REDUCING ELECTIVE SURGERY WAITING TIME AT PUBLIC HOSPITAL IN BANDUNG

• Main Author: Fachry Nindyo Yuwono, Muhammad
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/64725
• Institution: Institut Teknologi Bandung

The “Direktur Jenderal Bina Upaya Kesehatan” of the Ministry of Health of the Republic of Indonesia issue performance appraisal guideline for hospital managers to measure and evaluate hospital quality based on its health service performance, and to ensure the quality of service and patient satisfaction. The guideline state the operational definition, calculation formula, and other definition of each service performance indicator. A public hospital in the city of Bandung plan to evaluate its health service performance on the managerial areas using the guideline. One of the services that the hospital plan to evaluate is its elective surgery service, using waiting time as the indicator of evaluation as stated in the guideline. Elective surgery is one of the two major categories of surgery based on timing that can be scheduled in advance to be performed on a future date, because it is not involved a medical emergency and it is a subject to choice by the patient or doctor. The waiting time is calculated from when the patient enter hospitalization until the surgery is carried out, that is when the first surgery incision performed. Using the hospital elective surgery service data from January until June 2018, it is discovered that it surpass the set standard in the guideline. To determine what caused it, the data is analyzed using control chart. It is discovered that the process is not stable and out-of-control data point exist, which indicate the presence of special-cause variation and common-cause variation that contribute to the long waiting time. Then FGD with the key actors in the elective surgery service is held to get deeper understanding of the process, and it is determine that fundamental change of pathway of the elective surgery service that would solve the common-cause variation issue is the first thing to do. The fundamental change of the elective surgery process is not only limited to fixing the process from the step where the calculation of the waiting time starts until it ends, but the whole elective surgery process from patients comes until patients undergo surgery are also evaluated whether they have added value to patients so that patient satisfaction increases. The elective surgery process is then depicted with BPMN, and the assess using value-added analysis. The result shows that the elective surgery process is not efficient and it contains activity that does not give value to the patient. So the process work steps sequence is reconstructed, unnecessary steps are eliminated, and some steps are consolidated as an improvement effort to eliminate non-value-added activities and simplify the process. Thus created a to-be process diagram as a proposed solution to make the elective surgery process more efficient, reduce waiting time, increases patient satisfaction, and potentially reduce cost