Kepatuhan discharge planning sebelum dan setelah standardisasi berbasis lean management di rumah sakit pendidikan
DOI: https://doi.org/10.33024/hjk.v20i7.3607
Discharge Planning Lean Management Length of Stay Nurse Compliance Nursing Management
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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