<![CDATA[This study aimed to analyze the effects of patient safety culture implementation and service time efficiency on patient satisfaction and their implications for the image of Puskesmas Kubu 1 Karangasem. This study employed a quantitative explanatory approach with a cross-sectional design. Data were collected through questionnaires administered to outpatients at Puskesmas Kubu 1 Karangasem. The study involved 422 respondents selected through consecutive sampling. Data were analyzed using the Partial Least Squares Structural Equation Modeling (PLS-SEM) method in SmartPLS 4 to examine the direct and indirect effects among the variables. The results showed that patient safety culture had a positive and significant effect on patient satisfaction, with a path coefficient of 0.682, a t-statistic of 11.282, and a p-value of 0.000. Service time efficiency also had a positive and significant effect on patient satisfaction, with a path coefficient of 0.163, a t-statistic of 2.408, and a p-value of 0.016. Patient satisfaction had a positive and significant effect on the image of the Puskesmas, with a path coefficient of 0.907, a t-statistic of 20.275, and a p-value of 0.000. The mediation analysis showed that patient safety culture affected the image of the Puskesmas through patient satisfaction, with a coefficient of 0.619, t-statistics of 8.254, and p-values of 0.000, while service time efficiency affected the image of the Puskesmas through patient satisfaction, with a coefficient of 0.148, t-statistics of 2.426, and p-values of 0.015. The R-Square value was 0.507 for patient satisfaction and 0.823 for the image of the Puskesmas. Thus, improving patient safety culture and service time efficiency can increase patient satisfaction, which in turn strengthens the positive image of Puskesmas Kubu 1 Karangasem.]]>
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