Implementation of Lean Kaizen to Reduce Waiting Time for the Indonesian Health Social Security Agency Prescription Services in Hospital Pharmacy InstallationImplementation of Lean Kaizen to Reduce Waiting Time for the Indonesian Health Social Security Agency Prescription Services in Hospital Pharmacy Installation

BACKGROUND: The second largest Health Social Security Agency (BPJS) outpatients visits in Hospital Pharmacy Installation, Indonesia, has reached 450-600 visits / day between 2017 and 2018. This has an impact on the number of prescriptions to be served. Simultaneous doctor practice schedule and less human resources are the reasons for not achieving the service standard time set by the Ministry of Health (≤60 minutes for concoctions and ≤30 minutes for non-concoctions). AIM: The purpose of this study was to determine the waiting time for BPJS prescription services in the current state and future state after the implementation of lean kaizen through Plan-Do-Check-Act (PDCA) approach at Grha Permata Ibu (GPI) Hospital. METHODS: The research method is operational research with qualitative and quantitative approaches through direct observation and in-depth interviews. RESULTS: The implementation of lean kaizen decreased the lead time from 135.31 minutes to 9.11 minutes in scenario-1 and 7.49 minutes in scenario-2 and a decrease in lead time from 185.17 minutes to 31.09 minutes in scenario-1 and 29,15 minutes in scenario-2 for the concoctions. PDCA in lean kaizen is for use in conditions where waste is most closely related to human behavior, but there is still a waste motion that has not been intervened. CONCLUSION: This study suggests an updating information to prioritize changes in pharmaceutical layout, carry out continuous monitoring, and encourage IT to develop IT-based pharmaceutical services.

Decision Support System Applications for Scheduling in Professional Team Sport. The Team's Perspective

Background: Periodization implies the systematic planning of training and competition with the goal of reaching the best possible performance in the most important competition. In team sports, this consists of finding a flight-and-practice schedule that maximizes the opportunities to perform the periodized contents (e.g., trips, practices, games, and days off). This process is conducted whilst considering known constraints (e.g., competitive schedule, roster availability, weather, especial events, holidays, or emotional effect of days away). The way a scheduling decision support system (DSS) leads users to make a decision should allow for flexibility, whilst minimizing users' confusion and facilitating the understanding of the recommendation given by the scheduling decision support system. Traditional approaches to solving scheduling problems use either simulation models, analytical models, heuristic approaches or a combination of these methods. When it comes to evaluate how the scheduling DSS is performing, three overarching aspects need to be reviewed: context satisfaction, process efficiency, and output quality. Appropriate training periodization and scheduling of trips and training sessions are critical for teams to optimize training and recovery processes in order to maximize health and performance. This article presents a methodological framework for designing decision-support systems for scheduling in professional team sports.

SISTEM INFORMASI GEOGRAFIS (GIS) PADA RUMAH SAKIT DI KABUPATEN LABUHANBATU BERBASIS WEB

Geographical information system (GIS) is a tool with computer and android systems used to map conditions and events that occur on earth. With the current mapping system's capabilities, it can be used by the community. There are still few people who know the hospitals around them, especially with people outside the district. They have to ask the local community to find out the location of the hospital. With a system designed to provide convenience through determining the hospital location points that are available on the system. The data collection process and methods using the waterfall method. Testing this geographic information system with BlackBox. Someone searches Al-Aziz hospital data by selecting the al-Aziz hospital symbol contained in the system. A detailed menu will appear on the symbol so that it provides information about the hospital address, the schedule for opening and closing of the clinic, the name of the doctor, receiving PBJS health patient services, and the doctor's practice schedule at Al-Aziz Hospital. Keywords: Blackbox Testing; Hospital; Location; Waterfall method; Webgis Abstrak: Sistem Informasi Geografis (SIG) adalah alat komputer dan sistem android yang digunakan untuk memetakan kondisi dan peristiwa yang terjadi di bumi. Dengan kemampuan sistem pemetaan yang ada saat ini dapat dimanfaatkan oleh masyarakat. Masih sedikit masyarakat yang mengetahui rumah sakit di sekitar mereka, terutama yang berada di luar kabupaten. Mereka harus meminta masyarakat sekitar untuk mengetahui lokasi rumah sakit tersebut. Dengan sistem yang dirancang untuk memberikan kemudahan melalui penentuan titik lokasi rumah sakit yang tersedia dalam sistem. Proses dan metode pengumpulan data menggunakan metode waterfall. Uji sistem informasi geografis ini dengan BlackBox. Seseorang mencari data rumah sakit Al-Aziz dengan memilih simbol rumah sakit al-Aziz yang terdapat dalam sistem. Pada simbol ini akan muncul menu detil sehingga memberikan informasi mengenai alamat rumah sakit, jadwal buka tutup klinik, nama dokter, penerimaan pelayanan pasien kesehatan PBJS, dan jadwal praktek dokter di RS Al-Aziz. Kata kunci: Blackbox Testing; Lokasi; Rumah sakit; Waterfall; Webgis

Combining Observation and Physical Practice: Benefits of an Interleaved Schedule for Visuomotor Adaptation and Motor Memory Consolidation

Visuomotor adaptation to novel environments can occur via non-physical means, such as observation. Observation does not appear to activate the same implicit learning processes as physical practice, rather it appears to be more strategic in nature. However, there is evidence that interspersing observational practice with physical practice can benefit performance and memory consolidation either through the combined benefits of separate processes or through a change in processes activated during observation trials. To test these ideas, we asked people to practice aiming to targets with visually rotated cursor feedback or engage in a combined practice schedule comprising physical practice and observation of projected videos showing successful aiming. Ninety-three participants were randomly assigned to one of five groups: massed physical practice (Act), distributed physical practice (Act+Rest), or one of 3 types of combined practice: alternating blocks (Obs_During), or all observation before (Obs_Pre) or after (Obs_Post) blocked physical practice. Participants received 100 practice trials (all or half were physical practice). All groups improved in adaptation trials and showed savings across the 24-h retention interval relative to initial practice. There was some forgetting for all groups, but the magnitudes were larger for physical practice groups. The Act and Obs_During groups were most accurate in retention and did not differ, suggesting that observation can serve as a replacement for physical practice if supplied intermittently and offers advantages above just resting. However, after-effects associated with combined practice were smaller than those for physical practice control groups, suggesting that beneficial learning effects as a result of observation were not due to activation of implicit learning processes. Reaction time, variable error, and post-test rotation drawings supported this conclusion that adaptation for observation groups was promoted by explicit/strategic processes.

Distribution of Practice Combined with Observational Learning Has Time Dependent Effects on Motor Skill Acquisition

Studies of the benefits of a distributed practice schedule on motor skill acquisition have typically found that distribution of practice results in better learning. However, less research has focused on how the benefits of distributed practice are impacted by timing during acquisition. To examine how timing of skill acquisition interacts with distribution of practice we had two groups of participants complete either an extensive massed or distributed training schedule to learn a speed stacking sequence across ten sessions. For participants in both groups, we provided observational learning to facilitate skill acquisition. Analysis of speed stacking time on a retention test revealed an overall benefit for the distributed relative to the massed practice group. Interestingly, our analysis of the benefits of distributed practice during training only showed performance benefits in the early session (session one) and later sessions (sessions eight, nine, and ten) of skill acquisition but not mid-way through it (sessions two through seven). Our results support previous findings highlighting the learning benefits of a distributed practice schedule but suggest that these benefits occur differentially throughout acquisition. Our work also replicates research demonstrating that observational learning is more beneficial when it is yoked to actual practice.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190