Common problems that occur in outpatient services in hospitals are the length of waiting time, administrative processes, availability of information, and others. One of the quality improvement method used in this study is lean hospitals with the aim of achieving the effectiveness and efficiency of the use of time, labor, space, and other resources. This study aims to determine the description of value stream mapping (VSM), analyze things that become waste, and proposed improvements using the lean hospital approach in internal disease polyclinic RSUD Arga Makmur. The study was conducted with a qualitative approach through direct observation, in-depth interviews and document review. The results showed the highest Non Value Added was in the polyclinic unit that was equal to (97.09%) with a Value Added (2.91%) and waiting time (107.22 minutes) on patient non-insurance with additional examination. Waste that occurs in outpatient services are waste of waiting, transportation, overproduction, overprocessing, inventory, motion, human potential and defects. From the results of the fishbone diagram it is known that the root causes of problems that occur in the polyclinic unit are in terms of management, equipment, layout, officers and information systems. Proposed improvements can be given in the form of short term, medium term and long term proposals.