Analisa Waktu Tunggu Pelayanan Rawat Jalan di RS Universitas Brawijaya

Waiting time for patient services is one indicator of patient satisfaction and quality of service in a hospital. The length of time a patient is waiting is one of the important things in determining the quality of health services. Based on the results of preliminary studies that have been carried out at Universitas Brawijaya Hospital in Malang, the implementation of outpatient services is still not running optimally. During the study the waiting time for outpatient services was more than 143 minutes (minimum service standard <60 minutes). The purpose of this study was to determine the factors that influence the length of waiting time for outpatient services and solution solutions. Researchers used qualitative methods, data collection was done by unstructured interviews, Focus Group Discussions, and observations with time and motion study. The number of participants was 30 people. The final results of the study, are the factors that influence the waiting time of outpatient visitors are the queuing number collection system and the medical record file ordering system. Solutions for long waiting times for patients in outpatient services that affect patient satisfaction by changing the Medical Record file order system and changing the queue number group. Waktu tunggu pelayanan pasien merupakan salah satu indikator kepuasaan pasien dan mutu pelayanan di rumah sakit. Lamanya waktu tunggu pasien merupakan salah satu hal penting dalam menentukan kualitas pelayanan kesehatan. Berdasarkan hasil studi pendahuluan yang telah dilakukan di RS Universitas Brawijaya di kota Malang pelaksanaan pelayanan pasien di rawat jalan masih belum berjalan optimal. Saat penelitian waktu tunggu pelayanan rawat jalan lebih dari 143 menit (setandar pelayanan minimal < 60 menit). Tujuan penelitian untuk mengetahui faktor yang mempengaruhi lama waktu tunggu pelayanan rawat jalan dan solusi pemecahan. Peneliti menggunakan metode kualitatif, pengumpulan data dilakukan dengan wawancara tidak terstruktur, Focus Group Discussion, dan observasi dengan time and motion study. Jumlah participan 30 orang. Hasil akhir penelitian, adalah faktor yang mempengaruhi lama waktu tunggu pengunjung rawat jalan adalah sistem pengambilan nomor antrian dan sistem pemesanan berkas rekam medis. Solusi untuk lama waktu tunggu pasien di pelayanan rawat jalan yang mempengaruhi kepuasan pasien dengan merubah sistem pemesanan berkas Rekam Medis dan merubah kelompok nomor antrian.

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Identifikasi Waste Tahap Pra Analitik dengan Pendekatan Lean Hospital di Laboratorium Patologi Klinik RS XYZ Depok Jawa Barat Tahun 2021

Jurnal Manajemen Kesehatan Indonesia ◽

10.14710/jmki.9.2.2021.101-112 ◽

2020 ◽

Vol 9 (2) ◽

pp. 101-112

Author(s):

Rini Prasetyo Wahyu Wijayati ◽

Dumilah Ayuningtyas

Keyword(s):

Waiting Time ◽

Average Length ◽

Added Value ◽

Laboratory Examination ◽

Time And Motion Study ◽

Time And Motion ◽

Laboratory Error ◽

Motion Study ◽

Depth Interviews ◽

Examination Process

ABSTRACT The pre-analytic stage includes a series of processes that are difficult to define because they occur in different places and times. Pre-analytical stage errors account for 50% to 70% laboratory error. The research aims to identify waste and provide recommendations for improvement. This type of research is operational research with a mix method research design. Quantitative data from direct observation of the laboratory examination process. Qualitative data from in-depth interviews with Laboratory Medical Technical Analysts (ATLM), on duty doctors and nurses. Non-participant observations use themethod Time and Motion study and calculate the time of each pre-analytical stage activity using a stopwatch to get the standard movement of the sample staged effectively and efficiently. Analysis with lean stages identify activities that do not provide added value (non added value) and waste (waste). Exploring the root causes of problems through in-depth interviews using the 5 (five) Whys approach and proposing recommendations for improvement. The results of the average length of time for the pre-analytic stage are due to the waiting time for new samples due to hemolysis samples. Waste found waiting for samples to be sent back (waiting time), no inspection orders, non-standard identity stickers (defect) and sticker repair (over processing). Phlebotomy training, re-education on handling laboratory specimens for nurses as well as SOPs on laboratory examination packages and sample handover, are expected to reduce pre-analytic waste.Keywords: Waste, Pre Analytical Stage, Concept Lean ABSTRAKTahap pra analitik mencakup serangkaian proses yang sulit didefinisikan karena terjadi ditempat dan waktu yang berbeda. Kesalahan tahap pra analitik menyumbang kesalahan hasil laboratorium sebesar 50% hingga 70%. Penelitian bertujuan mengidentifikasi pemborosan dan memberikan rekomendasi perbaikan. Jenis penelitian adalah penelitian operasional dengan disain penelitian mix method. Data kuantitatf dari observasi langsung proses pemeriksaan laboratorium. Data kualitatif dari wawancara mendalam dengan Analis Teknis Medik Laboratorium (ATLM), dokter jaga dan perawat. Observasi non partisipan menggunakan metode Time and Motion study serta menghitung waktu setiap kegiatan tahap pra analiitk menggunakan stopwatch untuk mendapatkan pergerakan standar sampel ditahap secara efektif dan efisien. Analisis dengan tahapan lean mengidentifikasi kegiatan yang tidak memberikan nilai tambah ( non added value) dan pemborosan (waste). Menggali akar penyebab masalah melalui wawancara mendalam menggunakan pendekatan 5 (lima) Whys dan mengusulkan rekomendasi perbaikan. Hasil rata rata lama waktu tahap pra analitik disebabkan waktu tunggu sampel baru karena sampel hemolisis. Waste yang ditemukan menunggu sampel dikirim ulang (waiting time), tidak ada order pemeriksaan, stiker identitas tidak standar (defect) dan perbaikan stiker (over processing). Pelatihan plebotomi, re edukasi penanganan spesimen laboratorium untuk perawat serta SPO tentang paket pemeriksaan laboratorium dan serah terima sampel, diharapkan dapat mengurangi pemborosan tahap pra analitik.

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QUALITY OF NURSING DOCUMENTATION AND NURSE’S OBJECTIVE WORKLOAD BASED ON TIME AND MOTION STUDY (TMS)

INDONESIAN NURSING JOURNAL OF EDUCATION AND CLINIC (INJEC) ◽

10.24990/injec.v1i2.117 ◽

2017 ◽

Vol 1 (2) ◽

pp. 173

Author(s):

Mira Amelynda Prakosa ◽

Nursalam Nursalam ◽

Candra Panji Asmoro

Keyword(s):

Random Sampling ◽

Simple Random Sampling ◽

Nursing Documentation ◽

Cross Sectional ◽

Time And Motion Study ◽

Time And Motion ◽

Motion Study ◽

Independent Variable ◽

Quality Of Nursing

Introduction. The quality of documentation can decrease because of bad admission filling of documentation. Workload is one of the factor that can influence admission filling of documentation. This study was aimed to analyze the correlation between nurse’s objective workload and the quality of nursing documentation in RSU Haji. Method. The design of this study was descriptive correlation with cross-sectional approach. The population on this study was the nurse that works in Marwah 3 and 4 inpatient care in RSU Haji Surabaya. The number of the sample was 14 respondents were selected by simple random sampling. The independent variable was nurse’s objective workload and the dependent variable was quality of nursing documentation. The data were analyzed by using regression logistic. Result. Nurse’s objective workload in RSU Haji was 72%. There was no correlational between nurse’s objective workload with the completeness of nursing documentation (P= 0,999), also nurse’s objective workload with accurate of nursing documentation (P= 0,999). Discussion. This study concluded that nurse’s objective workload was low and quality of nursing documentation was accurate enough and complete enough. Next researcher should provide precise operational so the factors that affected the quality of documentation can be reached and the workload of the nurses in RSU Haji become ideal.Keyword: nurses, quality of nursing documentation, objective workload

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A Time and Motion Study of ICU Resident Work Practice in the Era of the Electronic Medical Record (EMR)

CHEST Journal ◽

10.1378/chest.2270853 ◽

2015 ◽

Vol 148 (4) ◽

pp. 457A

Author(s):

William Marino

Keyword(s):

Medical Record ◽

Electronic Medical Record ◽

Work Practice ◽

Time And Motion Study ◽

Time And Motion ◽

Motion Study ◽

Resident Work

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Sistem Penjadwalan Poliklinik Rawat Jalan Berbasis Manajemen Lean di RSUD Kota Padang

Jurnal Warta Pengabdian Andalas ◽

10.25077/jwa.27.4.235-244.2020 ◽

2020 ◽

Vol 27 (4) ◽

pp. 235-244

Author(s):

Adila Kasni Astiena ◽

Rika Ampuh Hadiguna ◽

Acim Heri Iswanto ◽

Hardisman Hardisman ◽

Dedy Irfan ◽

...

Keyword(s):

Patient Satisfaction ◽

Medical Record ◽

Model Building ◽

Lean Management ◽

Outpatient Services ◽

Input Process ◽

General Hospitals ◽

Increase Patient Satisfaction ◽

Process Output

Waiting is a waste that is common in outpatient services, especially at Regional General Hospitals, thus reducing the quality of service. The results of the 2018 and 2019 service studies at Rasidin Hospital, the waiting time for outpatient services was 239 and 122 minutes (standard ≤60 minutes). The queuing process started at night and the queue was overflowing in the morning which resulted in late medical record processing, less seating, and low patient satisfaction. The purpose of this service is to design a queue for outpatient services based on Lean Management. The service was carried out in February-July 2020. Lean Management reduces waste on everything involved in the service process, namely Supply, Input, Process, Output and Customer (SIPOC). The service target is the management, head of installation, registration officer, medical record, doctor and nurse and patient. Approaches in the form of surveys, brainstorming, trainning and FGDs for model building. The resulting model is written in a mobile-based application to facilitate queuing patients. The resulting model is an application for booking registration and consultation. Applications can be downloaded on the Googleplay Store. It takes 1 operator to run the application. This application is expected to decipher long queues, provide certainty of time and increase patient satisfaction. It takes commitment and discipline from all parties to carry out services that are on time as promised so that they run on target.

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