<![CDATA[Background: Patient safety is a system aimed at improving safety in healthcare services to prevent harm from medical errors. In 2019, Indonesia recorded 7,465 patient safety incidents, indicating persistent challenges in improving healthcare quality. East Lampung Regency, with 34 Community Health Centers, reflects similar issues, making it a relevant setting for examining the quality of governance in primary care. Objective: This study aimed to evaluate the impact of quality governance on Patient Safety Incident (PSI) performance at Community Health Centers in East Lampung from 2023 to 2024. Methods: A qualitative approach was applied using in-depth interviews, observations, and document reviews at three centers representing different accreditation levels (Paripurna, Main, and Madya). A total of 11 informants were purposively selected, including health center leaders, quality officers, health office officials, and service users. Data triangulation was conducted across multiple sources to ensure consistency and reliability, supported by cross-validation between interviews, observations, and documents. Results: Input factors revealed shortages of key personnel, limited budgets, and suboptimal coordination despite generally adequate facilities. The USE PDSA cycle was implemented; however, only 15 of 34 centers met the SMART planning criteria, with implementation constrained by budget and technology availability. PSI reporting compliance reached 100% in 2024, although data accuracy remained at 80% due to reporting inconsistencies and blame culture. Outcome evaluation showed a 15% reduction in incidents, with higher improvements in better-accredited centers. Conclusion: Quality governance remains suboptimal owing to resource and system limitations. Strengthening reporting accuracy, capacity building, infrastructure, and coordination is essential for improving patient safety. ]]>
