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Pelaporan Insiden Keselamatan Pasien (IKP) merupakan komponen penting dalam peningkatan mutu layanan dan budaya keselamatan rumah sakit. Menurut National Patient Safety Agency, pelaporan insiden berfungsi sebagai sarana pembelajaran untuk mencegah kejadian serupa di masa mendatang. Namun, data tahun 2019 menunjukkan bahwa hanya sekitar 12% rumah sakit di Indonesia yang melaporkan IKP. Penelitian ini bertujuan untuk menilai tingkat pelaporan IKP rumah sakit di Provinsi DKI Jakarta secara eksternal berdasarkan wilayah administrasi, kelas rumah sakit, jenis pelayanan, dan status kepemilikan rumah sakit, serta menganalisis hubungannya dengan keempat variabel tersebut. Penelitian ini menggunakan pendekatan kuantitatif dengan desain potong lintang dan dilengkapi wawancara untuk memperkaya pembahasan. Data sekunder berasal dari laporan IKP rumah sakit Provinsi DKI Jakarta tahun 2024, dianalisis menggunakan distribusi frekuensi dan Uji Kruskal-Wallis yang merupakan uji statistik nonparametrik. Hasil menunjukkan bahwa hanya variabel wilayah administrasi yang memiliki hubungan signifikan dengan tingkat pelaporan IKP. Jakarta Timur menjadi wilayah dengan tingkat pelaporan terendah, diduga dipengaruhi oleh jumlah rumah sakit yang lebih banyak dan efektivitas supervisi wilayah. Sementara itu, rumah sakit kelas C, rumah sakit umum, dan rumah sakit pemerintah cenderung memiliki pelaporan lebih rendah, meskipun tidak signifikan secara statistik. Penelitian ini memberikan gambaran variasi pelaporan IKP antar karakteristik rumah sakit dan menyoroti pentingnya peran wilayah administrasi dalam pembinaan dan pengawasan. Temuan ini diharapkan dapat menjadi bahan evaluasi untuk meningkatkan strategi pelaporan IKP secara eksternal di tingkat provinsi, terutama bagi Dinas Kesehatan Provinsi DKI Jakarta.
The reporting of Patient Safety Incidents (IKP) is a critical component in improving service quality and fostering a culture of safety in hospitals. According to the National Patient Safety Agency, incident reporting serves as a learning tool to prevent the recurrence of similar events. However, 2019 data showed that only about 12% of hospitals in Indonesia reported their IKP. This study aims to assess the level of external IKP reporting by hospitals in DKI Jakarta Province based on administrative region, hospital class, type of service, and ownership status, and to analyze the relationship between these variables and reporting compliance. This study used a quantitative cross- sectional design, with additional interviews to support the discussion. Secondary data were obtained from the 2024 IKP reports submitted by hospitals in DKI Jakarta Province. Data were analyzed using frequency distribution and Kruskal-Wallis test, a nonparametric statistic test. Results indicated that only the administrative region variable had a significant relationship with the level of IKP reporting. East Jakarta was identified as the region with the lowest reporting rate, which may be influenced by a higher number of hospitals and the effectiveness of local supervision. Meanwhile, Class C hospitals, general hospitals, and government-owned hospitals tended to report less frequently, although the differences were not statistically significant. This study highlights the variation in IKP reporting across hospital characteristics and underscores the important role of administrative regions in supervision and support. These findings may serve as evaluation material to strengthen external IKP reporting strategies, particularly for the DKI Jakarta Provincial Health Office.
Patient safety in hospitals is still a crucial issue worldwide, because hospitals are service institutions that seek to cure patients. So patient safety becomes a necessity, it is hoped that there will be no patient safety incidents (zero incidents). One way to control the increasing number of incidents in hospitals is to utilize a reporting system. This study discusses the description of patient safety incident reporting in hospitals in Indonesia and the factors that influence it, in terms of individual, organizational, and government factors. The purpose of this study was to obtain information about the factors that influence the reporting of patient safety incidents in hospitals in Indonesia. This study uses a literature review method with the Garuda Ministry of Education and Culture database, Rama Kemendikbud, Directory of Open Acces Journals (DOAJ), UI Library, Science Direct, PubMed, ProQuest, and Scopus. The results showed that hospitals in Indonesia already have regulations governing patient safety incident reporting. The reporting system used is still manual-based, and reporting practices cannot be said to be successful because there is still a punitive culture, guarantees for the confidentiality of whistleblowers are still in doubt, reporting is not timely, and feedback is still minimal. From the results of the study, it was also found that the factors that can affect the reporting of patient safety incidents in hospitals are individual factors (knowledge, fear, workload, and motivation), organizational factors (feedback, reporting systems, confidentiality, socialization and training, and safety culture), and government factors in terms of policy
Latar Belakang: Salah satu langkah keselamatan pasien adalah perbaikan pelayanan kesehatan dari pelaporan insiden. Dalam praktiknya, laporan Insiden Keselamatan Pasien (IKP) yang terkumpul secara lingkup global dan di Indonesia masih terbatas dikarenakan berbagai faktor dan masalah, baik underreporting, time response, ataupun adanya insiden yang berulang terjadi. Studi ini bertujuan menganalisis akar masalah dari ketiga fenomena tersebut menggunakan kerangka root cause analysis oleh VHA National Center for Patient Safety.
Metode: Studi ini menggunakan pendekatan kualitatif dengan metode studi kasus pada Bulan Maret-April 2025 dengan wawancara mendalam terhadap 14 informan utama dan dua informan kunci dan dengan analisis konten menggunakan software Nvivo 15. Studi ini juga menggunakan data sekunder dari rumah sakit studi mengenai insiden yang masuk di sistem rumah sakit per Bulan Januari 2024 hingga Februari 202.
Hasil: Hasil studi menunjukkan bahwa faktor knowledge and skills, organizational factors, just culture, dan process and system reporting memiliki bobot pengkodean yang lebih banyak dibandingkan faktor lainnya. Dua insiden yang paling sering berulang adalah masalah identifikasi pasien dan medikasi. Human error adalah faktor utama dari kedua insiden berulang tersebut. Pengembangan sistem pelaporan, edukasi mengenai urgensi dan no-blaming culture, serta pemberlakuan komunikasi yang efektif menjadi rekomendasi action plan dari RCA yang dibentuk.
Kesimpulan: Pengembangan sistem, edukasi mengenai urgensi dan no-blaming culture, serta pemberlakuan komunikasi yang efektif menjadi rekomendasi dari akhir tahapan analisis masalah.
Kata Kunci: Root Cause Analysis, Pelaporan IKP, Blaming Culture, Senioritas, Umpan Balik
Background: One of the patient safety measures is improving healthcare services through incident reporting. In practice, Patient Safety Incident (PSI) reports collected globally and in Indonesia remain limited due to various factors and issues, including underreporting, time response, or recurring incidents. This study aims to analyze the root causes of these three phenomena using the root cause analysis framework by the VHA National Center for Patient Safety. Methods: This study employed a qualitative approach with a case study method conducted from March to April 2025, involving in-depth interviews with 14 primary informants and two key informants, utilizing content analysis with Nvivo 15 software. The study also incorporated secondary data from the hospital study regarding incidents recorded in the system from January 2024 to February 2025. Results: The study findings indicate that factors such as knowledge and skills, organizational factors, just culture, and process and system reporting had higher coding weights compared to other factors. The two most frequently recurring incidents were patient identification and medication issues. Human error was identified as the primary factor in both incidents. System development, education regarding urgency and no-blaming culture, and implementation of effective communication emerged as recommendations from the final stage of problem analysis. Conclusion: System development, education regarding urgency and no-blaming culture, and implementation of effective communication are recommended based on the final stage of problem analysis. Keywords: Root Cause Analysis, Patient Safety Incident Reporting, Blaming Culture, Seniority, Feedback
Ancaman pandemi flu burung yang disebabkan oleh virus I-ISNI, mendorong berbagai upaya Pemerintah untuk mcncari cara mencegah, menanggulangi dan mengobatinya, di antaranya dengan kebijakan penyediaan obat antiviral. Penyediaan obat antiviral ini memegang peranan yang sangat penting, sehingga hams dikelola secara baik dan kebijakan yang melandasinya harus berdasarkan formulasi yang tepat mulai dan tahap perencanaan hingga pengendalian. Oleh karena ilu perlu dianalisis secara komprehensif dengan mclihat aspek-wpek pada sistem kebijakan meliputi public policies, policy stakeholders, dan policy environment. Tujuan penelitian ini adalah untuk menganalisis kebijakan pengelolaan obat antiviral dalam pengendalian kasus ilu burung dan implementasinya di rumah sakit rujukan wilayah DKI Jakarta pada tahun 2005-2007. Jenis penelitian adalah kualitatif yang dilakukan secara rctrospektif dengan menganalisis sistem kebiiakan, melibatkan I0 informan. Data dilcmnpulkan melaiui wawancara mendalam dan telaah dokumen, kemudian dilakukan analisis isi. Hasil penelitian menunjukkan bahwa kebijakan pemilihan Oseltamivir sebagai obat antiviral meskipun efektiiitas obat belum teruji secara klinis, tetapi mengingat kondisi kedaruratan menghadapi ancaman pandemi flu burung maka Indonesia menerima rekomendasi dari WHO untuk penggunaan obat tersebut. Perencanaan penyediaannya belum bisa berdasarkan data evidences jumlah kasus riil yang terjadi pada instansi rumah sakit rujukan ataupun kebutuhan rumah sakit akan obat tersebut, karena pertimbangan kasus yang dihadapi merupakan kasus baru yang terus menunjukkan progresivitas angka kematian pada manusia, sehingga dilakukan strategi stoc/qoilling yang memperhitungkan jmnlah kebutuhan berdasarkan pada prediksi persentase jumlah penduduk Indonesia yang akan terkena jika terjadi pandemi. Besaran anggaran yang disediakan mengalami peningkatan dibandingkan dengan anggaran yang dialokasikan sebelumnya. Pengadaan dengan teknik dropping dapat mengakibatkan terjadinya penumpukkan obat di rumah sakit rujukan, tetapi hal tersebut dilakukan karena adanya hibah obat dari negara lain sehingga obat harus sacara didistribusikan ke unit pelayanan kesehatan agar bisa terpakai mengingat masa kadaluarsanya yang relatif dekat. Pendistribusiannya secara terbatas pada instansi pemerintah dan tidal: dijual bebas dilakukan mengingat pentingnya obat tersebut bagi keselamatan manusia, akan tetapi perlu dipikirkan juga akses unit pelayanan kesehatan swasta (rumah sakitfklinik) untuk mcmperoleh obat tersebut. Sehingga kebijakan pengelolaan obat antiviral dalam penanganan kasus flu burung di rumah sakit rujukan di wilayah DKI Jakarta dibuat secara terbatas dan pada pelaksanaannya tidak mencakup pada keseluruhan lini yang memerlukan. Diharapkan kepada pihak Depkes dalam pengelolaan obat antiviral ini juga memberdayakan apotek yang ditunjuk untuk menyediakan obat antiviral sehingga selain mempermudah akses unit pelayanan kesehatan swasta lainnya dalam memperoleh obat tersebut dan bisa dijadikan stockpile. Bagi rumah sakit ke depan perlu mengadakan suatu penelitian untuk membuktikan efelctivitas Oseltamivir ini terhadap kasus flu burung manusia.
Avian Influenza pandemic which is caused of HSNI virus pushed various goverment effort to look for prevention way, overcoming and curing it, one of them is preparation policy of antiviral drugs. This preparation of antiviral drugs played the most important role, so that it must be managed well and basic policy must pursuant to the right formulation, starting iiom planning until control phase. Therefore, require to be analyzed comprehensively based on policy system aspect such as : public policies, policy stakeholders, and policy environment. This studi purpose is for analyzing management policy of antiviral medicine in controlling Avian Influenza case and its implementation at reference hospital in DKI Jakarta, 2005 - 2007. This study used a qualitative method which has done retrospectively by analyzing policy system with 10 informants. The data were collected by in-depth interview and study document. The data were a content analyzed. Study result indicated that selection policy of Oseltamivir as antiviral drugs even though medicine effectivity is not tested clinically yet, but because of emergency condition of Avian Influenza pandemic, so Indonesia received a recommendation fiom WHO for using that medicine. Its supply planning can not base on evidences data of reality case ntunber that happen on reference hospital instance or the need of medicine for hospital, considering of presence case is a new case which indicated human modality level progressively, so it has dones stockpilling strategy which calculated stock number based on percentage prediction of Indonesian population number which will happen because of pandemic. There are big allocation budget compared with allocation budget before. If allocation is done by dropping technique so it makes heaping medicine at Reference Hospital, but this done because of medicine donation from another country, so that medicine must be distributed to health service unit to use it considering its expire so close relatively. A limited distribution for goverment instance and it is not for sale freely has done considering how important that medicine for human safety, but it is important that acces for private health service unit (hospital/clinic) to obtain this medicine. Management policy of antiviral drugs in overcoming Avian Influenza case at reference hospital in DKI Jakarta is made limited and its implementation dose not involve for all sides. It was suggested for Health Service Department to involve reference apotek for providing antiviral drugs so it is easy on access for Health Service Unit in stockpile. It was also suggested for hospital to perform a research to proving the this effectiveness Oseltamivir on human avian influenza.