Self-Assessment Instrument for the Implementation of Occupational Health in Hospitals

This research is a qualitative exploratory study, conducted from May 2024 to March 2025, developed a semi-quantitative <b>instrument prototype</b> to assess occupational health service programs in hospitals by first identifying risk factors through an in-depth literature review of Health Risk Assessments (HRA) and occupational disease case reports, then collecting primary data via in-depth interviews (with managers from hospital OSH, IPC, medical services, emergency departments, medical support, and nursing, selected by saturation and a one-year minimum tenure criterion) and field observations at three purposively sampled accredited Type B hospitals (representing government, private, and teaching institutions for accessibility and resource adequacy); the interview and observation data were analyzed using thematic analysis to identify five key workplace health risk factor groups (environment, ergonomics, workers' somatic conditions, worker behavior, and work organization/culture), which informed the adaptation and modification of OSHA's Hospital Safety and Health Management System Self-Assessment Questionnaire into the prototype, which was subsequently validated through a two-day Focus Group Discussion (FGD) with experts, practitioners, professional organizations, regulators, and hospital directors (also selected by saturation and a one-year minimum position criterion); the study received ethical approval from the Rumah Sakit Universitas Indonesia Institutional Review Board (Approval No. S-091/KETLIT/RSUI/VII/2024), with written informed consent obtained from all participants, ensured anonymity, and secured all identifiable data to adhere to legal and ethical requirements.

本研究为质性探索性研究，实施周期为2024年5月至2025年3月，旨在开发一款半定量**工具原型（instrument prototype）**以评估医院职业健康服务项目。研究首先通过对健康风险评估（Health Risk Assessments, HRA）及职业病病例报告开展深入文献综述，明确相关风险因子；随后通过两种方式采集一手数据：其一为深度访谈，访谈对象为医院职业安全与健康（OSH）、感染预防与控制（IPC）、医疗服务、急诊科、医疗辅助及护理部门的管理人员，招募标准采用饱和抽样法且需满足入职满一年的要求；其二为实地观察，观察对象为经目的性抽样选取的3家认证乙类医院，覆盖公立、民营及教学三类机构，以保障研究的可及性与资源充足性。研究采用主题分析法对访谈与观察数据进行分析，识别出五大类职场健康风险因子群组，即环境、人机工效、劳动者躯体健康状况、劳动者行为、工作组织与文化。基于上述分析结果，本研究对美国职业安全与健康管理局（OSHA）的《医院安全与健康管理体系自我评估问卷》进行适配与修订，形成本次开发的工具原型；随后通过为期两天的焦点小组讨论（Focus Group Discussion, FGD）对该原型进行验证，参与讨论的人员包括专家、从业者、专业组织代表、监管人员及医院管理者，招募标准同样为饱和抽样法且需满足任职满一年的要求。本研究已获得印度尼西亚大学医院伦理审查委员会的伦理批准（批准号：S-091/KETLIT/RSUI/VII/2024），所有参与者均已签署书面知情同意书，研究保障了参与者的匿名性，并对所有可识别信息进行加密存储，以符合相关法律法规与伦理准则。