Latar Belakang: Unit Gawat Darurat (UGD) merupakan unit pelayanan yang membutuhkan tata kelola mutu yang efektif untuk menjamin keselamatan pasien dan kualitas pelayanan. Meskipun sebagian besar indikator mutu UGD RSU Kertha Usada Singaraja telah mencapai target, masih ditemukan beberapa keluhan pasien yang menunjukkan perlunya evaluasi implementasi tata kelola mutu. Tujuan: Menganalisis implementasi tata kelola mutu dalam pencapaian indikator mutu di UGD RSU Kertha Usada Singaraja Tahun 2025–2026 berdasarkan dimensi struktur, proses, dan outcome Model Donabedian. Metode: Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Data diperoleh melalui wawancara mendalam, observasi, dan telaah dokumen terhadap informan yang terdiri atas direktur, komite mutu, pimpinan UGD, penanggung jawab mutu, dokter, perawat, dan apoteker. Analisis dilakukan secara tematik berdasarkan dimensi struktur, proses, dan outcome. Hasil: Dimensi struktur menunjukkan bahwa UGD didukung oleh sumber daya manusia yang kompeten, sarana prasarana yang memadai, serta komitmen manajemen yang kuat. Namun, masih terdapat kendala berupa beban kerja ganda PIC mutu, keterbatasan dukungan radiologi, dan sistem pelaporan mutu yang belum terintegrasi dengan SIMRS. Pada dimensi proses, pelayanan telah berjalan sesuai standar melalui penerapan triase ATS dan START, pelayanan klinis yang berorientasi pada keselamatan pasien, serta monitoring indikator mutu secara berkala. Pada dimensi outcome, sebagian besar indikator mutu berhasil mencapai target yang ditetapkan, termasuk waktu tanggap pelayanan, kemampuan tindakan lifesaving, pengendalian mortalitas, dan pengelolaan komplain pasien. Kesimpulan: Implementasi tata kelola mutu di UGD RSU Kertha Usada telah berjalan dengan baik dan mendukung pencapaian indikator mutu pelayanan. Penguatan integrasi sistem informasi mutu, optimalisasi beban kerja petugas mutu, dan peningkatan dukungan layanan radiologi diperlukan untuk mendukung perbaikan mutu secara berkelanjutan. Kata kunci: tata kelola mutu, indikator mutu, Unit Gawat Darurat, Donabedian, rumah sakit

Background: The Emergency Department (ED) is a healthcare service unit that requires effective quality governance to ensure patient safety and service quality. Although most quality indicators at the Emergency Department of Kertha Usada General Hospital Singaraja have achieved their targets, several patient complaints were still identified, indicating the need to evaluate the implementation of quality governance. Objective: To analyze the implementation of quality governance in achieving quality indicators at the Emergency Department of Kertha Usada General Hospital Singaraja during 2025–2026 based on the structure, process, and outcome dimensions of the Donabedian Model. Methods: This study employed a qualitative approach with a case study design. Data were collected through in-depth interviews, observations, and document reviews involving informants consisting of the hospital director, quality committee representatives, emergency department managers, quality coordinators, physicians, nurses, and pharmacists. Data were analyzed thematically according to the structure, process, and outcome dimensions. Results: The structure dimension demonstrated that the Emergency Department was supported by competent human resources, adequate facilities and infrastructure, and strong management commitment. However, several challenges were identified, including the dual workload of the quality coordinator, limited radiology support, and a quality reporting system that was not yet integrated with the Hospital Management Information System (HMIS). In the process dimension, services were implemented in accordance with established standards through the application of the Australasian Triage Scale (ATS) and START triage system, patient safety-oriented clinical services, and regular monitoring of quality indicators. In the outcome dimension, most quality indicators successfully achieved the established targets, including response time, lifesaving performance, mortality control, and patient complaint management. Conclusion: The implementation of quality governance in the Emergency Department of Kertha Usada General Hospital has been effectively carried out and has supported the achievement of service quality indicators. Strengthening the integration of quality information systems, optimizing the workload of quality personnel, and enhancing radiology service support are necessary to sustain continuous quality improvement.