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Prolonged outpatient waiting time remains a major challenge in public hospitals and reflects inefficiencies in service process management. Internal medicine clinics are characterised by high service complexity and patient volume, making them particularly vulnerable to process waste that contributes to extended waiting times. Objective: This study aimed to develop an outpatient service flow model based on the Lean Hospital approach to reduce waiting time in the internal medicine clinic of RSUD Balaraja. Methods: A qualitative case study design was employed. Data were collected through direct observation of outpatient service processes, document review, and Focus Group Discussions (FGD) with relevant stakeholders. Process analysis was conducted using Value Stream Mapping (VSM) to identify value-added and non–value-added activities, while Fishbone Diagram analysis was applied to explore the root causes of process inefficiencies. All findings were integrated to develop a future-state outpatient service flow model. Results: The findings indicate that prolonged outpatient waiting time is primarily influenced by inefficient service flow design, repetitive administrative processes, and weak coordination among service units. The proposed service flow model demonstrates a more streamlined, integrated, and patient-centred process, with potential reductions in waiting time through systematic waste elimination and process improvement. Conclusion: The Lean Hospital approach provides an effective framework for developing outpatient service flow models in public hospitals. The proposed model offers a practical basis for improving outpatient service efficiency in complex clinical settings such as internal medicine clinics.

Prescription waiting time is a key indicator of pharmacy service quality that directly influences patient satisfaction and hospital efficiency. Data from the Outpatient Pharmacy Installation of Pelabuhan Jakarta Hospital show average waiting times of 30.49 minutes for non-compounded medications and 35.93 minutes for compounded medications. Although these figures are still within national standards, they have not met the hospital’s internal targets, indicating inefficiencies that require systematic improvement.This study aimed to analyze prescription waiting times and identify waste in outpatient pharmacy services using Lean Hospital and Continuous Improvement approaches. A qualitative analytical method with a case study design was applied. Data collection involved participatory observation, in-depth interviews with key informants (head of pharmacy, pharmacists, and technicians), and document review. Analysis utilized Lean tools such as Value Stream Mapping (VSM), identification of Value Added (VA) and Non-Value Added (NVA) activities, bottleneck analysis, fishbone diagram, and Failure Mode and Effects Analysis (FMEA).The findings revealed that service processes were dominated by non-value-added activities, especially during prescription receipt, verification, packaging, and dispensing. Major wastes included waiting, motion, and overprocessing. Contributing factors were uneven staff distribution, suboptimal e-prescribing systems, incomplete prescriptions, and lack of standardized procedures. The proposed future state VSM demonstrated potential improvements in reducing waiting time and enhancing service efficiency.

The production process of graphite glass at ABC faces challenges in the form of waste that has an impact on low operational efficiency. Waste in production activities can affect the quality, cost, and timeliness of product completion. This study aims to identify the most dominant types of waste and provide relevant improvement recommendations to improve production efficiency. The method used is Value Stream Mapping (VSM), a visual approach that maps the flow of the production process from raw materials to final products. The research stage is carried out through direct observation on the production floor, time study, interviews with employees, and documentation of production activities. The results of the analysis show that the most dominant form of waste is overprocessing, which is a repetitive activity that does not add value to the product. This causes longer production cycle times and reduces the effectiveness of resource use. To overcome this, this study provides several recommendations, including: combining production processes that have similar functions, redesigning workflows to make them more concise, and eliminating activities that do not provide added value. The implementation of this improvement has proven to be effective by increasing the Process Cycle Efficiency (PCE) value from 45% to 67%. The increase in PCE reflects that the production process has become more efficient, the workflow is smoother, and the rate of waste has decreased significantly. In addition, the results of this study also confirm that the application of the VSM method can be a strategic solution in identifying sources of inefficiency, designing continuous improvements, and increasing the competitiveness of companies. Thus, the company is expected to continue to evaluate, control, innovate, and improve technology so that efficiency achievements can be maintained, expanded, and improved consistently and sustainably in the future.

UMKM Roti Bakar Azhari adalah UMKM yang bergerak pada bidang industri makanan dalam pembuatan roti tawar yang terletak di Rejowinangun, Kota Gede, Yogyakarta. Permasalahan kurang efektif dan efisien dalam proses produksi masih terjadi pada UMKM Roti Bakar Azhari. Terdapat 56 aktivitas produksi pada UMKM Roti Bakar Azhari, Ada beberapa aktivitas yang dapat berfungsi sebagai penyebab utama pemborosan, seperti, transportasi, motion dan delay. Oleh karena itu, penelitian dilakukan untuk mengurangi pemborosan. Value Stream Mapping dan Process Activity Mapping. Metode tersebut dapat memetakan aliran proses produksi yang nantinya menghasilkan current value stream mapping dan process activity mapping untuk mengkategorikan jenis aktivitas produksi, kemudian telah dilakukan upaya untuk mengurangi pemborosan yang menghasilkan future value stream mapping. Mengurangi jumlah waktu yang dihabiskan untuk aktivitas adalah perbaikan yang dilakukan A1,A2,A7,A11,A15,B2,C1,C6 dan D1 untuk aktivitas yang dilakukan penyesuaian aktivitas C12 dan C15, adapun aktivitas yang dihilangkan yaitu aktivitas A3 dengan total waktu yang sebelumnya 7819,6006 detik menjadi 7511,121 detik.

UMKM Roti Bakar Azhari adalah UMKM yang bergerak pada bidang industri makanan dalam pembuatan roti tawar yang terletak di Rejowinangun, Kota Gede, Yogyakarta. Permasalahan kurang efektif dan efisien dalam proses produksi masih terjadi pada UMKM Roti Bakar Azhari. Terdapat 56 aktivitas produksi pada UMKM Roti Bakar Azhari, Ada beberapa aktivitas yang dapat berfungsi sebagai penyebab utama pemborosan, seperti, transportasi, motion dan delay. Oleh karena itu, penelitian dilakukan untuk mengurangi pemborosan. Value Stream Mapping dan Process Activity Mapping. Metode tersebut dapat memetakan aliran proses produksi yang nantinya menghasilkan current value stream mapping dan process activity mapping untuk mengkategorikan jenis aktivitas produksi, kemudian telah dilakukan upaya untuk mengurangi pemborosan yang menghasilkan future value stream mapping. Mengurangi jumlah waktu yang dihabiskan untuk aktivitas adalah perbaikan yang dilakukan A1,A2,A7,A11,A15,B2,C1,C6 dan D1 untuk aktivitas yang dilakukan penyesuaian aktivitas C12 dan C15, adapun aktivitas yang dihilangkan yaitu aktivitas A3 dengan total waktu yang sebelumnya 7819,6006 detik menjadi 7511,121 detik.

This study aims to analyze the RCM (Reliability Centered Maintenance) and MVSM (Maintenance Value Stream Mapping) strategies implemented by PT. XYZ in machine maintenance at the Sabroe Line. RCM is used to reduce equipment failures and ensure that each physical item or system is functioning as intended. Meanwhile, MVSM is used to identify waste in maintenance activities and perform repair analysis. The research method used is qualitative research with a case study approach. Data was collected through observation, interviews and analysis of related documents. The results of the research show that PT. XYZ has implemented the RCM and MVSM strategies effectively in engine maintenance at the Sabroe Line. RCM implementation helps to reduce machine failure and increase machine reliability. Meanwhile, MVSM helps identify and overcome waste in maintenance activities. In conclusion, the RCM and MVSM strategies are effective approaches in engine maintenance at the Sabroe Line. This research provides a better understanding of the importance of a planned and structured maintenance strategy in improving engine performance. The recommendation for future research is to involve more departments and measure the impact of RCM and MVSM strategies on overall operational productivity and efficiency.