Implementation of Lean Kaizen to Reduce Waiting Time for the Indonesian Health Social Security Agency Prescription Services in Hospital Pharmacy InstallationImplementation of Lean Kaizen to Reduce Waiting Time for the Indonesian Health Social Security Agency Prescription Services in Hospital Pharmacy Installation
DOI:
https://doi.org/10.3889/oamjms.2021.7610Keywords:
Waiting time, Prescription services, Lean kaizen, Plan-Do-Check-ActAbstract
BACKGROUND: The second largest Health Social Security Agency (BPJS) outpatients visits in Hospital Pharmacy Installation, Indonesia, has 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 set by the Ministry of Health (≤60 minutes for concoctions and ≤30 minutes for non-concoctions).
AIM: The purpose of this study was to determine the waiting time for BPJS prescription services in the current state and future state after the implementation of lean kaizen through Plan-Do-Check-Act (PDCA) approach at Grha Permata Ibu (GPI) Hospital.
METHODS: The research method is operational research with qualitative and quantitative approaches through direct observation and in-depth interviews.
RESULTS: The implementation of lean kaizen decreased the lead time from 135.31 minutes to 9.11 minutes in scenario-1 and 7.49 minutes in scenario-2 and a decrease in lead time from 185.17 minutes to 31.09 minutes in scenario-1 and 29,15 minutes 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 motion that has not been intervened.
CONCLUSION: This study suggests an updating information to prioritize changes in pharmaceutical layout, carry out continuous monitoring, and encourage IT to develop IT-based pharmaceutical services.
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References
World Health Organization, Organisation for Economic Co-Operation and Development and International Bank for Reconstruction and Development. Delivering Quality Health Services: A Global Imperative for Universal Health Coverage. Geneva: World Health Organization; 2018.
Zuber M, Alkhamis AA, Juned M, editors. Global Trends in University Hospitals. J Community Med Public Health. 2019;1(3):111-39.
Allemann SS, van Mil JW, Botermann L, Berger K, Griese N, Hersberger KE. Pharmaceutical care: The PCNE definition 2013. Int J Clin Pharm. 2014;36(3):544-55. https://doi.org/10.1007/s11096-014-9933-x PMid:24748506 DOI: https://doi.org/10.1007/s11096-014-9933-x
Direktorat Jenderal Bina Kefarmasian dan Alat Kesehatan Departemen Kesehatan RI. Standar Pelayanan Farmasi di Rumah Sakit. Jakarta, Indonesia: Direktorat Jenderal Bina Kefarmasian dan Alat Kesehatan Departemen Kesehatan RI; 2006.
Bleustein C, Rothschild DB, Valen A, Valatis E, Schweitzer L, Jones R. Wait times, patient satisfaction scores, and the perception of care. Am J Manag Care. 2014;20(5):393-400. PMid:25181568
Alam S, Osama M, Iqbal F, Sawar I. Reducing pharmacy patient waiting time. Int J Health Care Qual Assur. 2018;31(7):834-44. https://doi.org/10.1108/IJHCQA-08-2017-0144 PMid:30354876 DOI: https://doi.org/10.1108/IJHCQA-08-2017-0144
Al-Harajin RS, Al-Subaie SA, Elzubair AG. The association between waiting time and patient satisfaction in outpatient clinics: Findings from a tertiary care hospital in Saudi Arabia. J family Community Med. 2019;26(1):17-22. https://doi.org/10.4103/jfcm.jfcm_14_18 PMid:30697100 DOI: https://doi.org/10.4103/jfcm.JFCM_14_18
Maharani AE. Gambaran Waktu Tunggu Pelayanan Resep Pasien BPJS Pada Peak Hours di Depo Farmasi Rawat Jalan RSUP Fatmawati Tahun 2015. Depok: Universitas Indonesia; 2015.
Gaspersz V, Fontana A. Lean Six Sigma for Manufacturing and Service Industries: Waste Elimination and Continuous Cost Reduction Bogor. Bogor: Vinchristo Publication; 2011.
Oliveira J, Sá JC, Fernandes A. Continuous improvement through “Lean Tools”: An application in a mechanical company. Procedia Manuf. 2017;13:1082-9. DOI: https://doi.org/10.1016/j.promfg.2017.09.139
Fauzia U, Setiawati EP, Surahman ES. Analysis of waiting time for filing prescriptions in hospital pharmacy. Pharmacol Clin Pharm Res. 2017;2(3):75. DOI: https://doi.org/10.15416/pcpr.v2i3.16226
Loh BC, Wah KF. Impact of value added services on patient waiting time at the ambulatory pharmacy Queen Elizabeth Hospital. Pharm Pract (Granada). 2017;15(1):846. https://doi.org/10.18549/PharmPract.2017.01.846 PMid:28503218 DOI: https://doi.org/10.18549/PharmPract.2017.01.846
Kusumowardhani D, Ilyas Y, editors. Waiting Time of Pharmacy Service as an Indicator of Patient Satisfaction: A Systematic Review. The 6th International Conference on Public Health; 2019. DOI: https://doi.org/10.26911/the6thicph-FP.04.14
Alodan A, Alalshaikh G, Alqasabi H, Alomran S, Abdelhadi A, Alkhayyal B. studying the efficiency of waiting time in outpatient pharmacy. MethodsX. 2020;7:100913. https://doi.org/10.1016/j.mex.2020.100913 PMid:32461924 DOI: https://doi.org/10.1016/j.mex.2020.100913
Rais A, Viana A. Operations research in healthcare: A survey. Int Trans Oper Res. 2011;18(1):1-31. DOI: https://doi.org/10.1111/j.1475-3995.2010.00767.x
Cohen L, Manion L, Morrison K. Research Methods in Education. 3rd ed. Newyork: Routledge 270 Madison Avenue; 2007. DOI: https://doi.org/10.4324/9780203029053
Sugiyono D. Metode Penelitian Bisnis. Bandung: Alfabeta; 2012.
Patton M. Qualitative Research and Evaluation Methods; 2002. Available from: http://www.lst-iiepiiep-unescoorg/cgibin/wwwi32exe/[in=epidoc1in]/?t2000=018602/(100). [Last accessed on 2020 Jul 21].
Standar Pelayanan Minimal Rumah Sakit, Keputusan Menteri Kesehatan Republik Indonesia Nomor: 129/Menkes/SK/II/2008; 2008.
Hicks BJ. Lean information management: Understanding and eliminating waste. Int J Inform Manage. 2007;27(4):233-49. DOI: https://doi.org/10.1016/j.ijinfomgt.2006.12.001
Hines P, Holweg M, Rich N. Learning to evolve. Int J Oper Prod Manage. 2004;24:994-1011. DOI: https://doi.org/10.1108/01443570410558049
Boyer GR, Smith RS. The development of the neoclassical tradition in labor economics. ILR Rev. 2001;54(2):199-223. DOI: https://doi.org/10.1177/001979390105400201
Tinsley HE. The congruence myth: An analysis of the efficacy of the person-environment fit model. J Vocat Behav. 2000;56(2):147-79. DOI: https://doi.org/10.1006/jvbe.1999.1727
Bramble T. In: Womack JP, Jones DT, Roos D. Book Reviews: The Machine that Changed the World. New York: Rawson Associates; 1990. p. 323.
Baldus O, Heckmann C. Lean IP-management-savings costs for IP management based on a paradigm change in assessing inventions. Am J Ind Bus Manage. 2017;7:760-70. DOI: https://doi.org/10.4236/ajibm.2017.76054
Beale J. Employee motivation to adopt lean behaviours: Individual-level antecedents. Rev Adm FACES J. 2007;6:11-31.
Fiume OJ. Lean at wiremold: Beyond manufacturing, putting people front and center. J Organ Excell. 2004;23(3):23-32. DOI: https://doi.org/10.1002/npr.20013
Putra NN. Analisis Penerapan Budaya Kaizen Pada Perusahaan Joint Venture Asal Jepang di Indonesia (Studi pada PT. X). Indonesia: Fakultas Ilmu Administrasi Universitas Brawijaya; 2018.
Lot LT, Sarantopoulos A, Min LL, Perales SR, Boin I, Ataide EC. Using lean tools to reduce patient waiting time. Leadersh Health Serv (Bradf Engl). 2018;31(3):343-51. https://doi.org/10.1108/LHS-03-2018-0016 PMid:30016918 DOI: https://doi.org/10.1108/LHS-03-2018-0016
Imai K, King G, Stuart EA. Misunderstandings between experimentalists and observationalists about causal inference. J R Stat Soc Ser A Stat Soc. 2008;171(2):481-502. DOI: https://doi.org/10.1111/j.1467-985X.2007.00527.x
Spagnol G, Li L, Min L, Newbold D. Lean principles in healthcare: An overview of challenges and improvements. Vol. 6. In: IFAC Proceedings Volumes (IFAC-Papers Online); 2013. DOI: https://doi.org/10.3182/20130911-3-BR-3021.00035
Dinda Sri R, Titik S, Opstaria S. Lean hospital approach toidentify critical waste of drug services in the outpatientpharmacy installation at RSUD X Manna in 2020. Media Ilmu Kesehatan. 2021;9(3):231-6.
Realyvásquez A, Arredondo-Soto K, Carrillo-Gutiérrez T, Ravelo G. Applying the plan-do-check-act (PDCA) cycle to reduce the defects in the manufacturing industry. A case study. Appl Sci. 2018;8:1-17. DOI: https://doi.org/10.3390/app8112181
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