Utilizing Lean Management Techniques to Improve Head CT Scan Turnaround Time of Ischemic Stroke Patients in the Emergency Department of Dr. Mohammad Hoesin Hospital, Palembang

Stroke is the most common neurological problem encountered in an emergency department. The management of acute stroke in an emergency department in South Sumatra has not been the most important standard of examination in the diagnosis of stroke, especially ischemic stroke. Thrombolytic therapy was performed on patients within 3 hours after onset. The process of CT Scan of head at the arrival department of Emergency Department Mohammad Hoesin Hospital Palembang takes 4 hours from arrival to examination[1], while according to the guideline, it should take no more than 25 minutes [2]. The application of lean method is expected to improve the service quality for ischemic stroke patients in emergency departments. This study used an operational study method with lean management approach in accordance with the head CT scan evaluation of ischemic stroke patients in emergency departments. The evaluation started from the triage until the head CT scan examination. This study was conducted at the Mohammad Hoesin Hospital Palembang emergencydepartment from November until December 2016. Primary data were collected from direct observation as well as interviews with informants, while secondary data were obtained with document search, patient service flow charts and other related data in emergency departments. Current value stream map showed that the CT scan turnaround time was 175.41 minutes, in 87.8% were waste activities (non-value-added), 6.9% were value-added activities and 5.26% were NVA but necessary. After utilizing lean management techniques, simulated value stream map showed significant decrease in lead time to 30.09 minutes, followed by increased in value-added activities and percentage of non-value-added activities. The results of this study are in accordance with what was disclosed by McManus [3] and Eitel [4] that the lean principle on increasing the percentage of value-added activities and reducing waste, thus providing considerable success in improving the quality of emergencyroom services. Lean management technique successfully improves the head CT scan turnaround time of ischemic stroke patients in the emergency department. Keywords: lean management, value streaming map, value-added, non-value-adde

Characteristics and Mineral Content of Sediment at Muara Pulau Kayu (MPK) of Southwest Aceh District

Study on sediment characteristics and mineral content at Muara Pulau Kayu (MPK) of Southwest Aceh District was conducted to find a general description of grain size and mineral content regarding to hydro-oceanographic process. Sampling was collected at MPK, Southwest Aceh District during March 2016. Purposive sampling method was used to determine 4 sampling sites covering estuary and beach area. Grain size and mineral content were analyzed with a set of sieves and X-Ray Fluorescence (XRF with standard reference mineral). Observation on the grain roundness and sphericity showed that sediment grains are generally more rounded at beach area. Mineral content at MPK are dominated by Si, Fe, K, Ca and Ti that are categorized into volcanic mineral which conclude that sediment at MPK originated from Mount Leuser which was an active volcano in the past

Analisis stok karbon tegakan seumur Shorea balangeran menggunakan kombinasi interpretasi foto udara

Studi ini dilakukan dengan penggabungan dua metode analisis yaitu teknik pengukuran di lapangan nondestructive dan Interpretasi foto udara menggunakan UAV, yang berfokus untuk mengetahui Jumlah Pohon, Biomassa dan Stok C pada tegakan S. balangeran di kawasan Hutan Kota Pulang Pisau. Hasil studi menunjukan Jumlah Pohon tegakan S. balangeran sebanyak 3.278 pohon dengan luas area penanaman 5,62 Ha, serta Biomassa dan Stok C secara berurut sebesar 1.444,30 ton dan 678,82 ton. Jika diakumulasi kedalam hektar maka tegakan S. balangeran memiliki potensi Biomassa 256,99 ton/ha dan Stok C 120,78 ton/ha. Hasil tersebut menunjukan bahwa kombinasi dua metode analisis dalam studi mampu mempermudah proses estimasi Biomassa dan Stok C tegakan

Pengaruh Kualitas Produk dan Kualitas Pelayanan terhadap Keputusan Pembelian Mobil Merek Chevrolet Captiva

The development of the automotive industry in Indonesia has grown rapidly, with the number of vehicle manufacturers in Indonesia currently making consumers have many choices before deciding which car to buy. In 2014-2016 Chevrolet Captiva can not achieve sales targets. Chevrolet Captiva should still have a chance to reach the target. Chevrolet should strive to know what the consumer wants and needs, Chevrolet should figure out what factors are affecting in making purchasing decisions.This study aims to determine the effect of product quality and service quality variables on Chevrolet Captiva purchase decisions on Chevrolet Semarang consumers.Type of this research is explanatory with 45 respondents were taken with purposive sampling technique. Data collection techniques used questionnaires and interviews. Data analysis technique used in this research is regression analysis with SPSS software (Statistical Product and Service Solutions) version 20.0.The results showed that product quality has an effect on purchasing decision with correlation coefficient 0,591 and coefficient of determination 35%, Service quality has an effect on purchasing decision with correlation coefficient 0,621 and coefficient of determination 38,6%. Product quality and service quality together have influence to purchase decision with equation Y = 4,362 + 0,199 X1 + 0,317 X2. It means the more influential product quality and service quality will increase purchasing decisions.The conclusion of research is product quality and service quality influence to purchasing decision. The advice given to the company is to strengthen product quality and re-evaluate the quality of its services

Kandungan Magnetit dan Distribusi Sedimen pada Pantai Anoi Itam, Pulau Weh

Keberadaan pasir besi dalam suatu wilayah memiliki peran ekonomis penting, umumnya dimanfaatkan sebagai bahan baku untuk industri. Di sisi lain, kandungan mineral dan magnetit dalam sedimen dapat digunakan sebagai bahan penjejak untuk menelusuri proses transport sedimen dalam suatu lingkungan perairan. Penelitian ini bertujuan memberikan gambaran pola distribusi magnetit di lingkungan Pantai Anoi Itam (PAI) yang berada di bagian timur Pulau weh, Kota Sabang. Analisis komposisi magnetit bersama dengan parameter ukuran butiran rata-rata, digunakan untuk mendeskripsikan pola sebaran pasir besi yang terbentuk pada kawasan PAI. Sampel sedimen diambil pada bulan Februari 2017 menggunakan coring pada 20 stasiun di sepanjang pantai (alongshore). Parameter ukuran butiran rata-rata diperoleh menggunakan metode ayak basah, sedangkan kandungan magnetit dihasilkan dari separasi menggunakan magnet kuat Neodynium tipe n-35. Sedimen PAI dicirikan memiliki tekstur yang agak kasar, dimana tipe pasiran dengan sedikit kerikil (Slightly Gravelly Sand) umum ditemukan. Diperoleh nilai ukuran butiran rata-rata sedimen antara 0,30 mm hingga 1,72 mm, dengan rerata (average) 0,74 mm. Magnetit memiliki nilai ukuran butiran rata-rata antara 0,31 mm hingga 1,82 mm, dan diperoleh rerata sebesar 0,76 mm. Keterdapatan magnetit ditemukan dalam persentase yang tinggi pada bagian utara PAI dan menjadi lebih rendah menuju bagian selatan, sehingga disimpulkan bahwa pola sebaran magnetit berasal dari bagian utara PAI