Erna Puspita Sari
Instalasi Rawat Inap, Rumah Sakit Pendidikan Universitas Indonesia

Published : 1 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 1 Documents
Search

Kepatuhan discharge planning sebelum dan setelah standardisasi berbasis lean management di rumah sakit pendidikan Friska Simarmata; Hanny Handiyani; Tuti Nuraini; Erna Puspita Sari
Hik Vol. 20 No. 7 (2026): Volume 20 Nomor 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v20i7.3607

Abstract

Background: Suboptimal discharge planning contributes to prolonged length of stay, increased readmission rates, and reduced patient satisfaction. At Hospital X, a type-A teaching hospital, mean length of stay was recorded at 5.3 days, exceeding the hospital's 5-day quality target. Purpose: This study aimed to analyze lean management-based discharge planning implementation and evaluate the impact of standard operating procedure (SOP) socialization on nurse compliance. Method: This quality improvement study followed Lewin's three-stage change model (unfreezing, changing, refreezing). Assessment was conducted through data triangulation comprising in-depth interviews, a questionnaire distributed to 18 inpatient nurses, and direct observation over five weeks (April-May 2026). Findings were analyzed using a POSAC fishbone diagram, SWOT analysis, and the USG (Urgency, Seriousness, Growth) method for problem prioritization. Results: Two main priorities were identified: unsocialized discharge planning SOP (highest USG score: 15) and absence of an estimated discharge date (EDD) from the first day of admission (USG score: 14). Intervention through development and socialization of a lean-based SOP to all inpatient nurses increased mean compliance from 20.6% to 72.6% (+52 percentage points), with two components reaching the 80% target: SOP documentation (80%) and staged patient and family education (85%). Conclusion: Consistent lean management implementation is projected to reduce length of stay toward the 5-day target and sustainably improve discharge planning quality.   Keywords: Discharge Planning; Lean Management; Length of Stay; Nurse Compliance; Nursing Management.