Pendekatan Lean Hospital Untuk Meminimalisasi Waste Pada Proses Discharge Di Ruang Rawat Inap VIP RS Keluarga Sehat Kabupaten Pati

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2017 ABSTRAK Hana Triwanggono Pendekatan Lean Hospital Untuk Meminimalisasi Waste Pada Proses Discharge Di Ruang Rawat Inap VIP RS Keluarga Sehat Kabupaten Pati xiv + 86 halaman + 9 tabel + 12 gambar + 6 lampiran Pelayanan kesehatan di rumah sakit menjadi sangat penting demi tercapainya kepuasan pelanggan. RS Keluarga Sehat masih menerima keluhan atas proses pemulangan pasien (discharge). Keluhan yang sering diajukan adalah mengenai lamanya waktu proses pemulangan. Tujuan penelitian ini adalah untuk menganalisis dan usulan perbaikan dengan meminimalisasi waste di ruang rawat inap VIP RS Keluarga Sehat dengan menerapkan pendekatan konsep Lean Hospital. Penelitian ini menggunakan metode campuran kuantitatif dan kualitatif. Pengumpulan data dilakukan dengan telaah dokumen, observasi pada 20 responden, dan wawancara mendalam terhadap manajer rawat inap, kepala ruang rawat inap, dan perawat. Hasil penelitian adalah bahwa proses discharge di instalasi rawat inap RS Keluarga Sehat sebelum penerapan Lean dimulai dari dokter mengizinkan pasien pulang hingga mengantar pasien pulang yang terdiri dari 16 tahapan. Setelah penerapan Lean, tahapan proses discharge berkurang menjadi 14 tahapan. Waste terjadi di sela-sela tiap aktivitas. Di antaranya menunggu dokter melengkapi rekam medis dan menulid resep, menungggu pengitungan alkes dan obat tidak terpakai, dan menunggu obat dari farmasi. Layout ruangan memengaruhi mobilitas perawat dalam melaksanakan aktivitas proses discharge. Kesimpulan dari penelitian ini adalah bahwa waktu keseluruhan proses discharge di ruang rawat inap VIP Rumah Sakit Keluarga Sehat sebelum penerapan Lean Management Hospital adalah 189 menit. Setelah penerapan Lean Management Hospital menjadi 162 menit. Waktu tunggu/waitting merupakan bentuk pemborosan yang paling dirasakan tidak nyaman bagi pasien/keluarga. Minimalisasi Waste gerakan (motion) dapat dilakukan dengan mengurangi motion perawat, mendesain pergerakan perawat ke pasien jauh lebih terarah dan menghindari pasien menunggu terlalu lama. Kata kunci : Lean Hospital, waste, discharge Kepustakaan : 24 (1992-2016)Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2017 ABSTRACT Hana Triwanggono Lean Hospital Approach to Minimise Waste on a Discharge Process at VIP Inpatient Rooms of Healthy Family Hospital in Pati Regency xiv + 86 pages + 9 tables + 12 figures + 6 appendices Health services at a hospital play an important role to satisfy customers. A Health Family Hospital still receives complaints of patients discharge process. The most patients complained about the length of discharge process time. This study aimed at analysing and proposing the improvement by minimising waste at VIP inpatient rooms of the Healthy Family Hospital using Lean Hospital approach. This was a mixed method design (quantitative and qualitative approaches). Data were collected by undertaking a literature review, observing to 20 respondents, and conducting indepth interview to managers of inpatient rooms, heads of inpatient rooms, and nurses. The results of this study showed that the discharge process at the inpatient rooms of the Healthy Family Hospital before applying Lean starting from issuing permits for patients to go home from physicians to accompanying them until arriving in their homes safely which consisted of 16 steps. In contrast, after applying Lean, number of the steps was reduced to be 14. Waste occurred during undertaking the activities such as waiting for a physician in completing medical record and writing a prescription, waiting for calculating unused health equipment and medicines, and waiting for medicines from a pharmacist. Layout of a room influenced a nurse’s mobility in conducting the activity of the discharge process. To sum up, overall time for the discharge process at the VIP inpatient rooms of the Healthy Family Hospital before applying the Lean Management Hospital (LMH) was 189 minutes, otherwise it decreased to be 162 minutes after applying the LMH. Waiting time was inconvenient for patients/their families. Waste could be minimised by reducing a nurse’s motion, designing a nurse’s motion to patients in order to be more focused and to avoid the waiting time that was too long. Keywords : Lean Hospital, Waste, Discharge Bibliography: 24 (1992-2016

Phase transitions induced by correlated hopping in the Falicov-Kimball model

The extrapolation of finite-cluster calculations is used to examine properties of the one-dimensional Falicov-Kimball model with correla It is shown that the correlated hopping strongly influences both the transitions and the conducting properties of the model and so it sho neglected in the correct description of materials with correlated el This is illustrated for two selected values of the Coulomb interacti that represent typical behavior of the model for small and intermedi (strong) interactions. In both cases the insulator-metal transitions (accompanied by continuous or discontinuous valence transitions) ind correlated hopping are observed.Comment: 11 pages, 7 figures, LaTe

Method of lines transpose: High order L-stable O(N) schemes for parabolic equations using successive convolution

We present a new solver for nonlinear parabolic problems that is L-stable and achieves high order accuracy in space and time. The solver is built by first constructing a single-dimensional heat equation solver that uses fast O(N) convolution. This fundamental solver has arbitrary order of accuracy in space, and is based on the use of the Green's function to invert a modified Helmholtz equation. Higher orders of accuracy in time are then constructed through a novel technique known as successive convolution (or resolvent expansions). These resolvent expansions facilitate our proofs of stability and convergence, and permit us to construct schemes that have provable stiff decay. The multi-dimensional solver is built by repeated application of dimensionally split independent fundamental solvers. Finally, we solve nonlinear parabolic problems by using the integrating factor method, where we apply the basic scheme to invert linear terms (that look like a heat equation), and make use of Hermite-Birkhoff interpolants to integrate the remaining nonlinear terms. Our solver is applied to several linear and nonlinear equations including heat, Allen-Cahn, and the Fitzhugh-Nagumo system of equations in one and two dimensions

Spectral Decomposition and Invariant Manifolds for Some Functional Partial Differential Equations

AbstractWe study the integrodifferential convolution equationddt(x+μ∗x)−Ax−ν∗x=fon [0, +∞),x=φon (−∞, 0],as well as a nonlinear perturbation of the corresponding homogeneous equation. HereAis the generator of an analytic semigroup on a Hilbert spaceH, andμandνare operator-valued dominated measures with values inL(H) andL(D(A), H) respectively. Under the assumption that the operator given by the Laplace transform of the left-hand side of the equation is boundedly invertible on some right half-plane and on a line in the left half-plane, parallel to the imaginary axis, we decompose the solutions into components with different exponential growth rates. We construct projectors onto the stable and unstable subspaces, which are then used for the construction of stable and unstable manifolds for the nonlinear equation, which can have a fully nonlinear character. The results are applied to two equations of parabolic type. Moreover, the spectrum of the generator of the translation semigroup in various weighted spaces is determined, including the stable and unstable subspaces of our problem

Impact of Strategic Planning and Innovation on Organisational Performance of the Saudi Red Crescent Authority

A survey-based empirical examination was made on the impact of strategic planning and innovation on the organisational performance of Saudi Red Crescent Authority. Data was collected from 212 workers in Riyadh and Jeddah. The majority of the sample are educated and experienced. The results of a multiple regression analysis test revealed statistically significant positive associations between each of strategic planning and innovation with organisational performance. Theoretical and practical implications are drawn and recommendations are made as well to assist decision-makers in undertaking strategic planning and emphasising innovation

v1v_1-periodic motivic homotopy over prime fields

We compute the motivic stable homotopy groups of a variant of the connective image-of-$J$ spectrum over prime fields of characteristic not two. Together with the analogous computation over algebraically closed fields, this yields information about $v_1$-periodic motivic stable homotopy groups over arbitrary base fields of characteristic not two.Comment: 30 pages, 16 figures. Comments welcome

Aplikasi Pengelolaan Surat Masuk, Surat Keluar Serta Pembuatan Surat Perintah Perjalanan (Studi Kasus : Dinas (Sppd) di Kpu Prov. Jawa Barat)

Komisi Pemiliahan Umum (KPU) Prov. Jawa Barat merupakan sebuah instansi pemerintahan yang bertugas sebagai penyelenggara pemilihan umum (pemilu). Dalam pengelolan setiap surat yang masuk, keluar dan pembuatan SPPD (Surat Perintah Perjalanan Dinas) masih dilakuakan secara manual. Dengan sistem yang sedang berjalan saat ini cukup menyita waktu yang cukup banyak hanya untuk sekedar mencari posisi surat masuk tersebut di pejabat terkait dan pembuatan laporan yang harus menyita waktu yang cukup lama, sedangkan pada pembuatan SPPD masih melakukan perhitungan rincian biaya menggunakan kalkulator dan penyimpanan data pun kadang terbengkalai dan itu menyebabkan buku register dalam pencatatan SPPD tidak berurutan.Tujuan dari penelitian ini adalah untuk mengetahui sistem yang sedang berjalan, membuat perancangan Sistem Informasi, mengimplementasikan Sistem Informasi serta melakukan analisis pengujian program yang terbatas pada sistem pengelolaan surat masuk, surat keluar serta pembuatan SPPD di Komisi Pemilihan Umum (KPU) Prov. Jawa Barat. Kegunaan penelitian ini diharapkan bisa meningkatkan semua aspek yang terlibat di dalamnya.Metode penelitian merupakan cara atau teknik ilmiah untuk memperoleh data dengan tujuan dan kegunaan yang diinginkan.Metode pengembangan sistem yang digunakan dalam pembuatan Sistem Informasi Pengelolaan Surat Masuk, Surat Keluar serta Pembuatan SPPD ini yaitu menggunakan metode prototype. Sebab metode ini merupakan metode waterfall yang dilakukan secara berulang–ulang dan mengacu pada kepuasan user.Setelah melewati tahapan implementasi diperoleh hasi yaitu keamanan data lebih terjamin sebab tidak semua staff bisa mengakses program aplikasi tersebut. Pada proses penyimpanan data pun dibilang aman dan rapih. Maka dapat disimpulkan bahwa sistem ini dapat membantu dan mempermudah proses pembuatan laporan, pencarian surat yang ditujukan untuk ketua maupun sekertaris, dan perhitungan biaya yang dikeluarkan dalam pembuatan SPPD pun terbilang aman dan efisisen

Analisa Pengaruh Kualitas Produk Dan Kualitas Layanan Terhadap Kepuasan Konsumen Dengan Nilai Yang Dipersepsikan Sebagai Variabel Perantara Pada Hotel Syariah Di Surabaya

Penelitian ini dilakukan untuk menganalisa pengaruh kepuasan konsumen atas kualitas produk dan layanan terhadap nilai yang dipersepsikan konsumen pada hotel syariah di Surabaya. Penelitian ini menggunakan pendekatan kuantitatif deskriptif dan kausal dengan penyebaran kuesioner yang dibagikan kepada 100 responden yang pernah menginap di hotel syariah di Surabaya. Hasil penelitian menunjukkan bahwa kualitas produk berpengaruh positif dan signifikan terhadap nilai yang dipersepsikan. Namun demikian, oleh responden kualitas layanan berpengaruh negatif dan tidak signifikan terhadap nilai yang dipersepsikan. Selanjutnya, oleh konsumen nilai yang dipersepsikan berpengaruh positif dan signifikan terhadap kepuasan konsumen. This research aimed to analyze the effect of customer satisfaction upon product quality and service quality on perceived value at sharia hotel in Surabaya. Survey with questionnaire as a research instrument was conducted to 100 respondents who had ever stayed at sharia hotels in Surabaya. The result showed that product quality had a positive and significant effect on perceived value, while service quality had a negative and not significant effect on perceived value. Customer\u27s perceived value positively and significantly affected customer satisfaction