STRATEGI MANAJEMEN FARMASI UNTUK MENINGKATKAN EFISIENSI PELAYANAN DI RS R. D. KANDOU MANADO
Keywords:
Pharmacy Management, Service Efficiency, Hospital, Lean–Six Sigma, Electronic Medical Record (EMR), Pharmaceutical Supply ChainAbstract
An efficient pharmacy service is a crucial component of the hospital care system because it directly affects service quality and patient safety. This study aims to identify and formulate an integrated pharmacy management strategy to improve service efficiency at R. D. Kandou General Hospital Manado, focusing on inefficiencies in drug distribution flows, delays in the procurement of medicines and consumables, and limited integration between the pharmacy information system and the Electronic Medical Record (EMR). The research uses a qualitative approach with a case study design and purposive sampling of 11 informants representing pharmacy staff, medical staff, and support management. Data were collected through in-depth interviews, observation of service flows, and document review, then analyzed using thematic analysis. The findings reveal process waste (duplicate documentation, manual queuing and communication), occurrences of stockout due to a non-anticipatory pharmacy supply chain management, and suboptimal EMR–pharmacy integration that leaves coordination heavily dependent on phone calls and instant messaging. The study concludes that an integrated pharmacy management strategy is required, combining workflow improvement based on Lean–Six Sigma, strengthened supply chain management with a stock early warning system, and accelerated EMR–pharmacy integration within the Hospital Information System (HIS/SIMRS) framework, all supported by effective change management and enhanced human resource capacity.
References
Adhikari, B., Ranabhat, K., Khanal, P., Poudel, M., Marahatta, S. B., Khanal, S., Paudyal, V., & Shrestha, S. (2024). Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal. PLOS Global Public Health, 4(5).
Ahtiainen, H. K., Kallio, M. M., Airaksinen, M., & Holmström, A. R. (2020). Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: A systematic review. European Journal of Hospital Pharmacy, 27(5), 253–262.
Bahadori, M., Teymourzadeh, E., Ravangard, R., Raadabadi, M., & Nasiri, S. (2017). Prioritization of factors influencing medication errors in hospital: Using analytical hierarchy process (AHP) model. Iranian Journal of Pharmaceutical Research, 16(1), 306–314.
Bates, D. W., Teich, J. M., Lee, J., Seger, D., Kuperman, G. J., Ma’luf, N., Boyle, D., & Leape, L. (1999). The impact of computerized physician order entry on medication error prevention. Journal of the American Medical Informatics Association, 6(4), 313–321.
Batson, S., et al. (2020). Automation of in-hospital pharmacy dispensing. Future Healthcare Journal, 7(1), e29–e34.
Devin, J., Parsons, R., & Rogers, K. (2020). Impact of computerized physician order entry (CPOE) on medication safety: A systematic review. Journal of the American College of Clinical Pharmacy, 3(2), 422–432.
Engström, A., Callenmark, J., Johansson, P., & Salomon, L. (2023). Time in medication errors (TIME) study: Medication errors before and after digitization in a large university hospital. NPJ Digital Medicine, 6, 147.
Gwen, A., Nirmala, S., & Rahma, D. (2023). Implementasi Lean Kaizen untuk menurunkan waktu tunggu pelayanan resep BPJS di instalasi farmasi rumah sakit X. Jurnal Manajemen Pelayanan Kesehatan, 26(2), 101–112.
Hammoudeh, S., Al-Ali, N., & Mansour, I. (2021). Application of Lean methodology to improve outpatient pharmacy waiting time at a comprehensive cancer center. BMJ Open Quality, 10(3), e001296.
Hohmeier, K. C., Britt, R. B., Westrick, S. C., & et al. (2022). Applying DMAIC to improve efficiency and patient satisfaction in a community pharmacy transitions-of-care program. Research in Social and Administrative Pharmacy, 18(5), 3000–3008.
IQVIA Institute. (2021). The global use of medicine in 2021 and beyond: Outlook and implications. IQVIA Institute for Human Data Science.
Kallal, K., et al. (2023). Lean Six Sigma to reduce patient wait times in an outpatient pharmacy. American Journal of Health-System Pharmacy, 80(Supplement_1), S36–S41.
Kementerian Kesehatan Republik Indonesia. (2016). Peraturan Menteri Kesehatan Republik Indonesia Nomor 72 Tahun 2016 tentang Standar Pelayanan Kefarmasian di Rumah Sakit. Kementerian Kesehatan RI.
Kunnen, M. (2023). Lean Six Sigma in hospital pharmacy: Sustainability of process improvement and the role of leadership. International Journal of Lean Six Sigma, 14(2), 311–329.
Mobasher, A. M. (2022). The importance of implementing integrated information systems in hospitals. International Journal of Advanced Computer Science and Applications, 13(3), 501–507.
Naamneh, M., & Bodas, M. (2024). Electronic medical records and nurses’ workload: A systematic review of impacts on efficiency and patient safety. BMC Nursing, 23, 115.
Pratasik, G., Wungouw, H., & Citraningtyas, G. (2023). Evaluasi pengelolaan obat di instalasi farmasi RSUP Prof. Dr. R. D. Kandou Manado berdasarkan indikator WHO. Pharmacon: Jurnal Ilmiah Farmasi, 12(1), 45–56.
Rathi, P., Vakharia, A., & Shankar, R. (2022). Lean Six Sigma in healthcare: A systematic literature review on trends and future directions. Processes, 10(10), 1945.
Rawis, J., et al. (2025). Analisis kesiapan implementasi SIMRS terintegrasi di RSUP Prof. Dr. R. D. Kandou Manado.
Sallam, M. (2024). Enhancing hospital pharmacy operations through Lean and Six Sigma strategies: A systematic review. Cureus, 16(3).
Satibi. (2014). Manajemen Obat di Rumah Sakit. Gadjah Mada University Press.
Sembiring, P., & et al. (2025). Evaluasi implementasi rekam medis elektronik di rumah sakit pendidikan di Indonesia: Tinjauan multi-situs.
Sittig, D. F., & Singh, H. (2010). A new socio-technical model for studying health information technology in complex adaptive healthcare systems. Quality & Safety in Health Care, 19(Suppl 3), i68–i74.
Wang, Y., Coiera, E., & Runciman, W. (2016). Electronic prescribing systems and medication errors: A systematic review. Journal of the American Medical Informatics Association, 23(5), 1010–1018.
World Health Organization. (2019). WHO guideline on country pharmaceutical pricing policies (2nd ed.). World Health Organization.
Yuliati, R., & Anita, D. (2024). Penerapan manajemen kinerja di rumah sakit: Keseimbangan efisiensi dan mutu layanan dalam kerangka Donabedian. Jurnal Manajemen Pelayanan Kesehatan, 27(1), 1–12.
Zheng, W., Tham, Y. C., Toh, Z. H., et al. (2022). Electronic medical record–linked real-time prescribing support to reduce medication errors in hospitals: A narrative review. Global Implementation Research and Applications, 2(3), 245–258.pm.v4i2.1
