Article Sidebar

Download
Download Article

Main Article Content

Abstract

Health services require speed, accuracy, and quality in order to be able to meet expectations and increase patient satisfaction. However, in practice, problems in the form of waste are still often found in the service flow, such as long queues, long waiting times, data recording errors, and inefficient manual activities. This condition also occurs at the Nerve Polytechnic of dr. Darsono Pacitan Hospital, which is the main referral hospital in Pacitan Regency. This study aims to identify forms of waste in services at the Nerve Polytechnic and provide suggestions for improvements to improve service efficiency. The method used is a Lean Healthcare approach with the help of Root Cause Analysis (RCA) and the 5 Why technique to trace the root cause of problems. The results of the analysis using BPM show that the lead time of the initial service is 127 minutes. After the implementation of the improvement recommendations, non-value added activities were completely eliminated, so that the lead time was reduced to 68 minutes, or equivalent to a time reduction of 46.5%. The improvement recommendations are focused on improving the efficiency of polyneural services through optimizing human resources, adjusting the work system, implementing 5S, utilizing information technology, digitizing medical records, and involving medical personnel in improving service quality.

Keywords

Lean Healthcare Waste Root Cause Analysis Poly Neraf

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

How to Cite
Mukti, P., & Rochmoeljati, R. (2026). Analysis of Time Waste in Healthcare Services Using Lean Healthcare and the 5 Whys Root Cause Analysis: Case Study Neurology Outpatient Clinic at Dr. Darsono Regional General Hospital, Pacitan. Golden Ratio of Mapping Idea and Literature Format, 6(2), 1871–1889. https://doi.org/10.52970/grmilf.v6i2.2102
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Alfatiyah, R., & Bastuti, S. (2022). Optimization of the Queue System at the Outpatient Pharmacy of Grha Permata Ibu Hospital with the Lean Hospital Method. Performance: Industrial Engineering Scientific Media, 21(1), 1. https://doi.org/10.20961/performa.21.1.50455
  2. Astuti, F. H., & Saskia, T. (2021). Lean Healthcare Analysis to Minimize Waste in Pediatric Disease Polyclinics. JISI: Journal of Industrial Systems Integration, 8(1), 23–33. https://doi.org/10.24853/jisi.8.1.23-33
  3. Ayunani, D. I., Garside, A. K., & Wardana, R. W. (2024). Waste Minimization in the Pasteurized Milk Production Process with a Lean Manufacturing Approach. Performance: Industrial Engineering Scientific Media, 23(2), 97. https://doi.org/10.20961/performa.23.2.84224
  4. Baharudin, I., Purwanto, A. J., & Fauzi, M. (2021). Waste Analysis Using "9 Waste" in the Production Process of Pt Abc. Scientific Journal of Applied Information Technology, 8(1), 187–192. https://doi.org/10.33197/jitter.vol8.iss1.2021.745
  5. Banjarnahor, B., Juliana, M., & Zaenal, D. (2025). APPLICATION OF ROOT CAUSE ANALYSIS TO IDENTIFY ACTUAL DATA DISCREPANCIES AND SAP INPUTS IN OPERATIONAL PROCESSES IN PT XY ROOT CAUSE ANALYSIS FOR IDENTIFYING DATA DISCREPANCIES BETWEEN. [EOS]03(01). https://doi.org/10.24843/JRATI.2025.v03.i01.p15
  6. Basuki, F. H. A., Aknuranda, I., & Perdanakusuma, A. R. (2023). Analysis of Dinasty CV Business Process Using Root Cause Analysis and Lean Approach. Journal of Information Technology and Computer Science Development, 7(4), 1533–1542. http://j-ptiik.ub.ac.id
  7. Bestafirli, & Saifuddin. (2024). Improvement Productivity Using the Time and Motion Study Method in the Area of Line F PT KHI. Venus: Journal of Engineering Science Publications, 2(1), 77–88. https://doi.org/10.61132/venus.v2i1.95
  8. Brivan Ardhandy Studynka, & Enny Aryanny. (2024). Improvement Productivity Using the Time Motion Study Method in the Soy Dissolving Area of PT XNX. Venus: Journal of Engineering Science Publications , 2(1), 99–108. https://doi.org/10.61132/venus.v2i1.100
  9. Earley, J. (2016). The Lean Book of Lean: A Concise Guide to Lean Management for Life and Business (John Earley (ed.)). John Wiley & Sons Ltd. https://doi.org/10.1002/9781119271703
  10. Fansuri, M. (2018). Lean Management. https://doi.org/97896705046306
  11. Fhadillah, I., Anggraeni, N. F., & Awaliah Sugiarto, A. R. (2020). Analysis of Waste in Pt. Xyz Using 8 Waste. Scientific Journal of Applied Information Technology, 6(2), 157–162. https://doi.org/10.33197/jitter.vol6.iss2.2020.335
  12. Firdaus, R. Z., & Wahyudin, W. (2023). Application of Lean Manufacturing Concept to Minimize Waste at PT Anugerah Damai Mandiri (ADM). Journal of Integrated System, 6(1), 21–31. https://doi.org/10.28932/jis.v6i1.5632
  13. Graban, M. (2018). Lean hospitals: Improving quality, patient safety, and employee engagement, third edition. Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition, 1–319. https://doi.org/10.4324/9781315380827
  14. Hezbollah, J. A., & Wahyuni, H. C. (2023). Integration of Six Sigma and Root Cause Analysis in Performance Improvement at PT XYZ. Matrix: Journal of Production Industry Management and Engineering, 24(1), 73. https://doi.org/10.30587/matrik.v24i1.5950
  15. Kania Rizqita Dewi, Putri Regita Miolda, Triayu Nur Afifah, & Acim Heri Iswanto. (2023). An Analysis of the Impact of Lean Hospital Implementation on Hospital Outpatient Installation Patient Services in Indonesia: A Literature Review. Indonesian Journal of Medical and Health Sciences, 3(2), 43–52. https://doi.org/10.55606/jikki.v3i2.1574
  16. Kartika, N., Melati, I. P., & Hanum, F. (2021). Leanhealthcare Analysis to Identify Waste in Hospital X. MEA Scientific Journal (Management, Economics, and Accounting), 5(3), 2149–2165.
  17. Kartika, N., & Widayanti, P. (2024). Lean Healthcare Analysis at Airlangga Health Service Center. Southeast Asian Business Review, 2(1), 59–66. https://doi.org/10.20473/sabr.v2i1.55029
  18. Kencana, R. N. W., & Iriani, I. (2025). Order Status Analysis of Supply Chain Management of Pt. Kepuh Kencana Arum Using the Root Cause Analysis (RCA) Method. Journal of Exact Scientific Research and Assessment, 4(1), 23–34. https://doi.org/10.47233/jppie.v4i1.1788
  19. Krisnanti, E. D., & Garside, A. K. (2022). The Application of Lean Manufacturing to Minimize Box Printing Waste. Journal of Industrial Engineering INTECH, Serang Raya University, 8(2), 99–108. https://doi.org/10.30656/intech.v8i2.4780
  20. Kulkarni, R. G. (2007). Going lean in the emergency department: A strategy for addressing emergency department overcrowding. MedGenMed Medscape General Medicine, 9(4).
  21. Moengin, P., & Ayunda, N. (2021). Lean Manufacturing to Minimize Lead Time and Waste to Achieve Production Targets (Case study: PT. Rollflex Manufacturing Indonesia). Journal of Industrial Engineering, 11(1), 77–92. https://doi.org/10.25105/jti.v11i1.9699
  22. Mukti, P., Cattleya, M., & Anissa, P. (2025). Analysis of The Application of Lean Manufacturing with Methods Material Information Flow Chart ( MIFC ) and Fuzzy Failure Mode , Effects and Criticality Analysis ( FMECA ). Golden Ratio, 5(2), 16–23.
  23. Nurlaelah. (2023). Implementation of Value Stream Mapping in Simple Housing in Indonesia.
  24. Purbasari, A., Sumarya, E., & Mardhiyah, R. (2023). Application of Time and Motion Study Methods to the Packing Process at Pt. Abc. Sigma Teknika, 6(2), 290–299. https://doi.org/10.33373/sigmateknika.v6i2.5633
  25. Savira Winda Devie, & Subadi Wahyu. (2023). Winda Devie Savira ; Wahyu Subadi. Journal of Public Administration & Business Administration, 6(2), 749–762.
  26. Vioni, L., Jatmiko, P., & Safirin, M. T. (2025). Waste Reduction in the Sickle Production Process Using the VALSAT Method and Value Stream Mapping. Golden Ratio, 5(2), 8–15.
  27. Wati, A. L., Muhardi, & Numan, H. (2021). The Application of Lean Hospital in Emergency Unit Services at Bayu Hospital. Journal of Social and Technology (SOSTECH), 2(4), 313–329.
  28. Wibowo, S. A. (2021). Application of Lean Manufacturing in Increasing Productivity of Aluminum Baking Trays. Journal of Industrial Systems Engineering, 7(1), 38–47. https://doi.org/10.33884/jrsi.v7i1.4543