Latar Belakang: Pelayanan farmasi merupakan komponen yang penting dalam layanan kesehatan di rumah sakit. Standar Pelayanan Minimal (SPM) yang terdapat dalam Kepmenkes RI Nomor: 129/ Menkes/SK/II/2008 tentang Standar Minimal Rumah Sakit, menetapkan standar minimal waktu tunggu farmasi yang meliputi obat jadi (non racikan) kurang dari 30 menit dan obat racikan kurang dari 60 menit. Tingginya angka keluhan terhadap layanan instalasi farmasi menunjukkan adanya masalah yang perlu ditangani. Berdasarkan hal tersebut, kajian ini disusun untuk mengetahui faktor-faktor yang berhubungan dengan waktu tunggu di instalasi rawat jalan. Tujuan: Penelitian ini bertujuan utnuk menganalisis waktu tunggu dan faktor-faktor yang berhubungan dengan waktu tunggu pelayanan resep di Instalasi Farmasi Rawat Jalan Rumah Sakit Siloam TB Simatupang. Metodologi Penelitian: Penelitian ini menggunakan metode kuantitatif. Data penelitian dikumpulkan melalui tarikan data SIMRS Hasil Penelitian: Analisis bivariat pada resep racikan menunjukkn faktor yang berhubungan dengan waktu tunggu adalah jumlah item obat (OR= 2,002; 95% CI: 1,469–2,728; p-value <0,001), cara bayar (OR = 5,704; 95% CI: 4,923–6,608; p < 0,001), jam kunjung (OR = 0,330; 95% CI: 0,279–0,389; p < 0,001), dan jumlah kunjungan poli (OR = 2,098; 95% CI: 1,354–3,249; p < 0,001). Sedangkan pada analisis bivariat resep non racikan, faktor yang berpengaruh adalah jumlah item obat (OR = 2,119; 95% CI: 1,877–2,391; p < 0,001), cara bayar (OR = 2,270; 95% CI: 2,052–2,510; p < 0,001), tipe obat (OR = 0,698; 95% CI: 0,617–0,790; p < 0,001), dan jam kunjung (OR = 0,602; 95% CI: 0,538–0,673; p < 0,001). Analisa multivariat ditemukan faktor yang paling berpengaruh terhadap waktu tunggu farmasi adalah cara bayar, pada resep racikan (OR = 5,568; 95% CI: 4,785–6,480; p < 0,001) dan resep non racikan (OR = 2,162; 95% CI: 1,951–2,396; p < 0,001)

Background: Pharmaceutical services are an important component of hospital healthcare services. The Minimum Service Standards (SPM) contained in the Indonesian Minister of Health Decree Number: 129/Menkes/SK/II/2008 concerning Minimum Hospital Standards, stipulates minimum waiting times for pharmacy services, which include less than 30 minutes for ready-made (non-compounded) drugs and less than 60 minutes for compounded drugs. The high number of complaints about pharmacy services indicates that there are problems that need to be addressed. Based on this, this study was conducted to determine the factors related to waiting times in outpatient facilities. Objective: This study aims to analyze waiting times and factors related to prescription waiting times at the Siloam TB Simatupang Hospital Outpatient Pharmacy. Research Methodology: This study uses quantitative methods. Research data was collected through SIMRS data extraction. Research Results: Bivariate analysis of prescription formulas indicates that the factor associated with waiting time is the number of drug items (OR = 2.002; 95% CI: 1.469–2.728; p-value <0.001), payment method (OR = 5.704; 95% CI: 4.923–6.608; p < 0.001), visiting hours (OR = 0.330; 95% CI: 0.279–0.389; p < 0.001), and number of clinic visits (OR = 2.098; 95% CI: 1.354–3.249; p < 0.001). Meanwhile, in the bivariate analysis of non-compounded prescriptions, the influencing factors were the number of drug items (OR = 2.119; 95% CI: 1.877–2.391; p < 0.001), payment method (OR = 2.270; 95% CI: 2.052–2.510; p < 0.001), drug type (OR = 0.698; 95% CI: 0.617–0.790; p < 0.001), and visit time (OR = 0.602; 95% CI: 0.538–0.673; p < 0.001). Multivariate analysis found that the most influential factor on pharmacy waiting time was payment method, for compounded prescriptions (OR = 5.568; 95% CI: 4.785–6.480; p < 0.001) and non-compounded prescriptions (OR = 2.162; 95% CI: 1.951–2.396; p < 0.001).

Peningkatan jumlah kunjungan pasien Jaminan Kesehatan Nasional (JKN) di RS Islam Jakarta Pondok Kopi berdampak langsung pada meningkatnya beban kerja Unit Farmasi Rawat Jalan, khususnya dalam pelayanan resep obat. Data rumah sakit menunjukkan bahwa waktu tunggu pelayanan resep pasien JKN masih melebihi standar pelayanan yang ditetapkan, terutama pada pelayanan resep obat jadi/nonracikan. Kondisi ini berpotensi menimbulkan keluhan pasien, menurunkan kepuasan, serta memengaruhi mutu pelayanan farmasi rawat jalan. Penelitian ini bertujuan untuk menganalisis waktu tunggu pelayanan resep obat jadi/nonracikan pasien JKN di Unit Farmasi Rawat Jalan RS Islam Jakarta Pondok Kopi dengan menggunakan pendekatan manajemen lean. Penelitian ini menggunakan desain operational research dengan pendekatan kuantitatif deskriptif dan kualitatif. Pendekatan kuantitatif dilakukan melalui time and motion study untuk mengukur waktu tunggu, lead time, cycle time, value added time, dan non value added time. Pendekatan kualitatif dilakukan melalui wawancara mendalam dan telaah dokumen untuk menggali hambatan pelayanan serta faktor penyebab terjadinya pemborosan. Analisis dilakukan dengan menggunakan Value Stream Mapping untuk memetakan kondisi awal dan kondisi setelah perbaikan, identifikasi aktivitas value added dan non value added, analisis waste, diagram Pareto, diagram fishbone, serta penerapan lean tools secara terbatas seperti 5S, Kanban, dan Spaghetti Diagram. Hasil penelitian menunjukkan bahwa lamanya waktu tunggu pelayanan resep pasien JKN dipengaruhi oleh tingginya volume resep, keterbatasan tenaga kefarmasian, alur kerja yang belum efisien, pergerakan petugas yang belum optimal, serta pemanfaatan sistem informasi yang masih perlu diperkuat. Identifikasi waste menunjukkan bahwa aktivitas waiting, overprocessing, dan defect merupakan pemborosan yang dominan dalam proses pelayanan. Setelah dilakukan uji coba perbaikan terbatas berbasis manajemen lean, terjadi penurunan waktu tunggu pelayanan resep obat jadi/nonracikan. Rata-rata lead time menurun dari 2 jam 15 menit 13 detik pada kondisi current state menjadi 58 menit 34 detik pada kondisi future state. Penurunan ini menunjukkan bahwa perbaikan alur kerja, penataan area kerja, penerapan sistem Kanban, dan penguatan koordinasi antarunit dapat menurunkan aktivitas non value added serta mempercepat proses pelayanan. Kesimpulan penelitian ini menunjukkan bahwa pendekatan manajemen lean dapat digunakan untuk mengidentifikasi sumber inefisiensi dan mengurangi waktu tunggu pelayanan resep obat jadi/nonracikan pasien JKN di Unit Farmasi Rawat Jalan. Rekomendasi penelitian ini meliputi evaluasi waktu tunggu secara berkala, penyesuaian jumlah tenaga kefarmasian dengan beban kerja, penguatan sistem informasi, standardisasi alur kerja, serta keberlanjutan penerapan lean tools untuk mendukung peningkatan mutu pelayanan farmasi rawat jalan.

The increase in the number of National Health Insurance (JKN) patient visits at Jakarta Pondok Kopi Islamic Hospital has had a direct impact on the workload of the Outpatient Pharmacy Unit, particularly in prescription services. Hospital data show that waiting times for JKN patient prescription services still exceed established service standards, especially for ready-to-use/non-compounded medications. This situation has the potential to lead to patient complaints, lower satisfaction, and affect the quality of outpatient pharmacy services. This study aims to analyze the waiting time for ready-to-use/non-compounded medication prescriptions for JKN patients at the Outpatient Pharmacy Unit of Jakarta Pondok Kopi Islamic Hospital using a lean management approach. This study employed an operational research design with both descriptive quantitative and qualitative approaches. The quantitative approach involved a time-and-motion study to measure waiting time, lead time, cycle time, value-added time, and non-value-added time. The qualitative approach utilized in-depth interviews and document reviews to identify service barriers and factors contributing to waste. Analysis was performed using Value Stream Mapping to map the initial conditions and conditions after improvement, identify value-added and non-value-added activities, analyze waste, and utilize Pareto diagrams, fishbone diagrams, and a limited application of lean tools such as 5S, Kanban, and Spaghetti Diagrams. The research findings indicate that the waiting time for prescription services for JKN patients is influenced by high prescription volume, limited pharmacy staff, inefficient workflows, suboptimal staff movement, and the need to strengthen the use of information systems. The identification of waste revealed that waiting, overprocessing, and defects are the dominant forms of waste in the service process. Following a limited pilot improvement project based on lean management, there was a reduction in waiting times for ready-to-use and non-compounded prescription services. The average lead time decreased from 2 hours, 15 minutes, and 13 seconds in the current state to 58 minutes and 34 seconds in the future state. This reduction demonstrates that workflow improvements, workspace reorganization, the implementation of the Kanban system, and strengthened inter-unit coordination can reduce non-value-added activities and accelerate the service process. The conclusion of this study indicates that the lean management approach can be used to identify sources of inefficiency and reduce waiting times for ready-to-dispense and non-compounded prescription services for JKN patients in the Outpatient Pharmacy Unit. The recommendations of this study include periodic evaluation of wait times, adjusting the number of pharmacy staff to match the workload, strengthening the information system, standardizing workflows, and continuing the application of lean tools to support improvements in the quality of outpatient pharmacy services.

Pelayanan farmasi rawat jalan merupakan salah satu komponen penting dalam penyelenggaraan pelayanan rumah sakit yang berperan dalam menjamin mutu pelayanan, keselamatan pasien, serta tingkat kepuasan pasien. Salah satu indikator mutu pelayanan farmasi adalah waktu tunggu pelayanan resep. Hasil pengamatan awal di Instalasi Farmasi Rawat Jalan Charitas Hospital Palembang menunjukkan bahwa waktu tunggu pelayanan resep, khususnya resep racikan, masih belum memenuhi Standar Pelayanan Minimal (SPM) yang ditetapkan. Penelitian ini bertujuan untuk menganalisis penerapan Lean Hospital sebagai upaya meningkatkan efisiensi proses pelayanan dan menurunkan waktu tunggu pelayanan resep di Instalasi Farmasi Rawat Jalan Charitas Hospital Palembang. Penelitian ini merupakan studi operasional dengan pendekatan Lean Hospital. Pengumpulan data dilakukan melalui observasi langsung terhadap alur pelayanan resep dan pengukuran waktu pada setiap tahapan pelayanan. Sebanyak 200 resep dianalisis, yang terdiri atas 152 resep obat jadi dan 48 resep racikan. Analisis dilakukan menggunakan Value Stream Mapping (VSM), identifikasi pemborosan (waste) berdasarkan prinsip Lean dan fishbone diagram, serta pengukuran efisiensi proses melalui perhitungan Value Added Ratio (VAR). Hasil penelitian menunjukkan bahwa pada kondisi current state, lead time pelayanan resep obat jadi mencapai 34,5 menit yang terdiri atas Value Added Time (VAT) sebesar 16,8 menit dan Non-Value Added Time (NVAT) sebesar 17,8 menit. Sementara itu, lead time pelayanan resep racikan mencapai 74,3 menit dengan VAT sebesar 45,4 menit dan NVAT sebesar 29,1 menit. Analisis waste menunjukkan bahwa jenis pemborosan yang paling dominan adalah waiting waste, yaitu sebesar 61,8% pada pelayanan resep obat jadi dan 53,61% pada pelayanan resep racikan, diikuti oleh overprocessing waste. Berdasarkan hasil analisis penyebab waste, dilakukan berbagai intervensi perbaikan Lean yang meliputi penambahan Tenaga Teknis Kefarmasian (TTK) pada shift pagi dan siang, pemanfaatan WhatsApp Blast sebagai media pemberitahuan real-time kepada pasien terkait penyelesaian obat, penguatan koordinasi dengan pihak provider asuransi, penyediaan hand blender dan alat pengisi kapsul untuk mendukung proses peracikan, implementasi prinsip 5S, optimalisasi tata letak ruang pelayanan, penerapan visual management, serta penyesuaian jadwal praktik dokter spesialis dan peningkatan kepatuhan terhadap jadwal pelayanan. Hasil future state mapping menunjukkan adanya peningkatan efisiensi proses pelayanan. Lead time pelayanan resep obat jadi menurun menjadi 20,3 menit atau berkurang sebesar 41,2%, sedangkan lead time pelayanan resep racikan menurun menjadi 52,9 menit atau berkurang sebesar 28,8%. Selain itu, nilai VAR pada resep obat jadi meningkat dari 48,7% menjadi 49,75%, sedangkan nilai VAR pada resep racikan meningkat dari 61,1% menjadi 62,75%. Penelitian ini menyimpulkan bahwa penerapan Lean Hospital mampu mengidentifikasi dan mengeliminasi aktivitas yang tidak memberikan nilai tambah sehingga meningkatkan efisiensi proses pelayanan farmasi dan menurunkan waktu tunggu pelayanan resep di Instalasi Farmasi Rawat Jalan Charitas Hospital Palembang.

Outpatient pharmacy services constitute an essential component of hospital healthcare delivery, playing a significant role in ensuring service quality, patient safety, and patient satisfaction. One of the key indicators of pharmacy service quality is prescription waiting time. Preliminary observations conducted at the Outpatient Pharmacy Department of Charitas Hospital Palembang indicated that prescription waiting times, particularly for compounded prescriptions, had not yet met the established Minimum Service Standards (MSS). This study aimed to analyze the implementation of Lean Hospital principles as an approach to improving service efficiency and reducing prescription waiting times at the Outpatient Pharmacy Department of Charitas Hospital Palembang. This study employed an operational research design using a Lean Hospital approach. Data were collected through direct observation of prescription service workflows and time measurements at each stage of the dispensing process. A total of 200 prescriptions were analyzed, comprising 152 non-compounded prescriptions and 48 compounded prescriptions. Data analysis was conducted using Value Stream Mapping (VSM), waste identification based on Lean principles and fishbone diagram analysis, as well as process efficiency assessment through the calculation of the Value Added Ratio (VAR). The findings revealed that, in the current state, the lead time for non-compounded prescriptions was 34.5 minutes, consisting of 16.8 minutes of Value Added Time (VAT) and 17.8 minutes of Non-Value Added Time (NVAT). Meanwhile, the lead time for compounded prescriptions was 74.3 minutes, comprising 45.4 minutes of VAT and 29,1 minutes of NVAT. Waste analysis demonstrated that waiting waste was the most dominant type of waste, accounting for 61.8% of total waste in non-compounded prescription services and 53.61% in compounded prescription services, followed by overprocessing waste. Based on the analysis of waste causes, several Lean improvement interventions were implemented, including the addition of pharmacy technicians during morning and afternoon shifts, the utilization of WhatsApp Blast as a real-time notification system to inform patients when medications were ready for collection, enhanced coordination with insurance providers, the provision of hand blenders and capsule-filling devices to support compounding activities, implementation of the 5S methodology, optimization of pharmacy layout, application of visual management techniques, and adjustment of specialist physicians’ practice schedules along with improved compliance with service schedules. The future state mapping demonstrated improved process efficiency. The lead time for non-compounded prescriptions decreased to 20.3 minutes, representing a 41.2% reduction, while the lead time for compounded prescriptions decreased to 52.9 minutes, representing a 28.8% reduction. Furthermore, the VAR for non-compounded prescriptions increased from 48.7% to 49.75%, whereas the VAR for compounded prescriptions increased from 61.1% to 62.75%. This study concludes that the implementation of Lean Hospital principles effectively identified and eliminated non-value-added activities, thereby improving pharmacy service efficiency and reducing prescription waiting times at the Outpatient Pharmacy Department of Charitas Hospital Palembang.