Quality and Risk Staff

Siloam Hospitals Group; Depok; On-site; IDR 111,600,000 - 178,560,000; Full time

Job summary

Siloam Hospitals Group seeks a leader to oversee the Hospital Quality Improvement and Patient Safety (PMKP) program across all divisions, ensuring compliance with policies, risk management, and effective audit processes.

You will manage data collection and analysis, document control, incident grading, and accreditation preparation while guiding staff through quality initiatives and training programs.

Qualifications

• Minimum 3 years of clinical work experience at shift supervisor level or as head nurse.
• Experience in hospital settings and understanding of business processes across departments.
• Experience supervising clinical service delivery and coordinating teams.
• Familiarity with risk management practices and incident reporting.

Responsibilities

• Oversee the entire PMKP quality improvement and patient safety program across all departments.
• Conduct audits of clinical and non-clinical services according to accreditation standards and policies.
• Collect, validate, and analyze quality data from all departments at hospital level.
• Manage hospital documents from development through revision, ratification, and distribution.
• Grade incidents, appoint owners, and escalate according to the matrix.
• Lead proactive risk reduction via Failure Mode & Effects Analysis (FMEA) in at least one clinical process per year.
• Manage the hospital's Quality Management System (Medblaze) including users and access.
• Serve as SME in Quality Improvement, Patient Safety and Risk Management and conduct trainings.
• Assist department head in preparing reports for directors and accreditation bodies.
• Prepare for accreditation, including internal self-assessments and reporting results.

Skills

Quality Improvement

Patient Safety

Risk Management

Supervision

Education

D3 Health Diploma

Job description

Responsibilities

• Responsible for supervising the entire Hospital Quality Improvement and Patient Safety (PMKP) program which includes quality improvement, patient safety and risk management, through various clinical service audit processes, auditing compliance with policies and procedures in all divisions and departments in the hospital, carrying out process improvement based on incidents and risks, as well as ensuring the proper functioning of the Quality Management System (Medblaze) as a means of supporting quality improvement efforts.
• Conduct audits of clinical and non-clinical services in accordance with hospital accreditation standards and various hospital policies & procedures, together with Patient Safety Officers in each department / service unit.
• Carrying out quality data collection (various quality indicators) from all departments, validating data according to data validation policy, aggregating and analyzing data at the hospital level.
• Manage hospital documents, starting from developing new documents, reviewing and revising old documents, ratifying, to distributing and communicating documents throughout the hospital.
• Receive and carry out grading of incident reports, appoint incident owners, investigation owners, and action owners in accordance with the escalation grading matrix to superiors based on incident levels.
• Carry out pro‑active risk reduction strategies in the form of Failure Mode & Effect Analysis (FMEA) in at least 1 clinical process every year.
• Responsible for managing the hospital level Quality Management System (Medblaze), including the document module, incident & risk, audit module, including managing users and access for all staff in the hospital.
• Acting as a Subject Matter Expert in the fields of Quality Improvement, Patient Safety and Risk Management in the Hospital, and conducting teaching (as a trainer / resource person) on the above topics to all employees in various training programs organized both by Human Capital and by Quality & Risk dept.
• Assist the Quality & Risk department head in preparing reports to the director, chairman of the hospital quality committee, and external parties (accreditation agencies, health services, ministry of health).
• Assist the Quality & Risk department head in preparing for accreditation, especially internally by carrying out self‑assessments with the accreditation Working Group, Working Group and reporting the results of the self‑assessment to the QR Dept Head, Chair of the Quality Committee and Director.

Qualifications

• Diploma (D3) Degree from Health Professional
• Have minimum of 3 years of clinical work experience at shift responsibility/supervisor level or preferably head nurse.
• Preferably those who have worked in a hospital and understand business processes in several departments/service units. Have an understanding of various hospital policies & procedures.
• Have experience in supervising the process of providing clinical services, for example serving as supervisor / coordinator / in charge in a clinical service unit, both in nursing and medical support.
• Familiarity with risk management practices and incident reporting processes.