A Root Cause Analysis of Prolonged Waiting Times for Compounded Prescriptiobs at an Indonesian Private Hospital

Abstract

Background: Waiting times have been shown to contribute to patient satisfaction with hospital services.
Previous studies investigated long waiting times in the hospital, one of which was the time it takes to
prepare compounded prescriptions in pharmacy unit. However, few studies have explored the main causes
of prolonged waiting times for compounded medications in the hospital. This study aimed to understand the
causal factors that influence prolonged waiting times for compounded prescriptions in Indonesian private
hospital. Methods: A root cause analysis was used to identify the root cause of a reoccurring issue in pharmacy
unit. Data were collected from hospital documents, observations, and interviews of 15 representatives from
the hospital directors, head of pharmacy department, purchasing staff, pharmacy storage manager, other
pharmacy staff, and service quality manager. Results and Discussions: This study identified possible causes
of prolonged waiting times for compounded prescriptions which include drug shortage, human resources
shortage, waiting times for drug preparations, and duration of health insurance coverage confirmation. In
addition, this study determined the actual causes of the problem, such as managerial, and health insurance
factors which in turn provide suitable recommendations and solutions. Conclusion: It can be concluded
that there were four key factors to the success of hospital pharmacy services: drug and human resources
management, waiting times for drug preparations, and duration of health insurance coverage confirmation.
It is recommended that hospital management could optimize drug formulary management, improve
coordination in drug distribution system to patients, and redesign waiting room in the hospital.