Efficiency of outpatient service at three health centers in Palembang City, Indonesia_peer review 2 (original) (raw)
Related papers
Efficiency of outpatient service at three health centers in Palembang City, Indonesia_peer review 1
2020
Background: Health center (it is called Puskesmas) is a health facility that provides basic health services through outpatient units. In an effort to improve the efficiency of outpatient services, the health center could apply the Lean Concept. The aim of this study was to analyze efficiency of outpatient service process at three health centers in Palembang city, Indonesia. Method: This was a descriptive study. The unit of analysis was outpatient activity at three health centers in Palembang city, Indonesia including: Puskesmas Dempo, Puskesmas Merdeka and Puskesmas Pembina. We used direct observation technique for collecting data. A total of 300 patients with national health insurance were observed and 100 patients for each health center using accidental sampling. Results: The non value added (NVA) activity at most in each health center was service waiting time. Buildup of patient files was found in all health centers, while stock out of medicine was still found when several patients submitted prescription in Puskesmas Pembina. Time efficiency of outpatient services in Puskesmas Dempo, Puskesmas Merdeka and Puskesmas Pembina respectively was: 61.76%; 62.63%; 62.23%. In other words, the time spent on waiting activities included in the category of NVA was respectively: 32 minutes 30 seconds, 26 minutes 25 seconds, and 12 minutes 3 seconds. Conclusion: The efficiency of outpatient services in three health centers where research was conducted was moderate category. It can be improved by reducing the waiting time in each activity during the service process.
Efficiency of Outpatient Service at Three Health Centers in Palembang City, Indonesia
2020
Background: Health center (it is called Puskesmas) is a health facility that provides basic health services through outpatient units. In an effort to improve the efficiency of outpatient services, the health center could apply the Lean Concept. The aim of this study was to analyze efficiency of outpatient service process at three health centers in Palembang city, Indonesia. Method: This was a descriptive study. The unit of analysis was outpatient activity at three health centers in Palembang city, Indonesia including: Puskesmas Dempo, Puskesmas Merdeka and Puskesmas Pembina. We used direct observation technique for collecting data. A total of 300 patients with national health insurance were observed and 100 patients for each health center using accidental sampling. Results: The non value added (NVA) activity at most in each health center was service waiting time. Buildup of patient files was found in all health centers, while stock out of medicine was still found when several patien...
2020
The implementation of “lean hospital” has been conducted in several countries. The most implementation resulted in the service acceleration and cost efficiency there are still few hospitals in Indonesia that implement “lean consumption” in their services. Thus, this study aimed to test the lean consumption at the hospital with “Lean Consumption Map” (LCM) method and using “Define, Measure, Analyze, Improve, and Control” (DMAIC) instrument. This empirical study is expected to give insight to the management in the hospital to make acceleration improvement of the outpatient service wait time by comparing the wait time length before and after the test with LCM method was conducted. The analysis in this study used Time Plot Series, Value Added Assessment, FMEA and LCM, with an inductive qualitative method. The final result shows that the lean consumption implementation is applicable through the DMAIC instrument and LCM method in the acceleration improvement of the executive outpatient wa...
Open Access Macedonian Journal of Medical Sciences, 2021
BACKGROUND: The second largest Health Social Security Agency (BPJS Health) outpatients' visits in Hospital Pharmacy Installation, Indonesia, have reached 450-600 visits/day between 2017 and 2018. This has an impact on the number of prescriptions to be served. Simultaneous doctor practice schedule and less human resources are the reasons for not achieving the service standard time requirement by the Ministry of Health (≤60 min for concoctions and ≤30 min for non-concoctions). Reducing waiting time has implications for the patients' satisfaction and quality of care. AIM: The purpose of this study was to determine the waiting time for BPJS prescription services in the present state and future state after the implementation of lean kaizen through Plan-Do-Check-Act (PDCA) approach at Grha Permata Ibu Hospital. METHODS: The research method is operational research with qualitative and quantitative approaches through direct observation using the time and motion study technique and in-depth interviews. The number of samples was 30 BPJS Health outpatient prescriptions consisting of concoction and non-concoction prescriptions and seven informants for in-depth interviews. The data were classified based on the type of waste and confirmed by in-depth interviews. After the implementation of lean kaizen through PDCA, the researcher carried out future state value stream mapping and recalculated value-added activities and non-value-added activities. Finally, the present state and future state conditions are compared. RESULTS: The implementation of lean kaizen decreased the lead time (LT) from 135.31 min to 9.11 min in scenario-1 and 7.49 min in scenario-2 and a decrease in LT from 185.17 min to 31.09 min in scenario-1 and 29, 15 min in scenario-2 for the concoctions. PDCA in lean kaizen is for use in conditions where waste is most closely related to human behavior, but there is still a waste of motion that has not been intervened. CONCLUSION: This study suggests an updating information to reduce LT in pharmacy services by changing in pharmacy layout, conducting continuous monitoring and evaluation, and developing IT-based pharmaceutical services.
2021
This study aimed to discuss the flow of outpatient care process of Indonesian National Health Insurance (BPJS by customer perception and standards time at Hermina Ciruas Hospital using Lean Hospital approach. In order to achieve the result, we obtain empirical evidence of the outpatient service process and provide proposed improvements from in-depth interview in outpatient BPJS. In addition, we proposed qualitative by using timemotion studies with observation method and in-depth interview in outpatient BPJS. Here the research was carried out in an outpatient installation at Hermina Ciruas Hospital with data analysis using lean hospital approach (Visio software device). The limitations in the process of this study subjectivity in observation collection of inevitable data due to, the calculation of time in each related unit is carried out by the researchers themselves. The results show average patient service process time is 299 minutes with the assessment of activity value added 26 m...
The Efficiency of Healthcare System in Indonesia in 2014-2018
Humanities & Social Sciences Reviews
Purpose of the study: The purpose of the study is to measure the efficiency of the healthcare system in Indonesia in 2014-2018. Methodology: The Data Envelopment Analysis model was used to analyze 33 Provinces in Indonesia in the 2014-2018 period. The input variables are the number of health human resources at the community health centre, health human resources at the hospital, the number of hospitals, the number of community health centres and the realization of per capita deconcentration health funds. The output variable was Life Expectancy Index. Main Findings: The results of the analysis show that Lampung, West Java, Banten, West Nusa Tenggara and West Sulawesi whose health system reaches efficiency compared to other provinces in Indonesia during the observation period. Applications: This result suggests that the provinces where health services are inefficient are caused by the low absorption of health deconcentration funds. These findings indicate that the distribution of healt...
Application of lean technique for outpatient service time improvement in public hospital of Thailand
Currently, the number of outpatients at one of the public hospitals has been rising. The 3-month data showed that the average total time of each outpatient is 92.884 minutes. This research aims to improve this igure by applying lean technique. Current business process is mapped into simulation model. The model is built based on the itted data that are collected from each process. The result from running simulation model shows that the maximum number of work in process takes place at payment unit by 43.26 people. The blood test unit yields the highest waiting time at 31.57 minutes. Two approaches are proposed for improvement. From the simulation result, the irst approach can reduce the average total time by 6.34% and the average number of patients at the payment process to 78.36%. Similarly, the second approach can reduce the average total time by 1.63% and the waiting time at the blood test unit by 21.25%. When two approaches are both applied together, the results show that the average total time, the average number of patients at the payment process reduces by 6.28 and 63.15 percent respectively.
Analysis of Outpatient Service Queue of Public Hospital in Jakarta
MATEC Web of Conferences, 2018
In recent years Public hospital services are becoming a burden in many large cities. Many patients are needed to be served, but it was constrained by the number of doctors. Even though the resources are limited, the efficiency of public hospital services is important. The patient's queues can be shortened by service quality enhancement of outpatient. This study has applied Business Process Reengineering (BPR) method to improve the efficiency of public hospital services. Igrafx software is used to visualize the improvement design. The result has suggested a solution to accelerate the outpatient health services of a public hospital in Jakarta.
The Analysis of Appointment System to Reduce Outpatient Waiting Time at Indonesia’s Public Hospital
Human Resource Management Research, 2013
Outpatient services have become an important component of health care. By hidebound thinking, the medical profession emphasized that a physician's time is more valuable than a patient's time. Consequently, the appointment system was designed to min imize physicians' idle time overlooking patients' waiting t ime. Th is is no longer valid in today's consumer oriented society. Long wait ing times for t reat ment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Therefo re, idle time of both parties must be considered in designing an appointment system although these two objectives are contradicted to each other. This research aims to provide a study of the major causes of patients length of time for medical t reat ment in a outpatient clinic at one of Indonesian public hospital and also provide recommendation on the best strategy to improve the appointment system so that can maximize the effectiveness and efficiency of resource and capacity. The hospital queue model use single-channel mu ltiphase systems. Queuing theory be the first tool to look at patient wait ing times on each server independently. The results show that the hospital should change the appointment system for physicians. Applying 'doctor on call' system may appear to reduce doctor's idle time but lead to high patients' wait ing times. In some cases, the appointment system make doctor to be back and forth to the hospital, so it was not directly affect the productivity of a doctor. Not only construct the appointment system, they should take attention of patient flow and set scheduling of the capacity to increase the effective and efficiency outpatient department performance.
Hospital Efficiency in Indonesia with Frontier Analysis
KnE Social Sciences
Hospitals are health care institutions for people who provide individual health services. Health services in hospitals are provided for inpatients, outpatients, and emergency unit patient. Facilities in the hospital are also provided for the fulfillment of health services for all patients. However, currently, there are still many doctors who are unbalanced in getting patients. For example, in a hospital, there is a doctor who is a favorite of patients, so they have a large queue of patients. However, on the other hand, some doctors are not favorites so that almost no patients come. This makes the hospital inefficient in terms of labor and time. This study discusses the efficiency of existing resources in hospitals which includes input variables (beds, general practitioners, specialist doctors, nurses, pharmacists, medical technicians, health workers, non-health workers, building area) and output variables (inpatient, outpatient, and patient emergency unit). The method used in this s...