Effect of Lean Hospital on Waiting Time at Outpatient Unit in Indonesia

Hairani, Agustin Kusumayati


Faculty of Public Health, Universitas Indonesia



Background: Prolonged waiting time in hospitals especially in outpatient unit resulted in dissatisfaction among patients. In order to improve the efficiency, quality of healthcare, and patients‘ satisfaction, lean has been introduced widely as a quality improvement method at hospitals. It may improve patient flow to reduce the waiting time at the outpatient unit. This study aimed to review systematically the effect of lean hospital on waiting time at outpatient unit in Indonesia.

Subjects and Method: This was systematic review conducted by searching published articles from EBSCO, Science Direct, Google Scholar, and Willey Online Library. The key words were “waiting time”, “waiting time improvement”, “outpatient unit”, and “lean hospital”. The articles collected were using qualitative data. Initially 17,514 articles obtained. During screening 200 were excluded. After review process 4 articles were finally retained in this review.

Results: In outpatient unit, non-value added activity was higher (>70%) than value added activities (<50%). Analysis of Cycle Time and Takt Time at outpatient unit showed that there were more work requests than it can process (Bottleneck). It causes interruption to the flow of work and delays the services. Waiting time was varying in all sectors including: (1) Registration (30.9 minutes); (2) Waiting for doctor (25.2 minutes); and (3) Submission of medical records (8.8 minutes). Implementation of lean hospital with eliminate non-value added and continuous improvement with Plan– Do–Check–Action (PDCA) cycle were efforts to reduce waiting time at outpatient unit in hospital

Conclusion: Lean hospital and continuous improvement at all levels are efforts to reduce waiting time at outpatient unit in hospital.

Keywords: waiting time, outpatient unit, Lean hospital.

Correspondence: Hairani. Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia. Email: raniza22@yahoo.com. Mobile: 089507248144.

DOI: https://doi.org/10.26911/the6thicph-FP.04.19

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