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

Jaminan pelayanan persalinan bagi masyarakat miskin bertujuan untuk meningkatkan akses terhadap pelayanan persalinan dalam rangka menurunkan AKI dan AKB. Analisis ini bertujuan mengevalusi pelaksanaan kebijakan jaminan pelayanan persalinan untuk akses masyarakat miskin di Provinsi DKI Jakarta. Penelitian dilakukan di DKI Jakarta dengan studi kasus pelayanan di Puskesmas Kecamatan Penjaringan pada bulan Juni 2013. Pendekatan kualitatif dilakukan dengan wawancara mendalam dan Focus Group Discussion (FGD). Pedoman wawancara dibuat berdasarkan metode implemantasi kebijakan George Edward III yang terdiri dari komunikasi, sumberdaya, struktur birokrasi dan disposisi. Masyarakat miskin mudah mengakses pelayanan persalinan di Puskesmas. Tetapi tetap dibutuhkan perbaikan metode komunikasi ke masyarakat.

Guarantee of service delivery for the poor aims to improve access to maternity services in order to reduce the MMR and IMR. This analysis aims to evaluate the implementation of policies to guarantee labour care access for the poor in Jakarta. The study was conducted in Jakarta with a case study in health centers Penjaringan service in June 2013. A qualitative approach was done by in-depth interviews and Focus Group Discussion (FGD). Interview guidance is based on the model of public policy implementation by George Edward III consisting of communication, resources, bureaucratic structure and disposition. Poor society can easily access labour service in the health center. But still, improvement to the method of communication is needed.