PENGEMBANGAN MODEL KESELAMATAN PASIEN BERDASARKAN MALCOLM BALDRIGE DI PUSKESMAS PONED DALAM IMPLEMENTASI KESELAMATAN IBU DAN ANAK

ABSTRAK Pengembangan Model Keselamatan Pasien Berdasarkan Malcolm Baldrige Di Puskesmas Poned Dalam Implementasi Keselamatan Ibu Dan Anak Kematian ibu 75% terjadi masa persalinan dan nifas. Menjamin keselamatan ibu dan anak diharapkan dapat menurunkan angka kematian ibu dan anak secara signifikan. Tercatat 289 Kejadian Tidak Diinginkan (KTD) di Rumah Sakit. Belum ada laporan KTD di puskesmas tercatat. Dari kasus hokum dan media masa diketahui KTD juga terjadi di Puskesmas disebabkan belum adanya model dan pedoman pelaksanaan keselamatan pasien di Puskesmas Pelayanan Obstetri Neonatal Emergensi Dasar (PONED). Penelitian bertujuan mengembangkan model keselamatan pasien berdasarkan Malcolm Baldrige di Puskesmas PONED dalam implementasi keselamatan ibu dan anak. Penelitian dilakukan 3 tahapan.Tahap 1 mengkonstruksi model berdasarkan Malcolm Baldridge dengan wawancara mendalam dan panel ekspertinformankuncidariKomiteKeselamatanPasienRumahSakit, DinasKesehatanPropinsiSumbar Dan Kota Padang, KepalaPuskesmas PONED dan FGD denganstaf. Tahap 2 penelitiankuantitatifmenganalisakuesionerdari 194 stafpuskesmasmengunakan SEM PLS sebagaidasarpembuatan model danmodulpelatihan.Moduldisusunmelaluiujivalidasiisi, materi, bahasadanmodulsertaujicobaskalaterbatas.Tahap 3 menganalisa model denganmembandingkanpengetahuanstafsebelumdansetelahdiberikanpelatihan. Hasiltahap 1 didapatkankepemimpinan, kebijakan, deteksiinsiden, mitigasi, kepuasanpasien, komitmenpasien, risk grading, RCA&FMEA, bebankerjastaf, komitmenstafdan audit internal merupakanvariabelpembentuk model. Hasilanalisatahap 2 semuavariabelberhubungansecarasignifikandengankeselamatanpasienkecualikepuasanpasiennamunteori, penelitiandanpakarmendukungtetapdimasukanke model. Tahap 3 terlihatpeningkatanpengetahuanstafsecarasignifikanantarasebelumdansesudahpelatihan. DirekomendasikanKementrianKesehatanmembuatkebijakandanpedoman.KementrianPendidikanTinggidanorganisasiprofesikesehatanmemasukansebagaimateripembelajaran.Puskesmas PONED mengadopsi model dalammemperbaikisistempelayanankesehatansehubungandengankredensialingdanakreditasi. Penelitiselanjutnyamenelitibudayakeselamatanpasien, Puskesmasdengankarakteristik lain (non rawatan, daerahpedesaan) sertamenelitidarisisipasien. Kata kunci : KTD, Malcolm Baldrige, KeselamatanPasien, PONED ABSTRACT Development of Patient Safety Model Based on Malcolm Baldrige In BEMONC CHC As Implementation of Mother and Child Safety Maternal deaths 75% occured during labor and childbirth. Ensuring maternal and child safety significantly reduce maternal and child mortality. Recorded 289 Adverse Event at the Hospital. No adverse event reported from Community Health Canter (CHC). Many law problem and media report shown adverse event also occurred in CHC due to the absencenances of models and guidelines for the patient safety implementation in Basic Obstetric Neonatal Emergency Services (BONES). The study aims to develop a patient safety model based on Malcolm Baldrige at the BEMONC CHC as implementation of maternal and child safety. The study was conducted in 3 stages. Phase 1 constructs the model based on Malcolm Baldridge with in-depth interviews and discussion with key informant Patient Safety Hospital Committee, West Sumatra Provincial Health Office and Padang City, Head of BEMONC CHC and FGD with health worker. Phase 2 of quantitative research analyzed questionnaires from 194 puskesmas staff using SEM PLS as the basis for modeling and training modules. Modules are prepared through validation tests of content, materials, languages and modules as well as a limited-scale trial. Stage 3 analyzes the model by comparing staff knowledge before and after training. Stage 1 results leadership, policy, incident detection, mitigation, patient satisfaction, patient commitment, risk grading, RCA & FMEA, staff workload, staff commitment and internal audit as model variables. The results of the 2nd stage analysis was all variables correlated significantly with patient safety except patient satisfaction but theories, research and expert reenter to the model. Phase 3 shows significantly increase in staff knowledge between before and after training. Recommended Ministry of Health establish policies and guidelines. Ministry of Higher Education and health profession organizations include as the learning materials. The BEMONC CHC adopted a model in improving the health care system FOR credentials and accreditation. The researchers then examined the safety culture of patients, Puskesmas with other characteristics (non-care, rural areas) and examined from the side of the patient. Keywords: Adverse Event, Malcolm Baldrige, Patient Safety, BEMONC CH