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Outpatient services are an important part of health services provided by hospitals. However, some BPJS hospitals experience obstacles in providing efficient and quality outpatient services, such as long queues, long waiting times, and lack of a good management system. the application of Lean Management to the outpatient services of BPJS patients in hospitals can help hospitals improve operational performance, so as to increase public trust in BPJS Health. This study aims to analyze the application of Lean Management to the outpatient services of BPJS patients in hospitals. This research uses a literature study method or Systematic Literature Review using the Google Scholar search engine and journal databases, such as Researchgate. The results showed that most outpatient service activities for BPJS patients still have patient waiting times below the established service standards. In analyzing the flow that patients go through, each activity is identified into two groups, namely Value Added (VA) as an activity that is considered necessary and profitable and Non Value Added (NVA) as an activity that is considered unnecessary. Based on the percentage of waste in the form of the largest waiting time can be described, namely, 35.1% in the registration process, 30.2% in the poly examination process, and 20.7% in the process of receiving drugs in the pharmaceutical installation

Lean is a concept and technique for systems that optimizes patient benefit by decreasing waste and waiting time. The literature review approach is used in this study to acquire research data, with internet searches serving as a supplementary tool while looking for relevant papers. According to the study findings, mean hospital length of stay (LOS) fell by 24% throughout the intervention period in 259 patients with PMV (131 pre-intervention; 128 post-intervention) (29 vs. 22 days, p 0.001). This demonstrates that clinical redesign based on Lean Six Sigma decreases LOS in intensive care units. Other studies show that utilizing Lean Six Sigma has resulted in a 57% reduction in length of stay and an 88% reduction in the identification of non-value added tasks. Lean management in hospitals is a step toward greater service efficiency that has been shown to outperform Total Quality Management (TQM) and Plan, Do, Check, Action (PDCA) improvements. Customers and their families gain from shorter wait times, as do healthcare employees (medical, emergency, and non-medical) and hospital administration. The use of the lean six sigma approach in conjunction with the DMAIC cycle effects LOS reduction, indicating that lean six sigma can reduce LOS in hospitals.