Health Workers’ Perspective on Patient Safety Incident Disclosure in Indonesian Hospitals: A Mixed-Methods Study

Abstract

Inge Dhamanti,1– 3 Ni Njoman Juliasih,4 I Nyoman Semita,5 Nasriah Zakaria,6,7 How-Ran Guo,8 Vina Sholikhah2 1Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia; 2Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia; 3School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia; 4Department of Public Health, School of Medicine, Universitas Ciputra Surabaya, Surabaya, Indonesia; 5Department of Orthopedic, Faculty of Medicine, University of Jember, Jember, Indonesia; 6College of Applied Science, Al Maarefa University, Riyadh, Saudi Arabia; 7Ehealth Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; 8Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, TaiwanCorrespondence: Inge Dhamanti, Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, 60115, Indonesia, Tel [phone], Email [email protected]: This study examined how health staff in Indonesian hospitals perceived open disclosure of patient safety incidents (PSIs).Patients and Methods: This study employed a mixed method explanatory sequential approach. We surveyed 262 health workers and interviewed 12 health workers. Descriptive statistical (frequency distributions and summary measures) analysis was performed to assess the distributions of variables using SPSS. We used thematic analysis for the qualitative data analysis.Results: We discovered a good level of open disclosure practice, open disclosure system, attitude toward open disclosure and process, open disclosure according to the level of harm resulting from PSIs in the quantitative phase. The qualitative phase revealed that most participants were confused about the difference between incident reporting and incident disclosure. Furthermore, the quantitative and qualitative analyses revealed that major errors or adverse events should be disclosed. The contradictory findings may be due to a lack of awareness of incident disclosure. The important factors in disclosing the incident are effective communication, type of incident, and patient and family characteristics.Conclusion: Open disclosure is novel for Indonesian health professionals. A good open disclosure system in hospitals could address several issues such as lack of knowledge, lack of policy support, lack of training, and lack of policy. To limit the negative implications of disclosing situations, the government should develop supportive policies at the national level and organize many initiatives at the hospital level.Keywords: open disclosure, patient safety incident, health worker, patient safety

Keywords

• open disclosure
• patient safety incident
• health worker
• patient safety