Risk Management Implementation in Primary Health Care Quality Improvement: A Qualitative Case Study at Siriwo Community Health Center
DOI:
https://doi.org/10.54832/phj.v8i1.1448Keywords:
Patient Safety; Primary Health Care; Risk ManagementAbstract
Introduction: Primary health care plays a vital role in ensuring equitable access to essential health services; however, quality and patient safety gaps remain significant, particularly in resource-limited settings. Risk management is recognized as a governance strategy for reducing preventable harm and improving service quality, yet its implementation at the facility level is often inconsistent.
Objectives: This study aimed to examine how risk management was implemented and its contribution to improving service quality at Siriwo Primary Health Care in Indonesia.
Methods: A qualitative single-case study design was conducted. Participants included the health center director, quality improvement officers, health professionals, and administrative staff with at least 1 year of experience. Data were collected through in-depth semi-structured interviews, non-participant observations, and document reviews. All interviews were audio-recorded and transcribed verbatim. Data were analyzed thematically using coding, categorization, and theme development. Triangulation across data sources was applied to enhance credibility and rigor.
Results: Risk management was implemented progressively through risk identification, assessment, and control integrated into routine service activities. Key risks included patient safety incidents, service delays, procedural errors, supply limitations, and human resource constraints. The implementation strengthened adherence to standard operating procedures, improved internal monitoring, enhanced staff awareness of patient safety, reduced the recurrence of complaints, and increased perceived community satisfaction.
Conclusions: Integrating structured risk management into daily operations improved service quality and fostered a stronger patient safety culture. Context-adapted risk governance may be an effective strategy for enhancing primary health care performance in resource-limited settings.
Downloads
References
Aswad, F., Lestari, Y., & Yetti, H. (2025). Journal la medihealtico. 06(01), 172–180. https://doi.org/10.37899/journallamedihealtico.v6i1.1845
Basuki, P. L., & Setiawan, R. (2022). Implementation of Enterprise Risk Management in Medium- Sized Priority Sector Companies in East Java. Jurnal Akuntansi Dan Keuangan, 24(2), 80–90. https://doi.org/10.9744/jak.24.2.
Chaneliere, M., Poyau, K. B., Gascou, M. K., Rabilloud, M., Colin, C., Jacques, C. L., & Touzet, S. (2024). A multifaceted risk management program to improve the reporting rate of patient safety incidents in primary care: a cluster-randomised controlled trial. BMC Primary Care, 25, 244–258. https://doi.org/10.1186/s12875-024-02476-4
Ferial, L., & Wahyuni, N. (2022). Mutu pelayanan kesehatan meningkat dengan menerapkan keselamatan pasien di puskesmas. Jurnal JOUBAHS, 2(1), 36–46.
Goldberg, D. G., Owens-jasey, C., Haghighat, S., & Kavalloor, S. (2023). Implementation strategies for large scale quality improvement initiatives in primary care settings : a qualitative assessment. BMC Primary Care, 24, 242–251. https://doi.org/10.1186/s12875-023-02200-8
Hardy, S. M., & Paramarta, V. (2025). International Journal of Economics , Accounting , and Management Impact of Risk Management , Safety Culture , and Service Quality on Patient Satisfaction. International Journal of Economics, Accounting, and Management, 1(6), 358–365.
Harkensia, L. S., Budi, S., Atikah, N., & Maulani, U. (2025). Implementasi Manajemen Risiko Keperawatan untuk Meningkatkan Keselamatan Pasien di Puskesmas Kabupaten Aceh Utara. Future Academia, 3(2), 525–530. https://doi.org/10.61579/future.v3i2.456
Heinzova, R., Peterek, K., & Hoke, E. (2021). Risk Management in Health Care Organizations in the Czech Republic. Chemical Engineering Transactions, 86, 271–276. https://doi.org/10.3303/CET2186046
Lestari, T. R. P. (2018). Upaya Peningkatan Mutu Pelayanan di Puskesmas Melalui Pendekatan Manajemen Sumberdaya Manusia Kesehatan. Kajian, 128, 157–174.
Naidoo, M., & Suthiram, K. T. (2025). Optimising clinical governance and risk management in resource-limited hospitals : A family medicine model. African Journal of Primary Health Care & Family Medicine, 17(1), 1–5. https://doi.org/10.4102/ phcfm.v17i1.4876 Copyright:
Nasrullah. (2024). Analisis Peningkatan Mutu Pelayanan Kesehatan Upaya Keselamatan Pasien Di Puskesmas Pembantu X Lombok Barat. Jurnal Tampiasih, 3(46).
Oluoch, G. B., & Kisimbii, J. (2021). Risk Management Strategies and Implementation of Healthcare Projects in Low Resources Countries George Bernard Oluoch & Dr . John Bosco Kisimbii ISSN : 2616-8464 Risk Management Strategies and Implementation of Healthcare Projects in Low Resources Countri. Journal of Entrepreneurship & Project Management, 5(1), 81–105.
Park, S. J., & Sharp, A. L. (2019). Improving health and health care efficiency through risk management. Journal of Hospital Management and Health Policy, 3, 9–11. https://doi.org/10.21037/jhmhp.2019.04.02
Qurrotaayun, S. F., Sabilla, R. N., Lestari, D. M., Anastasia, V. W., Noufalwafiq, M. R., Aisyah, S., & Fauzi, H. (2025). Literature Review: Dampak Akreditasi Fasilitas Kesehatan terhadap Efektivitas Sistem Pengawasan Manajemen. Jurnal Kesehatan Cendekia Jenius, 2(3).
Rumondang, P. R., Tanggono, A., Erlan, A., & Herdyana, E. (2025). ( Natural Sciences ） October 2025 Risk Management Innovation to Improve Service Quality and National Patient Safety. Journal of Hunan University (Natural Science)Ience), 52(10). https://doi.org/10.55463/issn.1674-2974.52.10.5
Saputro, L. E., Suyuthi, N. F., & Muin, S. A. (2023). Implementation of Strategic Risk Management in Improving the Quality of Services. Journal La Bisecoman, 04(04), 225–240. https://doi.org/10.37899/journallabisecoman.v4i4.1684
World Health Organization. (2023). Risk Management Strategy. https://www.who.int/publications/m/item/risk-management-strategy
Yostin, A. N., Nofierni, & Tahjoo, A. (2023). The Development of Clinical Risk Management Impelmentation Model in Improving Quality and Patient Safety. Healthsains, 04(06), 44–59.
