Pada tahun 2023 industri perkebunan kelapa sawit tercatat sebagai sektor dengan angka
kecelakaan kerja tertinggi nasional (60,5%) dengan tren kenaikan sebesar 18–20 % per
tahun. Dua faktor utama penyebab kecelakaan dan penyakit pada pekerja di sektor ini
adalah kurangnya pengawasan dari manajemen (lack of management control) dan
rendahnya tingkat pengetahuan pekerja (human factor). Untuk mengatasi hal tersebut,
penelitian ini mengembangkan Model Edukasi K3 melalui penyusunan Modul Edukasi
K3 dan pembentukan Kader Sawit, yang bertujuan meningkatkan literasi dan praktik
keselamatan kerja pekerja sawit. Penelitian menggunakan pendekatan mix-method
exploratory yang dilakukan selama 6 bulan dengan tahapan penelitian: (1) analisis
penyelenggaraan K3 dan mengidentifikasi status gizi pekerja, (2) penyusunan Modul
Edukasi K3 melalui studi literatur dan expert judgement serta pembentukan Kader Sawit,
dan (3) uji coba/menilai dampak intervensi dengan Quasi Experiment Design (Wilcoxon
Test). Hasil intervensi menunjukkan peningkatan signifikan pada skor pengetahuan (dari
38,68 menjadi 50,60), sikap (61,87 menjadi 68,13), dan perilaku (25,38 menjadi 30,53).
Peningkatan skor Pengetahuan, Sikap dan Perilaku pada kelompok intervensi rata-rata
7.4 kali lebih tinggi daripada kelompok kontrol. Selain itu, kecelakaan kerja menurun dari
66,7 % menjadi 10 %, dan angka kejadian penyakit turun dari 43,3 % menjadi 33,3 %
setelah intervensi. Dengan demikian, intervensi melalui Modul Edukasi K3 dan Kader
Sawit terbukti efektif dalam meningkatkan pengetahuan, sikap, dan perilaku K3 serta
menurunkan angka kecelakaan dan penyakit, sehingga dapat menjadi langkah strategis
dan efektif untuk meningkatkan literasi dan praktik K3 di industri perkebunan kelapa
sawit di Indonesia.

In 2023, the palm oil plantation industry was recorded as the sector with the highest
national rate of occupational accidents (60.5%), with an annual increasing trend of 18
20%. The two main contributing factors to accidents and occupational illnesses in this
sector are lack of management control and low levels of worker knowledge (human
factor). To address these issues, this study developed an Occupational Safety and Health
(OSH) Education Model through the formulation of an OSH Education Module and the
establishment of “Kader Sawit” (Palm Cadres), aimed at improving workers’ safety
literacy and practices. This research applied an exploratory mixed-method approach over
a six-month period, with the following phases: (1) analysis of OSH implementation and
identification of workers’ nutritional status, (2) development of the OSH Education
Module through literature review and expert judgment, along with the training of Kader
Sawit, and (3) trial and evaluation of the intervention impact using a Quasi-Experimental
Design (Wilcoxon Test). The intervention resulted in a significant increase in knowledge
scores (from 38.68 to 50.60), attitudes (from 61.87 to 68.13), and safety behavior (from
25.38 to 30.53). The average increase in knowledge, attitude, and behavior scores in the
intervention group was 7.4 times higher than in the control group. Furthermore, the
incidence of occupational accidents decreased from 66.7% to 10%, while the occurrence
of work-related illnesses declined from 43.3% to 33.3% after the intervention. These
findings demonstrate that the implementation of the OSH Education Module and the
involvement of Kader Sawit are effective strategies for enhancing OSH-related
knowledge, attitudes, and behaviors, and for reducing the incidence of accidents and
diseases, thereby offering a strategic and impactful approach to improving OSH literacy
and practices in Indonesia’s palm oil plantation industry.

Keselamatan pasien merupakan kewajiban rumah sakit dan bagian integral dari akreditasi sejak 2008. Namun, berbagai permasalahan masih sering ditemukan, sehingga keberlanjutan perbaikan menjadi tantangan. Penelitian ini bertujuan merumuskan model konseptual strategi peningkatan keselamatan pasien. Penelitian menggunakan pendekatan mixed method dengan desain convergent parallel. Data kuantitatif berasal dari Riset Fasilitas Kesehatan 2019 (523 rumah sakit) dan data akreditasi (917 rumah sakit), dianalisis menggunakan uji chi-square, regresi logistik, dan analisis jalur. Data kualitatif dikumpulkan melalui wawancara mendalam dan telaah dokumen dari enam rumah sakit, dinas kesehatan provinsi, dan Perhimpunan Rumah Sakit Seluruh Indonesia (PERSI) wilayah di Sumatera Utara dan Bali, dengan total 95 informan. Analisis tematik menggunakan perangkat NVivo, dengan kerangka Malcolm Baldrige dan model implementasi Van Meter-Van Horn, meliputi ukuran dan tujuan kebijakan, sumber daya, kepemimpinan, perencanaan strategis, fokus tenaga kerja, fokus operasi, fokus pelanggan, pengukuran, analisis, dan manajemen pengetahuan, komunikasi antar organisasi, serta peran akreditasi. Hasil kuantitatif menunjukkan bahwa pelaporan insiden keselamatan pasien berhubungan signifikan dengan lokasi (Jawa-Bali), status akreditasi, jumlah tempat tidur (> 200), kelas rumah sakit (A dan B), evaluasi pelayanan, audit internal, serta keaktifan komite keselamatan pasien dan pengendalian infeksi. Hasil kualitatif menunjukkan bahwa implementasi kebijakan keselamatan pasien sudah berjalan, namun bervariasi tergantung kepemilikan dan ketersediaan sumber daya. Semua dimensi yang diteliti berpotensi menjadi faktor pendukung maupun penghambat tergantung pengelolaannya. Kepemimpinan yang kuat, fasilitas yang memadai, serta budaya keselamatan yang ditanamkan secara konsisten memperkuat implementasi, sedangkan lemahnya komitmen dan keterbatasan dana menjadi kendala. Hambatan juga muncul dalam pelaporan insiden, baik dari sisi organisasi maupun individu. Penelitian ini menghasilkan model konseptual strategi peningkatan keselamatan pasien yang mencakup integrasi keselamatan pasien dalam perencanaan strategis, penguatan kepemimpinan, peningkatan kapasitas staf, alokasi anggaran memadai, monitoring dan evaluasi berkelanjutan, serta pelibatan pasien. Model ini diharapkan dapat mendorong peningkatan keselamatan pasien secara menyeluruh dan berkelanjutan di rumah sakit.

Patient safety is a mandatory obligation for hospitals and has been an integral part of hospital accreditation since 2008. However, various patient safety issues are still frequently found, making the sustainability of improvements a major challenge. This study aims to formulate a conceptual model of patient safety improvement strategies. A mixed-methods approach with a convergent parallel design was employed. Quantitative data were obtained from the 2019 Rifaskes (523 hospitals) and accreditation records (917 hospitals), and analyzed using chi-square tests, logistic regression, and path analysis. Qualitative data were collected through in-depth interviews and document reviews from six hospitals, provincial health offices, and the Indonesian Hospital Association (PERSI) in North Sumatra and Bali Provinces, involving a total of 95 informants. Thematic analysis was conducted using NVivo software, guided by the Malcolm Baldrige framework and the Van Meter–Van Horn policy implementation model. Quantitative findings showed that the reporting of patient safety incidents was significantly associated with location (Java–Bali), accreditation status, bed capacity (>200 beds), hospital class (A and B), presence of service evaluations, internal audits, and the activity of patient safety and infection control committees. Qualitative results indicated that while policy implementation was underway, it varied depending on hospital ownership and available resources. All dimensions could act as either enablers or barriers depending on how they were managed. Strong leadership and adequate facilities enhanced implementation, while weak commitment and limited funding were key constraints. Incident reporting also faced challenges at both organizational and individual levels. This study produced a conceptual model for improving patient safety through the integration of safety into strategic planning, strengthened leadership, staff capacity building, sufficient budget allocation, continuous monitoring and evaluation, and enhanced patient engagement. The model is expected to support comprehensive and sustainable patient safety improvements in hospitals

Latar belakang: Keberhasilan ASI eksklusif di Indonesia masih rendah. Self-efficacy ayah dan ibu berperan penting dalam praktik menyusui. Penelitian ini bertujuan mendapatkan model prediksi penghentian ASI eksklusif pada 0-12 postpartum menggunakan Paternal dan Maternal BSE framework.
Metode: Penelitian menggunakan metode kualitatif dan kuantitatif. Studi kualitatif menggunakan FGD terhadap 5 informan ayah secara purposive dengan tujuan menggali infomasi mengenai paternal BSE. Desain studi kuantitatif longitudinal bertujuan mengevaluasi model penelitian. Sebanyak 201 pasangan yang bersalin di rumah sakit ibu dan anak di Kota Tangerang Selatan berhasil diikuti sampai 12 minggu postpartum. Data kuantitatif dikumpulkan melalui kuesioner dan dianalisis menggunakan SEM-PLS untuk menguji pengaruh antar variabel dan mendapatkan nilai prediktif model.
Hasil: Instrumen Paternal BSE dan sumber self-efficacy ayah valid dan reliabel. Faktor signifikan yang berpengaruh terhadap penghentian ASI eksklusif meliputi paternal BSE, maternal BSE, pengalaman ayah, pengalaman ibu, persuasi verbal bagi ibu, kondisi fisik emosi ibu, usia ibu, frekuensi ANC, dan tipe keluarga. Secara tidak langsung, ada pengaruh pengalaman ayah terhadap penghentian ASI eksklusif melalui paternal dan maternal BSE.
Simpulan: Model paternal-maternal BSE dapat memprediksi penghentian ASI eksklusif dengan baik.
Saran: Penghentian ASI eksklusif dapat dicegah dengan melibatkan ayah secara aktif melalui edukasi, pendampingan, dan penguatan paternal BSE sejak masa kehamilan.

Background: The rate of exclusive breastfeeding in Indonesia remains low. Both paternal and maternal self-efficacy play a crucial role in supporting breastfeeding practices. This study aims to develop a predictive model for exclusive breastfeeding cessation during the first 0–12 months postpartum using the Paternal and Maternal Breastfeeding Self-Efficacy (BSE) framework.
Methods: This study employed both qualitative and quantitative methods. The qualitative phase involved focus group discussions (FGDs) with five purposively selected fathers to explore aspects of paternal BSE. The quantitative phase used a longitudinal design to evaluate the proposed model. A total of 201 couples who delivered at a maternal and child hospital in South Tangerang City were followed up to 12 weeks postpartum. Quantitative data were collected using questionnaires and analyzed with Partial Least Squares Structural Equation Modeling (PLS-SEM) to examine relationships between variables and assess model predictive.
Results: The Paternal BSE instrument and sources of paternal self-efficacy were found to be valid and reliable. Significant factors influencing exclusive breastfeeding cessation included paternal BSE, maternal BSE, fathers’ experience, mothers’ experience, verbal persuasion for mothers, mothers’ physical and emotional condition, maternal age, antenatal care (ANC) frequency, and family type. Indirectly, there was a relationship between fathers’ experience and exclusive breastfeeding cessation through paternal and maternal BSE.
Conclusion: The paternal-maternal BSE model effectively predicts exclusive breastfeeding cessation.
Recommendation: Exclusive breastfeeding cessation can be prevented by actively involving fathers through education, support, and strengthening paternal BSE starting from pregnancy.