ENHANCING OUTPATIENT SERVICE QUALITY IN INDONESIAN HOSPITALS THROUGH LEAN HEALTHCARE MANAGEMENT: A SYSTEMATIC REVIEW
Berta Ivana Priladiantika, Arih Diyaning Intiasari, Joko Mulyanto

Jenderal Soedirman University

Abstract

Background: Lean management, originally part of the Toyota Production System, is now widely applied across various industries, including hospitals, to improve service quality by reducing waste. The implementation of lean in hospitals aims to enhance efficiency, reduce the length of hospital stays, and minimize medical errors, although the outcomes vary depending on factors such as leadership, training, and staff engagement. Objective: To examine the implementation of lean management in hospitals in Indonesia as a strategy to improve service quality and standards. Design: This article refers to a Cochrane systematic review with a PICO approach, with the population consisting of hospital outpatient clinics, the intervention being lean management, no comparison group, and the measured outcome being the success of lean management implementation in Indonesian hospitals. Data Sources: Relevant articles were searched through the Google Scholar database in October 2024. Review Methods: This article follows the PRISMA guidelines in the literature selection process, starting with a database search that yielded 256 articles. These were then screened based on inclusion and exclusion criteria, resulting in 12 relevant articles. The selection process included the removal of duplicate articles, screening of titles and abstracts, and full-text evaluation. Results: The implementation of lean management in Indonesian hospitals was carried out by observing and recording service flow from registration to payment, then analyzing service time based on Value-Added and Non-Value-Added Activities using Visual Stream Mapping or spaghetti diagrams, and discussing solutions through the 5 Whys and Fishbone Analysis methods. Conclusion: Lean management is suitable for application in hospital outpatient services to improve efficiency by eliminating waste and optimizing systems. It has been proven effective in enhancing healthcare services based on the conducted studies.

Keywords: Lean management, healthcare, outpatient, indonesia

Topic: Public Health Sciences