Tesis ini bertujuan untuk mengestimasi angka kematain bayi dan anak secara tidak langsung dan mengevaluasi keterbatasan-keterbatasan metodologi estimasi kematian bayi dan anak secara teoritik  dan empirik dan asumsi yang mendasari metode  perhitungan. Metode yang dipilih dalam penghitungan angka kematian bayi dan anak adalah metode Trussell. Angka kematian  bayi dan anak  secara tidak langsung adalah 43 per 1000 kelahiran hidup dan 14 per 1000 kelahiran hidup pada tahun 2003-2007. Keterbatasan metodologi secara teoritik bahwa responden adalah wanita usia subur yang masih hidup, sehingga mengecualikan mereka yang sudah meninggal pada saat survei tidak signifikan mempengaruhi angka kematian bayi dan anak . Keterbatasan metodologi secara empirik bahwa jumlah anak yang pernah dilahirkan  dan anak yang meninggal sangat tergantung pada daya ingat dari si ibu yang dapat dilihat dari rasio paritas antar kelompok tidak mengidentifikasi adanya  bayi yang pernah dilahirkan  tidak terlaporkan. Asumsi tingkat kematian dan fertilitas konstan selama beberapa tahun sebelum survei terpenuhi. Kata kunci : kematian bayi secara tidak langsung, estimasi.

The objectivity of this thesis is to estimate the infant and child mortality indirectly and to evaluate the methodology limitations of infant and child mortality estimation, theoretically and empirically, and also the assumptions underlying the calculations as well. The chosen method in calculating infant and child mortality was the Trussell method. Infant and child mortality indirectly rates were 43 per 1000 live births and 14 per 1000 live births in 2003-2007. Theoretically, methodological limitations was that the respondents were childbearing age women who were survive, therefore excluded those who had died during the survey did not significantly affect the infant and child mortality. The empirical methodology limitation was that the number of children ever born and children who had died was very dependent on the mother's memory which could be seen from the ratio of parity between the groups were not identifying  any unreported ever born baby. The assumption of constant mortality and fertility for several years before the survey was fulfilled. Key words: infant mortality indirectly, estimates

Keselamatan pasien merupakan isu global yang mendorong pengembangan sistem pelaporan insiden di fasilitas kesehatan. Siloam Hospitals Kelapa Dua telah mengimplementasikan Sistem Informasi Manajemen Mutu (SIMM) berbasis web sejak Maret 2023 untuk mendukung pelaporan insiden keselamatan pasien. Penelitian ini bertujuan mengevaluasi implementasi SIMM dan faktor-faktor yang memengaruhi penggunaannya.

Penelitian menggunakan pendekatan studi kasus dengan metode campuran. Data kuantitatif diperoleh dari 774 laporan insiden yang teregister di SIMM selama Maret 2023–Desember 2024. Data kualitatif dikumpulkan melalui wawancara mendalam dengan 10 informan dari berbagai profesi.

Hasil menunjukkan bahwa perawat merupakan pelapor terbanyak. Pengetahuan staf tentang pelaporan cukup baik, namun pelatihan formal masih terbatas. Budaya keselamatan tergolong baik, ditandai dengan dukungan manajemen dan komunikasi terbuka, meskipun masih ada persepsi menyalahkan. SIMM dinilai cukup mudah digunakan, namun terdapat kendala teknis dan kompleksitas formulir. Fitur proteksi identitas pelapor sering digunakan secara tidak sengaja.

Rata-rata 35 laporan diterima setiap bulan oleh 17 pelapor aktif. Fitur analisis akar masalah (RCA) digunakan pada 76,0% laporan, namun hanya 60,0% yang diselesaikan tepat waktu. Dashboard SIMM dimanfaatkan untuk analisis tren. Ketepatan waktu pelaporan dalam 1×24 jam tercapai pada 62,8% laporan, dan 73,8% laporan diproses lengkap. Pelaporan berkontribusi pada perbaikan proses dan pembelajaran organisasi, meskipun tingkat pelaporan 22,03 per 1.000 hari pasien—masih di bawah tolok ukur.

SIMM memberikan kontribusi positif terhadap pelaporan insiden, namun optimalisasi sistem, pelatihan, dan budaya pelaporan masih perlu ditingkatkan.

Patient safety is a global concern that has driven the development of incident reporting systems in healthcare facilities. Siloam Hospitals Kelapa Dua implemented a web-based Quality Management Information System (QMIS) in March 2023 to support patient safety incident reporting. This study aims to evaluate the implementation of QMIS and the factors influencing its use.  A case study with a mixed-methods approach was conducted. Quantitative data were obtained from 774 incident reports registered in QMIS between March 2023 and December 2024. Qualitative data were collected through in-depth interviews with 10 informants from various professional backgrounds.  Findings show that nurses were the most frequent reporters. Staff demonstrated adequate knowledge of incident reporting, although formal training was limited. The hospital’s safety culture was generally strong, supported by management commitment and open communication, though some perceptions of blame remained. QMIS was considered user-friendly, despite technical issues and form complexity. The anonymous reporting feature was often used unintentionally, complicating follow-up.  On average, 35 reports were submitted monthly by 17 active users. The root cause analysis (RCA) feature was used in 76.0% of reports, with only 60.0% completed on time. The QMIS dashboard was used for trend analysis. Timely reporting within 24 hours was achieved in 62.8% of cases, and 73.8% of reports were fully processed. Reporting contributed to process improvements and organizational learning, although the reporting rate remained at 22.03 per 1,000 patient days—below the benchmark.  QMIS has positively supported incident reporting, but further improvements are needed in system optimization, training, and fostering a stronger reporting culture.