Evaluation of Waiting Time Prescription Services in Hospital Pharmacy Installations in the Tasikmalaya Area

Pharmaceutical Services in Hospitals are part which is inseparable from the Home health service Hospital System that is oriented towards patient service, provision pharmaceutical preparations, medical devices and consumable medical materials quality and affordable for all levels of society. The aim of this research is to determine the suitability of the waiting timer for recipe service at Medika Citratama Hospital in Tasikmalaya base on Minister of Health Regulation No.129/Menkes/SK/II/2008, namely the waiting time for concoction ≤ 60 minutes and non-concoction waiting time ≤ 30 minutes. The research method is descriptive by making observations or observing directly using observation. Data taken were 370 outpatient prescriptions, consisting of 270 non-concocted and 90 concocted prescriptions. The average waiting time for prescription services is 26.30 minutes for non-mixed prescriptions and 52.20 minutes for prescriptions. concoction.


INTRODUCTION
Pharmacy services are one of the health services in hospitals are expected to meet minimum service standards.According to Minister of Health Regulation (PMK) number 72 of 2016 regarding the standard of pharmaceutical services in hospitals mentioned that a hospital (RS) is a health service institution provide comprehensive individual health services that provide inpatient, outpatient and emergency services.Pharmaceutical service standards in hospitals which aim to improve the quality of pharmaceutical services, ensure legal certainty for pharmaceutical personnel and protect patients and the public from irrational drug use in the context of patient safety.(Permenkes, 2016).Health is the most basic need for every human being.Increasing public knowledge and living standards mean that public awareness of the importance of quality health also continues to increase (Maftuhah et al, 2016).
Various services provided at the hospital divided into two groups.The first is the main service which consists of medical or nursing services carried out by various functional medical staff according to the type and status of a particular patient's disease.Functional medical staff generally consisting of general practitioners, dentists and specialist doctors from disciplines such as general surgery, surgery nerves.Cardiac and thoracic surgery, orthopedic surgery, surgery urology, anesthesia, obstetrics and gynecology surgery, surgery proctology, internal medicine and so on.
The second is Hospital Pharmacy Installation Services.have a big influence on development hospital, because almost all services are provided given to patients in related hospitals with pharmaceutical preparations or health supplies (Septiani, 2012).Hospital pharmacy services are one of the activities in hospitals that support the achievement of quality health services (Satibi, 2107).
One of the determining factors for the success of pharmaceutical services is the rational use of drugs (Kurniasih et al. 2022).Minimum Service Standards are provisions regarding the type and quality of basic services which are mandatory regional affairs that every citizen has the right to obtain at a minimum and are also technical specifications regarding minimum service benchmarks provided by public service agencies to the community.( Karuniawati, 2016) One of the minimum standards for pharmaceutical services in hospitals is waiting time ( Nurjanah et al, 2016).Waiting time is one of the minimum standards for pharmaceutical services in hospitals, waiting time for non-concocted drug services is the time period from when the patient submits the prescription to receiving the non-concocted drug with the minimum standard set by the Ministry of Health, namely ≤ 30 minutes, while the waiting time for drug services concoction is the time period from when the patient submits the prescription until receiving the concoction medication, which is ≤ 60 minutes.(Kepmenkes, 2008)

TOOLS AND MATERIALS
In this research the materials and tools used in data collection in the form of data collection sheets and stopwatch to calculate the duration of the recipe processing time receipt of the prescription until delivery of the drug to the patient.The Data Collection Sheet contains the initials of the patient's name, polyclinic, guarantor, type of prescription, time of receipt of the prescription, time of delivery of the drug, and total time of prescription service (minutes).

METHODS
Research procedure in this research are as follows: 1. Initial stage a.Permission from Kesbangpol Tasikmalaya City.
b. Permission to the director of Tasikmalaya Medika Citratama Hospital.

Observation
This stage is carried out to view patient visit data in Tasikmalaya Medika Citratama Hospital Outpatient Pharmacy Installation so that the samples taken in the research can be calculated.

Implementation stage
Collecting research data at Tasikmalaya Medika Citratama Hospital.The number of samples taken was 360 treatment prescriptionspaths consisting of concocted and nonconcocted recipes.

Data analysis
Data processing obtained and discussion of research results based on the data there are connected with related theories.Data analysis was carried out using Microsoft Excel.
Average formula (Mean): Where: X = average time, Σ X = total service time and N = number of samples The assessment of the speed of service for this prescription is said to be satisfactory The waiting time for prescription services at Medika Citratama Hospital for both concoction and non-concoction prescriptions after being averaged is as follows:

DISCUSSION
Based on the data in table.2, the average waiting time for concoction rescription services is 52.20 minutes.Based on the data in table.2above, the average waiting time for non-concocted pscription services is 26.30minutes.The waiting time for compounded prescription services is longer compared to non-mixed prescription services because compounded prescriptions require more time, not only preparing the medicine but also needing to calculate the dosage of the medicine, weighing the medicinal ingredients and compounding the medicine in powder, capsule and dosage forms.Others are carried out after the payment process is complete to avoid canceling the drug purchase after the drug has been compounded.This is in accordance with research conducted by (Septini, 2012) that there is a relationship between the type of prescription and the time the prescription is served.
Of all the samples studied, the daily average and total average of research results did not have a waiting time that exceeded the required waiting time.This is due to several things, namely the services at the outpatient pharmacy installation at Medika Citratama Hospital follow the SPO (Standard Operating Procedures) that have been established.The prescription service starts from handing over the prescription by the patient, then the prescription is screened (administrative, pharmaceutical and pharmacological), the prescription is input and the note is handed over to the patient after ensuring that the input results are correct, while the patient pays to the cashier, the medicine is prepared, then packaged and a label is attached to it.drug clip.The officers who carry out screening, inputting, checking, taking medicines, finishing and handing over medicines are carried out by different officers so that service times are faster and the possibility of medication errors can be avoided.Officers in pharmaceutical installations also receive regular training so that knowledge and skills in service can continue to be improved because skills have a significant influence on the quality of service.
So, the average time needed to complete a mixed recipe is 52.20 minutes and 26.30 minutes for a non-mixed recipe.The results of this study state that the average waiting time for prescription services at Medika Citratama Hospital has met the hospital's minimum service standards in accordance with Minister of Health No. 129 of 2008 which has a minimum service standard for non-concocted prescriptions ≤ 30 minutes and concocted prescriptions ≤ 60 minutes.

CONCLUSION
. The waiting time for drug prescription services is faster than the time for compounded drug prescription services because the finished drug prescription service does not go through a compounding process (Fadhilah et al, 2-19).Medika Citratama Hospital is one of the houses Type C Private Hospital in Tasikmalaya City which started operating on October 11 2010.During 2016 to 2018 the number of patients visiting the hospital increased, especially for BPJS patients which had an impact on the waiting time for outpatient prescription services at the Pharmacy Installation.

Table . 1
requirements of the Decree of the Minister of Health of the Republic of Indonesia Number 129 of 2008, concerning Minimum Hospital Service Standards for non-concocted drug prescriptions, meet the requirements if speed of service time ≤ 30 minutes.For prescriptions for compounded medicines, meet the requirements if the speed of service is ≤ 60 minutes.This research was carried out at Medika Citratama Hospital, Jln.HZ.Mustofa No. 310 Tasikmalaya City, West Java Province.Percentage of concocted and non-concocted recipes.
RESULTSTasik Medika Citratama Hospital with general guarantor and non-BPJS commercial insurance, namely ≤25% and non-mixed prescriptions ≤75%.So we got 90 mixed recipes and 270 non-mixed recipes as shown in table.1 below:

Table . 2
Average of Waiting time recipe at Installation of Pharmacy RS Tasik Medika Citratama