Liana Duta, Lestari Fatma, Sutoto Sutoto, Modjo Robiana, Bachtiar Adang
Candidate Doctoral Faculty of Public Health, Universitas Indonesia, Depok.
Faculty of Public Health, Universitas Indonesia, Depok.
J Public Health Res. 2022 Mar 10;11(2):2530. doi: 10.4081/jphr.2022.2530.
Studies on safety culture maturity in health care is very rare, and the existing ones only focus on patients and the use of Manchester Patients Safety Framework (MaPSaF) instrument. The objective of this study is to develop a comprehensive instrument for measuring safety culture maturity in hospitals.
This study used a cross-sectional design with three stages. First, we used secondary data analysis from the Hospital Accreditation Commission. Second, evaluation of primary data obtained from safety climate questionnaire. Third, we did focus group discussions, and in-depth interviews for validation of secondary data and development of DUTA-RS website. We analyzed using Structural Equation Modeling (SEM) test.
DUTA-RS instrument contains 1,118 elements based on the first edition of the Indonesian Hospital Accreditation National Standard. Its safety culture maturity is at the proactive level (58.0%), with the highest accreditation levels of proactive (50.8%) and generative (48.7%). The variables affecting the safety culture maturity are situational and safety behavior variables, with leadership, risk management, and safety compliance as the strongest indicators. The weakest indicators of climate are organizational learning and communication. The mean value of climate for primary and secondary data is in the good category and showed in proactive level.
The DUTA-RS as a website to measure the safety culture maturity in accredited hospitals by taking the advantage of the existing information technology of hospital accreditation committee as the benchmark enables improvement of SCML in hospitals. Further studies are required for the development of DUTA-RS website.
医疗保健领域中关于安全文化成熟度的研究非常罕见，现有的研究仅关注患者以及曼彻斯特患者安全框架（MaPSaF）工具的使用。本研究的目的是开发一种用于衡量医院安全文化成熟度的综合工具。
本研究采用横断面设计，分为三个阶段。首先，我们使用了医院评审委员会的二次数据分析。其次，对从安全氛围问卷中获得的原始数据进行评估。第三，我们进行了焦点小组讨论和深入访谈，以验证二次数据并开发DUTA-RS网站。我们使用结构方程模型（SEM）测试进行分析。
基于印度尼西亚医院评审国家标准第一版，DUTA-RS工具包含1118个要素。其安全文化成熟度处于积极主动水平（58.0%），其中积极主动（50.8%）和创新（48.7%）的评审水平最高。影响安全文化成熟度的变量是情境和安全行为变量，其中领导能力、风险管理和安全合规是最强的指标。氛围方面最薄弱的指标是组织学习和沟通。原始数据和二次数据的氛围平均值处于良好类别，并显示为积极主动水平。
DUTA-RS作为一个利用医院评审委员会现有信息技术作为基准来衡量认证医院安全文化成熟度的网站，能够促进医院安全文化成熟度水平的提高。DUTA-RS网站的开发还需要进一步研究。
