FINAL PAPER OPERATIONS MANAGEMENT

A CASE STUDY AT SILOAM HOSPITALS SURABAYA

Edwin Allein Mandagi Tommy Permadi Denny Sondang Pantas Sitorus Veronika Sri Mahayani 90120120009 90120120025 90120120019 90120120029

PELITA HARAPAN UNIVERSITY

Background of Study
Operations Management is a science that studies about the entire process which takes place in an organization, by looking at all aspects that influence each other in it. The final paper is observing a hospital used to be a special hospital but is now operating as a hospital that receives public service.

Objectives of Study
Obtain a real picture about the application of the theory of Operations Management in an organization that has already been running. Take part as a real learning process about how health services are carried out in a hospital Understand the role of management in running the operations of the hospital and the role of all members in it. Be aware of the problems and constraints that exist in the hospital Perform needs analysis for the improvement of this organization in the future

Scope / Coverage of Study

Nursing

&
Medical support Unit (laboratory, pharmacy and radiology)

Method of Data Collection and Analysis

Interviews with several sources related to the presentation materials.

Observations of the behaviour in the Siloam

Hospitals, Surabaya Documentation.

Findings of Study
Industry Description
Siloam Hospitals Surabaya is a hospital providing in and outpatient services and hospitalization.

Company / Organization Profile

Hospital Identity
Name : Siloam Hospitals Surabaya Legal Entity: PT. Siloam International Hospitals Address : Jl. Raya Gubeng 70, Surabaya

Historical Background
The hospital used to be known as Budi Mulia Hospital. Budi Mulia Hospital started its operation on

October 15, 1977, with permission from the Health

Ministry through the decision letter of the Minister

of health of Indonesia number 185/p. Kes/I.O/1974

on March 29, 1974.

 To further spur the professionalism and

competition with other medical service providers

especially in the city of Surabaya, Budi Mulia

Hospital affiliated with Siloam Hospitals-Karawaci

Tangerang, Graha Medika Hospital-Kebon Jeruk Jakarta, Singapore's Gleneagles Hospital and Mount Elizabeth Hospital in Singapore.

 In its development on the 20th July 2004 Budi Mulia Hospital, along with the Siloam HospitalsKarawaci Tangerang, Graha Medika HospitalKebon Jeruk Jakarta, Siloam Hospitals Lippo Cikarang joined in a group that is SILOAM HEALTH CARE with the ownership of PT LIPPO Karawaci Tbk., with regards to it all then SILOAM HOSPITALS SURABAYA existed replacing Budi Mulia Hospital with bed capacity up to 160 beds.

Excellence and Achievements

At the moment the hospital has 105 specialists in the Outpatient units and Specialist Clinics, 1 doctor of acupuncture, 16 general practitioners in ECU (emergency care unit) and public Clinics, 14 dentists at dental clinic and 21 visitng doctors. As for the specialists, they consist of 20 kinds of specialties. They are the doctors who are well known by the public as experienced, competent practitioners and experts in their respective field.

2010 Siloam Hospitals Lippo Village received prestigious award Mitra Bakti Husada from Minister of Health, dr. Endang Rahayu Sedyaningsih, MPH, PhD in recognition of their commitment -over the past 14 years, to international quality healthcare Siloam Hospitals Lippo Village reaccredited by the Joint Commission International Siloam Hospitals Group received the 2010 Frost & Sullivan Indonesia Best Practices Awards as Healthcare Services Provider of the Year Siloam Hospitals Surabaya received MarkPlus Surabaya Service Excellence Award 2010 as The Best Service Hospitals in Surabaya Siloam Hospitals Surabaya chosen as the Regional and National Winner of Hospital Best Administration from Astra Insurance (Garda Medika)

 2011

Siloam Hospitals Group received Excellence Asian Hospital Management Awards (AHMA) 2011 in Human Resources Development Category Siloam Hospitals Group received Indonesias Most Admired Company (IMAC) award as The Best Building and Managing Corporate Image in Hospital Category Siloam Hospitals Surabaya received Astra Zeneca Infection Management Award (Azima Award) as the 1st winner.

Some of the facilities:

Clinical pathology laboratory, Medical rehabilitation, ICU, One-Day Care, Nursery, Hemodialisa, a state of the art Neonatal Intensive Care Unit (NICU) in 2006 to support our IVF Program, USG 4-D, latest 64 Slice MSCT Scan, Echocardiografi, Endoscopy and Laparoscopy, a Treadmill Test, Spirometri, Audioskopi, 1.5 Tesla Magnetic Resonance imaging (MRI), Cathlab, etc.

Organizational Structure
CEO
Dir Medical Support Services Hospital Quality

Medical Director

Nursing Director

Business Analysis Director

Human Resoources Director

FinanceDirecto r

Head Dept :Pharmacyst,Ph ysiotherapist,Ra diologyst,Labora tories

Head Dept Dietition Medical Record Medical Services

Head Dept Nursing Quality IPD & OPD Critical Area Nursing Development

Head Dept Marketing

Head Dept Payroll Training Education

Head Dept Accounting Business Office

staff

staff

staff

staff

staff

staff

 a. Business Objectives International quality in the field of health

b. The vision of Siloam Hospitals Surabaya: International Quality Reach Scale Godly Compassion c. Mission of Siloam Hospitals Surabaya The trusted choice to obtain health services, health education and research that is holistic, and international standard.

Marketing Consideration
Implementation of marketing at Siloam Hospitals Surabaya has a purpose not only for introducing a superior product and a new product, but also increasing the volume of outpatient visits in hospitals and increase its market share the other units supporting the existing and increasing utilization of medical equipment available. High Competition Promotion mix ex. advertising, sales promotion & personal selling for brand image Corporate Social Responsibility Direct marketing, public relation & publicity Health Seminar & Sponsorship

Financial Concideration
Create Revenue
Create new product Enhance new modern tools Add to specialist doctors, which prioritizing on the doctors of the top 10 most cases happening in 2012 in Siloam Hospitals Surabaya. Reorganize using the doctor's office that aims to maximize the use of space and fills the empty time. Improve bed management through the setting of the door of the room availability up to the movement of patients from admission to patient transfers patients home, including both internal and external.

Efforts for reducing costs :

The management of drug formularies then be made of the drugs used in the hospital, so that from the type and amount can also be easily controlled minimum and maximum stock Review the use of forms that exist are often issued by each department and sometimes there is duplicate in other department. Minimize inventory and stock in the treatment room and the type and amount of item.

Operation Strategy and Marketing Competitive

Developing marketing product
Improving product and technology Decreasing OPEX Keeping good relationship with third party Increase quality improvement (to abide by international standard accreditation) Enforcing re-accreditation of IOS and national reaccreditation Reviewing guidelines and hospital policies, including standard operating procedures Improving skill and leadership competency

Contd
Improving and Developing Business Process
Developing systems through integrated Hospital Information System Developing work culture

Improving training and staff competency :

Developong competecy standard for all staf Consistency in the implementation of good performance management Improving staff development programs as required Improving the competence of the leaders

Facility Location and Layout Planning

Physiotherapy, Radiology, Pharmacy Laboratory, ABCDe Clinic, Fertility Ground Center, Endoscopy, Medical Check Floor Up, Staff, Cafeteria, Office, Musholla, ATM Centre, Boston, Excelso, Iwake, Holland Bakery, Trauma Centre Out Patient Department 1st Floor Maternity, Wards, The inpatient children, NICU Wards, : The inpatient adult class I, II and III 2nd Floor Operating Theater, Operating room, OPD, ICU, Haemodyalisis 3rd Wards, The inpatient adult class I and II Floor 4th Wards, VIP rooms Floor

The layout and location of facilities that need to be addressed is the integration of critical spaces (Space Special Care, Cath Lab and NICU) at the same level with the ICU and Operating Room. During the development and preparation of the construction, the office and the secretariat are not in the building as they were then, but were separated as well as with the purchasing department. So that these conditions have an impact on the growing need for employees as a runners.

Manpower Planning, Acquisition and Control

Manpower Planning
The basics of calculating workforce in each unit varies: Nursing workforce adheres calculation made by PPNI both for outpatient and inpatient care.
Number of Nurse per Unit JUMLAHThe PERAWAT PER UNIT
40 35 30 25 20 15 10 55 5
Maternity, LDS NICU ICU Pediatri OPD HD OT RPK L2B L2L ED L3 L4

37 33 31 23 20 1415 1110 11 10 45
CATH LAB

32

33 28

21 19 16 14 13 11 16 14

21 21

Actual

Budget

Contd
Acquisition
Recruitment nature consists of 2 kinds of plans according to manpower planning and incidental if there are staff nurses who will come out with a variety of reasons. Some of the incoming application files are submitted to the Human Resource Director of Nursing to be selected based on several criteria: Completeness files graduates The value of graduate nurses standards for specific areas: Medical Surgical Care, Emergency Care, Nursing Ethics and graduate institutions.

Contd

Control
Every employee in the employee selection process will undergo a period of probation during the first 3 months. Towards the end of the 3 month performance assessments conducted to assess whether they are going to be accepted as permanent employees by using the existing assessment indicators. From the results each unit will be ranked using Force Ranking and Bell Curve standard for each category A, B, C, D and E.

Contd Cost Control

Each year budget for revenue and cost is determined for the operation of the hospital. For revenue budget, it is taken from the core health services in SHSB, whereas for the costs in this case include maintenance costs, employee salaries including employees health allowances, facilities improvement, replacement of goods, the purchase of new items and the cost of marketing.

Contd Scheduling
Nursing and medical support units is run in 3 shifts per day. So in addition to the number of employees that needs to be taken into account, then the fulfillment of 40 hours of work per week are also taken into consideration. Referring to the Labor Law No. 13 of 2003 the SHSB regulates overtime and night duty allowances for its employees.

Summary of Findings and Detailed Recommendation

No Activity Problems Solutions

1. Marketing Mass marketing must go through Conduct rescheduling for the patients internally. Considera an online call center system tion based in Jakarta, causing Personalizing the internal operation problems in packages and displaying Surabaya. uniqueness of the Issuing different health packages services offered each month, but did not give compared with those of much impact on the revenue. the other hospitals. During a peak season or an Studying past records and outbreak of a certain disease make an anticipation plan for the future. e.g. diarrhea, dengue fever, the rooms/ beds are not sufficient.

No 3.

Activity

Problems

Solutions

4.

Facility Location Critical rooms are not The critical rooms must be and Layout integrated. redesigned or rearranged so Planning that each location is near to each other ensuring effectiveness and efficiency in the hospital operations. Manpower The gap between the Applying overtime schedule. Recruitment hospitals expectation Doing rotation for the nurses in terms of capability across treatment rooms/ places. and competence of the recruited staffs Doing internal training with what is available especially for new staff for in the labor market. upgrding their skills.

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