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ABSTRACT
Background: Cempaka Putih Hospital always strives to make continuous quality improvements along
with the increasing public awareness about the importance of health services, especially pharmaceutical
services in supporting an optimal health system. Pharmaceutical services are one of the factors that
influence the realization of policy making objectives that affect service quality as a measure of how well the
level of service provided can be in accordance with patient expectations. Quality of services is an advantage
that is perceived by the consumer services of the comparison between what customers want with what is
acceptable to the consumer after the purchase of services. This study aimed to analyze of waiting time for
pharmaceutical services Cempaka Putih Hospital.
Subjects and Method: This type of research is a mix method with an observational analytic design using
a cross sectional approach carried out during November 2017 - February 2018. The sampling technique used
was purposive sampling with a total sample of 352 samples from the population of pharmaceutical services.
The dependent variable is the waiting time and the independent variable is an effort to improve the quality
of pharmaceutical services including improving service flow, arranging pharmacy, making programs
between cashiers and pharmacy, making etiquette with the program, and socializing doctors about good and
correct prescription writing. Data analysis using Mann Whitney test with groups before and after
intervention.
Results: The average of waiting time for pharmaceutical services was faster after intervention 15 minutes
than before 24 minutes for non compound medicine and become 8 minutes than before 12 minutes for
compound medicine.
Conclusion: Efforts to improve the quality of pharmaceutical services have succeeded in reducing waiting
times for pharmaceutical services of Minimum Service Standards and improve customer satisfaction.
Correspondence:
Ferti Dwi Ekasari. Faculty of Public Health, Universitas Indonesia. Email: fertydwi@gmail.com.
Mobile: +6281510303716
BACKGROUND length of the waiting time for pharmaceutical
The hospital as one of the providers of services. According to the Kepmenkes RI Nomor
health services is required to provide quality 1197 Tahun 2004, it is stated that pharmaceutical
health services to the community. According to services are an inseparable part of the hospital's
Undang-Undang Republik Indonesia Nomor 44 health care system that is intact and oriented to
Tahun 2009 tentang Rumah Sakit it is stated that patient services, providing quality medicines,
the Hospital is a health service institution that including clinical pharmacy services that are
organizes individual health services affordable for all levels of society. The length of
comprehensively that provides inpatient, waiting time for pharmaceutical services can
outpatient and emergency services. Plenary health provide several risk effects including contracting
services are services that are expected to provide the disease (nosocomial infection, URI, TB) from
maximum hospital patient satisfaction according other patients, delay in taking medication,
to established standards. There are many ways to reducing patient rest time, increasing patient
improve patient satisfaction in getting services at complaints, decreased patient satisfaction and
the hospital, one of which is to accelerate waiting reduced number of hospital patient visits.
time in getting services at the hospital. Based on the Hospital Minimum Service
Service waiting time is the length of time Standards (SPM) it is known that the waiting time
needed by patients ranging from registering to for pharmaceutical services for compound
getting services. Patient satisfaction with a medicine is 30 minutes, while for non compound
hospital is determined by the waiting time. Patient medicine is ≤ 60 minutes. Analysis of waiting time
waiting time is one component that has the for pharmacy services at Cempaka Putih Hospital
potential to cause dissatisfaction that has an from 1 August 2017 to 30 September 2017 in
impact on the quality of service in a hospital. It is getting the average pharmacy waiting time for
understandable that patients who go to the compound medicine is 24 minutes, according to
hospital are people with conditions that are the Minimum Service Standard, which is ≤30
uncomfortable in their body, so they hope to get minutes. In an effort to improve service quality
service as soon as possible to eliminate the illness and satisfaction of pharmaceutical services, the
they suffered during a visit to the hospital. target waiting time for non compound and
Hospital management sometimes still ignores the compound medicine is expected to be 15 minutes
length of waiting time while almost the majority of according to Permenkes Nomor 73 Tahun 2016
patient complaints at the hospital are about the tentang Standart Pelayanan Kefarmasian di
length of service waiting time. Apotek. The formulation of the problem to be
Cempaka Putih Hospital tries to make discussed in this study is to analyze the
quality improvements by identifying problems at effectiveness of efforts to improve the quality of
the Hospital by the Quality Control Circle (QCC) pharmaceutical services to reduce waiting time for
team. The Cempaka Putih Hospital QCC team pharmaceutical services by improving service
found that the priority of the problem was the flow, arranging pharmacies, making programs
between cashiers and pharmacies, changing submits the prescription to the pharmacy
etiquette from manual to computerized by department until the patient gets the medicine.
connecting to programs and socialize doctors Efforts made in improving the quality of
about writing good and correct recipes. It is pharmaceutical services are by improving service
expected that these efforts can accelerate, simplify flow, arranging pharmacies, making programs
and reduce the level of error in the provision of between cashiers and pharmacies, making
drugs in pharmaceutical services. etiquette with the program, and socializing doctors
about good and correct prescription writing. The
SUBJECTS AND METHODS instrument used is a daily waiting time observation
This type of research is a mix method sheet. Data analysis using Mann Whitney test with
with an observational analytic design using a groups before and after intervention.
cross sectional approach. The population in this
study were patients of Cempaka Putih Hospital RESULTS
pharmacy services during November 2017 to The researcher tried to analyze the data
February 2018. The sample technique used was used in the form of a comparative test using the
purposive sampling with a total sample of 352 independent t-test to determine the difference in
samples obtained by the Slovin formula. the average waiting time of the Cempaka Putih
Slovin formula : Hospital pharmacy at the time before and after
n = ___N____ the intervention. Previously researchers tried to
N.d2 + 1 do a normality test and obtained the results data:
Which is :
n = Total sample Tabel 1. Tests of Normality
N = Total population
d2 = Precision ( 5%)
The number of patient population in Cempaka
Putih Hospital pharmacy services during
November 2017 to February 2018 is 3000 patients
with an error rate of 5%, then :
n = ____3000___ = 352
3000. (0.5)2 + 1
n = 352 patient
The dependent variable in this research is
the pharmacy service waiting time and the
independent variable is the effort made to improve
the quality of pharmaceutical services. The waiting The Kolmogorov Smirnov test results said that the
time for pharmaceutical services is the length of data had a normal distribution if p> 0.05 was
time the service is waiting since the patient obtained. Based on the table above, the results of
data that are normally distributed are the waiting Obtained difference in waiting time for
times for concocted drugs before the application compund medicine which was significant (p
of etiquette, while others are not normally <0.05) between before and after intervention.
distributed. Then the hypothesis testing Where the compound medicine waiting time is
requirements using independent T tests are not obtained before the Intervention takes longer with
fulfilled, so that the next will use the Mann the middle value 11 (2 - 40) compared to after the
Whitney alternative test. Intervention with the middle value 7 (1-27).
waiting time for compound medicine prescription Healthy The time needed by pharmacists to
services after being given an intervention in service all infectious disease patients
can be faster so that they can reduce
January and February 2018 was to be 8 minutes, the amount of disease transmission
which successfully decreased the waiting time by Morale The pharmacy service satisfaction
4 minutes. While the average non compound rate has increased to 90.95% after
intervention from the before 79.7%
medicine waiting time time after giving the
intervention for the month was 15 minutes, which
managed to decrease the waiting time by 9 Based on data analysis it can be concluded
minutes. Based on the results of the Mann that the intervention efforts that have been carried
Whitney Test, the difference in waiting time for out such as improving service flow, arranging
compound and non compound medicine was pharmacies, making programs between cashiers
significant (p <0.05) between before and after the and pharmacies, making etiquette with programs,
Before After
Recipe checked
Prescription
The drug is priced examination and
etiquette making
Payment of medicine
at the cashier The medicine is
prepared
Back to pharmacy
Checking and
delivering medicine
The medicine is
prepared
Etiquette making
Checking and
delivering medicine
Inf :
After the intervention the prescription is immediately checked and etiquette is made
Provision of prices and payment of drugs at the cashier has been computerized
Patient after being checked directly into the cashier and returned to the pharmacy to take the
medicine