Objectives This study examined the impact of hospital readiness on patient safety from the healthcare workers' perspective. Design The study employed a mixed-methods explanatory sequential design, with the quantitative phase taking precedence. We conducted an online survey of 235 healthcare workers at COVID-19 referral hospitals, followed by an interview with 11 participants from various hospital types. Setting COVID-19 referral hospitals in Indonesia. Participants Health workers working at COVID-19 referral hospitals. Measures Hospital ownership; hospital accreditation status; hospital readiness including incident management system, surge capacity, infection control and prevention, and human resource management; patient safety incident. Results According to the survey, 66.4% of the participants worked at a hospital owned by the provincial or district government, and 69.4% worked at a hospital which had received an excellent status accreditation. More than 80% of the hospitals scored well in the categories of the incident management system (86%), surge capacity (80.9%), infection control and prevention (97.9%), and human resource management (84.7%). However, only 50.6% of the hospitals scored well in managing patient safety incidents. Hospital ownership, accreditation status and hospital readiness all have an impact on patient safety incidents, which were reported in all types of hospitals by both studies. Conclusions This study provides significant results for Indonesia in terms of hospital preparedness and patient safety for the COVID-19 pandemic. The accreditation and ownership status of the hospital have aided hospital readiness. Despite the fact that no hospital in the world was prepared for the COVID-19 pandemic, hospital readiness has improved a year later; however, patient safety has not improved. Patient safety incidents occurred regardless of hospital status, with the most common occurrence being delayed treatment. Administrative errors were also recorded in COVID-19 field hospitals that were not accredited. Future research should focus on improving pandemic care quality and implementing initiatives that are applicable to all types of hospitals.

Original languageEnglish
Article numbere061702
JournalBMJ Open
Issue number7
Publication statusPublished - 22 Jul 2022


  • COVID-19
  • accreditation
  • patient safety
  • surge capacity


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