Sistem pelaporan insiden keselamatan pasien merupakan elemen penting dalam upaya mitigasi risiko yang dapat dicegah dalam layanan kesehatan. RSUPN dr. Cipto Mangunkusumo (RSCM) telah menerapkan pelaporan insiden melalui metode manual dan elektronik (e-Report), namun implementasinya belum optimal. Penelitian ini bertujuan mengevaluasi implementasi sistem pelaporan insiden di RSCM dengan pendekatan kualitatif, menggunakan kerangka Donabedian (struktur–proses–hasil) dan strategi perbaikan berbasis Plan–Do–Study–Act (PDSA). Hasil menunjukkan bahwa sistem e-Report belum memenuhi kebutuhan pengguna karena antarmuka tidak intuitif dan tidak tersedianya fitur pelacakan, notifikasi, serta umpan balik. Fragmentasi kanal pelaporan, dominasi laporan manual, serta persepsi bahwa pelaporan adalah beban administratif turut memperlemah budaya pelaporan. Di samping itu, proses tindak lanjut insiden dinilai tidak transparan dan jarang dikomunikasikan kepada pelapor, sehingga menurunkan kepercayaan terhadap efektivitas sistem. Temuan ini menjadi dasar penyusunan rekomendasi pengembangan sistem pelaporan yang terpusat, mudah digunakan, dan didukung pelatihan berbasis unit serta kebijakan pelaporan satu pintu. Pendekatan PDSA digunakan untuk merancang strategi perbaikan sistem yang lebih responsif dan berkelanjutan dalam rangka mendukung peningkatan mutu layanan dan keselamatan pasien.

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The patient safety incident reporting system is a critical component in mitigating preventable risks within healthcare services. Dr. Cipto Mangunkusumo National General Hospital (RSCM) has implemented both manual and electronic (e-Report) methods for reporting incidents. However, its implementation remains suboptimal. This study aims to evaluate the implementation of the incident reporting system at RSCM using a qualitative approach, guided by the Donabedian framework (structure–process–outcome) and the Plan–Do–Study–Act (PDSA) improvement cycle. The findings reveal that the current e-Report system does not sufficiently meet user needs due to an unintuitive interface and the absence of key functionalities such as report tracking, automated notifications, and feedback mechanisms. Additionally, fragmented reporting channels, a predominance of manual submissions, and the perception of reporting as a bureaucratic burden have contributed to a weakened safety culture. The follow-up process is also perceived as lacking transparency and is rarely communicated back to reporters, further reducing trust in the system. These challenges form the basis for recommendations to develop a centralized, user-friendly, and integrated reporting system, supported by unit-based training and a single-channel reporting policy. The PDSA cycle is applied as a strategic framework to design a more responsive and sustainable system that enhances both service quality and patient safety at RSCM.

Peluang konstruksi kelautan semakin vital dalam pengembangan industri maritim. Industri konstruksi dikenal dengan risiko kematian dan cidera yang lebih tinggi dari industri-industri lainnya. Konstruksi kelautan seperti pengerukan, dilakukan selama dua puluh empat jam dan tujuh hari dalam seminggu karena faktor cuaca dan lingkungan. Industri ini mengombinasikan bahaya kerja pada konstruksi ditambah dengan bahaya bekerja di atas kapal, dimana cuaca menjadi bagian yang tak terpisahkan dari kegiatannya. Konsep Design for Safety (DfS) merupakan integrasi dari identifikasi bahaya dan penilaian risiko pada tahap konseptual dan perencanaan proyek. Integrasi DfS dalam siklus hidup proyek konstruksi kelautan diharapkan mampu berdampak positif terhadap Incident Rate. Design for Safety dalam penelitian ini dikelompokkan menjadi empat dimensi yaitu metode kerja, peralatan kerja, tenaga kerja, dan lingkungan kerja. Penelitian ini merupakan penelitian kuantitatif dengan analisis data menggunakan desain potong lintang, dilaksanakan mulai dari Juni 2023 sampai dengan November 2023. Populasi penelitian adalah seluruh staff di Direktorat Operasional di PT X, dengan total sebanyak 33 orang. Teknik pengambilan sampel dalam penelitian adalah total sampling, yaitu sebanyak 33 sampel. Berdasarkan hasil penelitian, implementasi Design for Safety (DfS) dalam dimensi Metode Kerja, Peralatan Kerja, Tenaga Kerja, dan Lingkungan Kerja memiliki hubungan positif dan signifikan dengan Incident Rate, dengan tingkat korelasi yang kuat hingga sangat kuat. Terdapat beberapa faktor-faktor dominan DfS di PT X yang berpengaruh terhadap keselamatan konstruksi yaitu analisis bahaya, penilaian risiko, dan rencana mitigasi (MK4), kondisi/kesiapan peralatan kerja (PK3), pengetahuan kontraktor mengenai Design for Safety (TK9), ketersediaan biaya keselamatan kesehatan kerja (K3) dalam anggaran biaya proyek (LK13), dan komitmen klien terhadap Design for Safety (LK2).

Marine-construction opportunities are becoming increasingly vital in the development of the maritime industry. The construction industry is known for having a higher risk of fatalities and injuries compared to other industries. Marine construction, such as dredging, is conducted twenty-four-hour a day and seven days a week due to weather and environmental factors. The industry combines the hazards of construction coupled with the challenges of working on ships, where weather is an integral part of the construction activities. The concept of Design for Safety (DFS) involves integrating hazard identification and risk assessment in the conceptual and project planning stages. The integration of DfS in the lifecycle of marine construction project is expected to have a positive impact on the Incident Rate. In this research, Design for Safety is categorized into four dimensions : Work Methods, Equipment, Manpower, and Environment. This research of quantitative study with cross-sectional design, conducted from June 2023 to November 2023. Research population consist of all staff in the Operational Directorate at PT X, totaling 33 individuals as total samples. Based on the research findings, the implementation of Design for Safety in the dimensions of Work Methods,  Equipment, Manpower, and Environment has a positive and significant relationship to Incident Rates, with correlation levels ranging from strong to very strong. There are several dominant factors of Design for Safety at PT X that affect the construction safety include hazard analysis, risk assessment, and mitigation plans (MK4), equipment condition/readiness (PK3), contractror knowledge on Design for Safety (TK9), availability of occupational safety and health (OHS) costs in project budget (LK13), and client commitment to Design for Safety (LK2).