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"ABSTRAKNama : Patiyus Agustiansyah/NPM 1506706023Program Studi : Kajian Administrasi Rumah SakitJudul : Analisis dan Implementasi Lean pada Persiapan OperasiKanker Ginekologi di RSUP dr. Mohammad HoesinPalembangIndonesia saat ini memiliki beban kanker ginekologi besar yaitu insidensi,morbiditas dan mortalitasnya. Salah satu penanganan kanker ginekologi adalahpembedahan yang akan membantu kesintasan pasien. Waktu tunggu penjadwalanoperasi kanker ginekologi hendaklah memperhatikan progresifitas kankersehingga waktu tunggu operasinya tidak melebihi 2 minggu. Waktu tungguoperasi menggambarkan mutu pelayanan rumah sakit.Tujuan penelitian ini adalah,untuk menganalisis waktu tunggu penjadwalan operasi kanker ginekologi diRSUP dr. Moehammad Hoesin Palembang dengan menggunakan prinsip Lean.Hasil penelitian menunjukan penegakan diagnosis selama 43.844 menit dan waktutunggu operasi selama 66.700 menit, dengan menerapkan prinsip lean makapenegakan diagnosis 10.328,5 menit dan waktu tunggu operasi 10.325 menit.Kesimpulan penelitian, pada current state terdapat 26 aktifitas; 12 aktifitas VA value added ratio / VAR waktu 0,46 ; VAR jarak 89,6 dan 14 aktifitas NVA waste pasien dan 4 waste aktifitas petugas. Aliran proses yang menghambat bottle neck terdapat di pendaftaran, di poliklinik, di pemeriksaan penunjang dandi bagian praoperatif waktu tunggu paling lama . Future State memiliki 15aktifitas VA VAR waktu 33 ; VAR jarak 95,8 dengan 8 aktifitas NVA waste aktifitas pasien dan 0 waste aktifitas petugas, dengan waktu tunggudiagnosis 10.328,5 menit sedangkan waktu tunggu penjadwalan operasi 10.325menit. Hasil perbandingan current state dengan future state didapatkanpeningkatan aktifitas value added sebanyak 7,7 dengan penurunan waktutunggu 81,3 dan penurunan jarak tempuh 0,42 . Analisis akar masalahpenyebab waktu tunggu lama penjadwalan operasi kanker ginekologi di RSMHdikarenakan kekurangan SDM registrasi, rekam medis, DPJP dan keterbatasaninfrastruktur CT scan, kamar operasi dan instrumen dan kelemahan mengelolaproses penjadwalan operasi tersebut. Saran peneliti adalah peningkatan kinerjadan penambahan SDM, membuat regulasi untuk memprioritaskan pelayananpasien kanker ginekologi, serta integrasi Sistem Informasi Manajemen RumahSakit di setiap unit pelayanan.Kata Kunci : prinsip lean, value added VA , non value added NVA , waste,waktu tunggu penegakan diagnosis, waktu tunggu operasi, kanker ginekologi

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ABSTRACTName Patiyus Agustiansyah NPM 1506706023Program Studi Hospital Administration StudyTitle Lean Analysis and Implementation of Gynecology CancerOperative Scheduling in General Hospital dr. MohammadHoesin RSMH PalembangIndonesia currently has gynecologic cancer burden in the incidence, morbidityand mortality. One of gynecological cancer treatment is surgery which will helpthe survival rate of patients. The waiting time of gynecological cancer surgeryscheduling should bu focused to cancer progression so the waiting time should notexceed 2 weeks. The waiting time operation illustrates the quality of hospitalservices.The purpose of this study was to analyze the waiting time of gynecologiccancer surgery scheduling in RSMH by using the principles of Lean. The resultsshowed that establishing diagnosed need 43,844 minutes and the waiting timeoperation was 66,700 minutes. By applying Lean then the diagnosis establishing10,328.5 minutes, and operations waiting times 10,325 minutes. The studyconclusion showing for 26 activities of current state with 12 VA activities VARtime 0.46 VAR range for 89.6 and 14 NVA activities with 14 patient rsquo swastes activities and 4 employee wastes activities. The process flow whichinhibits bottle neck were lies in the stage of registration, at the outpatient clinic,at the laboratory examination and at the preoperative division the longest waitingtime . The waiting time for diagnosis process were 43.844 minutes, while thewaiting time scheduling of operation process were 66.700 minutes. Future Statehas 15 VA VAR time of 33 VAR range of 95.8 with 8 NVA activities and 8patients waste activity and 0 employee waste activities. The waiting time for adiagnosis process were 10328.5 minutes, while the waiting time for operationscheduling process were 10.325 minutes. The comparison between the currentstate to the future state resulted increasement of the VA activity for 7.7 with areduction in waiting time for 81.3 and mileage decrease of 0.42 . Analysis ofroot problems revealed that the long waiting times for scheduling process ofgynecologic cancer surgery in RSMH were due to lack of human resourcesquantity registration, medical records, doctor in charge and the lack ofinfrastructure CT scan, operating rooms and instruments and managerialweaknesses in managing the process of scheduling the surgery. Researcherssuggest to improve the performance of existing recruitment human resources,make regulations of a priority of gynecologic cancer patients, as well as theintegration of Hospital Management Information System in each unit.Keywords lean principles, values added VA , non value added NVA , waste,value added ratio, waiting time for establishing diagnosis, surgery waiting times,gynecological cancer"

"ABSTRAKDampak Jaminan Kesehatan Nasional di poliklinik spesialis Obstetric dan GynecologyRS. Annisa Citeureup Bogor adalah meningkatnya jumlah kunjungan pasien rawatjalan sebesar 61% pada awal tahun 2014. Semakin banyaknya jumlah pasien akanberakibat pada lamanya waktu tunggu. Tahapan penelitian ini menggunakan 5 (lima)prinsip lean untuk mendapatkan perbaikan yang berkelanjutan sehingga mampumeningkatkan efisiensi alur proses pelayanan di poliklinik spesialis Obstetric danGynecology. Hasil value assesment pada pasien tunai didapatkan 85% kegiatan yangtidak bernilai tambah dan 14% kegiatan yang bernilai tambah, sedangkan pada pasienJaminan Kesehatan Nasional didapatkan prosentase kegiatan yang tidak bernilaitambah sebesar 88% dan 11% untuk kegiatan yang bernilai tambah. Metode leandinilai mampu meminimalisir pemborosan, hasil future state value stream mapdidapatkan penurunan kegiatan yang tidak bernilai tambah menjadi 38,09%

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ABSTRACTThe impacts of the National Health Insurance at the Obstetric and Gynecologyspecialist polyclinic RS. Annisa Citeureup Bogor is increase frequency of outpatientvisits by 61% at the beginning of 2014. The increasing number of patients will resultin long waiting times. This research uses 5 (five) lean principles to get continuousimprovement to improve the efficiency of service process flow in Obstetric andGynecology specialist clinic. Result of assessment value in patients with cash paymentwas 85% non value-added activities and 14% value-added activities, while in theNational Health Insurance patients, the percentage of non value added activities was88% and 11% for value-added activities. Lean method is considered able to minimizewaste, the results of the future state value stream map can reduce activities that do notadd value to 38.09%"