Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) yang cepat dan tepat sesuai standar waktu response time yang ditetapkan Kementerian Kesehatan Republik Indonesia, diharapkan dapat menurunkan angka kematian ibu dan angka kematian bayi. Dengan menggunakan metode lean, dapat dirumuskan upaya perbaikan untuk memperpendek waktu response time pada tindakan Seksio sesarea emergensi di RSUD dr. Doris Sylvanus Palangkaraya. Tujuan dari penelitian ini ialah mengetahui value stream mapping alur tindakan, mengidentifikasi kegiatan non value added, waste dan kegiatan value added pada setiap alur pelayanan serta merencanakan future state map alur tindakan Seksio sesarea emergensi. Penelitian ini menggunakan desain kualitatif dengan menggunakan metode lean melalui observasi dan telaah dokumen proses pelayanan dan juga wawancara kepada direksi, tim PONEK, pasien atau keluarga. Alur proses pelayanan PONEK di RSUD dr. Doris Sylvanus melibatkan sub unit terkait mulai dari triase sampai dimulainya tindakan di kamar operasi. Proses pelayanan yang terkait response time tindakan Seksio sesarea emergensi pada penelitian ini yaitu sejak penetapan keputusan tindakan, depo farmasi, BDRS/ PMI, kasir, transfer dan kamar operasi. Hasil penelitian ditemukan pada current state value streaming mapping tindakan seksio sesarea emergensi sebelum dan sesudah intervensi bahwa waktu yang digunakan untuk kegiatan non value added sebesar 41.17% menjadi 33,9% sedangkan kegiatan value added sebesar 58.83% menjadi 66,1% dengan total lead time 114,4 menit menjadi 49,2 menit sehingga masih diperlukan upaya perbaikan untuk memperpendek response time pelayanan PONEK di RSUD dr. Doris Sylvanus Palangkaraya.
The Comprehensive Emergency Obstetrics and Newborn Care (CEmONC/PONEK) services are required to reduce maternal deaths and infant mortality in an easy and sufficient response time performance. Improving the response times in the behavior of caesarean sections at RSUD dr. Doris Sylvanus Palangkaraya by means, the lean method could be established in this research. The aims of this research are to determine the value stream mapping of the flow, value added activities, non-value added activities and waste in the flow of services, and to prepare the future map in PONEK 's unit of RSUD dr Doris Sylvanus for the operational flow. This research used a qualitative approach using lean methods, by reviewing and evaluating data, and by carrying out insightful interviews with PONEK management, the patient and the family, respectively. The PONEK services run by dr. Doris Sylvanus required few things to be considered such as triage, registration, midwife and doctor evaluation, assessments, acts, prescription, cashiers, transfers and operating rooms. Cesarean section response time systems at RSUD dr. Doris Sylvanus's PONEK facilities are based on some of the policy decisions on the pharmacy store, BDR/ PMI, cashier, relocation and surgical room. The results of this study showed that in the current state of the streaming value mapping, before and after intervention, 41.17% of the non valued added activities for the caesarean sections emergency have been used change to 33.9% while the value added activities were showed at 58.83 % change to 66.1% with the total lead time 114.4 minutes change to 49.2 minutes, so that appropriate steps were needed to shorten the caesarean sections response time mapping in PONEK service of dr. Doris Sylvanus Hospital, Palangkaraya. |
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