PATIENT SAFETY EVALUATION IN RADIODIAGNOSIS SERVICES IN GOVERNMENT AND PRIVATE HOSPITALS IN NORTH SUMATERA

Abstract

Patient safety in diagnostic radiology is a critical component of healthcare quality, directly impacting patient outcomes and the efficiency of medical diagnostics. Despite advancements in imaging technology, incidents related to radiation exposure, misdiagnosis, and procedural errors continue to pose significant risks. Recent global trends highlight an increasing demand for sophisticated diagnostic imaging, yet concurrently, reports suggest persistent challenges in implementing robust safety protocols, particularly in resource-constrained settings. In Indonesia, while the importance of patient safety is recognized, a comprehensive understanding of its status within the specific context of radiodiagnostic services across different hospital types remains elusive. This gap is particularly pronounced in regions like North Sumatra, where a disparity in healthcare infrastructure and regulatory enforcement between public and private institutions may lead to differential safety practices. Therefore, a systematic evaluation is urgently needed to identify these disparities and inform targeted interventions. This study aimed to comprehensively evaluate and compare the implementation of patient safety practices in diagnostic radiology services between public and private hospitals in North Sumatra, specifically seeking to identify the current status of patient safety protocols, assess the level of adherence to established standards, and investigate potential influencing factors, thereby contributing to the theoretical understanding of safety culture in diverse healthcare environments, as conceptualized by the Agency for Healthcare Research and Quality (AHRQ) patient safety framework. A comparative, cross-sectional study design was employed, utilizing a mixed-methods approach to provide a holistic evaluation. The study sample comprised 200 radiographers and radiology technicians, equally distributed between 10 public hospitals and 10 private hospitals in North Sumatra, selected through a stratified random sampling technique to ensure representativeness. Data were collected using a validated self-administered questionnaire, assessing knowledge, attitudes, and practices related to patient safety in radiology, which demonstrated a Cronbach's alpha of 0.88 for reliability and content validity index (CVI) of 0.92. This was supplemented by structured observation checklists for key safety procedures and qualitative semi-structured interviews with selected personnel to explore contextual factors. Statistical analysis included descriptive statistics, independent samples t-tests, and chi-square tests to compare practices between hospital types, with a significance level set at p < 0.05. The findings revealed significant differences in patient safety practices between public and private hospitals. Overall adherence to radiation protection protocols was higher in private hospitals (mean score = 4.2 ± 0.6) compared to public hospitals (mean score = 3.5 ± 0.7), with a statistically significant difference (t(198) = 7.87, p < 0.001, Cohen's d = 1.11). Specifically, private hospitals demonstrated superior implementation of quality assurance measures and patient identification procedures. However, a notable finding across both sectors was the inconsistent application of informed consent for contrast media use. Qualitative data highlighted that while private hospitals often possessed more advanced equipment and better-maintained facilities, staff training and continuous professional development opportunities were more prevalent in public institutions, suggesting a nuanced interplay of resources and human capital in shaping safety culture. This study concludes that while private hospitals in North Sumatra generally exhibit higher adherence to patient safety practices in diagnostic radiology, both sectors face challenges requiring targeted interventions. The findings underscore the need for standardized training programs, robust regulatory oversight, and a proactive safety culture across all healthcare facilities. Theoretically, this research contributes to the understanding of how organizational factors and resource allocation influence patient safety implementation. Practically, it provides evidence-based recommendations for policymakers and hospital administrators to enhance patient safety in radiodiagnostic services, potentially reducing adverse events and improving diagnostic accuracy. Future research should explore the long-term impact of specific interventions and investigate patient perspectives on safety in radiology.