MANAGEMENT SUPPORT AND HOSPITAL BYLAWS IMPLEMENTATION IN DELEGATING CLINICAL AUTHORITY TO RESIDENT DOCTORS IN TEACHING HOSPITALS

Abstrak

Objectives This study aims to analyze the role of management support in the implementation of Hospital Bylaws governing the delegation of clinical authority from supervising doctors to resident doctors in teaching hospitals. The study specifically examines how managerial commitment influences the effectiveness, accountability, and legal clarity of delegation practices. Methods This research employs a qualitative design using a normative juridical approach supported by empirical data. Data were collected through in-depth interviews with key stakeholders, including supervising physicians, resident doctors, hospital directors, medical committee members, and legal and risk management units. Document analysis of Hospital Bylaws and relevant national health regulations was also conducted. Data were analyzed thematically to identify patterns related to governance, supervision, and delegation practices. Results The findings indicate that although Hospital Bylaws are formally available, their implementation has not been fully integrated into clinical supervision systems and organizational culture. Delegation of clinical authority frequently occurs informally without adequate written documentation, leading to ambiguity in legal responsibility between supervising doctors and resident doctors. Insufficient management support in supervision, monitoring, and evaluation further weakens the effectiveness of Hospital Bylaws implementation. Conclusion Strong management support is essential to ensure effective implementation of Hospital Bylaws in teaching hospitals. Integrating structured supervision, formal documentation, and continuous quality improvement frameworks such as PDCA and Total Quality Management can enhance accountability, reduce medicolegal risk, and improve patient safety in delegation practices.