Hospital Occupational Safety and Health Management System based

on Internet of Things (IoT)

A. D. Nasution

and E. L. Mahyuni

Hospital Equipment Departement, Universitas Sumatera Utara, Jl dr. Mansyur 06, Medan Indonesia

Faculty of Public Health, University Street, 21 Campus Universitas Sumatera Utara, Medan Indonesia

Keywords: The Hospital, OSH-MS, Hospital of OSH, Hazard, Risk.

Abstract: The Hospital as the intensive of labor, expert, capital and technology industries have potential hazards and

complexity of risk that could increase work-related accidents or occupational diseases. To solve that, the

hospital has to implement the occupational safety and health which integrated into hospital management

system. The purpose of this research is to develop the implementation of Occupational Safety and Health

Management System (OSH-MS) that integrated to services for reach patient and hospital safety. The output

of this research is the Guidelines of Occupational Safety and Health Procedures based on technology 4.0

(Internet of Things). This study is explanatory research conducted at Hospital University of North Sumatra

Medan from January 2018 to November 2018. The populations are Occupational Safety and Health teams

and the management board of the hospital and sample selected by purposive technique sampling. Data

collected by observation and interview and will be analyzed by using descriptive statistics based on the

basic principles of OSH Management System and applicable regulatory standards. The result showed that

the base principal case of uncomplete OSH-MS application cause by lack of human resources that

competence in OSH management. For implement the program just doing by one staff and lack of

coordination with each unit at hospital. The impact of that, all program couldn’t be realize by schedule. The

one of difficulties of OSH-MS implementation is over tasking in duty and low of OSH socialization for

overall unit of hospital. Recommended to H-OSH management system implementation could be planned

programmatically and executed by applying computer-based information system of the computer.

1 INTRODUCTION

In globalization period, the demand for management

of Occupational Safety and Health (OSH) programs

increased, especially Hospitals Occupational Safety

and Health (H-OSH). It caused of the medical

provider, paramedics, and others, visitors, patients

and communities around the hospital should be

protected from occupational Regulation of the

Minister of Health Republic of Indonesia Number 66

of 2016, requires hospitals to implement OSH that

integrated into hospital management system. health

problems and accidents, either as the impact of

health service delivery activities or due to the

condition of facilities and infrastructure in hospitals

that have not met the standards. Based on the Decree

of the Minister of Health Number 1087 / MENKES /

SK / VIII / 2010 which was renewed to hospitals in

the intensive of labor, expert, capital and technology

industries have potential hazards and complexity of

risk that could increase work-related accidents or

occupational diseases. In addition to

Paper will be part of the conference proceedings

therefore we ask that authors follow the guidelines

explained in this example and in the file

«FormatContentsForAuthors.pdf»also on the zip

file, in order to achieve the highest quality possible

(Smith, 1998). being required to provide quality

services and treatment, the hospital has to be a

hospital safety to protect patients, visitors, workers

and communities around the hospital from various

potential hazards in the hospital. For that, the

purpose of H-OSH program must be implemented

and developed in an integrated and comprehensive.

Implementation of health services and

management systems in the hospital strived to

follow the development of technology by the

development of industrial revolution 4.0. The

industrial revolution 4.0 is characterized by a cyber-

physical system which every industry uses a virtual

Nasution, A. and Mahyuni, E.

Hospital Occupational Safety and Health Management System based on Internet of Things (IoT).

DOI: 10.5220/0010076004950499

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

495-499

ISBN: 978-989-758-449-7

495

world, in the form of human connectivity, machines,

and data otherwise known as the Internet of Things

(IoT). The implementation of IoT could improve the

quality of life and make the hospital able to compete

with the other hospital services.

Hospital University of Sumatera Utara is a

hospital that provides health care nuanced education

and global to the community, especially the people

who are in Medan. Based on the preliminary survey

conducted, the hospital has H-OSH team in hospital

management structure. Fulfillment of OSH signs for

building safety is quite well done, including signs of

building safety and fire safety with the APAR and

evacuation routes. However, H-OSH

implementation is still not optimized to implement

the program into services or guarantee activities of

health provider. This condition caused by the

absence of H-OSH Management System which is

fully integrated into the hospital environment.

The purpose of this study is to develop the

implementation of Occupational Safety and Health

Management System (OSH-MS) integrated into

hospital service process to reach patient and hospital

safety. The development adapted to the industrial

2 MATERIAL AND METHOD

Materials in this study are documents and activities

of health workers in the hospital environment related

to the implementation of OSH in hospitals. This is

an explanatory research using the qualitative

approach. This study was conducted in the period

from January 2018 to June 2018. The populations

were the H-OSH team and the management board of

the hospital. The sample reach by purposive

technique sampling.

The method of data collection is done by

observation and in-depth interview about H-OSH

implementation and conformity of OSH-MS.

Secondary data is collected by conducting the re-

evaluation of supporting documents including

policies, Standard Operating Procedure, technical

guidelines as well as matters relating to H-OSH

implementation. The result will be analyzed by

using phenomenology analysis with themes as an

analytical unit based on the basic principles of OSH-

MS and applicable regulatory standards

3 RESULT AND DISCUSSION

The Occupational Safety and Health Management

System (OSH-MS) is a reference for hospital

management to create a safe, healthy and productive

work environment for hospital staff, patients,

visitors, communities and the environment of the

hospital that create the hospital services process in

the running well and smoothly. Implementation of

OSH-MS refers to the Regulation of the Minister of

Health Republic Indonesia Number 66 of 2016 on

Hospital Occupational Safety and Health. The

implementation of OSH-MS cycle includes H-OSH

Policy, H-OSH Planning, Implementation of H-OSH

Plan, Monitoring and Evaluation of H-OSH

Performance and Review and Improvement of H-

OSH Performance. Implementation of OSH-MS is

responsible by Hospital-OSH Unit that divide in

little structure of organization with two persons as

the staff. Based on the interview and discussion with

staff of H-OSH Unit and develop by observation to

identify the OSH-MS implementation, it found some

problems divided into five basic principal of OSH-

MS.

3.1 Establishment of H-OSH Policy

The determinate of H-OSH policy has been well

implemented. This is indicated by the positive

appreciation and commitment from the management.

Initially, the existing H-OSH consisted of only one

person with multiple roles and within the structure

of the H-OSH Team which included the section on

the Patient Quality and Safety Committee. Given the

widely and comprehensive scope of H-OSH

implementation, the H-OSH team's research turned

into the H-OSH Unit consisting of three people with

one H-OSH expert and more structured

Establishment of H-OSH Unit is by the

provisions outlined in Labour Regulation No. Per-

04/ Men /1987. However, in the implementation, the

H-OSH Unit should be integrated with the

representation of each competency by the

complexity of positions in the hospital resulting

from the complexity of the services provided. The

hospital demands the presence of doctors, nurses,

midwives, dentists, labors, analysts, pharmacists,

paramedics and other competencies. The complexity

of these competencies surely provides different roles

and hazards in the service delivery process at the

hospital. Therefore, the cooperation between these

competencies must be incorporated within the scope

of OSH to create a safe and healthy work

environment as a form of achievement of good OSH

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

496

performance. Based on some previous research

states that competence has a significant effect on

employee performance.

3.2 H-OSH Planning

Based on the results of research, the OSH team said

that the Hospital had the H-OSH planning as stated

in OSH Program. The work program is prepared to

refer to the applicable regulations. The planning is

arranged in one period of 2016-2017. However, the

program has not yet covered decomposed in the

Decree of the Minister of Health Number 1087 /

MENKES / SK / VIII / 2010. OSH planning also has

not been contained in technical guidelines or the

existence of written forms and procedures. This can

affect how the next implementation in work

programs that have been prepared.

Therefore, OSH planning should also be

contained in hospital strategic plan and can be

disseminated through computer-based hospital

information system. Hospital Information System

should be developed to overcome the shortcomings

and inconsistencies between work units. For

example, the incongruence begins with the

complexity of the types in actions and services that

must be provided to each unit in unified

coordination.

3.3 Implementation of H-OSH Plan

The schedule of the programs has prepared in well-

timed. But the program has not been implemented

maximally. Based on interview, it causes by the lack

of OSH executive staff in hospitals and the

implementation still not integrated also cultivation

of safe and healthy work in the hospital

environment. Occupational Safety and Health

culture is a combination of attitude, beliefs, norms,

and perceptions of certain organizations related to

OSH climate and safe and healthy practice. The

most important issue in establishing a safety culture

is based on the working climate of a supportive

workplace to promote safety and health behaviour at

all times during work. Implementation OSH plan

also indicated by the absence of implementation

guidance H-OSH socialized to all units in the

hospital. Therefore, the pattern of health care work

in given the patient priorities and not paying

attention to safety and the risk that could be

experienced by the health provider. This situation is

supported by the knowledge of health care workers

who prioritize the target achievement of the work

than to maintain the safety and health. According to

WHO, a person can behave certain regarding

applying OSH due to four main reasons namely

knowledge, perception, attitude and trust. These four

things must support each other. By the results of

research which states that the implementation of

OSH in hospitals can be quite good as much as 68%

associated with knowledge of OSH enough, good

individual attitude and information of OSH that

reach by health workers.

Implementation of H-OSH can also be hampered

by the lack of facilities used in the services

provided. For example one of the units studied in

this research is the hemodialysis section. From

observation, it found that the sake of safety, the user

is required to have differentiation in sterilizing the

tube hemodialysis, but the hospital has only one unit

of sterilization equipment. This situation requires

officers to sterilize infectious patients manually to

avoid transmission of the disease to other non-

infectious patients. This manual work pattern may

increase the risk of workplace accidents or illnesses

because the possibility of direct contact may occur

concerning biological factors derived from

pathogenic germs from patients.

Also, hospitals waste management hampered due

to the minimum housekeeping officers to collect

medical and nonmedical waste. In collected the

medical or non-medical waste from each room,

officers still combine the medical and nonmedical

waste in a trolley/garbage train even it has been

classified in different colour plastics from each unit.

Medical waste is very important to be managed

properly and specifically because it can be

categorized as hazardous and toxic waste and

classified as an infectious. Improper management

will pose a risk for disease transmission. Based on

the results of interviews conducted, some of the

phenomena is due to lack of officers’ knowledge

about occupational safety and health. Officers also

adjust the work with existing tasks and facilities to

avoid repeated collection. The work environment of

the hospital should consider the physical aspects that

may affect the work. Based on the results of the

study found many health and safety risks that can

occur in workers at hospital include eye exhaustion

due to poor lighting, the risk of falling, work time

that exceeds standards and workloads are not in

accordance with the capacity so that increasing

fatigue in workers, limited work space, and poor

APAR evaluation.

Hospital Occupational Safety and Health Management System based on Internet of Things (IoT)

497

3.4 Monitoring and Evaluation of

H-OSH Performance

Monitoring and evaluation of H-OSH performance

has not been done well where the implementation

cycle of risk management not in Plan of Action

periodically. The process of supervision of OSH

implementation also has not run because of the lack

of members in organizing OSH Unit. It also has not

developed with maximum considering the

competence of officers arranged in organizing H-

OSH units still have one person who has the

competence of OSH. Workload to be carried out

exceeds the amount and capacity owned, so that

reasonable program that has been arranged well

couldn’t be done perfectly. The results show that

workload and individual characteristics in

significantly positive effect on burnout and worker

performance. The impact of this maximal

performance can lead to dissatisfaction in working.

Therefore, the factors that trigger this dissatisfaction

must be anticipated for the sake of management's

sustainability in hospital. Based on research the

factors of dissatisfaction related to policy and

reward. The dominant factors of work content that

lead to job satisfaction are the factors of appreciation

and autonomy, the dominant factors of the work

environment are the relationships with colleagues,

relationships with the direct supervisor and

workplace conditions (Subhan, 2018).

3.5 Review and Improvement of

H-OSH Performance

The review and improvement of H-OSH

performance have not been carried out according to

the circumstances of the four cycles described

earlier. This cycle could be done if the hospital can

jointly conduct an internal audit of OSH

implementation as an effort to maintain occupational

safety and health. The results of the audit become

inputs for the continuous improvement of the OSH

programs that have been prepared by the H-OSH

Unit. This is certainly supported by relevant

management inputs from resources, work facilities,

finances, and method. Based on the development of

industrial revolution 4.0, to support socialization and

OSH culture in hospital to be integrated as a whole

can be done by socialization using cyber physics

The communication of safety messages is not only

done manually through safety briefing, posters,

banners or safety signs, but supported by online such

as the socialization of H-OSH implementation

guidelines in every computer window, the video

Tron explaining about the hospital and safety video

in case of accident or even disaster (extraordinary

events), as well as safety messages delivered

through running text in strategic places and can be

known to every user of hospital services.

4 CONCLUSIONS

Based on the results, it concluded that the

implementation of OSH Management System at

USU Hospital has not been in maximum

implemented. The factors that need to be considered

include the lack of human resources, facilities that

need to be improved along with the increase of

hospital service users, the maintenance of the work

environment, job satisfaction and the lack of

socialization of the OSH implementation which is

integrated as a whole in the hospital environment.

Recommended to H-OSH management system

implementation could be planned programmatically

and executed by applying computer-based

information system of the computer. Socialization to

integrate of OSH to all parts in hospital could be

done openly through the service information

contained in cyber physics and known by all users of

the hospital through computers, banners, video Tron,

and running text.

ACKNOWLEDGEMENTS

We would like to thank the Hospital of USU and

Unit H-OSH which has been supporting in

conducting this research as an effort to develop

related in hospital in implementation of safety and

health. This research also be done financed by

TALENTA USU in Hospital of USU development

schema of Research on accordance with the contract

of research implementation Number 67 / UN5.2.3.1 /

PPM / KP-TALENTA USU / 2018.

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