Latar Belakang: Pandemi Coronavirus Disease 2019 (Covid-19) memberikan dampak luas dikarenakan risiko penularan virus SARS-COV-2 melalui kontak, droplet, dan kemungkinan airborne. Suatu tantangan bagi rumah sakit untuk menjamin mutu dan keselamatan. Dalam kondisi seperti ini, maka budaya keselamatan yang baik menjadi faktor kritikal untuk menjamin keselamatan baik pasien, pengunjung, maupun petugas rumah sakit. Komitmen Pimpinan dan dukungan seluruh staf khususnya staf klinis sangat diperlukan untuk terciptanya budaya keselamatan rumah sakit. Salah satunya pemenuhan standar layanan akreditasi rumah sakit untuk meningkatkan budaya keselamatan. Berdasarkan kondisi ini diperlukan suatu penelitian untuk mengukur sejauh mana standar akreditasi diimplementasikan untuk mendukung budaya keselamatan yang meliputi keselamatan pasien, keselamatan dan kesehatan pekerja rumah sakit. Tujuan: Penelitian ini bertujuan untuk mengukur budaya keselamatan staf klinis dengan prediktor yang dominan dalam mempengaruhi keselamatan pasien serta keselamatan dan kesehatan pekerja di rumah sakit terakreditasi Komisi Akreditasi Rumah Sakit (KARS) yang menjadi rujukan Covid-19. Metode: Penelitian ini merupakan cross-sectional study pada empat rumah sakit rujukan Covid-19 di DKI Jakarta diantaranya RSPAD Gatot Subroto, RSUP Persahabatan, RS Pusat Pertamina, dan RS Pertamina Jaya. Tiga variabel yang mempengaruhi budaya keselamatan yaitu iklim keselamatan, situasional, dan perilaku keselamatan. Responden adalah staf klinis berdasarkan jenis instalasi dan staf klinis di setiap rumah sakit yang dipilih secara acak. Kuesioner mengacu pada instrumen Standar Nasional Akreditasi Rumah Sakit (SNARS) edisi 1.1 dalam bentuk google form. Analisis data dilakukan secara univariat dan bivariat menggunakan uji chi-square sedangkan multivariat menggunakan regresi logistik. Hasil: Data penelitian ini diperoleh dari 560 responden yang terdiri dari instalasi dan staf klinis. Dari empat rumah sakit dihasilkan budaya keselamatan rumah sakit menurut 51,8% responden masuk dalam kategori baik dimana tiga dari sepuluh indikator yaitu kerjasama, lingkungan kerja, dan kepatuhan merupakan kategori baik dan dominan. Variabel situasional memiliki pengaruh terbesar terhadap budaya keselamatan (OR 4,46; 95% CI 2,67-7,42). Kepatuhan memiliki pengaruh terbesar terhadap keselamatan pasien (OR 5,59; 95% CI 3,27-9,56) dan manajemen risiko memiliki pengaruh terbesar terhadap keselamatan dan kesehatan pekerja (OR 5,59; 95% CI 3,29-9,49). Kesimpulan: Variabel situasional memiliki pengaruh terbesar terhadap budaya keselamatan, baik keselamatan pasien maupun keselamatan dan kesehatan pekerja. Indikator kepatuhan dan manajemen risiko merupakan indikator yang memiliki pengaruh terbesar terhadap budaya keselamatan.
IntroductionAs a disaster-prone country, hospital preparedness in dealing with disasters in Indonesia is essential. This research, therefore, focuses specifically on hospital preparedness for COVID-19 in Indonesia, which is important given the indication that the pandemic will last for the foreseeable future.MethodsDuring March to September 2022, a cross-sectional approach and a quantitative study was conducted in accordance with the research objective to assess hospital preparedness for the COVID-19 pandemic. This research shows the level of readiness based on the 12 components of the rapid hospital readiness checklist for COVID-19 published by the World Health Organization (WHO). Evaluators from 11 hospitals in four provinces in Indonesia (Capital Special Region of Jakarta, West Java, Special Region of Yogyakarta, and North Sumatra) filled out the form in the COVID-19 Hospital Preparedness Information system, which was developed to assess the level of hospital readiness.ResultsThe results show that hospitals in Capital Special Region of Jakarta and Special Region of Yogyakarta have adequate level (≥ 80%). Meanwhile, the readiness level of hospitals in West Java and North Sumatra varies from adequate level (≥ 80%), moderate level (50% – 79%), to not ready level (≤ 50%).ConclusionThe findings and the methods adopted in this research are valuable for policymakers and health professionals to have a holistic view of hospital preparedness for COVID-19 in Indonesia so that resources can be allocated more effectively to improve readiness.
Background: Studies on safety culture maturity in health care is very rare, and the existing ones only focus on patients and the use of Manchester Patients Safety Framework (MaPSaF) instrument. The objective of this study is to develop a comprehensive instrument for measuring safety culture maturity in hospitals.Design and methods: This study used a cross-sectional design with three stages. First, we used secondary data analysis from the Hospital Accreditation Commission. Second, evaluation of primary data obtained from safety climate questionnaire. Third, we did focus group discussions, and in-depth interviews for validation of secondary data and development of DUTA-RS website. We analyzed using Structural Equation Modeling (SEM) test.Results: DUTA-RS instrument contains 1,118 elements based on the first edition of the Indonesian Hospital Accreditation National Standard. Its safety culture maturity is at the proactive level (58.0%), with the highest accreditation levels of proactive (50.8%) and generative (48.7%). The variables affecting the safety culture maturity are situational and safety behavior variables, with leadership, risk management, and safety compliance as the strongest indicators. The weakest indicators of climate are organizational learning and communication. The mean value of climate for primary and secondary data is in the good category and showed in proactive level.Conclusions: The DUTA-RS as a website to measure the safety culture maturity in accredited hospitals by taking the advantage of the existing information technology of hospital accreditation committee as the benchmark enables improvement of SCML in hospitals. Further studies are required for the development of DUTA-RS website.
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