Latar Belakang: Angka Kematian Ibu (AKI) masih menjadi indikator utama kualitas pelayanan kesehatan, dan belum mencapai target SDGs, terutama akibat keterlambatan deteksi dini dan penanganan komplikasi maternal (WHO, 2023). Kondisi kegawatan maternal sering diawali dengan tanda yang tidak spesifik, sementara pemantauan kondisi ibu masih bersifat konvensional dan subjektif, sehingga meningkatkan risiko keterlambatan intervensi dan kejadian failure to rescue. Modified Early Obstetric Warning System (MEOWS) terbukti efektif dalam mengidentifikasi perburukan kondisi maternal secara objektif dan mempercepat respons klinis (Kemenkes RI, 2024). Namun, implementasi MEOWS sangat bergantung pada kesiapan struktural rumah sakit. RSUD Pasar Minggu sebagai rumah sakit rujukan dengan layanan PONEK menunjukkan peningkatan kasus komplikasi maternal, namun belum menerapkan sistem deteksi dini secara optimal, sehingga diperlukan analisis kesiapan struktural untuk implementasi MEOWS. Metode: Penelitian ini menggunakan desain kualitatif dengan pendekatan studi kasus di RSUD Pasar Minggu pada periode Desember 2025–Februari 2026. Data dikumpulkan melalui triangulasi metode yang meliputi wawancara mendalam, observasi non-partisipan, Focus Group Discussion (FGD), dan telaah dokumen. Informan dipilih secara purposive dan dikembangkan dengan teknik snowball sampling hingga mencapai kejenuhan data (data saturation), dengan melibatkan tenaga kesehatan dan manajemen yang berperan dalam implementasi MEOWS. Fokus penelitian adalah menganalisis kesiapan aspek struktur berdasarkan pendekatan 5M (man, material, machine, method, dan milieu). Analisis data dilakukan menggunakan pendekatan analisis tematik melalui proses transkripsi, pengodean, kategorisasi, dan penarikan tema. Hasil: Kesiapan implementasi MEOWS di RSUD Pasar Minggu belum optimal pada seluruh aspek struktur. Aspek man menunjukkan keterbatasan kompetensi dan belum adanya pelatihan terstruktur. Pada aspek material dan machine, sarana tersedia namun lembar MEOWS belum standar dan belum terintegrasi dengan SIMRS. Aspek method ditandai belum adanya SOP baku dan sosialisasi tanpa praktik. Sementara aspek milieu relatif mendukung, meskipun masih terdapat kendala pada privasi dan pelaporan insiden. Hambatan utama terletak pada regulasi, kompetensi SDM, dan integrasi sistem. Kesimpulan: Implementasi MEOWS di RSUD Pasar Minggu belum siap secara optimal ditinjau dari aspek struktur (5M), terutama pada regulasi, kompetensi SDM, dan integrasi sistem. Diperlukan penguatan melalui penyusunan SOP baku, peningkatan kapasitas tenaga kesehatan melalui on the job training, serta pengembangan integrasi MEOWS ke dalam SIMRS agar implementasi berjalan efektif dan berkelanjutan.

Introduction: Maternal Mortality Ratio (MMR) remains a key indicator of healthcare quality and has not yet achieved the SDGs target, primarily due to delays in early detection and management of maternal complications (WHO, 2023). Maternal emergencies often begin with non-specific signs, while clinical monitoring remains conventional and subjective, increasing the risk of delayed intervention and failure to rescue. The Modified Early Obstetric Warning System (MEOWS) has been proven effective in objectively identifying maternal deterioration and accelerating clinical response (Ministry of Health Indonesia, 2024). However, its implementation depends on the structural readiness of hospitals. RSUD Pasar Minggu, as a referral hospital with comprehensive emergency obstetric and neonatal care (PONEK) services, has shown an increase in maternal complication cases but has not optimally implemented an early warning system. Therefore, an analysis of structural readiness for MEOWS implementation is required. Method: This study employed a qualitative case study design conducted at RSUD Pasar Minggu from December 2025 to February 2026. Data were collected through methodological triangulation, including in-depth interviews, non-participant observation, Focus Group Discussions (FGD), and document review. Informants were selected purposively and expanded using snowball sampling until data saturation was achieved, involving healthcare providers and management personnel engaged in MEOWS implementation. The study focused on analyzing structural readiness based on the 5M framework (man, material, machine, method, and milieu). Data were analyzed using thematic analysis, including transcription, coding, categorization, and theme development. Result: The findings indicate that the readiness for MEOWS implementation at RSUD Pasar Minggu is not yet optimal across all structural aspects. The man aspect reveals limited competencies and the absence of structured capacity-building initiatives. In the material and machine aspects, facilities are available; however, the MEOWS chart is not standardized and has not been integrated into the hospital information system. The method aspect is characterized by the absence of standardized clinical guidelines and the implementation of training without practical components. The milieu aspect is relatively supportive, although challenges remain in patient privacy and incident reporting. Key barriers include regulatory gaps, limited human resource capacity, and lack of system integration. Conclusion: The implementation of MEOWS at RSUD Pasar Minggu is not yet structurally ready based on the 5M framework, particularly in terms of regulation, human resource capacity, and system integration. Strengthening efforts are required through the development of standardized clinical guidelines, capacity building of healthcare personnel through on-the-job training, and integration of MEOWS into the hospital information system to ensure effective and sustainable implementation.