IMPLEMENTATION STRATEGIES OF PATIENT SAFETY CULTURE IN MIDWIFERY CARE: A QUALITATIVE STUDY

Abstrak

Patient safety was a crucial element in improving healthcare quality. However, its implementation continued to face various challenges, particularly in midwifery units that were at high risk for maternal and neonatal incidents, such as hemorrhage due to episiotomy errors. This study aimed to explore the strategies used to implement a patient safety culture in RSUD X from December 2024 to January 2025.This research employed a qualitative approach using the Grounded Theory method. Data were collected through unstructured in-depth interviews with informants selected using purposive sampling based on inclusion criteria: the ability to communicate effectively, being information-rich, and willingness to participate. A total of nine informants were included: five healthcare providers, one member of the quality committee, two management representatives, and one midwifery patient. Data analysis followed the stages of open coding, axial coding, and selective coding to identify key themes. The study identified six interrelated strategic themes for building a patient safety culture: improving knowledge and capacity of healthcare workers; promoting visionary management through evaluation and system reform; enhancing professionalism by strengthening work ethic and collective responsibility; reinforcing risk mitigation systems; accelerating strategic collaboration between healthcare workers and management; and developing a modern, flexible, and accountable incident reporting system. The implementation of integrated and evidence-based strategies was essential to strengthening the patient safety culture. With appropriate strategies, RSUD X could establish a safer working environment and enhance the quality of midwifery services. These findings could serve as a reference for other hospitals with similar characteristics.