Pengaruh faktor kepemimpinan, pendidikan dan saluran komunikasi terhadap budaya keselamatan pasien

The patient safety goal is a requirement to be applied in all hospitals accredited by the Hospital Accreditation Commission. Increasing patient safety through management has been a major problem since 2000 where risk and safety management interventions are related to various aspects of the organization. An effective organizational culture is critical to the success of new initiatives in patient safety. In addition to efforts to meet human resource needs, improving the quality of human resources through improving patient safety culture needs to be carried out. For cultural improvement, it is necessary to understand the appropriate patient safety culture and to know how to measure and monitor it. RSJPDHK (Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita) as the national reference center establishes the achievement of strategic objectives aimed at realizing the satisfaction of key stakeholders (patients) in the form of effective, appropriate, safe, patient centered, one stop service. However, with the increasing need for services, the increasing number of patients affects the waiting time in which treatments take longer time. The mitigation program for the realization of the master plan for new buildings and facilities is established to solve the problem. In the realization of the master plan, it is estimated that the number of human resources will be required to meet the service needs with the highest number of nursing personnel. Based on this background, the objectives of this study are to analyze patients safety culture of the nurses and among groups of nursing work units, to analyze the influence of leadership, education and communication channel factors on the patient safety culture, and to analyze the influence of the patient safety culture on its impacts (perception of patient safety, frequency of reporting, and number of reporting). This research used a descriptive approach with survey method which was conducted on nurse profession groups in RSJPDHK. Qualitative data were obtained through resource person interviews and focus group discussions. Sampling size was referred to Slovin method with a fault tolerance level of 10% to obtain a minimum sample number (n) of 88 people. The sample selection (n) of 100 nurses was determined based on Quota Random Sampling method. Data processing was conducted by ANOVA and SEM Partial Least Square (PLS) test. The safety culture of patients among groups of nursing work units showed that there was no significant difference. Perceptions of patient safety based on the results of the study showed a mean score of 3.63 or 73% (high category). Incident reporting frequency had an average score of 3.06 or 61% (medium category). Data on the number of incident reporting that had been filled and submitted based on this study showed that the number of reporting made was obtained from the 43 respondents in this study or as much as 43%. This showed that culture of reporting was reasonably high in nurses in which incident reporting has been considered important so that it can be the beginning of the learning process to prevent or avoid incidents. The results showed that leadership had a load factor value of 0.552 and a T-count value of 4.778 (T-count ? 1.96) which means there is a significant influence on the patient safety culture. Education/training showed a load factor value of 0.285 and a T-count value of 2.153 (T-count ?1.96) which means there is a significant influence on the patient safety culture. Meanwhile, the communication channel shows the value of load factor of 0.090 and the value of T-count of 0.741 (T-count? 1.96) which means there is no significant effect on safety culture. The safety culture of the patient shows a load factor value of 0.426 and a T-count value of 4,393 (T-count ? 1.96) which has a significant influence on the impacts (perceptions of patient safety, frequency of reporting, and number of reporting). Leadership factor had a significant influence on patient safety culture and transformational leadership style was the most dominant with the highest t-count among other leadership styles. It is necessary to develop the need for leadership training that leads to the formation of a transformational leadership style. Training showed a significant influence on patient safety culture. Therefore, it is important for RSJPDHK to continuously improve the quality of training especially related to the job position, competence and teamwork to support the service. In addition, training was the first type of communication channel of choice to nurses at RSJPDHK as the most effective information intermediary related to patient safety. Intranet as one type of communication channels available in RSJPHK, although it is currently not a choice of the respondents related to patient safety; however, it should still be able to act as a medium of information to improve patient safety. It is; therefore, necessary to evaluate and improve its quality as well as to socialize it to the staff so that it can also become the communication channel of choice for the staff. Patient safety culture on the nurses based on analysis of mean and Loading Factor showed “supervisor /manager expectations and actions promoting safety“ and “staffing” needs to get more attention and improvement. Meanwhile “center management support for patient safety”, “organizational learning continuous improvement” and “teamwork within center unit” are the best dimension and should be maintained. Along with the new developments in researches related to the patient safety culture survey, suggestions for future researches are the need to conduct a survey of patient safety culture which not only measures based on staff perceptions on the patient safety culture but also links it to consumer reports regarding the consumer report related to the safety score toward the hospital in RSJPDHK. Therefore, it is expected to obtain a picture of research results related to patient safety culture which is more complete and directed to consumers, in this case, hospital patients and in accordance with the motto of the organization of "Patient First"