Criterion 5.4.2 QUALITY AND SAFETY CULTURE

 Criterion 5.4.2

Health care providers play an important role in improving behavior in providing services that reflects a culture of quality and safety culture.

1) Main Thoughts:

a) Efforts to improve the quality of clinical services and patient safety are the responsibility of all health workers who provide patient care. Puskesmas measures patient safety culture by conducting patient safety culture surveys every year. Patient safety culture is also known as a safe culture, namely an organizational culture that encourages each individual staff member (clinical or administrative) to report matters of concern about safety or quality of service without compensation from the Community Health Center.

b) Health personnel are medical personnel, nurses, midwives and other health personnel who are authorized and responsible for carrying out patient care.

c) Behavior related to safety culture in the form of

(1) provision of good services, including shared decision making;

(2) collaborate with patients;

(3) collaborate with other health workers;

(4) collaborating within the health care system;

(5) minimizing risks;

(6) maintaining professional performance;

(7) professional and ethical behavior;

(8) ensuring the implementation of standardized service processes; And

(9) quality and safety improvement efforts including involvement in incident reporting and follow-up.

d) Behavior that does not support a safety culture such as:

(1) inappropriate behavior, including the use of words or body language that demeans or offends fellow staff, for example swearing and cursing;

(2) disruptive behavior, including inappropriate behavior that is carried out repeatedly, forms of verbal or nonverbal actions that endanger or intimidate other staff, reckless comments in front of patients that have the effect of lowering the credibility of other clinical staff, for example by making negative comments the results of other staff's actions or treatment in front of the patient by saying, “This medicine is wrong. Where did he graduate?", prohibiting nurses from making incident reports, scolding other clinical staff in front of patients, or showing anger by throwing medical records in the ward;

(3) harassing behavior related to race, religion, ethnicity, including gender; And

(4) sexual harassment.

e) The quality of clinical services is not only determined by the existing service system, but also by behavior in providing services. Health workers need to evaluate behavior in providing services and make efforts to improve both the service system and service behavior, which reflects a culture of safety and a culture of continuous clinical service improvement.

2) Assessment Elements:

a) Patient safety culture is measured by conducting a patient safety culture survey which becomes a reference in the safety culture program (D,W).

b) The Community Health Center creates a system to identify and submit reports of behavior that does not support a safety culture or is "unacceptable" and efforts to improve it (D,W).

c) Education is carried out about clinical quality and patient safety for all health care workers (D, W).