Business Process Analysis of Outpatient Waiting Time Using Simulation Case Study: Puskesmas ABC

Abstract

The increased number of visitors and patients visiting public services such as Puskesmas has
been a serious concern while the service system stays constant. These unchanged system and growing
number of patients causing the long waiting problem. Puskesmas ABC's management said that their
flow of patient is slow, especially at Physician’s waiting line. Long waiting time affects patient’s
satisfaction and may cause patient’s illness get worse or transmit their illness to others. The purpose of
this research is to analyze the quality of the process business, outpatient waiting time, resource allocation
in Puskesmas ABC, and the use of a simulation model to analyze outpatient flow, variation of service
time, and resource utilization. A descriptive study is conducted in order to construct a model that
possibly used to estimate patient waiting time and service time at the outpatient counter. The waiting
time studied is the queue time starting from the patient registering until being served by a doctor
according to the standard of waiting time set by the Ministry of Health through the Permenkes on
minimum standards of hospital or health services. The data collected by conducting observation and
interview method in Puskesmas ABC. These data are processed and analyzed using Minitab to find the
control chart. Furthermore, the collected data examined with various simulations using iGrafx in order
to obtain the most efficient queuing model for proper appointment system. The result of the research
shows that the factors affecting the length of waiting time of the patient are the waiting time at
Physician’s room. Therefore, reducing the workload of medical record staff and improving the flow of
medical record are able to significantly reduce the waiting time. Furthermore, information and
communication technology (ICT) tools like online registration and electronic medical records (E-MR)
can cut some of the processes and reduce cycle time by a lot.

Keywords: Business process, puskesmas, resource utilization, simulation, waiting time