The Impact of Lean Management Implementation on Inpatient Discharge Prescription Services at Pertamina Central Hospital

Ajitya Kurnia Hermawati(1), Erna Kristin(2*), Firman Firman(3)


(1) Program Studi Magister Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(2) Departemen Farmakologi dan Terapi, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(3) Program Studi Magister Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: The lead time of inpatient discharge prescription services affects the overall discharge process. In 2022, lead times at Pertamina Central Hospital's Inpatient Pharmacy varied, requiring continuous efforts to meet target times and avoid disrupting discharge plans. This research aims to evaluate the impact of lean management on reducing these lead times. Methods: The study employs a combined quantitative and qualitative research design with an action research approach. It was conducted from March 4 to May 8, 2023, involving pharmacists, pharmaceutical technical personnel, compounders, and pharmacy couriers. Data analysis included measuring lead time changes pre- and post-lean management implementation and narrative analysis of qualitative findings. Results: After implementing lean management, the lead time for non-compounded prescriptions decreased from 42.6 to 25 minutes, with value added ratio (VAR) increasing from 18.9% to 27%. For compounded prescriptions, lead time dropped from 67 to 45.7 minutes, and VAR rose from 25.2% to 37.9%. The Mann-Whitney U test confirmed the significant difference in average lead time. Conclusion: The implementation of lean management in inpatient discharge prescription services has been proven to improve lead time and increase process efficiency (VAR).

Keywords


inpatient pharmacy; inpatient discharge prescription; lean management; lead time

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References


Kementerian Kesehatan RI. Menteri Kesehatan Republik Indonesia Nomor : 129/Menkes/SK/II/2008 Tentang Standar Pelayanan Minimal Rumah Sakit. Kementerian Kesehatan RI. 2008.

Rahayuningsih R. Faktor-faktor yang mempengaruhi keterlambatan pemulangan pasien di Ruang Rawat Bedah dan Penyakit Dalam Rawat Inap Terpadu Gedung A Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta pada tahun 2013. Universitas Gadjah Mada; 2014.

Alamsyah A. Percepatan Pemulangan Pasien Rawat Inap dengan Konsep Lean di Rumah Sakit Masmitra. J Adm Rumah Sakit Indones. 2017;3(2):139–49.

Graban M. Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition (3rd ed.) [Internet]. Productivity Press. 2016. Available from: https://doi.org/10.4324/9781315380827

Loh BC, Wah KF, Teo CA, Khairuddin NM, Fairuz FB, Liew JE. Impact of value added services on patient waiting time at the ambulatory pharmacy Queen Elizabeth Hospital. Pharm Pract (Granada). 2017;15(1):846.

Hammoudeh S, Amireh A, Jaddoua S, Nazer L, Jazairy E, Al-Dewiri R. The Impact of Lean Management Implementation on Waiting Time and Satisfaction of Patients and Staff at an Outpatient Pharmacy of a Comprehensive Cancer Center in Jordan. Hosp Pharm. 2021 Dec;56(6):737–44.

Green J, Valentini A. A Guide to Lean Healthcare Workflows. RedPaper. 2015;86.

Lemeshow S et al. Sample size determination in health studies. 1991;55–62.

Radnor Z. Why Lean Matters : Understanding and Implementing Lean in Public Service. Adv Inst Manag Res. 2012.

Embrey M. MDS-3: Managing Access to Medicines and Health Technologies. MDS-3. 2012.

Improta G, Romano M, Di Cicco MV, Ferraro A, Borrelli A, Verdoliva C, et al. Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC Health Serv Res [Internet]. 2018;18(1):914. Available from: https://doi.org/10.1186/s12913-018-3654-0.

Advistasari YD, Lutfan, Pudjaningsih D. Evaluasi Sistem Informasi Manajemen Farmasi Menggunakan D & M Is Success Model Untuk Mendukung Pengelolaan Obat Di RSUD Kota Semarang. J Manaj dan Pelayanan Farm [Internet]. 2015;5(4):219–24. Available from: https://jurnal.ugm.ac.id/jmpf/article/view/29512.

Al-Araidah O, Momani A, Khasawneh M, Momani M. Lead-time reduction utilizing lean tools applied to healthcare: the inpatient pharmacy at a local hospital. J Healthc Qual Off Publ Natl Assoc Healthc Qual. 2010;32(1):59–66.


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DOI: https://doi.org/10.26714/jkmi.19.3.2024.25-31

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Jurnal Kesehatan Masyarakat Indonesia

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Jurnal Kesehatan Masyarakat Indonesia is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.