Pengembangan Model Optimalisasi Waktu Tunggu Pasien RSKD Duren Sawit Berbasis Lean Hospital Management
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Abstract
Waktu tunggu pasien dari Instalasi Gawat Darurat (IGD) menuju rawat inap di RSKD Duren Sawit masih sering melebihi standar ≤6 jam, sehingga berdampak pada mutu pelayanan, keselamatan pasien, dan efisiensi operasional rumah sakit. Permasalahan ini tidak hanya disebabkan oleh satu unit pelayanan, tetapi merupakan akumulasi pemborosan proses (waste) sepanjang alur pasien dari IGD hingga rawat inap dan discharge. Penelitian ini bertujuan menganalisis alur pelayanan pasien dari IGD menuju rawat inap serta mengembangkan model efektivitas penurunan waktu tunggu berbasis Lean Hospital Management. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus. Data dikumpulkan melalui wawancara mendalam, observasi alur pelayanan lintas unit (IGD, admission, dan rawat inap), serta telaah dokumen operasional. Analisis dilakukan dengan memetakan value stream, mengidentifikasi aktivitas bernilai tambah (value added) dan tidak bernilai tambah (non-value added), serta mengkaji bottleneck dan bentuk pemborosan proses. Hasil penelitian menunjukkan bahwa waktu tunggu terbentuk secara kumulatif akibat variasi durasi registrasi dan triase, keterlambatan hasil laboratorium dan radiologi sebagai diagnostic bottleneck, variasi waktu respons DPJP, ketidaksinkronan informasi ketersediaan tempat tidur, serta proses discharge yang belum terintegrasi. Kondisi kapasitas rawat inap yang tinggi dengan rotasi tempat tidur yang lambat memperburuk boarding time pasien di IGD. Implikasi penelitian ini memperkaya penerapan Lean Healthcare pada pengelolaan patient flow dan memberikan dasar praktis bagi manajemen rumah sakit dalam mengendalikan waktu tunggu IGD secara sistemik.
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