ialah mengetahui value stream mapping alur tindakan, mengidentifikasi kegiatan non value added, waste dan kegiatan value added pada setiap alur pelayanan serta merencanakan future state map alur tindakan Seksio sesarea emergensi. Penelitian ini menggunakan desain kualitatif dengan menggunakan metode lean melalui observasi dan telaah dokumen proses pelayanan dan juga wawancara kepada direksi, tim PONEK, pasien atau keluarga. Alur proses pelayanan PONEK di RSUD dr. Doris Sylvanus melibatkan sub unit terkait mulai dari triase sampai dimulainya tindakan di kamar operasi. Proses pelayanan yang terkait response time tindakan Seksio sesarea emergensi pada penelitian ini yaitu sejak penetapan keputusan tindakan, depo farmasi, BDRS/ PMI, kasir, transfer dan kamar operasi. Hasil penelitian ditemukan pada current state value streaming mapping tindakan seksio sesarea emergensi sebelum dan sesudah intervensi bahwa waktu yang digunakan untuk kegiatan non value added sebesar 41.17% menjadi 33,9% sedangkan kegiatan value added sebesar 58.83% menjadi 66,1% dengan total lead time 114,4 menit menjadi 49,2 menit sehingga masih diperlukan upaya perbaikan untuk memperpendek response time pelayanan PONEK di RSUD dr. Doris Sylvanus Palangkaraya.

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The Comprehensive Emergency Obstetrics and Newborn Care (CEmONC/PONEK) services are required to reduce maternal deaths and infant mortality in an easy and sufficient response time performance. Improving the response times in the behavior of caesarean sections at RSUD dr. Doris Sylvanus Palangkaraya by means, the lean method could be established in this research. The aims of this research are to determine the value stream mapping of the flow, value added activities, non-value added activities and waste in the flow of services, and to prepare the future map in PONEK 's unit of RSUD dr Doris Sylvanus for the operational flow. This research used a qualitative approach using lean methods, by reviewing and evaluating data, and by carrying out insightful interviews with PONEK management, the patient and the family, respectively. The PONEK services run by dr. Doris Sylvanus required few things to be considered such as triage, registration, midwife and doctor evaluation, assessments, acts, prescription, cashiers, transfers and operating rooms. Cesarean section response time systems at RSUD dr. Doris Sylvanus's PONEK facilities are based on some of the policy decisions on the pharmacy store, BDR/ PMI, cashier, relocation and surgical room. The results of this study showed that in the current state of the streaming value mapping, before and after intervention, 41.17% of the non valued added activities for the caesarean sections emergency have been used change to 33.9% while the value added activities were showed at 58.83 % change to 66.1% with the total lead time 114.4 minutes change to 49.2 minutes, so that appropriate steps were needed to shorten the caesarean sections response time mapping in PONEK service of dr. Doris Sylvanus Hospital, Palangkaraya."

"Laporan Penilaian Kinerja Badan Layanan Umum Daerah (BLUD) yang dikeluarkan oleh Badan Pengawasan Keuangan dan Pembangunan (BPKP) menunjukkan bahwa masih belum maksimalnya pengelolaan anggaran di RSUD dr. Doris Sylvanus. Pengajuan klaim kepada Badan Penyelenggara Jaminan Sosial (BPJS Kesehatan) dan piutang yang belum terbayar kan menjadi masalah pengelolaan keuangan di RSUD ini. Kondisi tersebut mendorong dilakukannya penelitian yang bertujuan untuk menganalisis proses pengelolaan anggaran dan kapasitas kelayakan pengelolaan keuangan di RSUD dr. Doris Sylvanus Palangka Raya, Kalimantan Tengah. Penelitian ini menggunakan konsep teori yang dikemukakan oleh Olander (2007) terkait Proses Anggaran dan Kapasitas Kelayakan Pengelolaan Keuangan. Pendekatan penelitian yang digunakan pada penelitian ini adalah pendekatan post-positivist dengan teknik pengumpulan data kualitatif melalui wawancara mendalam dan juga studi kepustakaan. Adapun hasil penelitian ini menunjukkan pengelolaan anggaran berjalan sesuai proses anggaran yang ada, meskipun begitu dalam pelaksanaannya masih terdapat tahapan pada proses yang terkendala seperti pada pencairan anggaran, sistem akuntansi dan sistem pelaporan serta evaluasi hasil audit dan pelaporan. Kapasitas Kelayakan pengelolaan keuangan telah terpenuhi kecuali pada bagian kuantitas sumber daya manusia yang masih harus dikaji lagi dan juga peraturan pemerintah perlu dilengkapi.

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The Performance Evaluation Report of the Regional Public Service Agency (BLUD) issued by the Financial and Development Supervisory Agency (BPKP) shows the management of the budget in RSUD dr. Doris Sylvanus is still not optimal. Claim submission to the Social Security Organizing Agency (BPJS Healthcare) and their unpaid debts are matter of financial management in dr. Doris Sylvanus Hospital. These conditions encourage the conduct of this study which aims to analyse the process of budget management and the capacity for financial management feasibility at RSUD dr. Doris Sylvanus Palangka Raya, Central Kalimantan. This study used a theoretical concept proposed by Olander (2007) about the budget process and financial management feasibility capacity. The study also used a post-positivist approach with qualitative data, collection techniques through in-depth interviews and also library research. The results of this study show the management of the budget runs according to the existing budget process, however in its implementation there are still stages in the process that are constrained by budget disbursement, accounting systems, as well as evaluation of audit and reporting results. The capacity for financial management Feasibility has been fulfilled, except in the quantity of human resources that still needs to be reviewed and also government regulations that need to be completed."

"RSUD dr Doris Sylvanus Palangkaraya melakukan implementasi SIMRS GOS 2 untuk meningkatkan efisiensi, efektifitas, dan kinerja. Penerimaan penggunaan SIMRS merupakan penentu dalam kesuksesan implementasi. Tenaga medis dan nakes merupakan pengguna SIMRS GOS 2 terbanyak di rumah sakit, sehingga dianggap perlu untuk menganalisis penerimaannya. Analisis penerimaan pengguna dilakukan berdasarkan Technology Acceptance Model (TAM) dalam penelitian kuantitatif berdesain cross sectional. Responden penelitian sebanyak 265 tenaga medis dan tenaga kesehatan RSUD dr Doris Sylvanus. Analisis dilakukan dengan uji univariat dan Structural Equation Model (SEM).Hasil penelitian didapatkan terdapat hubungan langsung yang positif dan terbukti secara statistik antara persepsi kemudahan dengan persepsi manfaat. Persepsi manfaat memiliki hubungan yang positif dengan sikap. Sikap memiliki hubungan positif dengan niat menggunakan. Niat menggunakan memiliki hubungan positif dengan penggunaan SIMRS GOS 2 secara nyata. Hubungan tidak langsung dan positif didapatkan antara persepsi manfaat dengan niat menggunakan melalui sikap.Tidak didapatkan hubungan langsung antara persepsi kemudahan dengan sikap, demikian pula antara persepsi manfaat dengan niat menggunakan SIMRS GOS 2 oleh para tenaga medis dan nakes di RSUD dr Doris Sylvanus.

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RSUD dr Doris Sylvanus Palangkaraya implemented SIMRS GOS 2 to improve efficiency, effectiveness, and performance. Acceptance of the use of SIMRS is decisive in successful implementation. Health workers are the most users of SIMRS GOS 2 in hospitals, so it is considered necessary to analyze their acceptance. User acceptance analysis was conducted based on the Technology Acceptance Model (TAM) in crosssectional quantitative research. The respondents of the study were 265 health workers of Dr. Doris Sylvanus Hospital. The analysis was carried out with univariate tests and the Structural Equation Model (SEM). The results of the study found that there was a positive and statistically proven direct relationship between the perception of convenience and the perception of benefits. The perception of benefits has a positive relationship with attitude. Attitude has a positive relationship with intent to use. The intention to use has a positive relationship with the real use of SIMRS GOS 2. An indirect and positive relationship is obtained between the perception of benefits and the intention to use through attitude. There is no direct relationship between the perception of convenience and attitude, as well as between the perception of benefits and the intention to use SIMRS GOS 2 by health workers at Dr. Dosir Sylvanus Hospital."

"Menghadapi persaingan usaha yang semakin ketat sekarang ini apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya berencana melakukan kiat-kiat bisnis yang tepat untuk menyiasatinya. Untuk itu dibuat suatu perencanaan strategik yang sejalan dengan visi, misi dan budaya perusahaan PT Kimia Farma sebagai perusahaan induk yang tertuang dalam Perencanaan strategik Apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya Tahun 2001-2004.Perencanaan strategik Apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya disusun dengan menggunakan metoda penelitian operasional (Operational Research) dengan pendekatan kualitatif melalui wawancara mendalam dan pendekatan kuantitatif dengan analisis runtun waktu (time series analisis).Tahap pertama dan perencanaan strategik ini adalah melakukan analisis faktor-faktor eksternal dan internal apotik (input stage). Analisis ini dilakukan oleh Consensus Decision Making (CDM) Group yang terdiri dari Apoteker Pengelola Apotik (APA) apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya, Apoteker Pengelola Apotik (APA) apotik Kimia Farma lain, pejabat struktural, serta staf senior kantor cabang PT Kimia Farma di Palangkaraya. Berikutnya dalam tahap kedua melakukan penyesuaian (matching) dengan metoda Internal-External Matrix (IE-Matrix), TOWS-Matrix dan BCG Matrix (matching stage). Pada tahap ketiga sebagai tahap terakhir melakukan pilihan strategi terbaik menggunakan matriks QSPM (decision stage).Analisis dengan IE-Matrix memperlihatkan apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya berada pada posisi kuadran V yang berarti apotik direkomendasikan untuk menerapkan strategi memelihara dan mempertahankan (hold and maintain) dengan strategi market penetration dan product development. Mempergunakan TOWS-Matrix apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya berada pada posisi kuadran II yaitu internal-fix-it-quadrant yang berarti apotik direkomendasikan untuk menerapkan strategi-strategi yang dua strategi diantaranya adalah strategi market development dan product development. Analisis menggunakan BCG-Matrix memperlihatkan posisi apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya berada pada kuadran I (stars) yang berarti menunjukkan keberhasilan apotik sebagi market leader dalam pasar obat generik dan obat generik berlogo.Mempertimbangkan hasil yang diperoleh dari analisis dengan mempergunakan IE Matrix, TOWS-Matrix dan BCG-Matrix, maka apotik apotik Kimia Farma di RSUD Dr Doris Sylvanus Palangkaraya akan mempergunakan strategi market penetration, market development dan product development dalam menjalankan bisnisnya dimasa-masa datang.Sosialisasi dan pelaksanaan perencanaan strategik ini sebaiknya segera dilakukan, juga dengan terus melakukan pemantauan dan evaluasi secara berkala (periodik) agar tetap sejalan dengan visi, misi dan tujuan jangka panjang yang telah ditetapkan.

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Strategic Planning of Kimia Farma Drugstore at Dr Doris Sylvanus Hospital Palangkaraya Year 2001-2004To face the competitive business which grows rapidly and strictly nowadays, Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya is planning to apply the best business strategy ini order to be able to struggle and compete in the business competition. Therefore, strategic planning should be arranged in accordance with the vision, mission, and culture of PT Kimia Farma as the holding company which can be seen in the strategic planning of Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya year 2001-2004. The strategic planning of Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya should be arranged by using the operational research with qualitative approach like indepth interview and quantitative approach such as time series analysis.The first stage of the strategic planning is the input stage which analyzes the external and internal factors. Such analysis is done by the consensus decision making group which consists of the managers' pharmacy of the Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya, managers' pharmacy of other the Kimia Farma Drugstore, structural staff; and senior staff of PT Kimia Farma branches in Palangkaraya. The next step is the matching stage using the Internal-External matrix (IE-Matrix) method, TOWS-Matrix and BCG-Matrix. The last step is the decision stage to choose the best strategy using the QSPM-Matrix.The IE-Matrix analysis shows that the position of Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya is at quadrant Y. It means that Kimia Farma Drugstore is recommended to apply the hold and maintain strategy using market penetration and product development strategy. Meanwhile, the use of TOWS-Matrix brought the Kimia Farina Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya to be at quadrant II or what so called internal-fix-it-quadrant which means that it is recommended to apply some strategies such as market development and product development strategy. On the other hand, use of BCG-Matrix analysis caused Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya to be at quadrant I which shows the success of that pharmacy as the market leader of generic medicine and generic medicine with logo.Considering the result taken from the analysis using IE-Matrix, TOWS-Matrix and BCG-Matrix, the Kimia Farma Drugstore at Dr. Doris Sylvanus Hospital Palangkaraya is going to apply the market penetration, market development and product development strategies in running its business in the future.The socialization and application of the strategic planning should be done right away, and also makes periodic monitoring and evaluation in order that it is always in accordance with the vision, mission and the long term target of the company."

"Menurut standar nasional, pelayanan obstetri harus mampu melakukan tindakan bedah sesar emergensi dalam waktu 30 menit dari keputusan dibuat (response time). Evaluasi pada tahun 2012, RSUP dr Kariadi tidak dapat memenuhi standar tersebut.Penelitian ini bertujuan untuk mengetahui angka response tim bedah sesar emergensi dan faktor–faktor yang menyebabkan tidak tercapainya standar tersebut.Dilakukan penelitian kuantitatif untukmencari angka response tim disertai wawancara untuk mengetahui faktor-faktor apa yang mempengaruhi response time tersebut. Sebanyak 207 operasi bedah sesar emergensi dilakukan evaluasi.Didapatkan angka response time 54 menit.Tidak tercapainya standar nasional response tim berkaitan dengan belum adanya standar prosedur operasional tentang persiapan operasi bedah sesar emergensi. Sehingga disarankan untuk segera dibuat standar prosedur operasional yang melibatkan tim multidisiplin.

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According to national standards, obstetric services must be able to perform emergency cesarean section within 30 minutes of the decision made (response time). Evaluation in 2012, Doctor Kariadi General Hospital was unable to meet this standards. This study aims to determine the response time of emergency cesarean section and the factors that lead to failure to achieve this standards. Quantitative research conducted to find the response time and interview to determine what factors affect the response time. A total of 207 emergency cesarean section evaluated during the study. The mean response time was 54 minutes. Failure to achieve the national standard response time is related to the lack of standard operating procedures on the preparation of emergency cesarean section. So it is advisable to immediately create a standard operating procedure that involves a multidisciplinary team."

"Di era JKN ini, rumah sakit dituntut harus efisien dalam mengendalikan biayalayanan agar tidak melebihi tarif INA CBGs dengan catatan mutu layanan harustetap terjaga dengan baik. Penelitian deskriptif kuantitatif ini bertujuanmenganalisis biaya berdasarkan tarif rumah sakit dan klaim INA CBGs padapasien peserta BPJS kasus sectio caesarea di RSUD dr. Doris Sylvanus padaJanuari sampai Agustus Tahun 2016. Berdasarkan hasil penelitian diketahui biaya yang tidak dibayar sesuai tarifrumah sakit sebesar Rp 1.708.663.354 42 . Biaya pelayanan persalinan sesarringan sesuai tarif rumah sakit pada kelas 1 sebesar Rp 10.267.710,-, kelas 2sebesar Rp 9.441.399,- dan kelas 3 sebesar Rp 8.591.730,-. Komponen biayatertinggi adalah biaya tindakan operasi. Sehingga perlu dilakukan kajian ulangtarif pelayanan Sectio caesarea.

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In this National Health Insurance period, hospital ospitals are required to beefficient in controlling the cost of services so as not to exceed the tariff of INACBGs with the quality record of the service must be maintained properly. Thisquantitative descriptive study aims to analyze the cost of Sectio caesarea of BPJSparticipants based on hospital rates and INA CBGs rates in dr. Doris Sylvanusregional public hospital on January until August 2016.

The result revealed that the unpaid cost according to hospital rates is Rp1.708.663.354 42 . The cost of light cesarean delivery service according tohospital rates in grade 1 is Rp 10,267,710, , 2nd grade is Rp 9,441,399, and grade3rd is Rp 8,591,730, . The highest cost component is the cost of surgery. So it isnecessary to review the hospital rates of cesarean delivery service."

"Peningkatan penggunaan alat pelindung diri (APD) oleh tenaga kesehatan selama pandemi COVID-19 berkontribusi terhadap peningkatan timbulan limbah medis rumah sakit. RSUD Doris Sylvanus merupakan RS Rujukan COVID-19 Provinsi Kalimantan Tengah yang menangani baik pasien COVID-19 dan non COVID-19. Dalam rangka memenuhi standar kesehatan lingkungan rumah sakit yang tertuang pada Peraturan Menteri Kesehatan No.7 tahun 2019, rumah sakit perlu mengupayakan pengelolaan limbah medis rumah sakit yang benar karena rumah sakit memiliki dampak terhadap lingkungan sekitar yang cukup besar. Tujuan dari penelitian ini adalah untuk menganalisis ketaatan RSUD Doris Sylvanus dalam melakukan pengelolaan limbah medis APD selama pandemi COVID-19 tahun 2021 sesuai peraturan perundangundangan.Penelitian ini dilakukan secara kualitatif dengan pendekatan studi kasus melalui telaah dokumen, observasi langsung, dan wawancara mendalam. Hasil penelitian menunjukkan bahwa timbulan limbah medis meningkat sesuai dengan tren kasus COVID-19 dan sejalan dengan BOR rumah sakit. Estimasi proporsi limbah APD mencapai 22% di area COVID-19 dan 23% di area non COVID-19. Pengelolaan limbah medis APD mengikuti alur limbah medis secara umum karena pada akhirnya limbah APD akan dikelola layaknya limbah medis. Secara keseluruhan, pengelolaan limbah medis yang dilakukan RSDS telah taat terhadap Peraturan Menteri Kesehatan No.7 tahun 2019. Komponen yang masih tidak taat meliputi faktor SDM, kebijakan tertulis pimpinan rumah sakit, pelaporan berita acara penyerahan, jalur pengangkutan belum menggunakan jalur khusus dan warna kemasan. Hasil penelitian merekomendasikan pembuatan program seperti penimbangan limbah medis dan APD di ruangan, pelatihan SDM yang berkelanjutan, pembuatan kebijakan dan SPO, program evaluasi dan penelitian lanjutan terkait laju timbulan limbah medis, efisiensi penggunaan APD, dan faktor-faktor yang mempengaruhi ketaatan pengelolaan limbah medis di rumah sakit

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The increased use of personal protective equipment (PPE) by health care workers during the COVID-19 pandemic has contributed to an increase in the medical waste generation. Doris Sylvanus General Hospital is a COVID-19 Referral Hospital in Central Kalimantan that provides care for both COVID-19 and non-COVID-19 patients. RSUD Doris Sylvanus is a COVID-19 Referral Hospital in Central Kalimantan Province that treats both COVID-19 and non-COVID-19 patients. In order to meet the environmental health standards in health care facilities as stipulated in the Minister of Health Regulation No. 7 of 2019, hospitals need to put attention on hospital medical waste management because of its huge impact on the surrounding environment. This study aimed to analyze the compliance of Doris Sylvanus General Hospital in managing PPE medical waste during COVID-19 pandemic in accordance with statutory regulations. This research was conducted qualitatively with a case study approach through document review, direct observation, and in-depth interviews. The results showed that medical waste generation increased in accordance with the trend of COVID-19 cases and in line with hospital Bed Occupancy Rate. The proportion of PPE waste showed 22% in the COVID-19 area and 23% in the non-COVID-19 area. The management of PPE medical waste follows the flow of medical waste because PPE waste will be handled like medical waste in the end. Overall, the medical waste management carried out by the RSDS has complied with the Minister of Health Regulation No. 7 of 2019. The components that are still disobedient include human resources factors, hospital policies, report of medical and PPE waste generation, transportation routes and waste bags colour. The results of the study recommend the creation of programs such as weighing medical waste and PPE in the room, continuous HR training, internal policy making and SOPs, evaluation programs and further research related to the rate of medical waste generation, the efficiency of the use of PPE, and factors that affect compliance with medical waste management in hospitals."

"ABSTRAKPelaksanaan Program Jaminan Kesehatan Nasional (JKN) menyebabkan peningkatan kunjungan pasien IGD danangka pasien boarding sehingga terjadi penumpukan (stagnasi) pasien di IGD. RSUD Koja telah menerapkanmanajemen tempat tidur dalam rangka mereduksi waktu boarding pasien IGD tetapi belum optimal, sehinggadilakukan upaya untuk membantu mereduksi waktu boarding pasien IGD ke rawat inap dalam rangka perbaikanyang berkelanjutan sesuai prinsip lean thinking. Penelitian operasional ini mencakup intervensi dengan siklusPDCA (plan, do, check, action). Hasil penelitian menunjukkan penerapan lean thinking dapat mereduksi waktuboarding pasien IGD ke rawat inap dari rata-rata 4 jam 45 menit 18 detik (34,92 %) menjadi 3 jam 25 menit 59detik (68,25 %) dan menurunkan aktivitas non value added sebesar 2,02% (dari 93,16% menjadi 91,14%).Delapan jenis waste yang teridentifikasi dapat dieliminasi kecuali waste jenis waiting. Dalam rangka perbaikanyang berkelanjutan selanjutnya manajemen tempat tidur perlu ditetapkan sebagai persyaratan standard kerjauntuk menuju waktu boarding rata-rata menjadi 1 jam 45 menit 45 detik dengan aktivitas non value addedkurang dari 89,83% di masa mendatang.

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ABSTRACTThe implementation of the National Health Insurance Program (Program JKN) affects the increased number ofpatients to emergency unit and boarding patients that resulting crowding in the emergency unit. Koja Hospitalhas implemented bed management in order to reduce the boarding time of emergency unit patients but has notsucceeded, so an effort to help reducing the boarding time of emergency unit patients to inpatient in order tocontinuous improvement was done using the lean thinking principle. This research uses operational researchmethod and intervention with PDCA (Plan, Do, Check, Action) cycle. The study revealed that lean thinkingapproach could reduce the boarding time of emergency unit patients to hospitalization from the average of 4hours 45 minutes 18 seconds (34.92%) to 3 hours 25 minutes 59 seconds (68.25%) and decrease the activity ofnon value added at 2.02% (from 93.16% to 91.14%). Eight types of waste identified can be eliminated exceptwaiting. In order to continuous improvement, bed management should be set as standardized work for the goalof average boarding time of 1 hour 45 minutes 45 seconds with non value added activities less than 89.83% inthe future."

"ABSTRAKPeningkatan mutu dan keselamatan pasien merupakan dua hal yang tidak bisa dipisaahkan dan harus berkesinambungan. Upaya peningkatan mutu dan keselamatan pasien di Instalasi Farmasi Rumah Sakit Pusat Otak Nasional Prof. DR. dr. Mahar Mardjono digambarkan melalui capaian indikator pelayanan menurut Standar Pelayanan Minimal Rumah Sakit. Penelitian ini dilakukan untuk menganalisis waktu tunggu pelayanan obat jadi pasien JKN dan aktivitas risiko terjadinaya medication error dengan prinsip lean thinking dan swiss cheese model. Jenis penelitian ini adalah operational research dengan pendekatan kualitatif dan kuantitatif. Data kualitatif diperoleh melalui proses observasi dan telaah dokumen, sedangkan kuantitatif berdasarkan data waktu tunggu dari electronic health record dan waktu tunggu hasil observasi dengan menggunakan time motion study. Diambil 30 sampel resep selama 6 hari yang dilakukan observasi seluruh aktivitas pada proses pengkajian dan pelayanan obat pasien jadi pasien JKN. Hasil penelitian menunjukan waktu tunggu adalah 1 jam 3 menit 11 detik, dengan waktu tunggu terlama adalah pada proses penerimaan resep (30 menit 42 detik). Kegiatan VA (79%) yaitu 13 menit 13 detik. Aktivitas NVA (21%) dengan waktu 49 menit 21 detik. Waste terbanyak adalah pada kegiatan waiting dengan presentasi waktu 92% dari waktu NVA. Bottleneck pada penelitian ini diambil dari proses waktu tunggu terlama dan hasil analisis swiss chesse model pada tahapan pengkajian dan pemeriksaan sediaan obat.Usulan perbaikan berdasarkan hasil analisis proses pengkajian dan pelayanan resep obat jadi ini adalah perlu adanya penyusunan regulasi pengkajian dan pelayanan obat sesuai standar pelayanan kefarmasian, telaah profil indikator waktu tunggu obat jadi sesuai SPM rumah sakit, perlu adanya analisis beban kerja, dan monitoring supervise kajian pelayanan resep obat. Usulan perbaikan digambarkan dalam visual management dan future state map dengan menggambarkan alur pelayanan dengan waktu berdasarkan VA.

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ABSTRACT

Quality improvement and patient safety are two things that cannot separated and must be continuous. Effort to improve quality and patient safety at Outpatient Pharmacy Pusat Otak Nasional Prof. DR.dr. Mahar Mardjono Hospital is described through the achievement of service indicators according to the hospital minimum service standards. This study was conducted to analyze the waiting time for JKN patient medication services and risk activities of medication errors using principles of lean thinking and the swiss cheese model. This type of research is operational research with qualitative and quantitative approaches. Qualitative data is obtained through the process of observation and document review, while quantitative data is based on waiting time data from electronic health records and waiting time for observations using time motion study. Taken 30 samples of prescription for 6 days observation of all activities in the process of assessment and treatment of patients so patients JKN. The result showed that the waiting time was 1 hour 3 minutes 11 seconds, with the longest waiting time was in the process of receiving the recipe (30 minutes 42 seconds). Value_added activity (79%) was 13 minutes 13 seconds, non value added activity (21%) for 49 minutes 21 second. Most of waste is in waiting activities with a presentation time of 92% of the time for non value added. The bottleneck in this study was taken from the longest waiting time process and the result of the swiss cheese model analysis at the assessment and examination stage of drug preparations. Reviewing the waiting time indicator profile for the finished medicine according to the SPM of the hospital. There is a need for workload analysis, and monitoring of the review of prescription services. Proposed improvements are depicted in visual management and future state map by describing the flow of services with time based on VA."