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"Asuhan Keperawatan (Aske merupakan suatu pendekatan yang dilakukan seorang perawat terhadap kliennya. Motu Asuhan keperawatan di RSUD Dr. H. Abdul Moeloek Lampung masih diternokan pendokumentasian asuhan keperawatan pada rekam medik pasien yang asih belum terisi; masih adanya masyarakat yang merasa belum puas terhadap pelayanan yang dibe ·kan oleh perugas diruangan (20,3%); kelohan tentang pelayanan sebanyak 21,9%; 70% dari 20 pasien mengatakan perawat yang kurang ramah dalam menangani pasien, 75% dari 20 pasien merasa tidak diperhatikan oleh perawat. Hal ini perlu sekali mendapat perhatian dari semua pihak terkait:; dan menempatkan Pemantauan Motu Askep (PMA) sebagai kegiatan yang penting dilaksanakan secara berkesinambungan. Dalam pelaksanaannya, PMA belum didukung dengan sistem informasi pengolahan data yang masih dilakukan secara manual, belum ada analisis tiap penelitian adalah Ruang Rawat Inap yang ada di Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Propinsi Lampung. Sebagai hasil dari penelitian ini adalah diperolehnya prototipe Sistem lnformasi Pemantauan Mutu Asuhan Keperawatan yang diharapkan dapat effektif dan effisien dalam penyediaan informasi yang dibutuhkan. lnformasi yang diperoleh akan dirancang agar benar-benar relevan. cepat, tepat dan akurat, serta dapat lebih bennanfaat. terutama untuk kepentingan perencanaan peningkatan mutu pada umumnya, dan pemantauan Askep pada khususnya, sehingga dapat tercapai optimalisasi pemantauan mutu Askep di rumah sakit tersebut Agar pelaksanaan sistem infonnasi ini dapat berjalan dengan baik dan berkelanjutan, dibutuhkan pengembangan prototipe yang berbasis jaringan.

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Asuhan Keperawatan (Askep) represent an approach to do a nurse to its clien. Quality of Askep in Dr. H. Abdul Moeloek :cam pung hospital still found documentation of asuhan keperawatan on IJ&.tient record which still not yet loaded; there is still of society which feel not et satisfied to service given in a hospital (03%); sigh about ice counted 2 J,goA,; 70% from 20 patient tell less friendly nurse in handling patient, 75% from 20 patient feel not be paid attend on by nurse. This matter very important to get attention from all related partieand place Monitoring Quality of Askep ( PMA) as activity which is important to be implementation chronically.

In its implementation, PMA not yet been supported with infonnation system. data-processing which still (done/cond ucted) manually. there is no analysis every treatment upbringing step and also monitoring instrument quality of standard not yet altogether used to assess quality o askep. For that require to develop of monitoring.

This research was result a prototype of Information System Monitoring Quality of Askep. This system is expected to supply any needed information effectively earn and effektif of efficient in is ready of required information. obtained infonnation will be designed to really relevant, quickly, precisely and is accurate, and also earn more useful, especially for planning of make-up of quality in general, and monitoring of Askep especially, so that can reach by monitoring quality of Askep. For implementation of this information system can walk better and have continuation, required by development of prototype being based on network."

"From the Back Cover: The Health Care Leader's Essential Guide to driving quality, value, and performance. Advanced Performance Improvement in Health Care: Principles and Methods provides healthcare educators, leaders, and clinicians with the specific knowledge and tools vital for creating and advocating for quality-centric, next-generation healthcare organizations. This unique compilation of management, analytical, and statistical methods and techniques serves as a comprehensive guide to harnessing today's technology and developing a culture of quality that delivers sustainable, quantifiable value in healthcare organizations. Amidst a deepening crisis in U.S. health care, Advanced Performance Improvement provides a results-oriented approach to rehabilitating an ailing healthcare system. With his innovative, instructive strategies, the author offers a welcome road map to guide meaningful change in the industry and to equip healthcare managers to meet 21st century challenges. Offers a comprehensive methodology for improving quality in healthcare organizations. Details a process analysis toolkit with dozens of proven techniques. Illustrated with easy-to-follow diagrams and flow charts. Provides best practices for measuring value and performance. Includes extensive discussion of medical informatics, Lean, Six-Sigma, and more."

"Pelayanan di Instalasi Gawat Darurat (IGD) memegang peran penting dalam menentukan kualitas pelayanan dan keselamatan pasien di rumah sakit. Indikator kinerja IGD, seperti Length of Stay (LOS), yang mengukur lama pasien d IGD dari kedatangan hingga pemulangan atau pemindahan, dapat memengaruhi tingkat kepadatan di IGD. Penelitian ini bertujuan untuk mengidentifikasi alur pelayanan, hambatan, dan akar penyebab masalah terkait LOS di IGD. Pengumpulan data dilakukan pada bulan April-Mei 2024 dengan pendekatan kualitatif studi kasus, berupa observasi pada 30 pasien, wawancara, dan telaah dokumen. Analisis data menggunakan flowchart untuk mengidentifikasi alur pelayanan, Value Stream Mapping untuk mengenali kegiatan bernilai dan menemukan waste, serta The Five Whys untuk menganalisis akar penyebab hambatan. Metode Lean Thinking digunakan untuk menghasilkan alur dan Model BAS (Baseline, Assess, Suggest Solution) dari Model BASICS. Hasil penelitian menunjukkan bahwa alur pelayanan pasien IGD melibatkan lima tahapan; dengan 65,5% waktu pelayanan adalah kegiatan non-value added, 23,4% kegiatan necessary but non-value added, dan 11,1% kegiatan value added, dengan total Lead Time 7 jam 55 menit 29 detik. Dari sisi pasien, waste yang terjadi meliputi waste of waiting (94,9%) dan transportation (5,1%). Bottleneck terjadi pada aktivitas menunggu terdaftar di rawat inap (25,2%), menunggu advis DPJP (22,9%), menunggu hasil pemeriksaan penunjang (22,3%), dan menunggu kesiapan rawat inap (18,2%), dengan total 88,6%. Perbaikan LOS di IGD dapat menggunakan lean tools seperti standardized work, visual management, heijunka, kaizen, dan just in time agar waste dapat dikurangi.

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Emergency Department (ED) services play a crucial role in determining the quality of care and patient safety in hospitals. Performance indicators in the ED, such as Length of Stay (LOS) which measures the duration from a patient's arrival to their discharge or transfer can significantly impact the congestion levels in the ED. This study aims to identify the service flow, obstacles, and root causes of issues related to LOS in the ED. Data collection was conducted from April to May 2024 using a qualitative case study approach, including observations of 30 patients, interviews, and document reviews. Data analysis involved using flowcharts to identify the service flow, Value Stream Mapping to recognize value-added activities and identify waste, and The Five Whys to analyze the root causes of obstacles. Lean Thinking methodology was applied to develop a service flow and the BAS (Baseline, Assess, Suggest Solution) model from the BASICS model. The study results show that the patient service flow in the ED involves five stages, with 65.5% of service time consisting of non-value-added activities, 23.4% of necessary but non-value-added activities, and 11.1% of value-added activities, resulting in a total lead time of 7 hours, 55 minutes, and 29 seconds. From the patient's perspective, the waste observed includes waiting (94.9%) and transportation (5.1%). Bottlenecks were identified in activities such as waiting to be registered for inpatient care (25.2%), waiting for specialist advice (22.9%), waiting for the results of supporting examinations (22.3%), and waiting for inpatient readiness (18.2%), totaling 88.6%. Improving LOS in the ED can utilize lean tools such as standardized work, visual management, heijunka, kaizen, and just-in-time to reduce waste."