Implementation of Risk Management in The Medical Records Work Unit Reviewed From National Standards for Hospital Accreditation Through a Systematic Literature Review Approach

The hospital, there is no denying the possibility of unwanted or unexpected negative impacts in work activities, one of which is in the medical records work unit. The aim of the research is to determine the implementation of risk management in the medical records work unit in terms of the National Hospital Accreditation Standards. The research method used was a Systematic Literature Review with a search strategy using Google Scholar results criteria with the keywords "Risk management of medical records work units OR Risk management of medical records work units based on SNARS". The research results were obtained from an in-depth analysis of 6 journal articles, there was a link between the journal articles reviewed and the implementation of risk management in the medical records work unit in terms of the National Hospital Accreditation Standards where the problems found on average occurred in MIRM 12 Standards related to the determination of diagnosis code standards , procedure/action codes, symbols, abbreviations and their meanings, MIRM Standard 13 relating to the provision of medical records for each patient in hospitals, MIRM Standard 13.2 relating to hospital regulations which identify those who have the right to fill in patient medical records and determine the contents of medical records and format medical records, MIRM Standard 13.3 relates to filling in medical records by Professional Care Providers (PPA) by writing identification after the recording is made and MIRM Standard 13.4 relates to performance improvement efforts and hospitals regularly evaluating or reviewing medical records. The risk levels in the medical records work unit from these articles show that the risk categories are "Acceptable" (the intensity of risk is reduced to a minimum) to "Substantial" (requires technical improvement).


INTRODUCTION
Hospitals as health service providers have a responsibility to provide quality services (Kemp et al., 2024), namely by paying attention to the provision of health services in terms of security (Sudirjo et al., 2024), health and work safety which includes identification, assessment and risk management to minimize risks and injuries (Shah et al., 2024).Risk management is a proactive and continuous process including identification, analysis, evaluation, control, communication information, monitoring and reporting of risks (Harjoni et al., 2024), including various strategies implemented to manage risks and their potential (Zou et al., 2017).The implementation of health risk management in the workplace has the aim of minimizing losses due to accidents and illness (Zelko et al., 2024), increasing opportunities to increase production through a safe (Yu et al., 2023), healthy and comfortable working atmosphere (Gamal et al., 2022), cutting the chain of losses due to failure (Septian, 2024).The importance of risk management in hospitals is explained in the National Hospital Accreditation Standards (SNARS) Edition 1.1 contained in the Quality Improvement and Patient Safety (PMKP) standard 12 which explains that identifying risks, reducing risks or injuries is an ongoing program of useful risk management for patient safety and staff safety (Størkersen et al., 2024).
The implementation of risk management in the medical records work unit is an effort to analyze the existing system for potential errors to prevent incidents from occurring in the medical records work unit (Niv et al., 2024).Explained that in the medical records storage room, no risk identification had been carried out (Lopatina et al., 2021), but to prevent the risk that occurred, namely an injured hand, the head of medical records and the medical records coordinator monitored the development of the number of patients (Tahir et al., 2024).The implementation of risk management in the medical records work unit is carried out by all officers (Susilowati et al., 2020), to prevent further losses resulting from risks, it is necessary to carry out controls so that unwanted risks do not occur (Zhang et al., 2024).There are still problems in implementing risk management, namely that risk management has not been implemented and there are no SOPs for work safety (Al Annuri et al., 2023), risks that may occur in the medical records work unit because officers do not apply the rules that must be implemented in order to reduce risks such as officers could catch a cough if they take or returning medical record documents without wearing a mask, filing officers can cut the cover of medical record documents without wearing gloves, and so on (Reshma et al., 2024).Based on this background, researchers are interested in conducting a Systematic Literature Review study on "Application of Risk Management in the Medical Records Work Unit in terms of National Hospital Accreditation Standards" to determine the implementation of risk management for Medical Records Work Unit officers and to minimize the occurrence of work risks for medical records officers (Niv, 2024). in the hospital.

METHODS
The The systematics of journal searches in this research are as follows:

RESULTS AND DISCUSSION
The Systematic Literature Review (SLR) in this study was carried out to determine the implementation of risk management in the medical records work unit in terms of national hospital accreditation standards through a systematic literature review approach.The research results obtained from the data synthesis process are as follows: that the risk is classified as "Acceptable" where the intensity that creates the risk must be reduced to a minimum.

Literature 3
The results of research from Simanjuntak, Estiyana, and Anastasya (2020) entitled "Overview of Ergonomic Aspects in Storage Rooms Based on National Hospital Accreditation Standards (SNARS) Edition 1 at RSU Tere Margareth Medan in 2020" are related in terms of implementing risk management in record work units medical matters are viewed from the national standards for hospital accreditation, namely based on the National Standards for Hospital Accreditation (SNARS) edition 1 containing 16 chapters, in the sub-chapter Hospital Management Standards: Medical Information and Records Management (MIRM).The Implementation of Risk Management in the Medical Records Work Unit is viewed from the National Hospital Accreditation Standards through a Systematic Literature Review Approach in Literature 3 which is relevant, especially at the MIRM 13 Standard and PMKP 12 Standard points with consideration of risk which is classified as "Priority 3" which needs to be monitored.and monitored on an ongoing basis.

Literature 4
The results of research from Utomo, Santoso, and Nutrisha (2022) entitled "Information Management Design Based on National Hospital Accreditation Standards (SNARS) and Joint Commission International (JCI) at the Maranatha Dental and Oral Hospital (RSGM)" are related in terms of implementation Risk management of the medical records work unit is reviewed from the national standards for hospital accreditation, namely based on the National Standards for Hospital Accreditation (SNARS) edition 1 containing 16 chapters, in the sub-chapter Hospital Management Standards: Medical Information and Records Management (MIRM).The implementation of risk management in medical records work units is reviewed from the national standards for hospital accreditation through a systematic literature review approach in Literature 4 which is relevant, especially at MIRM Standard 13 points (Points 4 and 5), MIRM Standard 13.2, MIRM Standard 13.3, PMKP Standard 12 with Risk considerations are classified as "substantial" which requires technical improvements.

Literature 5
The results of research from Akbarsyah, Santosa, and Nutrisha (2022) entitled "Assessment of Medical Record Management Standards at the Maranatha Dental and Oral Hospital (RSGM)" are related in terms of the implementation of risk management for medical record work units in terms of national hospital accreditation standards, namely where based on the National Hospital Accreditation Standards (SNARS) edition 1 contains 16 chapters, in the sub-chapter Hospital Management Standards: Medical Information and Records Management (MIRM).The implementation of risk management in the medical records work unit is reviewed from national standards for hospital accreditation through a systematic literature review approach in Literature 4 which is relevant, especially at points MIRM Standard 12, MIRM Standard 13, Standard MIRM13.1 -MIRM13.4,Standard MIRM 14, Standard MIRM 15, PMKP Standard 12 with risk considerations is classified as "Substantial" which requires technical improvements.

Literature 6
The results of research from Danianti (2022) entitled "Standardization of the Use of Symbols in Patient Medical Record Documents at Hospital Hospital Accreditation (SNARS) edition 1 contains 16 chapters, in the sub-chapter Hospital Management Standards: Medical Information and Records Management (MIRM).The implementation of risk management in the medical records work unit is reviewed from national standards for hospital accreditation through a systematic literature review approach in Literature 4 which is relevant, especially at points in MIRM Standard 12, Standard 13, PMKP Standard 12 with consideration of risk in the "Acceptable" category.where the intensity poses a risk but can be reduced to a minimum.

CONCLUSION
In this research, there were 6 journal articles that were coherent and reviewed in more depth using a systematic literature review approach which complied with the inclusion and exclusion criteria using keywords according to the provisions.Apart from that, there is a link between the journal articles reviewed and the implementation of risk management in the medical records work unit in terms of the National Hospital Accreditation Standards, as follows: (1) The problems found on average occur in the MIRM 12 Standard related to the determination of diagnostic code standards, codes procedures/actions, symbols, abbreviations and their meanings, MIRM Standard 13 regarding the provision of medical records for each patient in hospitals, MIRM Standard 13.2 related to hospital regulations which identify those who have the right to fill in patient medical records and determine the contents of medical records and the format of medical records , MIRM Standard 13.3 is related to filling in medical records by Professional Care Providers (PPA) by writing their identity after the recording is made and MIRM Standard 13.4 is related to efforts to improve performance and hospitals regularly evaluating or reviewing medical records.(2) Journal articles also discuss and examine in more depth the levels of risk in the medical records work unit.It can be concluded that the risk categories are "Acceptable" (intensity of risk is reduced to a minimum) to "Substantial" (requires significant improvement).technical).Therefore, it is hoped that the results of this literature review can be used as a reference and basic material as a reference for further research on the implementation of risk management in medical records work units in terms of national hospital accreditation standards, as well as consideration for expanding the scope of research so that it is hoped that it can improve research quality, or continuing this research into primary or direct research.

Figure 1 .
Figure 1.Systematics of Journal Search design of this research is a Systematic Literature Review (SLR) or literature review.The article search used was Google Scholar with the keywords "Risk Management of the Medical Records Work Unit Based on SNARS OR Risk Management of the Medical Records Work Unit".The inclusion criteria table is as follows:

Table 2 .
Research Journal Data Synthesis Results MIRM).Meanwhile, the implementation of risk management in the Medical Records Work Unit is viewed from the National Hospital Accreditation Standards through a Systematic Literature Review Approach in Literature 2 which is relevant, especially at points in MIRM Standard 13 (Points 4 and 5), MIRM Standard 13.2, MIRM Standard 13.3, PMKP Standard 12 considering