Holistik Jurnal Kesehatan
Vol. 20 No. 7 (2026): Volume 20 Nomor 7

Kepatuhan discharge planning sebelum dan setelah standardisasi berbasis lean management di rumah sakit pendidikan

Friska Simarmata (Fakultas Ilmu Keperawatan, Universitas Indonesia)
Hanny Handiyani (Fakultas Ilmu Keperawatan, Universitas Indonesia)
Tuti Nuraini (Fakultas Ilmu Keperawatan, Universitas Indonesia)
Erna Puspita Sari (Instalasi Rawat Inap, Rumah Sakit Pendidikan Universitas Indonesia)



Article Info

Publish Date
27 Sep 2026

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.

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Journal Info

Abbrev

hjk

Publisher

Subject

Health Professions Nursing Public Health

Description

Berisi kumpulan karya ilmiah dari peneliti diberbagai perguruan tinggi di Indonesia, di bidang ilmu kesehatan khususnya bidang ilmu keperawatan yang berdasarkan kepada kebutuhan pasien secara total meliputi: kebutuhan fisik, emosi, sosial, ekonomi dan spiritual. Adapun penelitiannya mencakup 4 aspek ...