Conference PaperPDF Available

The Implementation of Patient Safety in Indonesia

Authors:
The Implementation of Patient Safety in Indonesia
Ahmad Ahid Mudayana
Faculty of Public Health
Ahmad Dahlan University
Yogyakarta, Indonesia
ahid.mudayana@ikm.uad.ac.id
Norma Sari
Faculty of Law
Ahmad Dahlan University
Yogyakarta, Indonesia
norma.sari@law.uad.ac.id
Heni Rusmitasari
Faculty of Public Health
Universitas Muhammadiyah Semarang
Semarang, Indonesia
heni.rusmitasari@gmail.com
Siti Fatonah
Faculty of Public Health
Ahmad Dahlan University
Yogyakarta, Indonesia
Sitifatonah726@gmail.com
Desi Aulia Setyaningsih
Faculty of Public Health
Ahmad Dahlan University
Yogyakarta, Indonesia
decyauliasn@gmail.com
AbstractPatient safety issues are a problem that needs to
be addressed immediately in health care facilities in Indonesia,
so that the standard of patient safety of health care facilities is a
reference for health care facilities in Indonesia to carry out their
activities. Based on Republic Indonesia Minister of Health
Regulation No. 11 of 2017 concerning patient safety that each
service facility must provide patient safety. This research is a
qualitative study with a phenomenological approach and the
research subjects were 7 people in each hospital with a total of
42 subjects in total. Data collection techniques in this study used
the method of in-depth interviews and observations. Qualitative
data analysis and data validity used source triangulation
techniques and method triangulation. This research aims to
determine the implementation of patient safety. The results of
this study are: 1) Patient safety standards related to patient
rights standards have been implemented and implemented in
accordance with the Minister of Health Regulation Number 11
of 2017, 2) Patient safety standards related to performance
standards educating patients and families have been
implemented and implemented in accordance with the
Regulations Minister of Health Number 11 of 2017, 3) Patient
safety standards related to patient safety standards in the
continuity of services have been implemented and implemented
in accordance with Minister of Health Regulation Number 11 of
2017, 4) Patient safety standards related to standards of use of
performance improvement methods to do evaluation and
improvement program for patient safety has been implemented
and implemented in accordance with the Minister of Health
Regulation Number 11 of 2017, 5) Patient safety standards
related to leadership roles in improving patient safety have been
implemented and implemented in accordance with the
Regulation Minister of Health Number 11 of 2017, 6) Patient
safety standards related to the standard of educating staff
criteria regarding patient safety have been implemented and
implemented in accordance with Minister of Health Regulation
Number 11 of 2017, 7) Patient safety standards related to
communication standards as key for staff to achieving patient
safety has been implemented and implemented in accordance
with the Minister of Health Regulation Number 11 of 2017. The
conclusions that can be drawn from this study are Wates
Hospital, Dr. H. Moh. Anwar, Sumenep Regency, Muntilan
Hospital, NTB Provincial Hospital, Sekayu Regional Hospital
and Batam City Embung Fatimah Hospital have implemented
patient safety standards in accordance with Minister of Health
Regulation Number 11 of 2017.
Keywordsstandards, patient safety, implementation
I. INTRODUCTION
Hospitals have an important role for the community,
where hospitals offer and provide services with various very
complex components such as types of drugs, tests, procedures,
tools with technology, professional and non-professional
personnel who are ready to serve 24 hours continuously at
patient. all these components if not managed properly can
potentially cause errors when providing services to patients,
thus threatening patient safety [1].
Research conducted by Ock, Jo, Choi, & Lee [2] Ock, Jo,
Choi, & Lee [2] that the community reported incidents of
patient safety. As many as 700 people surveyed, 24 (3.4%)
and 37 (5.3%) respectively reported that they or their families
experienced Patient Safety Incidents (PSI). Respondents with
bachelor degrees are more likely to report PSI compared to
those who have lower education. Approximately half of the
participants (48.2%) were involved in the PSI, and all
respondents (100%) who experienced PSI with severe injuries
answered medical errors.
Report on the patient safety incident in Indonesia by
province found in DKI Jakarta 37.9%; Cental Java 15.9%;
DIY 13.8%; East Java 11.7%; South Sumatera 6.9%; West
Java 2.8%; Bali 1.4%; Aceh 10.7%; and South Sulawesi 0.7%
[3]. While reports of patient safety incidents in cases of KTD
14.4% and KNC 18.5% caused due to clinical procedures
9.3%; and patient fall 5.15% [4].
According to Herkutanto's research [5] as many as 91% of
Public Hospitals and 15% of hospitals studied did not have a
medical committee. The role of the medical committee in
ensuring patient safety is very important. Movement (Patient
Safety) has become a spirit in hospital services throughout the
world not only hospitals in developed countries that
implement patient safety to ensure service quality, but also
hospitals in developing countries such as Indonesia.
The Ministry of Health of the Republic of Indonesia has
issued Regulation of the Minister of Health No. 11 of 2017
concerning patient safety at the hospital. This regulation is a
major milestone in the operationalization of patient safety in
hospitals throughout Indonesia [4]. Many hospitals in
Indonesia have tried to build and develop patient safety, but
these efforts are carried out based on management's
understanding of patient safety. This ministerial regulation
provides guidance for hospital management in order to carry
out the spirit of patient safety as a whole.
Ahmad Dahlan International Conference Series on Pharmacy and Health Science (ADICS-PHS 2019)
Copyright © 2019, the Authors. Published by Atlantis Press.
This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
Advances in Health Sciences Research, volume 18
II. METHODOLOGY
This research is a qualitative research with a case study
approach to find out the application of patient safety in Wates
Hospital, Kulon Progo Regency, Dr. H. Moh. Anwar
Sumenep, Muntilan Public Hospital Magelang Regency, West
Nusa Tenggara Provincial Hospital, Sekayu Regional
Hospital Musi Banyuasin Regency, South Sumatra Province,
and Embung Fatimah Hospital in Batam City. The subjects in
this study were 7 people from each hospital with a total of 42
subjects. The purpose of this study is to find out the
application of patient safety standards based on Minister of
Health Regulation No. 11 of 2017 in hospitals.
III. RESULT AND DISCUSSION
A. Standard of Patient Rights
Based on Minister of Health Regulation Number 11 of
2017 concerning Patient Safety the standard of patient rights
consists of 3 criteria, namely there must be a doctor in charge
of service, service plans made by the doctor in charge, and
clear and correct explanations carried out by the doctor in
charge.
Based on the standard criteria of patient rights, there must
be a doctor in charge of services, then the Wates Hospital, Dr.
H. Moh Anwar, Sumenep Regency, West Nusa Tenggara
Provincial Hospital, Muntilan Regional Hospital, Sekayu
Hospital, there are doctors in charge of services. This is in
accordance with the results of the following interview:
"There is a responsible doctor called DPJP. DPJP as a
doctor in charge of patients in the event of unwanted things
"(Informant 8).
The doctor in charge of the service must make a service
plan. This service plan is carried out when the patient begins
to enter the hospital to treat until the patient completes
treatment. This was conveyed by the following informants:
"... the patient service plan that manages the doctor in
charge of the service. For example the patient must have a
laboratory examination, x-ray examination ... "(Informant 4)
One of the fulfillment of patient rights standards is by
providing a complete, correct and clear explanation to patients
and their families regarding the actions and risks that will be
experienced when given services. This is supported by the
results of interviews as follows:
"Eee, if that's for sure, but if for example in the emergency
room, the doctor who is in the emergency room with the
doctor is the same, if the emergency room is also a specialist
doctor, usually visit early in the morning and afternoon is
none" (Informant 24)
Based on the results of the research standard patient rights
have been applied. This is supported by the existence of a
Dokter Penanggung Jawab Pelayanan (DPJP) or Doctor. In
addition, the doctor in charge of the service is also tasked with
providing detailed explanations to patients and families about
plans and results of services both about treatment, procedures
and possible unexpected outcomes. This will have an impact
on the comfort of patients when communicating with doctors
so as to create satisfaction for patients. This is the same as that
expressed by Mukti [6] who argued that the easier the patient
communicates with health workers, the more friendly health
care providers give attention to patients and the more easily
patients channel their aspirations, the higher the satisfaction
felt by patients.
B. Educational Standards for Patients and Families
Educational standards for patients and families have seven
criteria. The first criterion is the provision of correct
information. Information provided by the hospital to patients
and their families must be clear, clear, and honest. This is in
accordance with the results of the interview as follows:
"One of fulfilling the rights of patients is by providing
correct and clear information regarding their health conditions
..." (Informant 31)
The second criterion is the patient and family know the
obligations and responsibilities in the hospital. This is in
accordance with the results of the interview as follows:
"... knowing, because since the beginning of entering the
front there was informed consent, filling in the patient's
responsibilities and on the consent sheet already existed, so
that the patient stayed in to attend treatment for his illness ..."
(Informant 1)
The third criterion is that patients and families ask
questions for things that are not understood by the hospital. If
the patient and family of patients do not understand the
explanation given by the health worker, the patient and family
ask questions related to the action that will and has been given.
Therefore, health workers must explain the information very
clearly to patients and families. This information is proven by
the results of the following interview:
"There are patients who really care to ask, there are also
patients who ignore this. There is already an operational
standard procedure related to the actions given and the
consequences that are referred to. So the information is in
accordance with the existing SPO ... "(Informant 29)
The fourth criterion is that patients and families
understand and accept the consequences of service at home.
Officers at the hospital before taking action will understand
the patient and the patient's family to accept the consequences
of the service. As stated by informants as follows:
"If there are things that are not usually understood, the
patient and his family will ask the nurse in charge of the
patient. Nurses re-socialize regarding rights and obligations ...
"(Informant 33)
The next criterion is that patients and families of patients
adhere to instructions and respect hospital regulations.
Patients and families must obey instructions and respect the
regulations in the hospital. This is because hospitals are public
places where many people take medication or visit relatives
who are being treated. This is as expressed by the following
informants:
"Yes, as patients and families obey because it is clear that
there are regulations in the hospital if they violate, they will
be given a warning from the hospital ..." (Informant 27)
The sixth criterion is that patients and families have
respect and tolerance. Patients and families in the hospital
already have mutual respect and tolerance. This is as stated by
the following informants:
Advances in Health Sciences Research, volume 18
"This waiting card is what keeps the families of patients
from complying with hospital regulations regarding scheduled
hours ..." (Informant 29)
The last criterion is that patients and families fulfill the
financial obligations agreed upon at the hospital. Regarding
the financial agreement, the average patient and family fulfill
the agreed financial obligations. In payment of treatment
patients use health insurance. This was conveyed by the
following informants:
"In general, patients and their families fulfill agreed
financial obligations unless there are certain things such as not
being able to pay in full". (Informant 8)
Based on Republic of Indonesia Minister of Health
Regulation Number 11 of 2017 concerning Patient Safety that
safety in providing services can be improved by the
involvement of patients who are partners in the service process
[7]. Therefore, health facilities must have a system and
mechanism to educate patients and their families regarding the
obligations and responsibilities of patient care. With this
education, patients and their families are expected to
participate well, and be informed in making decisions about
the care they receive.
Based on the results of the study it is known that the
hospital has carried out education regarding the rights and
obligations of patients and their families. As regulated in
Republic of Indonesia Law Number 44 of 2009 concerning
Hospitals that patients and their families have the rights and
obligations that must be obeyed, each patient has the right to
obtain information about the rights and obligations of the
patient, and give approval or refuse action health against the
disease.
In educating patients and their families related to the
consequences of a service, carried out by means of education
and communication. So that it can be seen also that there is
good communication between doctors and patients. Because
communication is the main key for a program to run smoothly.
If there is no good communication, there will be a miss of
communication between patients / families of patients and
health workers.
Effective communication is not only between doctors and
patient care providers, but also between doctors and patients.
Patients feel satisfied when doctors provide opportunities to
communicate more freely, in no hurry, and be empathetic.
This is in accordance with the research conducted by
Sunaringtyas [8], that effective communication with patients
can improve understanding, minimize problems, improve
quality of care, and increase satisfaction. Satisfied patients are
valuable assets, because they will use services continuously.
While patients who feel dissatisfied will tell their bad
experiences to others.
C. Patient Safety Standards in Continuity of Service
The hospital has coordinated services thoroughly starting
when the patient enters until the patient exits. This information
is based on the results of interviews as follows:
"... that must be it. Patients enter we handle, doctors and
there are nurses who help us, so we take action and then we
coordinate between doctors and nurses after we have
stabilized patients to the specialist doctors who are responsible
for getting more specific therapies for those patients. So the
coordination remains here "(Informant 23)
In addition to comprehensive service coordination for
continuity of services, hospitals must have coordination of
services tailored to the needs of patients and the feasibility of
sustainable resources so that all stages of service can run well.
As stated by the informant in the interview process as follows:
"There is coordination, it must be clear according to the
patient's needs. The coordination will give the officer an
action from the results of recording related to the next
examination that will be carried out ... "(Informant 30)
There is coordination of services that included improved
communication to facilitate family support, care services,
social services, consultations and referrals, primary health
services and other follow-up. This is in accordance with the
results of the following interview:
"... Yes, we are fellow health workers. There is
coordination, both of us who are in the service, for example,
there is a problem, here we will report to the nursing
department. If he has a financing problem, we usually report
... "(Informant 1)
Health workers have implemented communication and
information transfer standards between health professions so
that they can achieve a process of unimpeded, safe and
effective coordination. This is in accordance with the results
of the interview as follows:
"Of course. We fellow health professionals must transfer
information to each other and strive for continued
communication. Afraid that the health personnel will be
quietly affected later by the patient, and we must refer the
patient if the hospital cannot afford it "(Informant 38)
Running patient safety standards in the continuity of
services has been carried out as referred to in article 5
paragraph (4) letter c of the Minister of Health Regulation of
the Republic of Indonesia number 11 in 2017 which includes
patient safety standards in continuity of services including
comprehensive service coordination starting from when
patients enter, examination, diagnosis, service planning,
treatment measures, referrals and when the patient is
discharged from the hospital.
Coordination is certainly in accordance with the directions
previously written on the patient's status record and refers to
the existing SOP. As well, all health workers work together to
provide the best service. After undergoing a treatment and
health period, the patient is allowed to go home.
There is coordination of services tailored to the needs of
patients and the feasibility of resources on an ongoing basis so
that at all stages of the transitional service between service
units can run smoothly. Coordination of services tailored to
the needs of patients of course hospitals provide convenience
for patients in fulfilling their obligations to pay bills at the
hospital.
Then, the doctors and nurses also provide actions in
accordance with the needs of patients and all are adjusted to
the records written by the previous doctor or nurse or
directives given directly from DPJP.
The information that is given to patients must be true and
clear, especially when it comes to giving action. This is in line
Advances in Health Sciences Research, volume 18
with Sunaringtyas [8] that interdisciplinary communication
aims to establish cooperation to exchange information and
coordinate. So that information errors, information delays do
not occur. This is aimed at providing care, handling the patient
to the fullest.
D. Standard Use of Performance Improvement Methods
Officers at the hospital understood "Seven Steps to
Hospital Patient Safety". In this standard health facilities
must design new processes or improve existing processes.
This is in accordance with the results of interviews with the
following informants:
"Every year we evaluate quality and safety guidelines.
Then if you need a revision it will be revised and the
guidelines will only be valid for 3 years. Then after being
revised, we also made the program ". (Informant 15)
The hospital conducts performance data collection. The
collection of performance data has monthly or quarterly
collection of performance and there is an annual collection of
performance every year.
"... there is annual performance data collection. If the
quality standard is monthly, if the performance is every year,
if the quality of the service is collected every month, there is
a standard ... "(Informant 2)
The next criterion is about implementing intensive
evaluations at the hospital. Evaluations are based on needs
and some are done six months and yearly. This information
is in accordance with the results of the following interview:
"Yes, every year it is evaluated that each name has an
evaluation of its performance". (Informant 9)
The final criterion is that the hospital used all data and
information on the results of the analysis. Information on the
results of the analysis is used for future planning, such as
improving quality and for completing administration. This is
in accordance with the results of the interview as follows:
"Yes of course. For future evaluation and planning
material. But there are still officers who do not understand in
analyzing the data. Maybe from the hospital side the training
will be given according to the unit officer. " (Informant 38)
Based on the results of the study, the hospital has
implemented and implemented safety standards. The patient
safety program is never the end of the process, because it
requires culture including sufficiently high motivation to be
willing to implement a patient safety program on an ongoing
and sustainable basis [9].
Performance data collection is carried out as performance
appraisal material. Before the performance data collection is
carried out, the data is in the form of a guard report in each
room, so that the performance of the results of the recording
by the doctor on duty and the nurse inpatient in each room
where there is a person in charge of the room. Then the
assessment by the head of the installation is then collected to
the personnel department to assess its performance and if
there are cases or incidents of patient safety, it is reported to
the PMKP section.
This is in line with Mulyadi's research [10] that the main
purpose of performance appraisal is to motivate employees to
achieve organizational goals and to meet predetermined
standards of behavior in order to produce actions and results
desired by the organization. Behavioral standards can be
either management policies or formal plans as outlined in the
organization's budget.
E. Standard Leadership Role
In the standard leadership role there are several criteria.
The first criterion is in the hospital there is a proactive
program to identify safety risks and the program minimizes
incidents, such as Potential Injury Conditions (PIC), Real
Injury Events (RIE), Non-Injury Events (NIE), Unexpected
Events (UE), and also Sentinel Events. Hospitals have met
the criteria for these standards. This can be seen from the
results of interviews conducted to hospital staff as follows:
"We known as risk management. So risk management
identifies the risks that arise. Risk identification is the first
time, including the most safety. Then the unit becomes a risk
assessment, at the hospital level it becomes a risk register
level. That's how to identify before an incident ". (Informant
15)
The next criterion is the existence of a working
mechanism to ensure that all components of health care
facilities are integrated and participate in patient safety
members. This is based on the results of the interview as
follows:
"The mechanism of action to ensure that all the
components are running smoothly is to carry out services in
accordance with the existing SPO ..." (Informant 29)
The hospital has met standard procedures for responding
quickly to incidents. This was revealed by the following
informants:
"There is also a guideline, starting with the needle
punctured by HIV, meningitis ...". (Informant 9)
Hospitals have met the criteria for standard leadership
roles, namely the existence of internal and external reporting
mechanisms relating to incidents including the provision of
correct and clear information about the analysis of the roots
of the RIE problem and sentinel events. This was revealed by
informants as follows:
"Yes there is, so it's like me who assesses the performance
of nurses in the room here. They report this, this is what later
I will judge, that's the report, huh. " (Informant 12)
In hospitals there are mechanisms to deal with various
types of incidents, for example dealing with "Sentinel
Events" or proactive activities to minimize risks. This was
conveyed by informants as follows:
"Later, just look at the guidebook, I explained a little so
that for the incident someone reported to us, later we will
determine whether it was an incident or not, there will
continue to be socialization, then form an RCA team for
analysis". (Informant 8)
The hospital has carried out open communication
collaborations voluntarily between units and between service
managers in health care facilities. The results of interviews
Advances in Health Sciences Research, volume 18
conducted with hospital staff based on these criteria are as
follows:
"That is certain, so for example I called the doctor that this
patient had already, so the doctor said that he could go home
in the afternoon. There is communication between doctors
and nurses. " (Informant 11)
Hospitals already have resources and information systems
needed in patient safety improvement activities, including
periodic evaluations of the adequacy of resources. This was
conveyed by informants as follows:
"The resource is 5M right? Man, money, method,
material, machine. If the resources are from the hospital, only
a hospital is available. Our information system has a hospital
SIM, but not all of them are covered by a hospital SIM. Our
hospital SIM is still very limited. Yes, we use a manual
system, how do we implement it, ... ". (Informant 15)
The final criterion is the existence of measurable targets,
and information gathering using objective criteria to evaluate
the effectiveness of improving the performance of patient
health and safety service facilities. The results of interviews
with informants are as follows:
"... in the quality section, in the service there are periodic
evaluations of service evaluations in each unit and there are
instruments that later you might be able to ask in the quality
section, what kind of emergency services are there quality
service standards? ... "(Informant 4)
Based on the results of the study, the hospital has carried
out a proactive program to identify patient safety risks and
the program minimizes incidents of patient safety, such as
minimizing Real Injury (RI), Potential Injury Conditions
(RIC), Non-Injury Events (NIC), Unexpected Events (UE),
and sentinel events. The application of these programs to
minimize incidents of patient safety to improve hospital
quality. This is in line with Syam's research [11] that the
patient safety culture at Ibnu Sina Makassar Hospital received
a positive response and inpatient installation was an
installation with a majority positive response to the patient
safety culture.
The role of leadership in improving reporting is one way
to minimize incidents of patient safety because with good
reporting an evaluation will be carried out to minimize
incidents of patient safety. Cahyono [12] revealed that the
reporting system functioned to raise errors as an effort to
improve the service system. If the error does not become a
lesson and is not corrected, the error will repeat itself and
result in serious injury in the future.
F. Educational Standards for Staff
The hospital has implemented educational standards for
staff with the criteria that the hospital has an education,
training and orientation program for new staff that includes
the topic of patient safety in accordance with their respective
duties. This information is based on the results of interviews
as follows:
"There is training for new nurses who are orientated
before being placed in their respective rooms. Usually the
training and socialization activities are about post-safety in
the hospital. If there is training activity outside the hospital,
the nurses are invited to take part in training activities ... ".
(Informant 33)
The hospital has integrated the topic of patient safety in
each training / apprenticeship activity and provides clear
guidance on incident reporting. This was revealed by the
following informants:
"Not only new staff, students were accompanied by the
material. So we must provide material about safety to
students. What then must be considered by students and how
they maintain security ”. (Informant 15)
The next criterion is that each health care facility in this
hospital has conducted training on teamwork to support an
interdisciplinary and collaborative approach in order to serve
patients. This is in accordance with what was revealed by the
informants as follows:
"Yes, there is cooperation training" (Informant 12)
Based on the results of the study it is known that the
hospital has implemented educational standards for staff.
This is supported by the existence of education, training and
orientation programs for new staff that cover the topic of
patient safety according to their respective duties. This is
similar to what was stated by Henriksen [13] who argued that
increasing knowledge is the expected impact of quality
training and patient safety. Training is one means of
increasing the need for new knowledge and for improving
individual performance and system performance.
According to Sutriningsih [14] training is expressed as a
part of education that involves the learning process to acquire
and improve skills outside the applicable education system in
a relatively short time. The amount of training that nurses
follow can be a strong influence in determining whether a
person is good at implementing patient safety. According to
Dewi [15] the factors that influence the application of patient
safety goals to nurses are the level of knowledge, attitudes,
and facilities. While the dominant factor is the level of
knowledge.
The positive impact of being implemented and the
implementation of standards to educate staff about patient
safety include hospital staff to minimize incidents of patient
safety by prioritizing patient safety. Because the house staff
had armed with knowledge related to patient safety held by
the hospital. With the education of staff about patient safety,
it can reduce the incidence of patient safety in hospitals. So
that if the hospital does not educate staff about patient safety,
there may be incidents of patient safety. Because hospital
staff do not have the knowledge that is related to patient
safety.
G. Communication Standards
In communication standards there are 2 (two) criteria,
namely the availability of a budget to plan and design a
management process to obtain data and information about
matters related to patient safety; availability of problem
identification mechanisms and communication constraints to
revise existing information management.
It is known that this hospital has a budget for and
designing management processes to obtain data and
Advances in Health Sciences Research, volume 18
100
information related to patient safety. This was revealed by the
following informants:
"... there is, but we don't know because it's about hospitals
in general ..." (Informant 5)
The hospital has identified problems and communication
constraints to revise existing information management. This
was revealed by the following informants:
"Eee has the term PAK (Perubahan Anggaran Kerja) or
Amendment to the Work Budget, the re-preparation or
revision. For example, yesterday's plan was apparently not
workable. For example there are obstacles, we plan A turns
out A can't, then we move to B "(Informant 8)
Based on Republic of Indonesia Minister of Health
Regulation Number 11 of 2017, communication standards are
activities of health service facilities in planning and designing
patient safety information management processes to meet
accurate and accurate internal and external information
needs. In order to meet these communication standards,
hospitals must implement predetermined criteria, namely a
budget must be available and a problem identification
mechanism available.
The budget functions for operations related to patient
safety programs. However, the budget is managed by the
hospital in general, not divided into each unit so that health
workers do not really understand the budget. Sari [16] argues
that the budget is a reflection of the plan of hospital service
business activities expressed in the value of money involving
estimates of income and costs, cash in and cash out, for
operational and investment activities. The budget that has
been prepared and approved is expected to be used by
management in all sections as a guideline for carrying out
planned activities.
The budget also deals with management to identify
problems. The role of the main budget is as work guidelines,
as a tool for work planning and work supervision. When
associated with the meaning and function of management, it
appears that the budget is closely related to management,
especially those related to planning, coordination and
supervision of work.
In the process of health care, communication is the basis
for ensuring that patients get the best treatment process,
explain the goals of treatment and discuss the process of
patient care with other professionals involved. Often
communication takes place in situations where the stress level
is high and must be done immediately. But communication is
also a means to overcome the situation, with good
communication, good team collaboration can be established.
Therefore, communication is one of the most important
things, especially related to patient safety. Communication is
an important part of teamwork, although it does not have a
meaningful influence with the application of patient safety.
Good communication will result in good cooperation [17].
Communication should be improved to realize and mitigate
risk factors related to patient safety [18].
IV. CONCLUSION
Based on the results of the study it can be concluded that:
1) Patient safety standards related to patient rights
standards have been implemented and implemented in
accordance with Minister of Health Regulation Number 11
of 2017.
2) Patient safety standards related to performance
standards educating patients and families have been
implemented and implemented in accordance with the
Minister of Health Regulation Number 11 of 2017.
3) Patient safety standards related to patient safety
standards in continuity of service have been implemented
and implemented in accordance with Minister of Health
Regulation Number 11 of 2017.
4) Patient safety standards related to the standard use of
performance improvement methods for evaluating and
improving patient safety programs have been implemented
and implemented in accordance with Minister of Health
Regulation Number 11 of 2017.
5) Patient safety standards related to leadership roles in
improving patient safety have been implemented and
implemented in accordance with Minister of Health
Regulation Number 11 of 2017.
6) Patient safety standards related to the standards of
educating staff about patient safety criteria have been
implemented and implemented in accordance with
Minister of Health Regulation Number 11 of 2017.
7) Patient safety standards related to communication
standards as a key for staff to achieve patient safety have
been implemented and implemented in accordance with
Minister of Health Regulation Number 11 of 2017.
REFERENCES
[1] Satibi, Manajemen Obat di Rumah Sakit.Gadjah Mada Universitas
Press, 2015.
[2] Ock,M., Jo, M., Choi, E. Y., & Lee, S., “ Patient Safety Incidents
Reported by the General Public in Korea: A Cross-Sectional Study,”
00(00), 2018, pp. 1-7.
[3] Komite Keselamatan Pasien Rumah Sakit. Panduan Nasional
Keselamatan Pasien Rumah Sakit. 2008.
[4] Komite Keselamatan Pasien Rumah Sakit. Laporan Insiden
Keselamatan Pasien. 2011.
[5] Herkutanto, “Profil Komite Medis di Indonesia dan Faktor-Faktor yang
Mempengaruhi Kinerjanya dalam Menjamin Keselamatan Pasien,”
Jurnal Manajemen Pelayanan Kesehatan, Vol.06, No. 02, pp.41-47,
2009.
[6] Mukti, “Pengaruh Mutu Layanan Kesehatan Terhadap Kepuasan
Pasien Rawat Inap di Rumah Sakit Woodward Kota Palu’’, Jurnal
AKK, Vol.2, No. 3, pp.35-41, 2013.
[7] Peraturan Menteri Kesehatan Republik Indonesia Nomor 11 Tahun
2017 tentang Keselamatan Pasien.
[8] Sunaringtyas, W., “Startegi Case Manager dalam Mengelola Kasus
Pasien Rawat Inao di RS B Kediri”, The Indonesian Journal of Health
Science, Vol.6, No.1, pp.26-33, 2015.
[9] Hakim, L. Pudjirahardjo W., “Optimalisasi Proses Koordinasi Program
Keselamatan Pasien (Patient Safety) Di Rumah Sakit X Surabaya”,
Jurnal Administrasi Kesehatan Indonesi, Vol.2, No. 3. pp. 198-208.
[10] Mulyadi, Sistem Manajemen Strategik Berbasis Balanced Scorecard,
Yogyakarta: UPP AMP YKPN, 2005.
[11] Syam, N.S, “Implementasi Budaya Keselamatan Pasien Oleh Perawat
di Rumah Sakit Ibnu Sina Makassar”, Jurnal Fakultas Kesehatan
Masyarakat, Vol. 11, Issue 2. Pp. 169-174, 2017.
Advances in Health Sciences Research, volume 18
101
[12] Cahyono, B.S., Membangun Budaya Keselamatan pasien (Dalam
Praktik Kedokteran), Yogyakarta: Kanisius, 2008.
[13] Henriksen, Patient Safety and Quality : An Evidence Base Handbook
For Nurses, Rockville MD: Agency, 2008.
[14] Sutriningsih, “Pengetahuan Perawat Tentang Keselamatan Pasien
Dengan Pelaksanaan Prosedur Keselamatan Pasien Rumah Sakit
(KPRS) Di Rumah Sakit Panti Waluyo Sawahan Malang”, Jurnal Care,
Vol. 3, No.1, Pp. 25-32, 2015.
[15] Dewi, “Faktor-Faktor Yang Mempengaruhi Penerapan Sasaran
Keselamatan Pasien Pada Perawat Di Ruang Rawat Inap Kelas I, II, III
RSUD Dr. Soedirman Kebumen”. Skripsi, Sekolah Tinggi Ilmu
Kesehatan Muhammadiyah Gombong, 2017. Tidak diterbitkan
[16] Sari, “Evaluasi Sistem Anggaran Sebagai Alat Pengendalian
Manajemen Studi Kasus Di Rumah Sakit Umum Kardinah Tegal’,
Jurnal Ilmiah Cermin, Vol.4, No.5, Pp. 1858-4500, 2018.
[17] Mudayana, A. A., 2015 “Pelaksanaan Patient Safety Oleh Perawat di
RS PKU Muhammadiyah Yogyakarta”, Jurnal Kesehatan Samodra
Ilmu, Vol. 06, No. 02, Pp. 145-149, 2015.
[18] Laal, F., Fazli, B., Balarak, D., et.al, “Attitude Toward the Patient
Safety culture in Healthcare Systems”, Patient Safety & Quality
Improvement Journal, Vol.4, No.2, Pp. 363-368, 2016.
Advances in Health Sciences Research, volume 18
102
ResearchGate has not been able to resolve any citations for this publication.
Article
Full-text available
Objectives: Previous studies have demonstrated that the general public can report various patient safety incidents (PSIs) that are not identified by other methods. In this study, we investigated the characteristics of PSIs that the general public experience in Korea. Methods: In face-to-face surveys, participants were asked to report the frequency and type of PSIs, level of patient harm, and whether the PSIs were perceived as a medical error. We conducted logistic regression analysis to identify the sociodemographic factors of participants associated with their PSI experiences. Additionally, we analyzed relationships between the perception of PSIs as a medical error and both the type of PSIs and level of patient harm. Results: Among the 700 participants surveyed, 24 (3.4%) and 37 (5.3%) individuals reported that they or their family members experienced PSIs, respectively. Participants with at least a college degree were more likely to report PSI experiences than those with a lower educational level (odds ratio, 3.54; 95% confidence interval, 1.86-6.74). Whereas approximately half of participants (48.2%) involved in PSI experiences that caused no harm thought that there were medical errors in their PSIs, all participants (100%) who experienced PSIs with severe harm responded that medical errors occurred in their PSIs. Conclusions: The general public can report their experiences with PSIs. Periodic surveys that target the general public will provide additional data that reflect the level of patient safety from the viewpoint of the general public.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Profil Komite Medis di Indonesia dan Faktor-Faktor yang Mempengaruhi Kinerjanya dalam Menjamin Keselamatan Pasien
  • Herkutanto
Herkutanto, "Profil Komite Medis di Indonesia dan Faktor-Faktor yang Mempengaruhi Kinerjanya dalam Menjamin Keselamatan Pasien," Jurnal Manajemen Pelayanan Kesehatan, Vol.06, No. 02, pp.41-47, 2009.
  • Mukti
Mukti, "Pengaruh Mutu Layanan Kesehatan Terhadap Kepuasan Pasien Rawat Inap di Rumah Sakit Woodward Kota Palu'', Jurnal AKK, Vol.2, No. 3, pp.35-41, 2013.
Startegi Case Manager dalam Mengelola Kasus Pasien Rawat Inao di RS B Kediri
  • W Sunaringtyas
Sunaringtyas, W., "Startegi Case Manager dalam Mengelola Kasus Pasien Rawat Inao di RS B Kediri", The Indonesian Journal of Health Science, Vol.6, No.1, pp.26-33, 2015.
Optimalisasi Proses Koordinasi Program Keselamatan Pasien (Patient Safety) Di Rumah Sakit X Surabaya
  • L Hakim
  • W Pudjirahardjo
Hakim, L. Pudjirahardjo W., "Optimalisasi Proses Koordinasi Program Keselamatan Pasien (Patient Safety) Di Rumah Sakit X Surabaya", Jurnal Administrasi Kesehatan Indonesi, Vol.2, No. 3. pp. 198-208.
Sistem Manajemen Strategik Berbasis Balanced Scorecard
  • Mulyadi
Mulyadi, Sistem Manajemen Strategik Berbasis Balanced Scorecard, Yogyakarta: UPP AMP YKPN, 2005.
Implementasi Budaya Keselamatan Pasien Oleh Perawat di Rumah Sakit Ibnu Sina Makassar
  • N Syam
Syam, N.S, "Implementasi Budaya Keselamatan Pasien Oleh Perawat di Rumah Sakit Ibnu Sina Makassar", Jurnal Fakultas Kesehatan Masyarakat, Vol. 11, Issue 2. Pp. 169-174, 2017.
Patient Safety and Quality : An Evidence Base Handbook For Nurses
  • Henriksen
Henriksen, Patient Safety and Quality : An Evidence Base Handbook For Nurses, Rockville MD: Agency, 2008.
Pengetahuan Perawat Tentang Keselamatan Pasien Dengan Pelaksanaan Prosedur Keselamatan Pasien Rumah Sakit (KPRS) Di Rumah Sakit Panti Waluyo Sawahan Malang
  • Sutriningsih
Sutriningsih, "Pengetahuan Perawat Tentang Keselamatan Pasien Dengan Pelaksanaan Prosedur Keselamatan Pasien Rumah Sakit (KPRS) Di Rumah Sakit Panti Waluyo Sawahan Malang", Jurnal Care, Vol. 3, No.1, Pp. 25-32, 2015.
  • Sari
Sari, "Evaluasi Sistem Anggaran Sebagai Alat Pengendalian Manajemen Studi Kasus Di Rumah Sakit Umum Kardinah Tegal', Jurnal Ilmiah Cermin, Vol.4, No.5, Pp. 1858-4500, 2018.