Analysis of The Implementation of The Occupational Safety and Health Management System at Bhayangkara Kendari Hospital

Background: The occupational safety and health management system is part of the overall management system in the context of controlling work-related risks in order to create a safe, efficient and productive workplace. The aim of this research is to analyze the implementation of the occupational safety and health management system in hospitals. According to the management report of the Occupational Safety and Health committee at Bhayangkara Kendari Hospital in 2023, it was stated that the hospital had not carried out occupational risk management as part of the hospital's occupational safety and health planning. Method: This research is a qualitative descriptive research method. There were 11 informants in the research. The sampling technique used was purposive sampling. Results: The results of the research show that Bhayangkara Kendari Hospital has implemented an Occupational Safety and Health Policy and Occupational Safety and Health risk management planning, but the results obtained in the Implementation of Occupational Safety and Health, Monitoring and Evaluation in the Hospital's Occupational Safety and Health program do not meet standards. Optimal Occupational Safety and Health. Conclusion: Bhayangkara Kendari Hospital has implemented the Hospital Occupational Safety and Health policy in accordance with Minister of Health Regulation No. 66 of 2016 with a commitment to implementing Occupational Safety and Health, but is hampered by the unavailability of special health services. There are still health workers who provide health services without using personal protective equipment, and there are still those who violate the KTR and there are no monthly and annual evaluation reports on Hospital Occupational Safety and Health. This research can be used as reference material for hospitals to optimally implement Hospital Occupational Safety and Health to increase the knowledge of health workers in implementing occupational safety and health by familiarizing themselves with occupational safety and health cultural behavior.


INTRODUCTION
Occupational Safety and Health is the main means of preventing accidents, disability and death as a result of work accidents.Occupational safety and health aims to prevent, reduce and even eliminate the risk of work accidents (zero accident).The application of this concept should not be considered as an effort to prevent work accidents and occupational diseases which cost the company a lot of money, but should be considered as a form of long-term investment that will provide abundant benefits in the future.Several factors that influence occupational safety and health include workplaces, equipment and workforce.Occupational safety and health issues in general in Indonesia are still often neglected (1) The World Health Organization (WHO) in the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury, 2000-2016: Global Monitoring Report, estimates that at least 19% (360,000) of deaths in the world are caused by occupational accidents.injuries).Meanwhile, the risk of long working hours is related to the cause of 750,000 deaths, and air pollution causes 450,000 deaths in the world which are related to work relations.(2).
According to global data released by the International Labor Organization (ILO), the number of cases of work accidents and occupational diseases globally reaches 430 million per year, consisting of 270 million (62.8%) cases of work accidents and 160 million (37.2%) ) cases of occupational diseases, causing the deaths of 2.78 million workers every year.40% of cases of work accidents and work-related illnesses occur in young workers (3).The large potential for danger and the high number of work accidents and work-related diseases means that it is necessary to successfully implement occupational safety and health management in hospitals to prevent and reduce health and safety hazards for workers.The occupational safety and health management system is part of the overall management system which includes organizational structure, planning, responsibilities, implementation, procedures, processes and resources in order to control workrelated risks in order to create a safe, efficient and productive workplace.In fulfilling these objectives, companies/hospitals are required to implement an occupational safety and health management system that is carried out evenly across all hospital human resources, disciplined, committed and in accordance with Minister of Health Regulation No. 66 of 2016 (4).
Minister of Health Regulation number 66 of 2016 concerning Hospital Occupational Safety and Health (SMKRS) is all activities to guarantee and protect the safety and health of hospital human resources, patients, patient companions, visitors and the hospital environment through efforts to prevent work accidents.and occupational diseases in hospitals (4).
The important infectious disease prevention behavior (PPI) for health workers is to always use personal protection and apply antiseptic when examining patients after carrying out the examination by washing their hands.This is to prevent the danger of transmitting microorganisms to patients, and to prevent the danger of transmitting microorganisms to medical staff and around the patient's area.If health care workers have not washed their hands for five minutes or fail to practice proper hand hygiene and have the effect of cleaning their hands, this can result in major nosocomial infections and the spread of multidrug resistance in health care settings and has been considered endemic, an important factor (5).
From the report of the Bhayangkara Kendari Hospital Occupational Safety and Health committee, information was obtained that the hospital already has a safety and health program, but its implementation has not gone well so that cases of work accidents and work-related illnesses increase every year.Another problem encountered at the Bhayangkara Kendari Hospital is that the Occupational Safety and Health Committee is not working optimally, this is because the Bhayangkara Level III Kendari Hospital only has one occupational safety and health manager who already has an occupational safety and health certificate and the manager is not full-time.time to do his job (6).
It is necessary to implement an occupational safety and health management system to reduce occupational accidents and illnesses, reduce costs by reducing the occurrence of accidents and damage thereby reducing loss costs, create an effective management system, increase customer/patient trust and satisfaction at Bhayangkara Kendari Hospital.Based on the background above, the author is interested in conducting research on Analysis of the Implementation of the Occupational Safety and Health Management System at Bhayangkara Kendari Hospital in 2024.

RESEARCH METHODS
This research is a qualitative descriptive research study.The number of informants in this study was 11 people, with the sampling technique using a sampling technique in the form of deliberate sampling or purposive sampling.The research variables consist of variables, namely Policy, Planning, Implementation, Monitoring, Evaluation and the variable Implementation of the Hospital Occupational Safety and Health Management System.The research uses data types and data sources, namely primary data and secondary data.Data collection techniques through interviews, observation and documentation techniques.Data validity is carried out by triangulation consisting of source triangulation and technique triangulation.Data analysis through data reduction, data presentation and data verification or conclusion.

a. Characteristics of research informants
The characteristics of the informants are as follows:

b. Implementation of an Occupational Safety and Health Management System Policy
Based on the results of in-depth interviews regarding the implementation of the hospital's occupational safety and health management system policy, it shows that the hospital's occupational safety and health policy is determined by the highest leadership of the hospital and is stated officially and in writing.Based on the results of the interview, it can be interpreted that the formation of the Hospital Occupational Safety and Health policy is based on applicable regulations and discussions carried out by the head of the section team.Suggestions from workers will be reported through the head of the respective team and then these suggestions will be brought to the discussion on the formation of the Hospital Occupational Safety and Health policy.
The results of in-depth interview analysis regarding the need for facilities and infrastructure to support patient safety in each section of facilities and safety management (MFK) are influenced by an adequate hospital budget.Based on the informant's statement above, it can be interpreted that the facilities and infrastructure are available in each section, including personal protective equipment, fire control equipment, occupational safety and health signs, standard operating procedures, and even human resources themselves are a means of implementing safety and health.Work.However, the fulfillment of Occupational Safety and Health facilities and infrastructure is carried out by the MFK committee according to adequate budget allocation.
The results of the interview analysis regarding professional human resources in the field of Hospital Occupational Safety and Health show that an important component in the implementation of Hospital Occupational Safety and Health is human resources who are the implementers in managerial and operational activities for the implementation of Occupational Safety and Health at the Bhayangkara Kendari Hospital.

Planning
The results of in-depth interview analysis on risk management show that reporting risky situations includes conducting comprehensive risk assessments throughout the facility on a regular basis.Bhayangkara Kendari Hospital carries out risk management as part of Occupational Safety and Health planning which is carried out in accordance with the schedule set by the Hospital and the person responsible is internal and for risk identification based on the Occupational Safety and Health committee team carrying out the work According to each portion, the risk analysis carried out only focuses on the workload of human resources and complaints from workers are not taken into consideration in the risk assessment.Therefore, hospitals need to develop a facility/environment/work process risk management program that discusses the management of safety and health risks through the preparation of a Hospital Occupational Safety and Health manual.

Implementation
Analysis of in-depth interviews regarding worker health services shows that the health service efforts provided to hospital human resources comprehensively include promotive, preventive, curative and rehabilitative services.Bhayangkara Kendari Hospital implements health services for workers including pre-work examinations by carrying out regular health examinations by carrying out examinations every 6 months, special examinations are carried out depending on the type of work required to carry out special examinations and hospital occupational safety and health education by carrying out various hospital occupational safety and health training.However, for simulations carried out such as the use of light fire extinguishers (APAR), personal protective equipment, if human resources experience an accident or illness due to work, the level of severity is first identified to be able to determine the action to be taken, the team responsible for the worker's health is Infection Prevention and Control (PPI) team.
The results of in-depth interview analysis regarding fire prevention and control show that the process for preventing and controlling fire hazards has been implemented well.Bhayangkara Kendari Hospital implements fire prevention and control by providing a special team, namely the code red team.However, risk identification and mapping in fire control is not implemented.Fire control education and training is not carried out simultaneously for all employees.However, simulations were not carried out during fire situations due to the difficulty of implementation involving many parties.

Monitoring
Analysis of in-depth interviews shows that monitoring efforts are carried out in every work area that has potential hazards.Based on the results of the interview above, it can be interpreted that the Bhayangkara Kendari Hospital carries out a process of monitoring the implementation of Hospital Occupational Safety and Health on a regular basis.Furthermore, to achieve the target, monitoring of the Hospital Occupational Health and Safety program must be carried out periodically so that it can be improved continuously in accordance with the risks that have been identified.

Evaluation
The results of in-depth interviews regarding the evaluation of the implementation of the occupational safety and health management system in hospitals show that the Bhayangkara Kendari Hospital has carried out a reporting evaluation process which is the result of mandatory standardization according to Minister of Health Regulation No. 66 of 2016.

Policy Implementation of Hospital Occupational Safety and Health
The commitment to occupational safety and health implemented at Bhayangkara Kendari Hospital is proven by the commitment of the hospital leadership and all employees at Bhayangkara Kendari Hospital.Based on the statement from the leadership of the Bhayangkara Kendari Hospital, the existence of occupational safety and health to ensure the health and safety of employees and the existence of occupational safety and health has become a mandatory thing to implement in accordance with applicable regulations.
Evidence of the commitment of the leadership of Bhayangkara Kendari Hospital, namely forming policies in accordance with hospital regulations and conditions, then socializing them to hospital human resources, such as using personal protective equipment, installing posters or signs for occupational safety and health, establishing and implementing occupational safety and health programs., training and education for human resources at Bhayangkara Kendari Hospital.It is not only the occupational safety and health commitment from the hospital leadership that is implemented but the occupational safety and health commitment must also be implemented by all employees at Bhayangkara Kendari Hospital.This policy is based on the Decree of the Head of Bhayangkara Kendari Hospital number: KEP / 70 / I / 2022 concerning the Policy for Establishing a Facilities and Safety Management Team (MFK) for Bhayangkara Kendari Hospital.
Based on this statement, if you look at the regulations in Minister of Health Regulation No. 66 of 2016 concerning occupational safety and health, there are similarities in the implementation of occupational safety and health in hospitals, the highest leadership of the Hospital must be committed to planning, implementing, reviewing and improving the implementation of occupational safety and health.hospitals in a systematic manner from time to time in every activity by implementing good occupational health and safety management.Hospitals must comply with applicable laws, regulations and provisions(8).This research is in accordance with research conducted by Ibrahim at the Haji Makassar Regional General Hospital.Implementing occupational safety and health in hospitals is very important because implementing occupational safety and health is the hospital's obligation to fulfill regulatory demands in the accreditation process and occupational safety and health is a one of the assessments for this accreditation (Ibrahim, 2018) and research conducted by Maringka at the Robert Wolter Mongisidi Hospital stated that the Hospital had issued a written occupational safety and health policy which was directly signed by the Hospital leadership and implemented by all Hospital employees (9).
According to researchers, the occupational safety and health commitment implemented in hospitals should be socialized in various ways, such as strengthening the occupational safety and health culture from management to employees, giving strict sanctions to anyone who violates occupational safety and health policies, and leaders will be better provide direct outreach to all employees.

Hospital Occupational Safety and Health Facilities and Infrastructure
Occupational safety and health facilities and infrastructure include the implementation of occupational safety and health policies.Occupational safety and health facilities and infrastructure must be provided to support the implementation of occupational safety and health in hospitals.Based on the results of interviews with the Head of Bhayangkara Kendari Hospital, the facilities and infrastructure are available in each section, including personal protective equipment, fire control equipment, occupational safety and health signs, standard operational procedures and even human resources themselves are a means of implementing safety and occupational health.However, fulfilling all the equipment and carrying out maintenance requires an appropriate budget.
Based on this statement, if you look at the regulations in Minister of Health Regulation No. 66 of 2016 concerning Occupational Safety and Health, there are similarities, such as in the implementation of Occupational Safety and Health in Hospitals, adequate budget allocation and other infrastructure are required.This is part of the hospital leadership's commitment.The budget allocation for the Hospital Occupational Safety and Health program should not be considered as mere expenditure, but the Hospital Occupational Safety and Health budget needs to be viewed as an asset or investment where Hospital Occupational Safety and Health efforts emphasize the aspect of preventing the occurrence of various major safety and security problems.health which if it occurs will cause enormous losses (10) Research conducted by Ibrahim at Haji Hospital Makassar shows that the Hospital Occupational Safety and Health team collaborates with the Hospital Facilities and Infrastructure Maintenance Installation (IPRS) team to identify, monitor, equip, maintain and update the Occupational Safety and Health facilities and infrastructure that required (11).

Professional Human Resources in the Field of Hospital Occupational Safety and Health
Human resources are the most important aspect in the implementation of Occupational Safety and Health at the Hospital.In implementing Hospital Occupational Safety and Health at Bhayangkara Kendari Hospital, credibility is needed from the Human Resources themselves so that the implementation of Hospital Occupational Safety and Health can run effectively, efficiently and sustainably.
Bhayangkara to occupational safety and health, having an occupational safety and health culture in the hospital, and following applicable occupational safety and health regulations so that it is not only occupational safety and health human resources who have knowledge occupational safety and health but all employees have basic knowledge of occupational safety and health.Based on this statement, if you look at the regulations in Minister of Health No. 66 of 2016 concerning occupational safety and health, there are similarities such as human resources in the field of occupational safety and health, which is an important component in the implementation of occupational safety and health, because human resources are the implementers of managerial activities.and operational implementation of occupational safety and health.Other elements in the hospital, such as facilities, infrastructure and other capital, will not be able to run well without intervention from human resources for occupational health and safety.Therefore, human resources for occupational safety and health are important factors so that the implementation of occupational safety and health can run efficiently, effectively and sustainably (4).

Planning
Occupational safety and health planning is part of the process in the occupational safety and health management system at Bhayangkara Kendari Hospital.There are several things that shape the implementation of occupational safety and health planning, namely risk management design and occupational safety and health programs (12).

Risk management a. Risk Identification
Bhayangkara Kendari Hospital in identifying, evaluating and reducing Occupational Safety and Health risks, it is necessary to carry out risk management to develop and implement the Occupational Safety and Health program.Identifying potential hazards is not carried out by the Hospital's Occupational Safety and Health agency itself but carried out by each committee according to the type of work and the potential dangers posed, with examples such as the facilities and infrastructure committee identifying the risks of using medical devices, identifying the risks of misuse of medical devices.The B3 Committee identifies the risks of spilled chemicals, incorrect placement, room temperature and B3 waste.However, the deficiency in the risk identification process at Bhayangkara Kendari Hospital is that it does not measure the work environment as part of identifying potential hazards, based on the results of observations and statements from the Head of the Occupational Sanitation and Safety and Health Section that Bhayangkara Kendari Hospital only measures estimates by the committee or the person responsible for identifying occupational safety and health risks.b.Risk Analysis Bhayangkara Level III Kendari Hospital analyzes risks using the severity level and the level of possibility for this risk to occur.Determination of the level of severity and level of possibility is assessed from the magnitude and duration of exposure to hazards to workers, workload, work behavior and personal hygiene c.Risk Evaluation Risk Evaluation is the process of comparing the level of risk that has been assessed with predetermined standard criteria.At this stage, the level of risk that has been assessed in the previous stage is compared with the standards that have been set.However, based on the results of interviews and document reviews at Bhayangkara Kendari Hospital, the hospital did not carry out this risk evaluation.

d. Risk Control
According to Minister of Health Regulation No. 66 of 2016.The principles of risk control include 5 hierarchies, namely eliminating danger (elimination), replacing the source of risk with other means/equipment with a lower/nonexistent risk level (substitution), engineering/technical control, and control administratively, Personal Protective Equipment (PPE (13).
Based on data from interviews and observational studies, the researchers compared the data with the principle of risk control hierarchy and found that Bhayangkara Kendari Hospital carried out risk control from the weakest level, namely level 5 Personal Protective Equipment (PPE) and level 4 administrative control.
The implementation of risk management carried out at Bhayangkara Kendari Hospital is in line with Purba's 2020 research at Mitra Sejati General Hospital Medan that the formation of the program carried out has been established and has guidelines for dealing with Occupational Safety and Health in Hospitals.(14).The establishment of risk management aims to meet predetermined achievements based on indicators from each hospital unit.
.47191/ijcsrr/V7-i6-72, Impact Factor: 7.943 IJCSRR @ 2024 www.ijcsrr.org4208 * Corresponding Author: Mubarak Volume 07 Issue 06 June 2024 Available at: www.ijcsrr.orgPage No. 4205-4214 Kendari Hospital provides one technical staff who has received accreditation training in General Occupational Health and Safety from the Ministry of Manpower.However, Bhayangkara Kendari Hospital does not facilitate other Human Resources to have expertise certification regarding Occupational Safety and Health.The only Human Resources that are prioritized to have certification are Human Resources who are members of the Occupational Safety and Health committee and almost all employees receive direct practice.regarding the science of Hospital Occupational Safety and Health.The provision of professional Human Resources in the field of Occupational Safety and Health at Bhayangkara Kendari Hospital is in contrast to research conducted by Maringka at Robert Wolter Mongisidi Hospital where the Hospital provides training to potential Human Resources regarding Occupational Safety and Health and team leaders.Hospital Occupational Safety and Health participates in training from the National Certificate and Professional Agency (BNSP) every 3 years (9).According to researchers regarding the provision of professional human resources in the field of occupational safety and health in hospitals, it is mandatory to meet the standardization of human resources for occupational safety and health according to the Ministry of Health of the Republic of Indonesia no: 1087/MENKES/SK/VIII/2010 for class C general hospitals and all employees must be equipped with occupational safety and health knowledge such as attending training, strengthening commitment

ISSN: 2581-8341 Volume 07 Issue 06 June 2024 DOI: 10.47191/ijcsrr/V7-i6-72, Impact Factor: 7.943 IJCSRR @ 2024 www.ijcsrr.org 4207 * Corresponding Author: Mubarak Volume 07 Issue 06 June 2024 Available
The key informant is the Head of Bhayangkara Kendari Hospital.There were 10 other supporting informants.Data collection was carried out using an in-depth interview method consisting of the Head of Bhayangkara Hospital,Headof Facilities and Safety Management (MFK), Hospital Occupational Safety and Health Coordinator, Security Coordinator, Environmental Health Coordinator, Hazardous and Toxic Materials, Fire Protection Coordinator, Equipment Coordinator Medical, Utility Systems Coordinator, Emergency and Disaster Management Coordinator, Construction and Renovation Coordinator, Training Coordinator(7).