Root Cause Analysis and Strategies to Improve Outpatient Pharmacy Services

Abstract

XYZ is a hospital that provides health services and also provides pharmaceutical services. According to Permenkes No.129 of 2008 concerning Minimum Service Standards for Hospitals, the waiting time for ready-made medicine is ≤ 30 minutes and the waiting time for concoction medicine is ≤ 60 minutes. However, in 2019 and 2020 XYZ Hospital has not been able to achieve it, so a preliminary study was carried out by evaluating the outpatient pharmaceutical service business processes using the Quality Evaluation Framework (QEF) approach with the results showing a mismatch in target achievement in the prescription review process which included prescription review failures. (Q5), the process of checking drug availability which includes failure to check drug availability (Q7), the drug billing process which includes drug billing time efficiency (Q14), the administrative process which includes administrative time efficiency (Q18) and the process of providing information/counseling which includes authority provision of information/counseling (Q24). After knowing the quality factors that are not achieved, it is necessary to analyze the root causes and strategies for improving outpatient pharmacy services. This study aims to analyze the gaps in the business process of outpatient pharmacy services and determine the improvement strategy at XYZ Hospital. Collecting data in this study by conducting Focus Group Discussion (FGD) and documentation studies. Analysis of the data used using qualitative methods by doing data reduction, data display and conclusion/verification. From the results of the study, it was found that the gap in outpatient pharmacy services using Root Cause Analysis (RCA) was in the categories of procedures, people, policies, and plant/technology so the strategy for improving outpatient pharmacy services was by implementing e-prescriptions, eliminating hanging billing procedures, adding human resources and infrastructure, strengthening the integrated hospital information system. Thus it can be concluded that an analysis of the root causes of the business processes of outpatient pharmacy services needs to be carried out so that service improvement strategies can be determined.