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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.
Work fatigue significantly affects hospital workers' performance, safety, and health. This study developed a fatigue risk management model using qualitative and quantitative approaches through literature review, FGD, interviews, and observations. The result is the ICHAFIT model (Integrated Collaboration Healthcare Adaptability for Fatigue Intervention and Tracking) comprising five key elements and a data-driven prevention strategy). It includes 24 valid and reliable indicators to assess implementation. ICHAFIT serves as both a conceptual framework and practical tool, and also produced a policy brief to support national advocacy for fatigue risk management in hospitals.
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