Analisis Budaya, Perilaku dan Kinerja serta Implementasi Keselamatan Pasien Rumah Sakit Gigi dan Mulut di Indonesia

KUSUMA ARBIANTI, drg Rosa Amalia, M.Kes., PhD; Dr.drg Julita Hendrartini, M.Kes; dr.Tjahjono Kuntjoro MPH., DrPH

2023 | Disertasi | S3 Kedokteran Gigi

Berbagai tuntutan pasien banyak dilayangkan kepada rumah sakit akibat kurang amannya tindakan dalam pelayanan kesehatan. Mengevaluasi dan membangun budaya keselamatan pasien di rumah sakit merupakan cara yang efektif untuk menghindari insiden keselamatan serta memahami upaya perbaikan yang dapat dilakukan. Hubungan budaya keselamatan pasien dan kinerja keselamatan masih belum jelas dan tidak konsisten. Penelitian ini bertujuan menganalisis pengaruh budaya, perilaku dan kinerja keselamatan pasien serta mengevaluasi implementasi enam sasaran keselamatan pasien RSGM di Indonesia. 

Metode: Studi mixed methode dengan pendekatan embedded design. Pengukuran budaya , perilaku dan kinerja keselamatan pasien menggunakan kuesioner. Sampel adalah 247 civitas hospitalia pada 22 RSGM Pendidikan di Indonesia dengan teknik convenience sampling. Pengumpulan data implementasi sasaran keselamatan pasien dilakukan Focus Group Discussion (FGD) terhadap delapan ketua komite mutu pada RSGM Pendidikan di Indonesia dengan teknik purposive sampling. Analisis data kuantitatif menggunakan Structural Equation Model (SEM). Analisis data kualitatif menggunakan framework analysis. Analisis data mixed methode dilakukan secara konkuren.

Hasil: Budaya keselamatan pasien berpengaruh positif terhadap perilaku keselamatan. (?=0.187; 95% CI=0,039 hingga 0.335; p=0.017). Budaya keselamatan pasien berpengaruh positif terhadap kinerja keselamatan. (?=0.559; 95% CI=0.442 hingga 0.677; p=<0 CI=0.134 xss=removed>

Kesimpulan: Budaya keselamatan pasien di RSGM di Indonesia berpotensi untuk perbaikan dan berpengaruh secara langsung terhadap kinerja keselamatan daripada melalui perilaku keselamatan pasien. Enam sasaran keselamatan pasien sebagian besar telah dilaksanakan namun perlu konsistensi dalam pelaksanaannya.

Many patient claims have been made against hospitals due to unsafe health services. Evaluating and building a patient safety culture is an effective way to avoid safety incidents and understand how corrective measures can be taken. The relationship between patient safety culture and safety performance remains unclear and inconsistent. The purpose of this study was to analyze the influence of patient safety culture, safety behavior and safety performance, also evaluate the implementation of the six patient safety goals of dental hospitals in Indonesia.

Methods: Mixed method study used embedded design. Measurement of patient safety culture, behavior and performance using a questionnaire. The sample was 247 hospital staff at 22 dental hospitals in Indonesia with convenience sampling technique. Data collection on the implementation of patient safety goals was carried out Focus Group Discussion (FGD) with eight chairpersons of quality committees in dental hospitals in Indonesia using purposive sampling technique. Quantitative data analysis used Structural Equation Model (SEM). Qualitative data analysis used framework analysis. Mixed method data analysis was conducted in concurrent

Results: Patient safety culture had a positive effect on safety behavior. (?=0.187; 95% CI=0.039 to 0.335; p=0.017). Patient safety culture has positive effect on safety performance. (?=0.559; 95% CI=0.442 to 0.677; p=<0 CI=0.134 xss=removed>

Conclusions: Patient safety culture in dental hospitals in Indonesia has potential for improvement and influences safety performance directly rather than through safety behaviors. The six patient safety goals had mostly implemented but needed consistency.

Kata Kunci : Budaya Keselamatan Pasien, Kinerja Keselamatan, Perilaku keselamatan, RSGM