Latar Belakang : Pengelolaan inventori obat yang efisien merupakan faktor penting dalam menjamin ketersediaan obat, mutu pelayanan, dan efisiensi biaya rumah sakit. Ketidakefisienan pengelolaan inventori dapat menimbulkan berbagai waste, seperti kelebihan stok, kekosongan stok, obat non-moving, dan obat kedaluwarsa, yang berdampak pada peningkatan biaya, penurunan mutu pelayanan, serta keterlambatan terapi pasien. Berbagai faktor, antara lain perencanaan yang tidak akurat, lamanya waktu pengadaan, penyimpanan yang belum optimal, dan variasi proses operasional, menjadi penyebab utama ketidakefisienan pengelolaan inventori obat. Tujuan: Mengoptimalkan manajemen rantai pasok internal farmasi di Instalasi Farmasi Medistra Hospital melalui pendekatan lean six sigma dalam pengendalian dan peningkatan efisiensi inventori obat sehingga dapat mengurangi pemborosan, menekan variasi proses, mengoptimalkan ketersediaan obat, serta mendukung mutu pelayanan rumah sakit. Metode: Penelitian ini menggunakan desain operational research dengan pendekatan mix method, dimana kerangka kerja Lean Six Sigma melalui DMAIC digunakan sebagai panduan sistematis untuk mengintegrasikan analisis data kuantitatif inventori obat dan data kualitatif operasional. Teknik pengambilan sampel yang digunakan adalah stratified random sampling, dengan total sampel sebanyak 400 nomor perencanaan obat. Hasil: Pendekatan Lean Six Sigma mengidentifikasi lead time pengelolaan inventori obat sebesar 139 jam 26 menit 30 detik (5,7 hari), dengan 99% waktu proses merupakan kegiatan non-value added yang didominasi oleh waste tipe waiting sebesar 137 jam 37 menit 3 detik. Kondisi awal inventori menunjukkan nilai persediaan sebesar Rp 12.223.885.423,40, terdiri atas 343 item obat overstock senilai Rp 301.047.282, 88 item obat kosong, 35 item obat stagnan senilai Rp 34.775.208, dan 9 item obat expired senilai Rp1.613.710. Akar masalah yang teridentifikasi meliputi belum optimalnya SIMRS inventori, tingginya variasi me-too brand dalam formularium rumah sakit, variasi pengetahuan dan kompetensi petugas, belum adanya regulasi tindak lanjut purchase order kepada distributor, kurangnya pemahaman staf pembelian terhadap kebutuhan pelayanan, pembatasan jam persetujuan purchase order, kurangnya supervisi pada tahap penerimaan, keterlambatan penyimpanan obat, belum tersedianya visual management untuk penerapan FEFO/FIFO, serta penempatan obat LASA yang belum sesuai regulasi. Intervensi Lean Six Sigma dilakukan melalui penerapan standardized work, sosialisasi ulang alur kerja, implementasi sistem kanban pada tahap perencanaan, optimalisasi prinsip 5R di gudang logistik farmasi, serta penerapan visual management untuk mendukung implementasi FEFO/FIFO. Kesimpulan : Implementasi lean six sigma berhasil menurunkan lead time pengelolaan inventori obat, menurunkan nilai stok inventori obat dan jumlah item inventori obat, menurunkan nilai pembelian obat, menurunkan nilai obat overstock, menurukan jumlah obat kosong, menurunkan jumlah obat stagnan dan menurunkan jumlah obat expired.

Background: Efficient drug inventory management is essential to ensure medicine availability, improve service quality, and enhance hospital cost efficiency. Inefficient inventory management can generate various forms of waste, including overstock, stockouts, non-moving medicines, and expired medicines, leading to increased costs, reduced quality of care, and delays in patient treatment. Inaccurate planning, prolonged procurement lead times, suboptimal storage practices, and variations in operational processes are among the major contributors to inefficiencies in drug inventory management. Objective: To optimize internal pharmaceutical supply chain management at the Pharmacy Department of Medistra Hospital through the implementation of Lean Six Sigma to improve drug inventory control and operational efficiency, thereby reducing waste, minimizing process variation, optimizing medicine availability, and supporting the quality of hospital services. Methods: This operational research employed a mixed-methods design. The Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) framework was used as a systematic approach to integrate quantitative drug inventory data with qualitative operational data. A stratified random sampling technique was applied, resulting in a total sample of 400 drug planning records. Results: The Lean Six Sigma approach identified a total drug inventory management lead time of 139 hours, 26 minutes, and 30 seconds (5.7 days), of which 99% consisted of non-value-added activities, predominantly waiting waste, accounting for 137 hours, 37 minutes, and 3 seconds. The baseline inventory value was IDR 12,223,885,423.40, comprising 343 overstock items valued at IDR 301,047,282, 88 stockout items, 35 non-moving items valued at IDR 34,775,208, and 9 expired items valued at IDR 1,613,710. Root cause analysis identified several contributing factors, including suboptimal utilization of the Hospital Management Information System (HMIS) for inventory management, a high variation of me-too brands in the hospital formulary, variations in staff knowledge and competencies, the absence of regulations governing purchase order follow-up with distributors, limited understanding among purchasing staff regarding clinical service requirements, restrictions on purchase order approval hours, inadequate supervision during the receiving process, delays in transferring medicines to designated storage locations, the absence of visual management tools to support FEFO/FIFO implementation, and non-compliant placement of look-alike, sound-alike (LASA) medicines. Lean Six Sigma interventions included the implementation of standardized work, workflow reorientation, a kanban system during the planning stage, optimization of the Indonesian 5R workplace organization principles in the pharmacy logistics warehouse, and visual management to strengthen FEFO/FIFO implementation. Conclusion: The implementation of Lean Six Sigma successfully reduced drug inventory management lead time, inventory value, the number of inventory items, drug purchasing expenditure, overstock value, stockout incidents, non-moving medicines, and expired medicines, thereby improving the efficiency of internal pharmaceutical supply chain management.

Latar Belakang : Waktu tunggu obat merupakan salah satu indikator penting rumah sakit dalam menilai mutu pelayanan kepada pasien. Lamanya waktu tunggu dapat memengaruhi tingkat kepuasan pasien yang berobat di rumah sakit. Berdasarkan Key Performance Indicator (KPI), standar waktu tunggu pelayanan obat non-racikan adalah  ≤ 10 menit dengan target pencapaian 90%, sedangkan untuk obat racikan ≤ 30 menit dengan target pencapaian 80%. Pencapaian waktu tunggu obat non-racikan pada tahun 2024 sebesar 62,57% dan tahun 2025 sebesar 63,17%. Sementara itu, pencapaian waktu tunggu obat racikan pada tahun 2024 sebesar 36,58% dan tahun 2025 sebesar 29,13%. Hasil tersebut menunjukkan bahwa pencapaian waktu tunggu pelayanan obat masih berada dibawah target yang telah ditetapkan. Tujuan : Menurunkan waktu tunggu obat non racikan dan racikan dengan menggunakan konsep Lean Six Sigma di Instalasi Farmasi Rawat Jalan Rumah Sakit Swasta Tipe B di Tangerang Selatan Metode : Penelitian ini mempunyai desain operational research yang menggabungkan metode kuantitatif dan kualitatif. Peneliti melakukan observasi dengan time motion study. Teknik pengambilan sampel yang digunakan adalah stratified random sampling, dengan total sampel sebanyak 202 pasien yang berobat dan mendapat obat di rumah sakit. Pemilihan sampel didasarkan pada shift dan jenis penjaminan yang telah ditetapkan. Hasil : Hasil        penelitian dengan pendekatan Lean Six Sigma berhasil mengidentifikasi Lead time waktu tunggu obat non-racikan di Rumah Sakit Swasta Tipe B di Tangerang Selatan yaitu sebesar 14 menit 16 detik dimana 72% merupakan kegiatan non-value added yang didominasi oleh waste tipe waiting sebesar 6 menit 3 detik (59%). Untuk Lead time waktu tunggu obat racikan 47 menit 1 detik dimana 64% merupakan kegiatan non-value added yang didominasi oleh waste tipe waiting sebesar 19 menit 19 detik (64%). Analisis akar masalah dilakukan menggunakan Pareto dan Five Whys. Penerapan lean six sigma dalam proses waktu tunggu obat racikan berhasil mengurangi lead time untuk waktu tunggu obat non-racikan sebesar 44,74% dari 14 menit 16 detik menjadi 7 menit 53 detik, pada tahap kontrol sebesar 6 menit 32 detik. Lead time waktu tunggu obat racikan menurun sebesar  42,61% dari 47 menit 1 detik menjadi 26 menit 59 detik, pada tahap kontrol lead time sebesar 22 menit 45 detik.  Terjadi penurunan waste total dari sebelum intervensi dengan setelah dilakukan intervensi pada obat non-racikan yaitu sebesar 72,98% dan obat racikan sebesar 72,17%. Penurunan waktu non-value added obat non-racikan dari 10 menit 18 detik menjadi 2 menit 47 detik, sedangkan untuk obat racikan dari 30 menit 18 detik menjadi 8 menit 26 detik. Kesimpulan        : Terdapat penurunan waktu tunggu obat racikan dan non-racikan di Rumah Sakit Swasta Tipe B di Tangerang Selatan setelah penerapan Lean Six Sigma. Penurunan waktu tunggu obat masih dibawah target KPI yang ditetapkan oleh Rumah Sakit Swasta Tipe B di Tangerang Selatan.

Background: A Drug waiting time is one of the key indicators used by hospitals to assess the quality of patient care services. Prolonged waiting times can significantly affect patient satisfaction. Based on the Key Performance Indicators (KPIs), the standard waiting time for dispensing non-compounded medications ≤10 minutes, with a target achievement rate of 90%, while the standard waiting time for compounded medications  ≤ 30 minutes, with a target achievement rate of 80%. The achievement rate for non-compounded medication waiting time was 62.57% in 2024 and 63.17% in 2025. Meanwhile, the achievement rate for compounded medication waiting time was 36.58% in 2024 and 29.13% in 2025. These results indicate that the performance of medication dispensing waiting times remains below the established targets. Objective: Reduction of Waiting Times for Non-Compounded and Compounded Medications Through the Lean Six Sigma Approach in the Outpatient Pharmacy Department of a Type B Private Hospital in Tangerang Selatan. Methods: This study employed an operational research design integrating quantitative and qualitative methods. Observations were conducted using a time-motion study to analyze the outpatient pharmacy workflow. A stratified random sampling technique was used to select a total of 202 outpatients who received medications from the hospital. Participants were stratified according to predetermined work shifts and payer categories. Results: The Lean Six Sigma approach successfully identified a lead time of 14 minutes and 16 seconds for non-compounded medications in the outpatient pharmacy department of a Type B private hospital in Banten Province, of which 72% consisted of non-value-added activities, predominantly waiting waste, accounting for 6 minutes and 3 seconds (59%). The lead time for compounded medications was 47 minutes and 1 second, with 64% classified as non-value-added activities, mainly waiting waste, totaling 19 minutes and 19 seconds (64%). Root cause analysis was conducted using the Pareto principle and the Five Whys method. Implementation of Lean Six Sigma reduced the lead time for non-compounded medications by 44.74%, from 14 minutes and 16 seconds to 7 minutes and 53 seconds, with a sustained lead time of 6 minutes and 32 seconds during the control phase. For compounded medications, the lead time decreased by 42.61%, from 47 minutes and 1 second to 26 minutes and 59 seconds, with a control-phase lead time of 22 minutes and 45 seconds. Total waste decreased by 72.98% for non-compounded medications and 72.17% for compounded medications following the intervention. Non-value-added time for non-compounded medications was reduced from 10 minutes and 18 seconds to 2 minutes and 47 seconds, while for compounded medications it decreased from 30 minutes and 18 seconds to 8 minutes and 26 seconds. Conclusion: There was a reduction in the waiting times for both compounded and non-compounded medications of a Type B private hospital in Banten Province following the implementation of Lean Six Sigma. However, despite this improvement, the medication waiting times remained below the Key Performance Indicator (KPI) target established by the hospital.