How to cite:
Eka Rakhmat Kabul, Subhan Nur Ramadhan, Sukiman, Harries
Madiistriyatno. (2022). Analysis of Safety Management System
Implementation and Occupational Health based on PP No 50 Year
2012. Journal Eduvest. Vol 2(2): 196-206
E-ISSN:
2775-3727
Published by:
https://greenpublisher.id/
Eduvest Journal of Universal Studies
Volume 2 Number 2, February, 2022
p- ISSN 2775-3735- e-ISSN 2775-3727
ANALYSIS OF SAFETY MANAGEMENT SYSTEM
IMPLEMENTATION AND OCCUPATIONAL HEALTH
BASED ON PP NO 50 YEAR 2012
Eka Rakhmat Kabul
1
, Subhan Nur Ramadhan
2
, Sukiman
3
, Harries
Madiistriyatno
4
Persada Indonesia University
1
, Stima IMMI Jakarta, Indonesia
2, 3, 4
ARTICLE INFO ABSTRACT
Received:
January, 26
th
2022
Revised:
February, 17
th
2022
Approved:
February, 18
th
2022
This research aims to know the implementation of
Occupational Health and Safety Management System which
is implemented in RSUD Karawang. Research Methods:
Qualitative Research, descriptive type. The sampling
technique used by the researcher is purposive sample.
Samples were taken as many as 3 employees of RSUD
Karawang as respondents in this study. Result : Leadership
commitments and policies towards the implementation of
K3 already exist and in writing, the facilities and
infrastructure that support the implementation of K3 have
been fulfilled. While the K3 policy at this hospital is the
appointment of the K3 Installation as an officer who
oversees the implementation of K3 at the Karawang
Hospital, the K3 Planning at the Karawang Hospital has
been going well starting from risk identification to risk
management. In addition, workers are also required to
follow SOPs every time they do their work, and workers
have been facilitated with complete PPE by the hospital.
The organization has formed an organization for the K3RS
Installation but it is still found that the workers from the K3
installation have double jobs where the implementation of
the SMK3 program is not optimal. The implementation of
OSH, most of the steps for implementing SMK3 have been
going well at the Karawang Hospital where the Hospital has
Eka Rakhmat Kabul, Subhan Nur Ramadhan, Sukiman, Harries Madiistriyatno
Analysis of Safety Management System Implementation and Occupational Health
based on PP No 50 Year 2012 197
stated a commitment, an OHS organization has been
formed, conducting K3 counseling to workers,
implementing K3 programs such as providing PPE, health
checks, and treating sick workers with provide BPJS
services. The audit at the Karawang Hospital has been
running, where internal and external audits have been
running to find out what are the shortcomings of the K3
program and further correct the shortcomings of the K3
program aimed at improving the K3 program.
KEYWORDS
Hospital OHS Management System, K3RS Installation
This work is licensed under a Creative Commons
Attribution-ShareAlike 4.0 International
INTRODUCTION
The hospital is an organization that through organized professional medical
personnel and permanent medical facilities provides medical services, continuous nursing
care, diagnosis and treatment of diseases suffered by patients, the hospital as a service
industry is an industry that has a variety of labor problems that complicated with various
risks of getting work-related diseases and even work-related accidents according to the
type of work, so it is obligatory to implement safety and security efforts Hospital
Occupational Health (K3RS).
According to the Minister of Health of the Republic of Indonesia Number 66 of
2016 concerning K3RS, it is stated that K3RS is an activity carried out to guarantee and
protect occupational safety and health for hospital workers, patients, visitors and the
hospital environment through efforts to prevent work accidents and occupational diseases
in hospitals (Nasution & Mahyuni, 2020). Usually there are 4 areas that are responsible
for K3RS, including: occupational health, as for the work program of the K3 committee
in the field of occupational health, including: employee health checks, monitoring of the
provision of personal protective equipment, treatment of sick workers, K3 counseling on
occupational health and safety,monitoring and reporting of KAK and PAK (Listyowati,
2021).
Hospital occupational safety and health is a new program for hospitals in
Indonesia, there are only a few hospitals that have a K3RS committee, and even then they
do not have a targeted program (Prasetya, Junaedi, & Prihanto, n.d.). Therefore, there is
no data on the number of disability, illness, and work-related death in hospitals (Sears,
Blanar, Bowman, Adams, & Silverstein, 2013). Seeing this condition, if we rely on these
data, it will be difficult to determine which hospital has a high incidence of accidents and
occupational diseases (Ledford, 2021). So that an initial assessment can be made on the
condition of the hospital and the work behavior of its officers (Berberoglu, 2018).
Because these two things can describe the risks that can be caused and one of the
hospitals that the author considers necessary to research efforts to prevent accidents and
occupational diseases, (in this case the application of SMK3) is the Karawang Regional
General Hospital (Polii, Wuisang, & Wuisang, 2021) (Einstein, 2018).
This study aims to determine how the implementation of the Occupational Health
and Safety Management System is carried out at the Karawang Regional General
Hospital.
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RESEARCH METHOD
This research approach is qualitative, descriptive type. The unit of analysis in this
study were employees of K3 and Management of the Karawang Hospital. This research
was conducted at the Karawang Hospital, Jl. Galuh Mas Raya No. 1 Sukaharja
Telukjambe Timur Karawang, while the time of the research will be carried out for ± 2
months, starting in July-August 2021. Participants or informants of this study were
determined using purposive sampling technique, namely the sampling technique was
based on a specific purpose (the right people were selected) really has the criteria as a
sample) (Manuaba & Darma, 2021). So the researchers decided the first informant or key
informant was most suitable for K3RS employees and Karawang Hospital Management.
From this key informant, interviews with people who have broad knowledge of the
implementation of occupational safety and health management systems will be conducted
(Neke, Gadau, & Wasem, 2018).
Qualitative research must reveal objective truth. Therefore the validity of the data
in a qualitative research is very important. Through the validity of the data, the credibility
(trust) of qualitative research can be achieved.
RESULT AND DISCUSSION
1. SMK 3 Value Analysis 1. SMK3 Value for the Government
In the implementation of SMK3 in Karawang Hospital, it is in accordance with
PP 50 of 2012 and OHSAS 18001 regulations where the value obtained for the
government is that companies that comply with applicable laws and regulations generally
look healthier and exist. Because after all the rules or regulations made are for the good of
all parties (Adorno, 2021). By complying with applicable laws and regulations, the
company will be more orderly and this can improve the good image of the company
itself. How many companies that disobey the applicable regulations experience
bankruptcy or losses due to experiencing many problems with employees, the
government and the local environment.
2. Value of SMK3 for Karawang Hospital
Value obtained by RSUD In implementing SMK3, the safety management system
will be well organized and effective (Bondroini, Kurniawan, & Tistogondo, 2020).
Because inside SMK3 or OHSAS 18001 requires a documented procedure, so that all
activities and activities carried out will be organized, directed, in an orderly corridor and
carried out consistently (Fujianti, Andarini, Aprilisa, Lestari, & Camelia, 2020). Records
as evidence of system implementation are kept to facilitate verification of root cause
identification of non-conformities (Anastasopoulos, Ramakrishnan, & Anastasopoulos,
2019). So that the analysis or identification of non-conformances is not protracted and
widens to be disorganized, which in turn provides inappropriate recommendations or does
not solve the problem (Berzins, Bøhren, & Stacescu, 2018). In this system, planning,
control, review, feedback, improvement and prevention are also required (French,
Deshpande, Evans, & Obregon, 2020). These are all forms of an effective management
system (Kim, Oh, & Lee, 2019). This system also requires management commitment and
participation from all employees, so that the total involvement of management with
Eka Rakhmat Kabul, Subhan Nur Ramadhan, Sukiman, Harries Madiistriyatno
Analysis of Safety Management System Implementation and Occupational Health
based on PP No 50 Year 2012 199
workers is highly demanded in carrying out all programs related to K3. This total
involvement will provide more opportunities to improve the quality of service or make
improvements more effective for hospitals.
3. Value of SMK3 for Customers (Patients)
The value obtained by customers (patients) in the application of SMK3 in
Karawang Hospital, namely in the implementation of SMK3 properly will affect
customer satisfaction. How many customers require their suppliers or suppliers to
implement SMK3 or OHSAS 18001. Because the implementation of SMK3 will be able
to guarantee patient and visitor satisfaction so that they can improve service quality and
improve the quality of good service. Workers will work better, because they are well
protected so they can be more productive. Accidents can be avoided so as to ensure that
the hospital provides full and normal service to ensure the quality of service to customers.
4. Value of SMK3 for Employees
The value obtained for employees in implementing SMK3 in Karawang Hospital
is seen from the main purpose of implementing SMK3 is to protect workers from all
forms of work-related accidents (KAK) and occupational diseases (PAK). However,
employees are the company's most important asset. By implementing K3 the number of
accidents can be reduced or eliminated altogether, this will also benefit the company,
because workers who feel safe from the threat of work accidents and occupational
diseases will work more enthusiastically and productively.
Analysis of SMK3 in Karawang Hospital
1. Commitment and Policy of SMK3 in Karawang Hospital
The commitment and policy of the Karawang Hospital management in
implementing Occupational Safety and Health (K3) is realized by establishing a hospital
occupational safety and health installation. Commitments and policies in the
implementation of occupational safety and health have been written and signed by the
hospital director. Next, the researcher asked about the commitments and policies in the
Karawang Hospital to the interviewees as follows:
Informant 1
―Hospital management's commitment related to K3RS has been realized in written form
regarding K3 which follows the Regulation of the Minister of Health No. 66 of 2016 and
PP No. 50 of 2012, in addition, funding related to K3RS and K3RS facilities has been
carried out. K3 efforts against work accidents have also been carried out by reducing risks
through the use of PPE". ―The Karawang Hospital already has an organization that is
responsible for organizing or implementing K3 namely the K3RS committee/Installation
and there are already hospital human resources who have received K3RS training,
although not all members have received training. The current K3 human resources do not
meet the needs of the workforce in the hospital, where there are still employees who have
double jobs and do not have an K3 background. RSUD Karawang also uses a budget that
comes from the hospital's APBDN and BLUD funds. Where the allocated funds are
sufficient for the work safety program at K3RS. Karawang Hospital also has Complete
PPE, where cabinets and PPE storage boxes are available in every room. And for existing
facilities, repairs will be made if there are reports of damage from the room.‖
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Informant 2
"The policy of the Karawang Hospital has been facilitated, especially for workers by
applying the mandatory use of PPE (gloves, masks, etc.) when exposed to patients and
visitors, and procedures in every job already exist, and we also make rules that all
employees are obliged to carry out their work. in accordance with standard operating
procedures that have been set by the Regulation of the Minister of Health No. 66 of 2016
and PP No. 50 of 2012, later from the K3 Installation or from the PPI Hospital there will
be someone who supervises every work, so later if there are employees who do not follow
the procedures we will give a warning, and if it continues, we will give a warning letter".
Based on the results of the interview seen from the statements of the informants
above, the Karawang Hospital in the Occupational Safety Regulations and Procedures has
been going well, the regulations regarding K3 at the Hospital have been well organized
based on the Minister of Health Regulation No. 66 of 2016 and PP No. 50 of 2012,
structured and easy to understand and reviewed against the relevant K3 regulatory
policies and procedures. In regulations, the implementation of regulations on work safety
has a significant effect on the success of SMK3, this is evidenced by the Karawang
Hospital by establishing regulations on work safety properly and correctly, it will help the
success rate of implementing the Management System Occupational safety and health.
2. Planning for SMK3 in Karawang Hospital
In planning for SMK3 at RSUD Karawang, an effective plan must be made in
order to achieve the successful implementation of an OHS management system with clear
and measurable targets. OHS planning in hospitals can refer to the standards of the
Hospital OHS Management System, including self-assessment of Hospital K3
accreditation and SMK3 following the results of interviews with informants:
Informant 1
"In planning the implementation of K3 at the Karawang Hospital, the first thing the K3
installation does is identify problems or potential hazards where to find out where the
place or environment causes accidents, where the identification results are made a report
once a year in the hospital risk management program".
Informant 2
"The implementation of the program is based on the readiness of the equipment and the
determination of the program is based on the results of meetings with other units and
from the reports given the main priorities are made which will later be used as a work
program by K3RS".
Informant 3
"We are the hospital and the installation"
K3RS collaborates to plan programs on occupational safety and health for employees
where work safety signs are installed in every corner of the hospital that has potential
hazards, and employee health checks are always carried out every 6 months or once a
year to find out whether the employee is exposed to work-related diseases or not, and for
the workers we have completed everything so that workers are always safe and secure‖.
From the results of the interview, it was found that the OHS Planning had been
carried out with various underlying reasons, the informant's answer was dominated that
the planning was carried out by conducting an initial analysis and determining the priority
Eka Rakhmat Kabul, Subhan Nur Ramadhan, Sukiman, Harries Madiistriyatno
Analysis of Safety Management System Implementation and Occupational Health
based on PP No 50 Year 2012 201
of the problem or source of the hazard. And the implementation of PPE equipment for
workers has been fulfilled and PPE equipment for workers is also one of the indicators
that supports the success rate of implementing the occupational safety and health
management system, if you look at the Karawang Hospital, the plan for the work
equipment needed includes signs that can bind workers to work. be more careful, and the
need for PPE that can protect workers from work accidents.
3. Organization of SMK3 in Karawang Hospital
In a clear division of tasks by determining the position of personnel, an organizational
structure for the K3 installation is made so that each personnel can carry out their
functions. Some of the informants' opinions regarding the organization of K3 at the
Karawang Hospital:
Informant 1
―The personnel who manage the K3 installation have been appointed by the Director of
the hospital, but they are still in the form of double jobs. For example, he is the Sanitation
Coordinator who also serves as a K3 field officer to monitor the hospital fire system, and
the work safety system for employees. The personnel assigned to manage the installation
have been taken from people who have a special educational background for K3‖.
Informant 2
―For the K3 installation personnel, some already have an K3 background or certificate but
there are 3 K3 personnel who do not yet have a basic knowledge of hospital K3. And
there are 4 K3 personnel who have workers double job in K3 and sanitation installations
for waste transportation‖.
From the results of the interview, it was obtained that in PP No. 50 of 2021 it is
explained that every hospital is obliged to make an organizational structure for K3 or
P2K3 where the organization is tasked with carrying out occupational safety and health
management and supervising the implementation of K3 by hospital workers. In the
implementation of the organization at the Karawang Hospital, there is already a K3
organization which can facilitate the division of work according to the field and can
support the success rate of implementing a work safety management system.
4. Application of SMK3 in Karawang Hospital
The implementation of occupational safety and health in hospitals has stages including;
preparation, planning, implementation, evaluation, review and improvement stages.
Opinions from interviews with informants regarding the application of K3 in RSUD
Karawang as follows:
Informant 1
"We are Karawang Hospital in implementing the K3RS implementation, where the
director of the Karawang Hospital himself has prepared an K3 organization, so that the
implementation of the SMK3RS can be carried out according to a predetermined plan. In
the implementation of SMK3RS, what has been done at the Karawang Hospital is to hold
a medical check-up, namely an initial examination for workers and periodic checks for
employees as well as Hepatitis B immunization and Covid 19 vaccination. In preventing
the occurrence of work accidents within the Karawang Hospital. The Karawang Hospital
also conducts training for employees, such as the use of work tools, how to use fire
extinguishers, training in the event of a disaster, training on the use of PPE, monitoring
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whether workers are working according to SOPs, using hazardous chemicals (B3), and
implementing a fire hazard management system. In the results of interviews, it was found
that at the Karawang Hospital, most of the steps for implementing SMK3 had gone well
at the Karawang Regional Hospital where the hospital had stated a commitment, carried
out K3 counseling to workers, implemented K3 programs such as providing PPE, health
checks, and treating workers who were sick. sick by providing BPJS services.
5. SMK3 audit at Karawang Hospital
In carrying out this evaluation (audit) to determine the effectiveness of the
implementation of SMK3 in the workplace, the results of interviews from several
informants were as follows:
Informant 1
"We at the Karawang Hospital for audit issues are divided into 2 internal audits, namely
from the K3 Installation itself which checks for work safety every month, 3 months, or 6
months, and there is an external audit where the hospital accreditation itself is once a
year. carried out by the MFK Audit team from outside the Hospital‖.
Informant 2
"Where the results of internal and external audits will be documented or followed up on
the findings obtained, after that we from the RSUD will fix whatever is lacking or be
improved from the hospital in the future".
In the interview results obtained where the Karawang Hospital must verify this aims to
ensure the core elements of the K3 program have been fully implemented and review the
audit results whether there are deficiencies in the program that has been implemented so
that the implementation of the occupational safety and health management system can run
properly and in accordance with PP No. 50 of 2012.
DISCUSSION
Commitments and Policies
Based on the results of the study, it can be concluded that the commitment and
policies of the Karawang Hospital in the Occupational Safety Regulations and Procedures
have been going well but are still in written form, the regulations regarding K3 at the
Hospital have been well organized based on the Minister of Health Regulation No. 66 of
2016 and PP No. 50 of 2012, structured and easy to understand and reviewed against the
relevant K3 regulatory policies and procedures. In regulation the implementation of
regulations on work safety has a significant effect on the success of SMK3, this is
evidenced by the Karawang Hospital by establishing regulations on work safety properly
and correctly will help the level of success of the implementation of the Occupational
Safety and Health Management System. PPE for employees to avoid work accidents and
hospitals have completed work SOPs in each work unit. This research is also in line with
previous research according to Wati, N. Dkk. (2017). With the research title Analysis of
Occupational Safety and Health Management Systems at the Mukomuko Regional
General Hospital in 2017, it states that the results of the study can be concluded that the
commitment of the Muko-Muko Hospital related to K3RS is only an initial commitment
that is expressed verbally, but the commitment has been realized in written form is proven
by the issuance of a decision letter from the Director of Hospital regarding K3. Which is
specifically about K3. However, policies regarding structure and organization have been
Eka Rakhmat Kabul, Subhan Nur Ramadhan, Sukiman, Harries Madiistriyatno
Analysis of Safety Management System Implementation and Occupational Health
based on PP No 50 Year 2012 203
formed and several work programs have been implemented, although not yet fully. In
addition, funding related to K3RS and facilities such as personal protective equipment is
complete.
Planning
The research concluded in planning the implementation of SMK3 seen from
SMK3 Karawang Hospital which has established a planning program has followed the
Minister of Health Regulation No. 66 of 2016, which stipulates that K3 planning
according to requirements must pay attention to initial identification, by estimating
potential hazards, how to control them. Then formulate a program with clear goals. In
addition, the Karawang Hospital has followed the regulations of PP No. 50 of 2012 it is
explained that companies must make effective plans and contain goals, targets and
performance indicators. Karawang Hospital has significantly set OHS goals and
objectives. RSUD Karawang has also outlined the timeframe and responsibilities for
achieving the goals and objectives of the K3 program and documenting it. This research
is also in line with previous research conducted by Wati, N. Etc. (2017). With the
research title Analysis of Occupational Health and Safety Management Systems at the
Mukomuko Regional General Hospital in 2017, it states that the results of the study can
be seen that the Muko-muko Hospital has identified potential hazards that may occur to
workers, including contracting infectious diseases when in contact with patients. .
Follow-up from the hospital is the installation of safety signs, immunization of
employees, namely Hepatitis B and providing personal protective equipment. In addition,
workers are required to follow the SOP for every existing job to prevent work accidents.
Some things are in accordance with the SMK3 guidelines in hospitals, where in this
guideline it is stated that planning includes:
a. Identification of hazard sources, assessment and control of risk factors. Hospitals must
conduct studies and identify sources of hazards, assess and control risk factors.
b. Making regulations by setting and implementing standard operating procedures (SOPs)
in accordance with regulations. Meanwhile, other planning parts have not been
implemented, such as:
1) Hospitals must consider statutory regulations, potential hazards and measurable OHS
risks, units/indicators of measurement, achievement targets and timeframe for
achievement (SMART).
2) Performance indicators must be measurable as a basis for evaluating K3 performance
which is also information about the success of achieving SMK3 RS.
3) The hospital must establish and implement the K3RS program, to achieve the target
there must be monitoring, evaluation and recording and reporting.
Organizing
The results of the study where the researcher stated that in the implementation of the
organization at the Karawang Hospital there was already a K3 organization which could
facilitate the division of work according to the field and could support the success rate of
implementing a work safety management system. The organizational structure of the
Karawang Hospital already has an K3 committee responsible for occupational safety and
health activities at the Karawang Hospital, but because of the double job of K3 members,
the implementation of the program is not optimal. The Karawang Hospital has completed
its organizational structure with the issuance of a decree for the establishment of an
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occupational safety and health executive committee based on the Decree of the Director
of the Karawang Regional General Hospital Number:
445.1/Kep.72/Sekrt/2016 which was set in Karawang on February 24, 2016. This research
is in line with previous research by Arikhman, N. Dkk (2020) in the research title
Analysis of Application of Occupational Safety and Health in Work Safety Programs at
Home The Sungai Dareh Regional General Hospital, stated that the organizational
structure of the Sungai Dareh Hospital already has an K3 committee responsible for
occupational safety and health activities at the Sungai Dareh Hospital, but because of the
double job of the K3 members the program implementation is not optimal. Coordination
between members of the K3 committee is usually carried out at coordination meetings or
more often through group chats that have been provided.
Application
In the results of interviews, it was found that at the Karawang Hospital, most of
the steps for implementing SMK3 had gone well at the Karawang Regional Hospital
where the hospital had stated a commitment, carried out K3 counseling to workers,
implemented K3 programs such as providing PPE, health checks, and treating workers
who were sick. sick by providing BPJS services. This research is in line with previous
research conducted by Wati, N. Etc. (2017). With the research title Analysis of
Occupational Health and Safety Management Systems at the Mukomuko Regional
General Hospital in 2017, stated that in In the implementation of K3RS, the Director of
the Muko-Muko Hospital has arranged an K3 organization, so that the implementation of
the SMK3RS can be carried out according to the predetermined plan. The implementation
of SMK3RS that has been carried out at the Muko-Muko Hospital is to hold a medical
check-up, namely an initial examination for workers as well as Hepatitis B immunization
and providing health insurance. To prevent work accidents, Muko-muko Hospital
conducts training for employees, such as using work tools, PPE, making SOPs, using
hazardous chemicals, and implementing a fire protection system.
Audit
In the results of the audit research conducted by researchers, the Karawang
Hospital has audited and evaluated internally or externally. internal audit on
RSUD Karawang which is carried out by the K3 Installation committee while the external
audit is carried out after an internal audit by the relevant institution (Team MFK) once a
year. As for the things that must be improved from the results of the external audit,
among others, being asked to implement the OHS program consistently. Where the
results of the audit and evaluation will look at the shortcomings of the K3 Program, and
correcting the shortcomings of the K3 program aims to improve the K3 program that is no
longer relevant to be more effective or add a new K3 program so that the occupational
safety and health management system runs as expected. This research is in line with
previous research researched by Marfiana, P. (2020) in the title Overview of the
Occupational Health and Safety Management System at Hospital "P", stating that the
SMK3 audit is appropriate and is carried out at least once a year by the internal auditor.
The division of skills development is carried out regularly, while in PP no. 50 of 2012 has
explained that employers are required to monitor and evaluate K3 performance through
Eka Rakhmat Kabul, Subhan Nur Ramadhan, Sukiman, Harries Madiistriyatno
Analysis of Safety Management System Implementation and Occupational Health
based on PP No 50 Year 2012 205
inspection, testing, measurement, and internal audit of SMK3 and carried out by
competent human resources, if they do not have competent human resources they can use
the services of other parties.
CONCLUSION
Based on the results of data analysis, conclusions can be drawn regarding the
application of the occupational health and safety management system at the Karawang
Hospital as follows:
1. The commitment and management policy of the Karawang Hospital to the
implementation of K3 has existed and is written, the facilities and infrastructure that
support the implementation of K3 have been fulfilled. While the K3 policy at this hospital
is the appointment of the K3 Installation as an officer who oversees the implementation
of K3 in this hospital.
2. OHS planning at the Karawang Hospital has been going well, starting from risk
identification to risk management. In addition, workers are also required to follow SOPs
every time they do their work, and workers have been facilitated with complete PPE by
the hospital.
3. The K3 organization at the Karawang Hospital has been formed and has carried
out their respective duties and functions, but it is still found that workers from the K3
installation have double jobs where the implementation of the SMK3 program is not
optimal.
4. Implementation of K3 Most of the steps for implementing SMK3 have been
going well at the Karawang Hospital where the Hospital has stated a commitment, K3
organizations have been formed, conducting K3 counseling to workers, implementing K3
programs such as providing PPE, health checks, and treating sick workers with provide
BPJS services.
5. The K3 audit at the Karawang Hospital has been running, which has been
running Internal and external audits to find out what are the shortcomings of the K3
program and further correct the shortcomings of the K3 program aimed at improving the
K3 program.
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