International Journal in Management and Social Science Volume 10 Issue 11, November 2022 ISSN: 2321-1784 Impact Factor: 7.088 Journal Homepage: http://ijmr.net.in, Email: irjmss@gmail.com Double-Blind Peer Reviewed Refereed Open Access International Journal 159 International Journal in Management and Social Science http://ijmr.net.in, Email: irjmss@gmail.com AN EMERGENCY INSTALLATION PERFORMANCE IMPROVEMENT OF ROYAL PRIMA HOSPITAL WITH LEAN MANAGEMENT METHOD Bunga Tiara Dita 1 , Ermi Girsang 2 , Ali Napiah Nasution 3 Pogram Study Master of Public Health Faculty of Medicine, Dentistry and Health Sciences University Prima Indonesia Medan, North Sumatera, Indonesia ABSTRACT Lean is a methodology that enables hospitals to improve the quality of patient care by reducing errors and waiting times. Lean is an approach that can support employees and physicians, removing barriers and enabling them to focus on providing care. IGD (Emergency Installation) is one of the busiest installations in hospitals. The ER is the first unit to treat patients. Lean methods are used by hospitals to improve the quality of service to patients by reducing two main problems, namely reducing errors and waiting time. This type of research is qualitative using in-depth interviews related to lean adoption and how far the implementation of the ER Royal Prima Hospital Medan, then analyzed by triagulation. The results showed that the adoption of lean management at Royal Prima Hospital came from the hospital itself, which had been established for 8 years. And its implementation has been carried out since the hospital was founded, especially the ER unit with the flow that has been set by the hospital in preventing wasting. Keywords :Lean Management, Lean Hospital, Emergency Room 1. INTRODUCTION Efforts to improve the quality of health services, especially hospitals, are based on increasing public awareness about health information and demands for quality health services. Hospitals are facing increasing pressure to improve the efficiency and cost- effectiveness of their services, due to competition among healthcare providers, higher customer expectations, stringent checks for insurance payments, new government regulations, an aging population, and reduced government spending (Al Owad, Samaranayake, Karim, & Ahsan, 2018). The problem that may occur at this time is that many hospitals already have good lean hospitals which may be adopted from several hospitals that already use lean management, and it has been proven that lean management can affect hospital performance, but there are still many obstacles. which may occur in hospitals that have adopted lean management but have not been able to implement it, this is where every hospital must be able to immediately implement lean management if the adopted lean management already has tangible results and benefits. for hospital performance. IGD (Emergency Installation) is one of the busiest installations in hospitals. The ER is the first unit that treats patients. This unit has the main purpose of receiving, triage, stabilizing, and providing acute health care for patients, including patients who need resuscitation and patients with certain emergency levels.(Mawlid, 2017). The process of patient care in the ER does not always run smoothly as expected. There are several problems that occur in the ER such as queues, waiting, and excessive transportation. These problems cause patient service time to be longer and lead to patient health and safety. Emergency room patient service time is 2 hours (Kemenkes, 2016).