END OF MODULE REFLECTION

Acquisition

a. The learning process obtained is the acquisition of additional knowledge, that to improve or
advance patient safety can be through the application of 5 renewal concepts that are
supported by the involvement of health service leaders in an organizational environment that
upholds a patient safety culture.
b. Consider which are most important, in my opinion there is nothing more important between
the 5 concepts of learning, health care leadership and patient safety culture. I say this
because these materials are equally important if they are related to patient safety in a health
service, besides that they are interrelated with each other. As an illustration can be described
as follows:
Currently, because there are always "adverse events" in a health service, it is appropriate that
the renewal process is still carried out, including:
1) That education about patient safety for actors working in health services such as
doctors, nurses, midwives, laboratory personnel, radiology staff, and pharmacists,
especially for health workers who have just completed their education is still needed.
We say this because when we receive new health workers at the hospital where we
work, it looks like they really don't understand the true meaning of patient safety or
patient safety culture. This proves that until now education about patient safety in
schools where they are educated is still not given properly. It is hoped that with the
learning process about patient safety that is better and more attention is paid to the
education providers, the health workers will be more familiar with, understand and be
willing to apply the learning about patient safety that is obtained at school.
2) Thus, when the health worker has started working, it will be easier to carry out
integrated services without any coercion. Likewise, when an unexpected event occurs,
the health workers involved will automatically resolve it in a transparent manner so that
they will consciously provide a report if an advers event occurs without any fear.
However, patient safety will not be achieved perfectly if the treatment for patients does
not involve patients and their families as sources of information. Also no less important
is the role of the workforce in carrying out their duties, because if the workforce
 involved in providing health services to patients is not provided with a healthy and
pleasant environment, it is not impossible to contribute to unexpected events.
3) For this, in order to achieve a patient safety culture in a health service, it requires the
involvement of a leader in the implementation process. This is expressed because a
leader has a role:
a) Creating a culture of openness based on accountability
b) Implement corrective behavior that is not acceptable
c) Identifying the workload and carrying out repairs if there is an excessive workload
on the health workforce
d) Organizing education related to hospital safety culture
e) Provide information such as library materials and reports related to safety culture
f) Explain how problems related to safety culture in the hospital can be identified and
controlled

In conclusion, we think that the concepts created by LLI are all important to be applied
in an effort to create patient safety.

c. Based on the above, especially regarding the role of leadership in creating a safety culture,
we also want to discuss especially those related to integrated services. We say this because
in the hospital where we work, there is no visible role of a leader in creating a safety culture
so that integrated health services are difficult to implement. This can happen because:
1) Our hospital is a new private private hospital, where the Director Operational Limited
Liability Company (PT) is not an employee who comes from the world health workers
who do not understand the true meaning of safety culture in hospitals.
2) There is a very large role in the administration of the hospital by the Director Limited
Liability Company Operations as Owner
3) Doctors who provide services at hospitals do not really understand the meaning of
culture,safety in the provision of health services, especially in inpatient services, so that
the meaning of the importance of integrated services in the provision of inpatient
services in patients to prevent the occurrence of adversary events cannot be applied.

Therefore, it is necessary to re-agree on the roles and duties between hospital owners and
hospital operational organizers. It is hoped that with the re-agreement of these two things,
 hospital operations can run properly and correctly in accordance with the regulations set by
our government. In addition, if there is a full role for the Hospital Director, he will be able
to carry out his functions and duties as a leader, including playing a role in creating a safety
culture in the hospital.

The different concepts and models that can influence leadership in our health services are
fostering mutual trust with the same perception about the importance of patient safety and
prevention efforts (Nico A Lumenta, 2021). For this reason, both the owner and the
Director of the Hospital and their staff must first be given learning about the true meaning
of patient safety as a whole starting from the understanding, principles of patient safety,
reporting methods and prevention efforts. In addition, we also carry out the obligations that
have been set by the Indonesian Hospital Accreditation Commission to provide lessons
about patient safety to every new employee at our hospital before they go into dealing with
real patients. The hope is that hospital leaders in collaboration with hospital owners can
make regulations related to patient safety, starting from establishing quality indicators to
monitor and evaluate the application of safety culture in health services, how to follow up
on improvement efforts that have been identified and how to prevent adversarial behavior.
event does not occur. Thus we believe that if the application of the concept of introducing
patient safety to the owner, hospital leadership and staff and all clinical and non-clinical
employees, safety culture will become a behavior that is rooted in every service delivery in
our health services.

2. Inquiry and Discussion

a. What has changed in our minds after reading this article is that the role of a leader in
creating a culture of safety and support from the government professional organizations and
observers of patient safety will accelerate the establishment of patient safety in a health
service which has subsequently been of course further processes such as integrated services,
patient involvement and family in a continuous service process and the creation of a positive
work atmosphere fun will be easily realized because the role of the leader is to create culture
safety in the hospital can be realized properly. We reveal this because in our hospital the role
of the leader has not been seen in creating culture safety, making it difficult to apply the 5
(five) concepts contained in this article. This matter can happen because:
 1) Our new hospital was founded in 2018
2) The leadership of the hospital owner is not from a health worker
3) Hospital leadership does not understand about patient safety
4) Medical personnel who work in hospitals do not understand the importance of patient
safety in a health service
5) Nurses and other health workers who work in our hospital started from health workers
who have just graduated, so they do not have experience
6) Hospital governance has not run according to the standards that have been set.
7) The supervisory body for the implementation of patient safety submitted to the health
service local not working

For this, the efforts that we will take are as follows:

1) Reorganizing Hospital Management Governance, especially related to Safety Patient

and Workforce Safety.
2) Establish a Hospital Quality Committee which will assist the Hospital Director in terms
of Quality Improvement and Patient Safety.
3) Formulate policies and work programs of the Quality Committee by referring to 5 (five)
concepts transformation of LLI.
4) Conducting meetings with stakeholders, such as: Hospital Owners, Medical Committee,
Nursing Committee, Specialist Doctors, Labor Representatives for socialize new
concepts that have been listed in the work program.
5) Overseeing the Quality Committee in its function as a supervisor, evaluating the results
of the work program related to safety quality.
6) Supervise the follow-up results proposed by the Quality Committee.
b. Does this article lead to better learning in the field?
We think it really brings better learning, especially when we compare with what we have
implemented in our own hospital, where many things have not been we do related to patient
safety-based health services. As an example patient safety culture has not been implemented,
this can happen because of the role of the leader involved in creating a culture of safety for
both patients and workers not seen yet. It is proven that the Patient Safety Team, Risk
Management Team and K3RS Team have not fully functioning, in addition to reports -
 reports of adverse events and work accidents are not been monitored or evaluated. Based on
this, there are services that do not integrated, the absence of patient involvement in the
services to be received and transparency in providing services is not realized and even
difficult to implement.

3. a. Mention 2 actions that will and have been carried out from day to day:

1) Create a new work plan related to quality and patient safety

2) Establish a Hospital Quality Committee which will assist the Hospital Director in terms
of manage and monitor quality improvement and patient safety programs
3) Forming the formulation of policies, guidelines and work programs related to
improvement quality and work safety and risk management where the 5 concepts will be
used one of the references
4) Dissemination to all hospital staff from medical personnel, nursing staff, other health and
non-clinical personnel
5) Overseeing the implementation of the quality and patient safety program implementation
by involves the Quality Committee, whose function is as a supervisor, evaluator, of
hospital work programs related to quality and patient safety
6) Evaluate, report and follow up on the results obtained or may exist problems in quality
improvement and patient safety and risk management. where is 5 (five) the concept as the
main reference.
7) Conducting meetings with decision makers such as: Hospital Owners, Hospital
Management, Medical Committee, Nursing Committee, Specialist Doctors,
Representatives workforce to discuss new concepts listed in the work program.
b. How does this make us act differently? Basically there is no difference in our actions but in
our country so that patient safety can be realized properly and correctly, the Government
through the Ministry of Health issued this because in our country there have been new
regulations that support quality and patient safety programs in Indonesia as well as programs
risk management. The regulation is contained in Permenkes number 80 of 2020 concerning
the Hospital Quality Committee. This committee is an element of non-structural organization
that assists the Director of the Hospital in managing and guiding programs for improving
quality and patient safety and maintaining hospital service standards. For this reason, every
 hospital in our country is required to establish a Hospital Quality Committee and the
Organizational Guidelines for a Hospital Quality Committee. The purpose of making the
Quality Committee Organizational Guidelines is because:
1) quality improvement and patient safety is an important instrument in carrying out
hospital organization wheel
2) Quality improvement and patient safety are aimed at increasing productive contributions
hospital quality in the organization in a strategic, ethical and responsible way social
3) So that the management of quality improvement and patient safety can be carried out
effectively and efficiently

In connection with the above, our Hospital will immediately take the following steps – the
steps we mentioned in point 3.a. on

c. Give example where this has been relevant to your context ? With the above explanation, in
our opinion context Five concepts of reform to accelerate the realization of the process
Patient safety is very relevant to the steps we will implement at home our pain, for example
that with the establishment of a quality committee where all the chair and its members must
have a commitment to quality improvement, patient safety and risk management means that
the tasks and functions assigned to the quality committee will be can easily be realized. In
addition, the regulation also states that members of the The Quality Committee must consist
of medical personnel, nursing personnel, other health personnel and personnel non-clinical
means that the implementation and monitoring of quality implementation, patient safety and
risk management can be realized more quickly because the members involved are in every
type of workforce work in the hospital. In conclusion, with the obligation of every hospital
to establishing a Quality Committee will facilitate the realization of the five innovation
concepts created by LLI. For this reason, improvements are needed to accelerate the process
patient safety is:
1) Quality Committees across all healthcare services in our country are mandatory
2) A monitoring system is needed by the government, especially the Ministry of Health to
supervise the implementation of the functions and duties of the Quality committee
3) There is an evaluation of the performance of the Quality Committee
d. What would you like to added to the module to assist your learning ? What to add in This
module is that the concept of this renewal in its application in health services need to be
supervised by the hospital itself, by forming an independent Unit/Team/Committee
domiciled directly under the Director of the Hospital and is directly responsible to Hospital
Director. In Our Country has been formed under the name of the Quality Committee
e. What would you change ? the changes we want to make are
1) The requirements to become a Director in a Health Service must be added where the
Director Health services must know the true meaning of Quality Improvement, Safety
Patients and Risk Management and able to apply these concepts
2) In implementing the concept, the Director must be assisted by a Unit/Team/Committee
independent who is domiciled under the Director of the Hospital and is directly
responsible to the Hospital Director.