A Proposed Model for Outpatient Care Service Improvement Using the Healthcare Lean Approach and Simulation

The health service industry cannot be separated from the demands of quality, affordable, accessible, efficient and effective services. The Central Public Hospital of Dr. Sardjito, Yogyakarta, where the level of satisfaction of Outpatient Installation patients does not meet the minimum hospital service standards. The results of a real system simulation also prove that for 93.23% of the total time, the patient in the system isallocated waiting time for the service of around 4.82 hours. This proves that the patient's waiting time is still far below the hospital's minimum service standard. The high number of patients plus too many procedures to be undergone coupled with an overworked nursing entity results in long queues and bottlenecks. The purpose of this paper is to improve the patient care system through the Lean healthcare approach with a VSM tool, combined with modeling and a simulation system to observe changes from each alternative produced. Based on VSM analysis, three waste problems from each NVA and NNVA were obtained. From 6 simulated alternatives, one of the best alternatives obtained gave the highest total change in waiting time of all alternatives, with a total change of 73.16% from 4.822 hours to only 1.294 hours.