Implementation of the “Gagean Fast Track” Program Based on Lean Healthcare Principles to Improve Outpatient Service Efficiency at Prof. Dr. Margono Soekarjo Regional General Hospital
DOI:
https://doi.org/10.32584/jkmk.v9i1.3187Keywords:
Lean Healthcare, Fast Track, Outpatient Services, Healthcare Efficiency, Patient Waiting Time, Healthcare InnovationAbstract
Hospitals continue to face substantial challenges in healthcare service delivery, particularly prolonged patient waiting times, inefficient patient flow, and suboptimal utilization of available resources. These challenges can compromise healthcare quality, patient satisfaction, and patient safety. Innovative service delivery models are therefore needed to improve operational efficiency without requiring additional infrastructure or substantial financial investment. This study aimed to evaluate the effectiveness of the “Gagean Fast Track” program, developed using Lean Healthcare principles, in improving outpatient service efficiency. An implementation-focused approach was employed, incorporating Lean principles to identify and eliminate non-value-added activities, streamline patient flow, optimize resource utilization, and strengthen patient-centered care. The intervention integrated the Smart Medica digital platform and electronic medical records (EMRs) to facilitate service coordination, accelerate administrative processes, and improve documentation accuracy. The findings indicated that implementing the Gagean Fast Track program reduced patient waiting times, improved resource utilization, and enhanced overall outpatient service workflows without requiring additional infrastructure investment. Successful implementation was supported by interdepartmental collaboration, stakeholder engagement, and continuous monitoring and evaluation. The program was also replicated in several hospitals, suggesting its potential adaptability and scalability across different healthcare settings. These findings suggest that the Gagean Fast Track program offers a promising Lean Healthcare–based approach to optimizing outpatient service delivery. Integrating digital health technologies with systematic workflow improvement may support more efficient, responsive, and patient-centered healthcare services. Further evaluation using standardized performance indicators is recommended to establish its long-term effectiveness and sustainability.
References
Adomah-Afari, A., Anakwa-Awuku, A., & Gadeka, D. D. (2023). Patients’ satisfaction with the quality of care upon implementation of electronic health records system at the 37 Military Hospital, Ghana. Health Sciences Investigations Journal. https://doi.org/10.46829/hsijournal.2023.12.4.2.494-501
Adrinko, B., & Wandara, F. (2020). Relevance Of Medical Records Management Of Health Care Services Delivery . Case Study Of Jinja Referral Hospital Jinja Municipality . Student’s Journal of Health Research Africa, 1–17.
Albalawi, M., Mahmud, A., Abdul Manaf, R., Mohd Nazan, A. I. N., Aljohani, A., & Mohamad, A. (2024). Improving the Waiting Time in Outpatient Clinics Using Lean Approach in Hospital: A Systematic Review. Malaysian Journal of Medicine and Health Sciences, 20(1 SE-Systematic Reviews), 263–270. http://mjmhsojs.upm.edu.my/index.php/mjmhs/article/view/755
Astiena, A. K., Hadiguna, R. A., Iswanto, A. H., & Hardisman, -. (2022). Digitalization of Outpatient Services Based on Lean Management to Reduce Waiting Time in Government Hospital. International Journal on Advanced Science, Engineering and Information Technology, 12(6 SE-Articles), 2248–2257. https://doi.org/10.18517/ijaseit.12.6.17212
Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. L. (2016). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. European Journal of Public Health, 26(1), 60–64. https://doi.org/10.1093/eurpub/ckv122
Chen, C., Sukmanee, J., Soon, K. W., Lim, J., D’Souza, J. L. A., & Teerawattananon, Y. (2025). Economic Evaluation of the Next Generation Electronic Medical Records in Singapore: Cost-Utility Analysis. J Med Internet Res, 27, e70484. https://doi.org/10.2196/70484
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy (Amsterdam, Netherlands), 119(9), 1197–1209. https://doi.org/10.1016/j.healthpol.2015.02.002
Dachyar, M., & Nattaya, N. (2020). Collaborating Internet of Things ( IoT ) and Electronic Medical Record ( EMR ) to Reduce Healthcare Waiting time . Outpatient Cardiology Service Case : A BPR Approach. Advances in Economics, Business and Management Research, 144(Afbe 2019), 88–95.
Holmberg, M., Tapio Innamaa, Ville Hällberg, Lukkarinen, T., & Palomäki, A. (2021). Patients Left Without Being Seen in the Emergency Department – A Retrospective Observational Patient Record Study. Research Square, 1–12. https://doi.org/https://doi.org/10.21203/rs.3.rs-744447/v1
Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017). Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open, 7(8), e016242. https://doi.org/10.1136/bmjopen-2017-016242
Made, N., Saraswati, D., Bagenda, W., & W, Y. R. (2025). Penerapan Lean Hospital Dalam Meningkatkan Efisiensi Manajemen Operasional Rawat Jalan Rumah Sakit Umum Daerah Sanjiwani Gianyar. Journal of Knowledge Management, 19(2).
Moraros, J., Lemstra, M., & Nwankwo, C. (2016). Lean interventions in healthcare: do they actually work? A systematic literature review. International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care, 28(2), 150–165. https://doi.org/10.1093/intqhc/mzv123
Mwanswila, M. J., Mollel, H. A., & Mushi, L. D. (2024). Outcome evaluation of technical strategies on reduction of patient waiting time in the outpatient department at Kilimanjaro Christian Medical Centre-Northern Tanzania. BMC Health Services Research, 24(1), 785. https://doi.org/10.1186/s12913-024-11231-5
Pradere, P., Caramella, C., Salem, F. Ben, Florea, V., Crutu, A., Hanna, A., Mabille, L., Kim, Y.-W., De Montpreville, V., Feuillet, S., Naltet, C., Planchard, D., Blanc, E., Fadel, E., Pavec, J. Le, & Mercier, O. (2023). A Patient-Centered Model of Fast-Track Lung Cancer Diagnosis. Clinical Lung Cancer, 24(5), 453–458. https://doi.org/https://doi.org/10.1016/j.cllc.2023.03.006
Purwito, D., Anggraini, M., Muhaemin, G., Fauzia, M. R., Prabawati, A. Y., Meitasari, N. W., Mustikaningsih, & Patima, S. (2026). Interprofessional Education and Collaborative Practice: Strategi, Kompetensi, dan Aplikasi Klinis (1st ed.). Pena Persada Kerta Utama.
Rotter, T., Plishka, C., Lawal, A., Harrison, L., Sari, N., Goodridge, D., Flynn, R., Chan, J., Fiander, M., Poksinska, B., Willoughby, K., & Kinsman, L. (2019). What Is Lean Management in Health Care? Development of an Operational Definition for a Cochrane Systematic Review. Evaluation & the Health Professions, 42(3), 366–390. https://doi.org/10.1177/0163278718756992
Souza, D. L., Korzenowski, A. L., Alvarado, M. M., Sperafico, J. H., Ackermann, A. E. F., Mareth, T., & Scavarda, A. J. (2021). A Systematic Review on Lean Applications’ in Emergency Departments. Healthcare (Basel, Switzerland), 9(6). https://doi.org/10.3390/healthcare9060763
Tapia, A. D., Howard, J. T., Bebo, N. L., Pfaff, J. A., Chin, E. J., Trueblood, W. A., April, M. D., Long, B. J., Long, A. N., Fernandez, W. G., & Schauer, S. G. (2022). A Retrospective Review of Emergency Department Visits That May Be Appropriate for Management in Non-Emergency Settings. Military Medicine, 187(9–10), e1153–e1159. https://doi.org/10.1093/milmed/usab553
Thamilnila, J., & Aryarathne, S. P. (2024). Impact of Lean Manufacturing Practices on Waiting Time of Patients in Outpatient Department ( OPD ): A Study in the Sri Lankan Public Healthcare Industry . International Journal of Scientific Research and Management, 12(05), 6320–6330. https://doi.org/10.18535/ijsrm/v12i05.em06
Usman, M., Siddiqui, H., & Majeed, F. (2023). Applying Lean Management Principles for Enhanced Outpatient Waiting Times. 43957–43966. https://doi.org/10.26717/BJSTR.2023.52.008290
Widiatmini, I. R., & Purwito, D. (2025). Analisis hubungan kepuasan pasien dengan kualitas pelayanan di puskesmas kabupaten banyumas. Jurnal Ilmiah Keperawatan, 11(i). https://doi.org/https://doi.org/10.33023/jikep.v11i1.2485
Widiyanto, F., & Widayati, A. (2021). The Challenges Of Hospital Information System Implementation: A Case Study Of A Public Hospital In Indonesia. Journal of Pharmaceutical Sciences and Community, 18, 56–64. https://doi.org/10.24071/jpsc.003010
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Kusumaningtyas, Restu

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges as well as earlier and greater citation of published work (See The Effect of Open Access).

This work is licensed under a Creative Commons Attribution 4.0 International License.
SINTA
Garuda
DOAJ
Dimensions
Copernicus
Google Scholar