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Patient safety still is a global issue throughout the world with the high incidence ofhospital patient safety. One way to control patient safety incident rate is through thedevelopment of a reporting system. This study discusses the description of the reportingof hospital patient safety incidents in Indonesia with a literature review design. This studyaimed to get an information about the description of hospital patient safety incidentreports reviewed in Indonesia in terms of the availability of policies and methods usedalso the factors that hinder the reporting of patient safety incidents. This study uses aliterature review design with a database of PubMed, Science Direct, CINAHL, GoogleScholar and Garuda Research and Technology. The search results show that mosthospitals in Indonesia already have a patient safety incident reporting policy and use theoffline reporting method with a form. Broadly speaking, the hospital's IKP reportingprocedures are in accordance with the National Patient Safety Guidelines. But in practicethere are still many that are not in accordance with the reporting flow that should be andstill encounter many obstacles, such as fear of reporting, lack of socialization, lack ofknowledge and motivation, complicated reporting systems, low patient safety culture, noreward, and feedback which is not optimal yet. Results showed, it was found that theoutput from incident reporting such as timeliness and completeness are not yet fullyachieved.Key words:Patient safety incident report, hospital, Indonesia, literature review.
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.
Pelaporan Insiden Keselamatan Pasien (IKP) merupakan komponen penting dalam peningkatan mutu layanan dan budaya keselamatan rumah sakit. Menurut National Patient Safety Agency, pelaporan insiden berfungsi sebagai sarana pembelajaran untuk mencegah kejadian serupa di masa mendatang. Namun, data tahun 2019 menunjukkan bahwa hanya sekitar 12% rumah sakit di Indonesia yang melaporkan IKP. Penelitian ini bertujuan untuk menilai tingkat pelaporan IKP rumah sakit di Provinsi DKI Jakarta secara eksternal berdasarkan wilayah administrasi, kelas rumah sakit, jenis pelayanan, dan status kepemilikan rumah sakit, serta menganalisis hubungannya dengan keempat variabel tersebut. Penelitian ini menggunakan pendekatan kuantitatif dengan desain potong lintang dan dilengkapi wawancara untuk memperkaya pembahasan. Data sekunder berasal dari laporan IKP rumah sakit Provinsi DKI Jakarta tahun 2024, dianalisis menggunakan distribusi frekuensi dan Uji Kruskal-Wallis yang merupakan uji statistik nonparametrik. Hasil menunjukkan bahwa hanya variabel wilayah administrasi yang memiliki hubungan signifikan dengan tingkat pelaporan IKP. Jakarta Timur menjadi wilayah dengan tingkat pelaporan terendah, diduga dipengaruhi oleh jumlah rumah sakit yang lebih banyak dan efektivitas supervisi wilayah. Sementara itu, rumah sakit kelas C, rumah sakit umum, dan rumah sakit pemerintah cenderung memiliki pelaporan lebih rendah, meskipun tidak signifikan secara statistik. Penelitian ini memberikan gambaran variasi pelaporan IKP antar karakteristik rumah sakit dan menyoroti pentingnya peran wilayah administrasi dalam pembinaan dan pengawasan. Temuan ini diharapkan dapat menjadi bahan evaluasi untuk meningkatkan strategi pelaporan IKP secara eksternal di tingkat provinsi, terutama bagi Dinas Kesehatan Provinsi DKI Jakarta.
The reporting of Patient Safety Incidents (IKP) is a critical component in improving service quality and fostering a culture of safety in hospitals. According to the National Patient Safety Agency, incident reporting serves as a learning tool to prevent the recurrence of similar events. However, 2019 data showed that only about 12% of hospitals in Indonesia reported their IKP. This study aims to assess the level of external IKP reporting by hospitals in DKI Jakarta Province based on administrative region, hospital class, type of service, and ownership status, and to analyze the relationship between these variables and reporting compliance. This study used a quantitative cross- sectional design, with additional interviews to support the discussion. Secondary data were obtained from the 2024 IKP reports submitted by hospitals in DKI Jakarta Province. Data were analyzed using frequency distribution and Kruskal-Wallis test, a nonparametric statistic test. Results indicated that only the administrative region variable had a significant relationship with the level of IKP reporting. East Jakarta was identified as the region with the lowest reporting rate, which may be influenced by a higher number of hospitals and the effectiveness of local supervision. Meanwhile, Class C hospitals, general hospitals, and government-owned hospitals tended to report less frequently, although the differences were not statistically significant. This study highlights the variation in IKP reporting across hospital characteristics and underscores the important role of administrative regions in supervision and support. These findings may serve as evaluation material to strengthen external IKP reporting strategies, particularly for the DKI Jakarta Provincial Health Office.
