Laundry service is one of the non-medical support services that carries out hospital linen management. Linen handling is necessary to prevent nosocomial and cross-infection, so it provides satisfaction and comfort for the patient. The results of preliminary study at X Hospital show that linen-loss incident was as much as 3.4%. This study aims to identify linen-loss problem and propose improvement suggestion through Lean Six Sigma approach. The research was conducted by integrating Lean and Six Sigma methods. Lean Six Sigma method is a systemic and systematic approach to identify and eliminate waste through continuous improvement in the flow of products (materials, work-in-processes, and output) and information using pull systems to achieve quality and excellence. Lean Six Sigma approach uses DMAIC Method (Define-Measure-Analyze-Improve-Control). The define stage was conducted with Focus Group Discussion (FGD), the obtained results is 'monitoring and control system in linen management to reduce linen loss' as a prioritized problem in Linen and Laundry Unit. Measure phase obtained low achievement of Minimum Service Standard on Laundry Service because there was still linen-loss incident as much as 3.4%. Analyze phase was done using Root Cause Analysis by making Ishikawa diagram (Fishbone) through questionnaires with Likert-scale, followed by arranging alternative solutions using Mc. Namara filtering theory. The selected solutions were creating procedures and a monitoring and control system document, as well as dissemination of linen-loss monitoring and control system. Improve phase was done by creating a handbook of linen-loss monitoring and control system consisting of four standard operating procedures in the Linen Room (Requirement Fulfillment SOP, Procurement SOP, Storage SOP, and Usage SOP), a standard operating procedure in Laundry Room (Distribution SPO), and eight supporting documents (linen inventory card, linen stock card, linen distribution form, linen checklist, dirty linen checklist, outgoing linen checklist, substitution form, and linen monthly report). The fifth phase (control) was to conduct short-term and long-term implementation evaluations. Short-term implementation is implemented for two weeks. Short-term implementation evaluations were performed by calculating a four-day Minimum Service Standard achievement by observing total linen on linen stock cards, linen checklists, dirty linen checklists, and linen distribution forms. Evaluation results obtained achievement of 100% Minimum Service Standard. Long-term implementation was carried out through creating Plan of Action (POA) covering the preparation, implementation and three-month and six-month evaluation. Lean Six Sigma approach in reducing linen loss is done through the application of linen-loss monitoring and control system. This system consists of five standard operating procedures and eight supporting documents. The result of the implementation of monitoring and control system gives a result of 100% no linen-loss incidence through simulation of Minimum Service Standard achievement.
