Developing an early discharge planning model to optimize the length of stay of national health insurance patients: Evidence from Ari Canti Hospital, Bali, Indonesia
Keywords:
Early discharge planning, length of stay, Lean Healthcare, hospital efficiency, National Health InsuranceAbstract
Length of Stay (LOS) is a key performance indicator used to evaluate hospital efficiency and the quality of patient care, particularly for patients covered by Indonesia's National Health Insurance (Jaminan Kesehatan Nasional/JKN). However, discharge planning in many hospitals remains predominantly focused on the day of patient discharge, limiting its effectiveness in reducing unnecessary hospitalization and improving patient flow. This study aims to analyze the current implementation of discharge planning and develop an early discharge planning model to optimize the LOS of JKN patients at Ari Canti Hospital, Ubud, Bali. A qualitative research design was employed using observations, semi-structured interviews, and document reviews. Data were analyzed through triangulation to ensure the credibility and comprehensiveness of the findings. The results revealed several barriers to effective discharge planning, including delayed discharge preparation, inadequate interdisciplinary communication, fragmented care coordination, and the presence of non-value-added activities throughout the discharge process. The findings further indicate that implementing an early discharge planning model based on Lean Healthcare principles can improve multidisciplinary collaboration, streamline discharge processes, eliminate operational waste, and facilitate more efficient patient flow. By initiating discharge planning at the early stage of hospitalization, hospitals can better coordinate clinical and administrative activities, resulting in more timely patient discharge without compromising the quality of care. This study concludes that the proposed early discharge planning model has the potential to optimize LOS among JKN patients while enhancing hospital operational efficiency, service quality, and patient-centered care. The findings also provide practical guidance for hospitals seeking to improve discharge management through Lean Healthcare implementation.
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