Identification of waste: DOWNTIME in the outpatient prescription services at the pharmacy installation of Rumah Sakit Islam Siti Hajar Mataram

Background: The hospital pharmacy installation is a health service unit that is required to provide professional services and improve quality which is oriented towards achieving patient satisfaction. Waste identification in pharmaceutical services is important because it has an impact on stakeholder satisfaction. Objective: Identifying waste using the DOWNTIME method for the outpatient prescription services at the pharmacy installation of Rumah Sakit Islam Siti Hajar Mataram. Methods: The study used the cross-sectional design, with the population being all outpatients who were provided with pharmaceutical services during February – April 2019 as well as all staff. Data were tabulated and analyzed descriptively. Critical waste was obtained through questionnaires and the root causes of critical waste were obtained through in-depth interviews with 5-why methods. Results: Waste waiting had the highest rate compared to other wastes, reaching 44% or 53 out of 121 respondents, followed by inventory (26%), extra processing (19%), transportation (14%), defects (14%), motion (13%), over production (8%), and non-utilized skills (7%). Meanwhile, from the staff respondents, waiting was also the highest waste (18%), followed by inventory (16%), motion (13%), over production (12%), transportation (12%), non-utilized skills (10%), extra processing (10%), and defects (9%). The root cause of waste waiting was the frequent drug unavailability due to delays in payment of services from the cooperating party to the hospital as well as the narrow service areas. Conclusion:Waste waiting became the critical waste with the highest percentage of dissatisfaction in the patient respondents (44%) and staff respondents (18%). Keywords: Waste, DOWNTIME, outpatient prescription services, pharmacy installation of RSI Siti Hajar Mataram