Both public and private hospitals are increasingly under pressure to improving patient care across all medical disciplines and departments. Hospitals must become patient-oriented, responsive, lean and adequate in order to properly realign and integrate health care processes. One way it is necessary to reform current systems of medical care and improve the efficiency of medical care. The subject of this study was an outpatient service in a hospital. The purpose of this study is to design improvement surgery in outpatient service in a hospital to be more efficient and effective. The research uses the approach business process re-engineering (BPR) to improve service process time and reduce waiting time. In the BPR approach two main step, which are mapping as-is process. The mapping as-is model, the model is created and simulated to examine the current process time of the hospital outpatient pharmacy, and then as-is model is analyzed,  and then several to-be models with different scenarios is designed and compared with as-is model. The models are simulated and run using Business Process Modeling Notation (BPMN) in iGrafx software to investigate how much the healthcare services has improved compared to the current condition.