RESUMO
Purpose: To assist hospitals in preparing for a surge of patients during the COVID-19 pandemic, the World Health Organization (WHO) published an assessment tool called the rapid hospital readiness checklist. This checklist has been used by numerous countries, including Indonesia. However, several technical issues were discovered, primarily as a result of the manual recording of the checklist on a spreadsheet. This study aimed to identify challenges related to the hospital readiness checklist that was implemented in Indonesia. Materials and Methods: This qualitative study used focus group discussions to collect data. The study was conducted in East Java, Indonesia, in October 2021, with the participation of nine organizations from the provinces of East Java and Bali. Data were thematically analyzed, and the findings were presented in a narrative format. Results: Hospital participants had experience in filling out a hospital readiness checklist every 3 months. Some challenges faced by the hospital was the need to manually enter data into the checklist, lack of coordination and communication, there were various perceptions in hospitals as there was no technical guide in completing the checklist, absence of feedback, and the data returning empty due to filling errors. Additionally, City X health office also identified challenges in monitoring and evaluating the hospital checklists. Conclusion: This study, which included both hospitals and the health office, described the challenges encountered in the assessment of the hospital readiness checklist. Both hospitals and DHO experienced some challenges with the current system. The checklist has the potential to evolve into a public reporting to improve efficiency and faster decision-making.
RESUMO
Background: Understanding the causes of patient safety incidents is essential for improving patient safety; therefore, reporting and analysis of these incidents is a key imperative. Despite its implemention more than 15 years ago, the institutionalization of incident reporting in Indonesian hospitals is far from satisfactory. The aim of this study was to analyze the factors responsible for under-reporting of patient safety incidents in Indonesian public hospitals from the perspectives of leaders of hospitals, government departments, and independent institutions. Methods: A qualitative research methodology was adopted for this study using semi-structured interviews of key informants. 25 participants working at nine organizations (government departments, independent institutions, and public hospitals) were interviewed. The interview transcripts were analyzed using a deductive analytic approach. Nvivo 10 was used to for data processing prior to thematic analysis. Results: The key factors contributing to the under-reporting of patient safety incidents were categorized as hospital related and nonhospital related (government or independent agency). The hospital-related factors were: lack of understanding, knowledge, and responsibility for reporting; lack of leadership and institutional culture of reporting incidents; perception of reporting as an additional burden. The nonhospital-related factors were: lack of feedback and training; lack of confidentiality mechanisms in the system; absence of policy safeguards to prevent any punitive measures against the reporting hospital; lack of leadership. Conclusion: Our study identified factors contributing to the under-reporting of patient safety incidents in Indonesia. The lack of government support and absence of political will to improve patient safety incident reporting appear to be the root causes of under-reporting. Our findings call for concerted efforts involving government, independent agencies, hospitals, and other stakeholders for instituting reforms in the patient safety incident reporting system.