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Abstrak :
Pelayanan pasien rawat jalan di RSUD Provinsi NTB memiliki waktu yang melebihi Standar Pelayanan Minimal Kepmenkes No.129/Menkes/SK/II/2008. Klinik Penyakit Dalam diambil sebagai subjek penelitian karena memiliki kunjungan terbanyak. Penelitian ini bertujuan mengurangi waktu tunggu pelayanan dengan menggunakan manajemen Lean. Peta Aliran Nilai disusun melalui data dari proses observasi, wawancara mendalam, dan telaah dokumen untuk memberikan potensi solusi perbaikan dan mengurangi waste/pemborosan. Waste waiting terjadi di seluruh tahapan pelayanan.  Root Caused Analysis menunjukkan faktor Man dan Methode yang berperan besar sebagai penyebab inefisiensi pelayanan.  Usulan perbaikan berupa penerapan 5S, visual management, spaghetti diagram, pendaftaran berbasis sms/what`s app/aplikasi, integrasilisasi SIM RS, dan menjalin komitmen dengan dokter spesialis. Perbaikan secara cepat dengan melakukan simulasi implementasi pendaftaran berbasis sms/aplikasi dan pengaturan interval kedatangan pasien 30 menit sebelum dokter spesialis memulai pemeriksaan mampu meningkatkan waktu pelayanan dari 276,3 menit menjadi 47,9 menit dengan peningkatan kegiatan value added 5,3% menjadi 30,9 %. ......Outpatient services at RSUD Provinsi NTB have a time that exceeds the Minimum Service Standards of Kepmenkes No.129/Menkes/SK/II/2008. The Internal Medicine Clinic was taken as the research subject because it had the most visits. This study aims to reduce patient waiting time by using Lean management. Value Stream Map was developed through data from the process of observation, in-depth interviews, and document review to provide potential solutions and eliminate waste. Waste waiting occurs at all stages of service. Root Caused Analysis shows the Man and Method factors as a major factor caused of service inefficiency. Proposed improvements in the form of 5S implementation, visual management, spaghetti diagrams, sms-based registration /what`s app/application, integration of RS SIM, and commitment with doctors. A quick increase by conducting a short message or application-based registration simulation and setting the patient`s arrival interval 30 30 minutes before the Internist started the examination was able to increase the service time from 276.3 minutes to 47.9 minutes with an increase value added activity 5.3% to 30, 9%.

Abstrak :
Pelayanan farmasi merupakan salah satu pelayanan vital di rumah sakit dan waktu tunggu obat non racikan memengaruhi mutu layanan rumah sakit secara keseluruhan. Di RS Inco Sorowako waktu tunggu telah memenuhi standar minimal 30 menit namun karena RS ini berjarak tempuh 2 jam dari RSUD di Kabupaten Luwu Timur dimana waktu sangat berharga untuk kembali bekerja dan kepuasan pasien terhadap layanan farmasi 79,5%         ( target >90%) sehingga diperlukan perbaikan waktu tunggu dengan target <12 menit. Penelitian ini menggunakan metode kualitatif action research  dengan melihat proses layanan obat non racikan farmasi rawat jalan terhadap 30 pasien, melakukan perbaikan dengan pendekatan Vale Production System (VPS) kemudian mengukur output dan outcome dari perbaikan tersebut. Ditemukan kegiatan bersifat value added sebesar 46,58% dan kegiatan non value added (waste) sebesar 53,42% dengan waktu tunggu rata-rata 17,7 menit. Eliminasi waste  dengan memperbaiki proses cek stok harian, memperbaiki inputan resep dokter tanpa free text, menghilangkan proses menulis kartu stok, mengatur susunan obat berdasarkan kategori slow dan fast moving dan menambah 1 loket kasir di sebelah loket penyerahan obat, sehingga kegiatan bersifat value added sebesar 73,12% dan kegiatan non value added (waste) dieleiminasi menjadi 26,88%, waktu tunggu menjadi 12,1 menit, kepuasan pasien naik menjadi 89%. Penelitian ini menyimpulkan adanya peningkatan mutu layanan setelah dilakukan implementasi perbaikan dengan Vale Production System (VPS). ......Pharmacy services are one of the vital services in hospitals and the waiting time for non compounded pharmaceutical drugs affects the overall quality of hospital services. At Inco Sorowako Hospital, the waiting time has met the minimum standard of 30 minutes, but because this hospital is 2 hours away from the Regional Hospital in East Luwu Regency where time is valuable for return to work and patient satisfaction with pharmacy services is 79.5% (target >90%), it is necessary to improve waiting times with a target of < 12 minutes. This study uses a qualitative action research method by looking at the process of outpatient pharmacy non compounded pharmaceutical drug services for 30 patients, making improvements with the Vale Production System (VPS) approach and then measuring the output and outcome of the improvement. It was found that value-added activities amounted to 46.58% and non-value added activities (waste) amounted to 53.42% with an average waiting time of 17.7 minutes. Elimination of waste by improving the daily stock check process, improving the input of prescriptions without free text, eliminating the process of writing stock cards, organizing the arrangement of drugs based on slow and fast moving categories and adding 1 cashier counter next to the drug delivery counter, so that value-added activities increased to 73.12% and non-value-added activities (waste) were eliminated to 26.88%, waiting time became 12.1 minutes, patient satisfaction rose to 89%. This study concludes that there is an increase in service quality after the implementation of improvements with Vale Production System.