Analisis Waste Pada Pelayanan Rawat Jalan Menggunakan Pendekatan Lean Management Di Rs Rahman Rahim Sidoarjo

Abstract

Background: Outpatient care is one of the services with a high number of visits in hospitals, requiring an effective and efficient service process. Increasing the number of patient visits has the potential to lead to long waiting times, decrease patient satisfaction, and impact the quality of hospital services. One approach that can be used to identify the causes of service inefficiencies is Lean Management through mapping the service process flow using Value Stream Mapping (VSM).
Objectives: This study aims to analyze the waiting time for outpatient services, map the service flow using Value Stream Mapping, and identify the types of waste that affect the waiting time for outpatient services at Rahman Rahim Hospital, Sidoarjo.
Methods: This study employed a descriptive method with a qualitative approach. Six informants participated in the study: the head of the registration unit, the head of the outpatient clinic, an internal medicine nurse, a psychiatric nurse, the head of the pharmacy, and an outpatient cashier. Data were collected through in-depth interviews, observation, and documentation. Data analysis was conducted by identifying value-added, non-value-added, and necessary non-value-added activities based on the Lean Management concept.
Results: The study results showed that waste in waiting was the most dominant source of waste, primarily caused by late doctor arrivals, service queues, and technical issues with the Electronic Medical Records (EMR) system. Furthermore, waste in transportation, motion, inventory, overprocessing, defects, and underutilized personnel were found, all impacting service efficiency at various stages of the outpatient care process.
Conclusions: The conclusion of this study indicates that various wastes persist, leading to suboptimal outpatient waiting times. Implementing Lean Management through waste identification and elimination can be a strategy to improve the efficiency of the service process and the quality of outpatient services at Rahman Rahim Hospital, Sidoarjo.