<![CDATA[Occupational Safety and Health Management System (SMK3) is essential to protect hospital workers and support safe and quality healthcare services. However, its implementation may vary according to organizational and operational conditions, while evidence regarding the factors associated with SMK3 implementation at the regional hospital level remains limited. This study aimed to analyze the factors associated with SMK3 implementation at Tuan Besar Syarif Idrus Regional General Hospital, Kubu Raya Regency, West Kalimantan. An analytical quantitative study with a cross-sectional design was conducted among 180 employees. From a total workforce of 210 employees, 30 non-healthcare employees were allocated for instrument validity and reliability testing. A total of 140 respondents were selected using proportionate stratified random sampling. Data were collected using a structured questionnaire and analyzed using Spearman rank correlation and multiple linear regression with a significance level of 0.05. The results showed significant positive associations between SMK3 implementation and OHS policy (r = 0.408), management commitment (r = 0.505), human resource competence (r = 0.377), facilities and infrastructure (r = 0.659), and work environment (r = 0.306), with all p < 0.001. The multivariable regression model was significant (F = 34.721; p < 0.001) and explained 56.4% of the variance in SMK3 implementation (R² = 0.564). Facilities and infrastructure were the only significant independent predictor (β = 0.562; p < 0.001). These findings indicate that strengthening the availability, adequacy, accessibility, and maintenance of safety facilities and infrastructure should be prioritized to improve SMK3 implementation, supported by effective policies, management commitment, competent human resources, and a safe work environment.]]>
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