Latar belakang: Didasari oleh pentingnya patient experience sebagai salah satu faktor kunci dalam meningkatkan loyalitas pasien di rumah sakit. Loyalitas pasien sangat berpengaruh terhadap keberlangsungan dan reputasi rumah sakit, khususnya di tengah persaingan layanan kesehatan yang semakin ketat. Namun, masih terdapat keterbatasan penelitian terkait hubungan antara pengalaman pasien dengan loyalitas pasien di ruang rawat inap. Tujuan penelitian: Penelitian ini bertujuan untuk menganalisis hubungan antara patient experience dengan loyalitas pasien di ruang rawat inap Rumah Sakit Umum Hermina Depok. Metodologi penelitian: Penelitian ini menggunakan metode kuantitatif dengan desain cross-sectional. Data dikumpulkan melalui kuesioner yang dibagikan kepada pasien rawat inap, yang mencakup dimensi pengalaman pasien seperti komunikasi perawat/bidan, komunikasi dokter, respon staf, kenyamanan fasilitas fisik, manajemen nyeri, komunikasi tentang obat, dan discharge planning. Loyalitas pasien diukur melalui niat untuk kembali menggunakan layanan rumah sakit dan merekomendasikan rumah sakit kepada orang lain. Hasil penelitian: Hasil penelitian menunjukkan bahwa sebagian besar pasien memiliki pengalaman positif selama menjalani perawatan di RSU Hermina Depok. Analisis statistik bivariat dan multivariat menunjukkan adanya hubungan yang signifikan antara patient experience secara keseluruhan dengan loyalitas pasien. Dimensi komunikasi perawat/bidan, komunikasi dokter, kenyamanan fasilitas fisik, dan discharge planning merupakan faktor yang paling berpengaruh terhadap loyalitas pasien. Temuan ini menegaskan pentingnya peningkatan kualitas pelayanan berbasis pengalaman pasien untuk mempertahankan dan meningkatkan loyalitas pasien.

.Background:This study is based on the importance of patient experience as a key factor in enhancing patient loyalty in hospitals. Patient loyalty significantly influences the sustainability and reputation of hospitals, especially amid increasingly competitive healthcare services. However, there is still a lack of research on the relationship between patient experience and patient loyalty in inpatient care settings. Research Objective: This study aims to analyze the relationship between patient experience and patient loyalty in the inpatient ward of Hermina General Hospital Depok. Research Methodology: This research uses a quantitative method with a cross-sectional design. Data were collected through questionnaires distributed to inpatients, covering dimensions of patient experience such as nurse/midwife communication, doctor communication, staff responsiveness, physical facility comfort, pain management, medication communication, and discharge planning. Patient loyalty was measured by the intention to return to the hospital and to recommend the hospital to others. Research Results: The results show that the majority of patients had a positive experience during their stay at Hermina General Hospital Depok. Bivariate and multivariate statistical analyses revealed a significant relationship between overall patient experience and patient loyalty. The dimensions of nurse/midwife communication, doctor communication, physical facility comfort, and discharge planning were the most influential factors affecting patient loyalty. These findings emphasize the importance of improving service quality based on patient experience to maintain and increase patient loyalty.

Skizofrenia merupakan gangguan mental berat yang menjadi beban utama pada layanan kesehatan mental di Indonesia. Hal ini terlihat dari tingginya kebutuhan rawat inap, dan lamanya perawatan, namun data tren pelayanan masih terbatas. Penelitian deskriptif retrospektif menggunakan data klaim BPJS Kesehatan pada fasilitas rujukan tingkat lanjut (FKRTL) tahun 2021–2024. Analisis univariat digunakan untuk menggambarkan tren proporsi dan pola rawat inap, sedangkan uji chi-square membandingkan rawat inap kunjungan skizofrenia dan non-skizofrenia. Dari 1,32 juta kunjungan gangguan kesehatan mental, 40,68% adalah skizofrenia. Proporsi menurun dari 46,52% (2021) menjadi 35,12% (2024), namun jumlah absolut tetap meningkat, terutama pada laki-laki, remaja, peserta PBI, dan kelas rawat III . Pola rawat inap skizofrenia terus meningkat dari 41,59% pada tahun 2021 menjadi 63,56% di tahun 2024. Analisis bivariat menunjukkan risiko rawat inap (RR=3,07; 95% CI: 3,06–3,09) dan lama rawat inap panjang (RR=15,06; 95% CI: 14,61-15,52) pada skizofrenia lebih tinggi dibanding non-skizofrenia. Skizofrenia tetap menjadi beban utama FKRTL, terutama pada kelompok sosial ekonomi rentan. Peningkatan kebutuhan rawat inap menegaskan pentingnya deteksi dini, kesinambungan pengobatan, dan penguatan layanan komunitas.

Schizophrenia is a severe mental disorder and represents a major burden on mental health services in Indonesia. This burden is reflected in high inpatient demand and long treatment durations, yet data on service trends remain limited. A retrospective descriptive study was conducted using BPJS Kesehatan claims data from advanced referral health facilities (FKRTL) between 2021 and 2024. Univariate analysis described trends in proportions and inpatient care patterns, while chi-square tests were used to compare inpatient outcomes between schizophrenia and non-schizophrenia visits. Out of 1.32 million mental health visits, 40.68% were for schizophrenia. Although the proportion declined from 46.52% in 2021 to 35.12% in 2024, absolute visit numbers increased, particularly among males, adolescents, PBI participants (social assistance program), and Class III inpatients. Inpatient care for schizophrenia rose steadily from 41.59% in 2021 to 63.56% in 2024. Bivariate analysis indicated that schizophrenia visits had higher risks of inpatient admission (RR = 3.07; 95% CI: 3.06–3.09) and prolonged inpatient stay (RR = 15.06; 95% CI: 14.61–15.52) compared with non-schizophrenia visits. Schizophrenia remains a primary burden on FKRTL, especially among socioeconomically vulnerable groups. The increasing inpatient demand highlights the importance of early detection, continuity of care, and strengthening community mental health services.

Klaim tertunda rawat inap BPJS Kesehatan masih menjadi permasalahan yang sering dihadapi rumah sakit karena berdampak pada keterlambatan pembayaran, gangguan arus kas, peningkatan beban kerja administrasi, dan potensi penurunan kualitas pelayanan. RSU X memiliki tingkat klaim tertunda yang relatif tinggi, yaitu sebanyak 697 klaim pada tahun 2025 atau rata-rata 58 klaim per bulan, sehingga diperlukan analisis mendalam terhadap faktor-faktor penyebabnya. Penelitian ini bertujuan untuk mengidentifikasi dan menganalisis faktor penyebab klaim tertunda rawat inap BPJS Kesehatan di RSU X berdasarkan perspektif unit casemix menggunakan Model Donabedian. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Pengumpulan data dilakukan melalui wawancara mendalam, observasi, dan telaah dokumen. Informan penelitian terdiri atas manajer casemix, koder rawat inap, petugas administrasi klaim BPJS, dan kepala instalasi rekam medis. Analisis data dilakukan melalui reduksi data, penyajian data, dan penarikan kesimpulan. Hasil penelitian menunjukkan bahwa faktor struktur yang berkontribusi terhadap klaim tertunda meliputi keterbatasan jumlah tenaga casemix dibandingkan volume klaim, belum meratanya kompetensi petugas akibat pelatihan yang belum berkelanjutan, belum tersedianya SOP pengajuan klaim serta pedoman internal casemix yang terdokumentasi, dan belum optimalnya dukungan anggaran serta sistem monitoring dan evaluasi. Pada komponen proses, penyebab utama klaim tertunda meliputi ketidakkonsistenan pengisian resume medis, ketidaklengkapan tanda tangan DPJP, ketidaksesuaian coding diagnosis dan tindakan pada kasus kompleks, kebutuhan klarifikasi klinis, serta hambatan teknis saat pengajuan klaim. Rekomendasi yang diajukan meliputi penyusunan mekanisme kontrol khusus terhadap kasus-kasus yang sering mengalami pending klaim, mengembangkan daftar periksa (checklist) dokumen berdasarkan pola penyebab pending klaim, melakukan audit berkala terhadap kasus yang mengalami revisi coding, meningkatkan kualitas dokumentasi klinis pada diagnosis yang sering memerlukan klarifikasi, membangun sistem umpan balik (feedback) pending klaim kepada unit pelayanan, memanfaatkan data pending klaim sebagai indikator mutu pengelolaan klaim, dan membuat Standar Operasional Prosedur dan Pedoman/Panduan Unit Casemix. Kata kunci: klaim tertunda, BPJS Kesehatan, rawat inap, casemix, Model Donabedian.

Delayed BPJS Health inpatient claims remain a significant challenge for hospitals because they contribute to reimbursement delays, cash flow disruptions, increased administrative workload, and potential declines in service quality. RSU X experienced a relatively high number of delayed claims, totaling 697 cases in 2025, with an average of 58 cases per month, highlighting the need for an in-depth analysis of the underlying causes. This study aimed to identify and analyze the factors contributing to delayed BPJS Health inpatient claims at RSU X from the perspective of the casemix unit using the Donabedian Model. This study employed a qualitative approach with a case study design. Data were collected through in-depth interviews, observations, and document reviews. The informants consisted of the casemix manager, inpatient coders, BPJS claim administration officers, and the head of the medical records department. Data analysis was conducted through data reduction, data display, and conclusion drawing. The findings revealed that structural factors contributing to delayed claims included an insufficient number of casemix personnel relative to the volume of claims, uneven staff competencies due to the lack of continuous training, the absence of documented claim submission standard operating procedures and internal casemix guidelines, as well as inadequate budgetary support and monitoring and evaluation systems. Process-related factors included inconsistencies in completing medical discharge summaries, incomplete signatures of attending physicians (DPJP), inaccuracies in diagnosis and procedure coding in complex cases, the need for clinical clarification, and technical obstacles during claim submission. The study recommends establishing specific control mechanisms for cases that frequently result in delayed claims, developing document checklists based on common causes of claim delays, conducting periodic audits of cases requiring coding revisions, improving the quality of clinical documentation for diagnoses that frequently require clarification, implementing a feedback system on delayed claims for service units, utilizing delayed claim data as a quality indicator for claim management, and developing Standard Operating Procedures and Guidelines for the Casemix Unit. Keywords: delayed claims, BPJS Health, inpatient care, casemix, Donabedian Model.

Latar Belakang: Proses pemulangan pasien rawat inap merupakan salah satu indikator mutu pelayanan rumah sakit yang mencerminkan efisiensi dan ketepatan waktu layanan. Keterlambatan discharge dapat menyebabkan penumpukan tempat tidur, meningkatnya waktu tunggu pasien baru, dan menurunnya kepuasan pasien. Standar pelayanan minimal waktu tunggu pemulangan pasien rawat inap menurut Kementerian Kesehatan RI adalah kurang dari 2 jam. Pada tahun 2025, capaian waktu tunggu pemulangan pasien rawat inap di Rumah Sakit Pusat Pertamina masih belum memenuhi standar tersebut dan hasil observasi peneliti pada saat PBL 3 rata-rata waktu tunggu mencapai 4 Jam 18 Menit. Tujuan: Menganalisis proses pemulangan pasien rawat inap menggunakan pendekatan Lean Six Sigma untuk mengidentifikasi waste, variasi proses, akar masalah, serta merumuskan usulan perbaikan. Metode: Penelitian ini menggunakan desain cross sectional dengan pendekatan kuantitatif dan kualitatif. Data dikumpulkan melalui observasi menggunakan time motion study dan wawancara mendalam terhadap informan terpilih. Sampel dipilih secara purposif pada pasien rawat inap reguler berdasarkan lantai perawatan dan jenis penjaminan. Hasil: Penelitian menunjukkan rata-rata lead time pemulangan pasien rawat inap di RSPP sebesar 5 Jam 08 Menit 02 Detik. Aktivitas non-value added (69,4%) didominasi oleh waste of waiting selama 2 Jam 14 Menit 22 Detik. Bottleneck terletak pada menunggu perawat mengantarkan obat pulang dan edukasi pasien, menunggu perawat mengisi resume keperawatan, menunggu pasien keluar kamar, menunggu DPJP dan dokter GP mengisi e-prescribing, serta menunggu perawat lapor pulang ke petugas administrasi. Usulan perbaikan mencakup penyempurnaan SPO, Sosialisasi terstruktur, Cheat Sheet daftar formularium dan cakupan penjamin, checklist board discharge, reminder batas waktu keluar kamar, Integrasi SIMRS, penyediaan discharge lounge. Kesimpulan: Proses pemulangan pasien rawat inap di RSPP masih belum memenuhi standar nasional. Pendekatan Lean Six Sigma mampu mengidentifikasi sumber inefisiensi dan menghasilkan rekomendasi perbaikan yang terukur untuk meningkatkan efisiensi pelayanan.

Background: The discharge process for inpatients is one of the indicators of hospital service quality that reflects the efficiency and timeliness of care. Delayed discharges can lead to bed occupancy, increased wait times for new patients, and decreased patient satisfaction. According to the Indonesian Ministry of Health, the minimum service standard for the wait time for inpatient discharge is less than 2 hours. In 2025, the discharge waiting time at Pertamina Central Hospital still did not meet this standard, and the researchers’ observations during PBL 3 showed that the average waiting time reached 4 hours and 18 minutes. Objective: To analyze the inpatient discharge process using the Lean Six Sigma approach to identify waste, process variation, root causes, and formulate improvement proposals. Methods: This study used a cross-sectional design with quantitative and qualitative approaches. Data were collected through observation using a time-motion study and in-depth interviews with selected informants. The sample was purposively selected from regular inpatients based on care floor and type of insurance coverage. Results: The study found that the average lead time for discharging inpatients at RSPP was 5 hours, 8 minutes, and 2 seconds. Non-value-added activities (69.4%) were dominated by waiting time, totaling 2 hours, 14 minutes, and 22 seconds. Bottlenecks included waiting for nurses to deliver discharge medications and provide patient education, waiting for nurses to complete nursing summaries, waiting for patients to vacate their rooms, waiting for attending physicians and general practitioners to complete e-prescriptions, and waiting for nurses to report discharges to administrative staff. Proposed improvements include refining SPOs, structured training sessions, a cheat sheet listing the formulary and insurance coverage, a discharge checklist board, reminders regarding room exit deadlines, SIMRS integration, and the provision of a discharge lounge. Conclusion: The inpatient discharge process at RSPP still does not meet national standards. The Lean Six Sigma approach was able to identify sources of inefficiency and generate measurable improvement recommendations to enhance service efficiency.

Persaingan rumah sakit swasta yang semakin ketat menuntut rumah sakit untuk memperkuat merek sebagai strategi dalam menarik dan mempertahankan pasien eksekutif atau non-JKN. RS Hermina Jatinegara menghadapi tantangan pada layanan rawat inap eksekutif, ditunjukkan oleh Bed Occupancy Rate (BOR) yang fluktuatif dan belum stabil pada ambang ideal, serta rendahnya konversi pasien dari rawat jalan eksekutif dan IGD eksekutif ke layanan rawat inap eksekutif. Penelitian ini bertujuan untuk menganalisis hubungan Customer-Based Brand Equity (CBBE) berdasarkan model Keller, yang terdiri dari dimensi brand salience, brand performance, brand imagery, brand judgments, brand feelings, dan brand resonance, dengan keputusan pasien memilih layanan rawat inap eksekutif di RS Hermina Jatinegara. Penelitian ini menggunakan pendekatan kuantitatif dengan desain potong lintang. Sampel penelitian berjumlah 96 responden pasien eksekutif, terdiri dari 87 responden dari unit rawat jalan eksekutif dan 9 responden dari unit IGD eksekutif, yang dipilih dengan teknik consecutive sampling dan proportional sampling. Data primer dikumpulkan melalui kuesioner berskala Likert, sedangkan data sekunder diperoleh dari data operasional rumah sakit dan referensi pendukung. Analisis data dilakukan menggunakan SEM-PLS melalui pengujian outer model dan inner model. Hasil penelitian menunjukkan bahwa keputusan pasien dalam memilih layanan rawat inap berada pada kategori baik. Seluruh dimensi CBBE juga menunjukkan persepsi yang baik, meskipun masih terdapat beberapa indikator yang perlu ditingkatkan, terutama pada aspek top of mind, kecepatan respons pelayanan, rasa aman, kebanggaan sosial, dan penghargaan personal. Nilai R-square sebesar 0,786 menunjukkan bahwa model mampu menjelaskan keputusan pasien sebesar 78,6%. Hasil uji bootstrap menunjukkan bahwa brand imagery berhubungan positif dan signifikan dengan keputusan pasien (p=0,023), demikian pula brand resonance (p=0,018). Sementara itu, brand salience, brand performance, brand feelings, dan brand judgments tidak menunjukkan hubungan yang signifikan. Penelitian ini menyimpulkan bahwa citra merek dan keterikatan emosional pasien merupakan faktor utama yang berhubungan dengan keputusan pasien memilih layanan rawat inap eksekutif di RS Hermina Jatinegara. Oleh karena itu, rumah sakit perlu memperkuat repositioning citra sebagai rumah sakit umum modern, meningkatkan komunikasi clinical excellence, memperbaiki responsivitas layanan, serta membangun relationship marketing melalui layanan personal dan berkelanjutan bagi pasien eksekutif.

Increasing competition among private hospitals requires stronger brand development as a strategic effort to attract and retain executive or non-JKN patients. RS Hermina Jatinegara faces challenges in its executive inpatient services, as reflected in fluctuating Bed Occupancy Rate (BOR) performance that has not consistently reached the ideal standard, as well as the low conversion rate of patients from executive outpatient and emergency department services to executive inpatient care. This study aims to analyze the relationship between Customer-Based Brand Equity (CBBE), based on Keller’s model consisting of brand salience, brand performance, brand imagery, brand judgments, brand feelings, and brand resonance, and patients’ decision to choose executive inpatient services at RS Hermina Jatinegara. This study used a quantitative approach with a cross-sectional design. The sample consisted of 96 executive patients, including 87 respondents from the executive outpatient unit and 9 respondents from the executive emergency department, selected using consecutive sampling and proportional sampling techniques. Primary data were collected through a Likert-scale questionnaire, while secondary data were obtained from hospital operational records and supporting references. Data analysis was conducted using SEM-PLS through outer model and inner model testing. The results showed that patients’ decision to choose inpatient services was generally categorized as good. All CBBE dimensions also demonstrated positive patient perceptions, although several indicators still require improvement, particularly those related to top-of-mind awareness, service responsiveness, sense of security, social pride, and personal appreciation. The R-square value of 0.786 indicated that the model was able to explain 78.6% of the variance in patients’ decision-making. Bootstrap testing showed that brand imagery had a positive and significant relationship with patients’ decision-making (p = 0.023), as did brand resonance (p = 0.018). Meanwhile, brand salience, brand performance, brand feelings, and brand judgments did not show significant relationships. This study concludes that brand image and patients’ emotional attachment are the main factors associated with patients’ decision to choose executive inpatient services at RS Hermina Jatinegara. Therefore, the hospital needs to strengthen its repositioning as a modern general hospital, improve communication of clinical excellence, enhance service responsiveness, and develop relationship marketing through more personalized and continuous services for executive patients.

Penyakit Jantung Koroner (PJK) merupakan penyebab utama kematian dan penyerap biaya katastropik terbesar dalam Program Jaminan Kesehatan Nasional (JKN), dengan total kunjungan rawat inap dan biaya yang terus meningkat setiap tahunnya. Penelitian ini bertujuan menganalisis pola pemanfaatan, biaya pelayanan, serta determinan utilisasi dan biaya rawat inap tingkat lanjutan (RITL) pada peserta JKN penderita PJK di Provinsi Jawa Barat tahun 2024. Penelitian menggunakan desain cross-sectional dengan data sekunder klaim BPJS Kesehatan (SSBI) yang mencakup 22.986 episode pelayanan rawat inap. Analisis dilakukan secara univariat, bivariat, dan multivariat menggunakan regresi Quasi-Poisson. Hasil penelitian menunjukkan bahwa sebagian besar pasien hanya menjalani satu kali episode rawat inap (98,55%), dengan utilisasi terkonsentrasi di Kota Bandung (25,92%). Total biaya pelayanan mencapai Rp320,01 miliar dengan rata-rata Rp13.922.137 per episode. Berdasarkan analisis multivariat, determinan yang berhubungan signifikan dengan utilisasi RITL adalah komorbid (IRR = 1,006; p = 0,009) dan tingkat keparahan level III (IRR = 1,011; p = 0,003). Sementara itu, determinan biaya RITL yang bermakna meliputi jenis case group INA-CBGs (koefisien +Rp22,68 juta; p < 0,001), tingkat keparahan, komorbid, hak kelas rawat, dan tipe FKRTL. Segmen peserta dan status kepemilikan FKRTL tidak terbukti berpengaruh secara independen terhadap utilisasi maupun biaya. Temuan ini mengindikasikan bahwa faktor klinis mendominasi utilisasi pelayanan, sedangkan kompleksitas tata laksana medis menjadi penentu utama biaya. Prinsip ekuitas JKN terbukti berjalan dengan baik pada pelayanan rawat inap PJK di Jawa Barat.

Coronary Heart Disease (CHD) is the leading cause of mortality and the largest driver of catastrophic healthcare expenditure within Indonesia's National Health Insurance (JKN) program, with inpatient visits and costs rising steadily each year. This study aimed to analyze utilization patterns, service costs, and the determinants of advanced inpatient care (RITL) utilization and expenditure among JKN participants with CHD in West Java Province in 2024. A cross-sectional design was applied using secondary data from BPJS Kesehatan claims (SSBI), covering 22,986 inpatient episodes. Data were analyzed through univariate, bivariate, and multivariate approaches using Quasi-Poisson regression. Results showed that the majority of patients underwent only a single inpatient episode (98.55%), with utilization concentrated in Bandung City (25.92%). Total service expenditure reached IDR 320.01 billion, with a mean cost of IDR 13,922,137 per episode. Multivariate analysis identified comorbidity (IRR = 1.006; p = 0.009) and severity level III (IRR = 1.011; p = 0.003) as significant independent determinants of inpatient utilization. Significant determinants of inpatient cost included INA-CBGs case group (coefficient +IDR 22.68 million; p < 0.001), severity level, comorbidity, ward class entitlement, and hospital type. Membership segment and hospital ownership status were not independently associated with either utilization or cost. These findings indicate that clinical need factors dominate inpatient utilization, while the complexity of medical management is the primary driver of costs. The equity principle of JKN is shown to be functioning effectively in CHD inpatient care in West Java.

Waktu pemulangan pasien rawat inap merupakan indikator mutu penting dalam pelayanan rumah sakit. Di RS Universitas Indonesia (RSUI), target check-out time sebelum pukul 12 siang belum tercapai selama empat tahun terakhir, berdampak pada keterlambatan alur rawat inap dari IGD dan menurunnya efisiensi pemanfaatan tempat tidur. Proses discharge yang kompleks, melibatkan banyak unit, serta dominasi aktivitas non-value-added menjadi penyebab utama rendahnya capaian indicator mutu tersebut. Penelitian ini menggunakan pendekatan Lean Six Sigma dengan desain DMAIC (Define, Measure, Analyze, Improve, Control). Pengumpulan data dilakukan melalui observasi proses discharge dan wawancara mendalam terhadap tujuh informan kunci lintas profesi. Sampel terdiri atas 40 pasien jaminan BPJS Kesehatan. Analisis dilakukan untuk mengidentifikasi aktivitas value-added, non-value-added, waste, dan variasi proses. Rata-rata lead time discharge sebelum intervensi adalah 20 jam 35 menit dengan 86% aktivitas tergolong NVA. Empat aktivitas prioritas dengan waste tertinggi adalah discharge billing (43,75%), penyusunan resume keperawatan dan surat kontrol (13,62%), pengorderan resep obat pulang (9,95%), dan penyusunan resume medis (9,86%). Intervensi dilakukan melalui penempatan tenaga administrasi ruangan (ADRU), surat edaran kebijakan peresepan oleh DPJP, serta pelatihan Kaizen. Setelah intervensi, capaian check-out sebelum pukul 12.00 meningkat dari 45% menjadi 53%, meskipun total lead time meningkat menjadi 22 jam 40 menit. Namun, beberapa subprocess mengalami perbaikan signifikan, seperti edukasi dan pemberian obat (turun 29%), pasien keluar ruang (turun 40%), dan discharge billing (turun 40%). Intervensi Lean Six Sigma berhasil meningkatkan capaian check-out time <12.00 meskipun belum menurunkan total lead time secara keseluruhan. Perbaikan cenderung parsial dan menunjukkan perlunya intervensi lebih menyeluruh terhadap tahapan proses discharge yang belum optimal.

Inpatient discharge time is a key quality indicator in hospital services. At Universitas Indonesia Hospital (RSUI), the target check-out time before 12:00 PM has not been achieved over the past four years. This delay negatively impacts the inpatient admission flow from the emergency department and reduces the efficiency of bed utilization. The complexity of the discharge process, which involves multiple units and is dominated by non-value-added (NVA) activities, is a primary factor contributing to the low performance of this indicator. This study applied a Lean Six Sigma approach using the DMAIC (Define, Measure, Analyze, Improve, Control) framework. Data collection was conducted through direct observation of the discharge process and in-depth interviews with seven key informants from different professional backgrounds. The sample consisted of 40 inpatients covered by the national health insurance scheme (BPJS Kesehatan). The analysis focused on identifying value-added (VA) and non-value-added (NVA) activities, waste, and process variation. The average pre-intervention discharge lead time was 20 hours and 35 minutes, with 86% of activities categorized as NVA. Four priority activities contributing the most waste were: system-based discharge billing (43.75%), preparation of nursing discharge summaries and follow-up letters (13.62%), prescription of discharge medications (9.95%), and preparation of medical summaries (9.86%). Interventions included the deployment of room-based administrative staff (ADRU), a policy circular mandating discharge prescriptions by the attending physician, and Kaizen training for process owners. Post-intervention, the proportion of patients discharged before 12:00 PM increased from 45% to 53%, although the total lead time rose to 22 hours and 40 minutes. However, several subprocesses showed significant improvements, such as patient education and medication handover (reduced by 29%), patient exit from the ward (reduced by 40%), and discharge billing (reduced by 40%). The Lean Six Sigma intervention succeeded in improving the achievement of the <12:00 PM discharge time indicator, although it did not reduce the overall discharge lead time. The improvements were partial, indicating a need for more comprehensive interventions targeting other suboptimal discharge process components.