Pendekatan Lean Hospital dalam Mengoptimalkan Pelayanan Laboratorium Rumah Sakit

Abstract

Abstrak
Pelayanan penunjang di rumah sakit merupakan salah satu penentu kualitas rumah sakit. Salah satu pelayanan penunjang di rumah sakit adalah laboratorium. Unit laboratorium seringkali mengalami permasalahan, yaitu belum mampu memberikan pelayanan kesehatan yang tepat waktu dengan standar pelayanan minimal di rumah sakit, kesalahan pengambilan darah, kerusakan sampel darah, dan terjadi kesalahan yang dapat menyebabkan pemborosan. Lean adalah upaya terus menerus untuk menghilangkan pemborosan, meningkatkan nilai tambah produk (barang dan jasa), dan memberikan nilai kepada pelanggan. Tujuan penelitian ini adalah mengetahui pendekatan lean hospital dalam mengoptimalkan pelayanan laboratorium dan kondisi sebelum dan setelah dilakukan pendekatan lean hospital pada laboratorium rumah sakit. Penelitian dilakukan pada September 2021 sampai dengan Februari 2022 di RS A Kota Cimahi dan RS B Kota Bandung. Jenis penelitian ini bersifat kualitatif. Informan dipilih secara non probability dengan teknik purposive sampling. Data diolah dengan metode analisis lean. Hasil penelitian menunjukkan bahwa rasio aktivitas value added terhadap total aktivitas di kedua rumah sakit adalah kurang dari 30%. Usulan perbaikan yang diajukan kepada manajemen di kedua rumah sakit menunjukkan quality improvement di antaranya penurunan waktu tunggu pasien, penunjuk arah ke laboratorium yang jelas, sistem informasi rumah sakit (SIMRS) yang terintegrasi, serta standar operasional prosedur (SOP) yang sesuai dipatuhi. Simpulan, kedua rumah sakit dianggap belum lean karena memiliki rasio aktivitas yang bernilai tambah (value added activities) terhadap total aktivitas adalah kurang dari 30%, pemborosan pada waiting time, process, transportation, motion dan defect dipengaruhi oleh man, methods, machine, dan environmental.

Kata kunci: Laboratorium, lean hospital, manajemen rumah sakit, pelayanan optimal, pemborosan

Lean Hospital Approach to Optimizing Hospital Laboratory Service

Abstract
Support services in hospitals are one of the determinants of hospital quality. One of the supporting services in hospitals is a laboratory. Laboratory units often experience problems, such as not being able to provide timely health services with minimum service standards in hospitals, blood sampling errors, damage to blood samples and medication error that can cause waste. Lean is a continuous improvement effort to eliminate waste, increase product value added (goods and services) and provide value to customers (customer value). The purpose of this study was to determine the lean hospital approach in optimizing laboratory services and to determine condition before and after the lean hospital approached. The research was conducted from September 2021 to February 2022 in A Hospital Cimahi and B Hospital Bandung. The research use qualitative method. Informants were selected non-probability with purposive sampling technique. The data is processed by lean analysis method. The results showed that the ratio of value added and non value added activities in both hospitals was less than 30%. The improvement proposals submitted to hospital management showed that there were quality improvements including decreasing patient waiting time, there are clear directions to the laboratory, an integrated hospital information system and appropriate standard operating procedure. In conclusion, the two hospitals are considered not lean because they have ratio of value added activities to total activities is less than 30%, there are wastes in waiting time, process, transportation, motion, and defects influenced by man, methods, machine and environment.

Keywords: Hospital management, laboratory, lean hospital, optimal service, waste