LEAN SIX SIGMA METHOD TO REDUCE LENGTH OF STAY IN EMERGENCY DEPARTMENT: SCOPING REVIEW
DOI:
https://doi.org/10.34011/jmp2k.v35i4.3314Keywords:
unit gawat darurat, length of stay, lean six sigmaAbstract
Instalasi Gawat Darurat (IGD) merupakan bagian yang sangat penting dalam sistem perawatan kesehatan. Length of Stay (LOS) salah satu indikator kinerja utama yang secara signifikan mempengaruhi outcome pasien, kualitas pelayanan dan kepuasan pasien. Scoping review ini meneliti efektivitas metodologi Lean Six Sigma (LSS) dalam menurunkan LOS di IGD dan meningkatkan throughput pasien di berbagai fasilitas pelayanan kesehatan. Empat database elektronik (MEDLINE via PubMed, Scopus, Emerald, dan ProQuest) ditelusuri untuk mencari literatur terkait dalam review ini. Review ini disusun menggunakan enam tahap metode scoping review sesuai dengan panduan metode PRISMA-ScR. Review ini berfokus pada implementasi yang menerapkan kerangka kerja Define-Measure-Analyze-Improve-Control, yang dilengkapi dengan pendekatan analitik dan manajemen perubahan. Ekstraksi data mencakup metodologi, hasil kuantitatif, strategi implementasi, dan faktor kontekstual yang memengaruhi keberhasilan. Dalam review ini, teridentifikasi 19 artikel yang memenuhi syarat. Hasil penelitian menunjukkan bahwa metode LSS secara signifikan mengurangi lama tinggal di IGD mulai dari 14% hingga 50%. Integrasi dengan model machine learning meningkatkan akurasi prediksi waktu tunggu pasien. Teknik simulasi mengoptimalkan alur pasien, dan pendekatan manajemen perubahan yang terstruktur memastikan perbaikan yang berkelanjutan dan melibatkan partisipasi staf. Dukungan kepemimpinan dan penggunaan sistem data yang efektif diidentifikasi sebagai faktor penentu keberhasilan, sementara tantangan yang dihadapi termasuk resistensi terhadap perubahan dan keterbatasan sumber daya. Metodologi LSS efektif dalam meningkatkan efisiensi dan mengurangi lama tinggal pasien di IGD, memberikan model yang dapat direplikasi yang bertujuan untuk meningkatkan efisiensi operasional dan perawatan pasien.
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