Identifying Potential Improvements In Drug Service Processes At Rs X Semarang Pharmacy Installation: Lean Management Approach

Abstract

Pharmacy installations are an integral part of the health service system in hospitals   which is oriented towards patient care. One indicator of the quality of pharmaceutical services is the waiting time for drug services, where the waiting time for drug services is very determining. This study aims to analyze the waiting time for drug services using the Lean concept in the Outpatient Pharmacy Installation X Hospital Semarang. This research is a descriptive analytical research conducted at the Pharmacy Installation X Hospital Semarang. The research was conducted from July to September 2023. Researchers calculated the waiting time for drug services for 100 prescriptions consisting of 50 compounded prescriptions (25 UHC prescriptions and 25 non- UHC prescriptions) and 50 ready-made or non-mixed drug prescriptions (25 UHC prescriptions and 25 prescriptions non- UHC). The data analysis technique was carried out in a qualitative descriptive manner by analyzing the results of observations, then root cause analysis was carried out by in-depth interviews with the Head of Pharmacy and source triangulation with the Medical Support Manager of Hospital X Semarang. The minimum time required to process non-concocted drug prescriptions for UHC patients is 23 minutes, while the maximum time required is 171 minutes (average 81.84 minutes). Prescribing non-concocted medicines for non- UHC patients takes a minimum of 21 minutes and a maximum of 108 minutes (average 44.60 minutes). Prescribing concocted medicines for UHC patients takes a minimum of 53 minutes and a maximum of 180 minutes (average 99.80 minutes). Prescribing concocted medicines for non- UHC patients takes a minimum of 48 minutes and a maximum of 128 minutes (average 73.56 minutes). The total mean time for non-concocted medication was 66.90 minutes, which was divided into a mean VA of 33.72 minutes with a percentage to CT of 51.89%, and NVA of 32.18 minutes with a percentage to CT of 48.11%. The total mean time for concocted medication was 86.06 minutes, which was divided into a mean VA of 43.08 minutes with a percentage of CT of 50.05%, and Non-VA of 42.98 minutes with a percentage of CT of 49.95%. Based on determining problem priorities according to the table above, the highest score for the problems found was man. Concocted medicines have a longer waiting time compared to non-concocted medicines, especially for UHC patients. The value stream mapping assessment of non-concocted medicines resulted in an average non-value added of >30%, which means there is high waste which affects the waiting time for medicines. The average overtime for non-concocted medicine services is more than 30 minutes, as well as more than 60 minutes for compounded medicines. The human resources aspect is what must be addressed first.