Shared Decision-Making Based Structured Communication in Improving Patient Understanding and Patient Safety

Diaz Alifarizki Zuvarcan; Dasrun Hidayat; Mira Veranita

doi:10.31949/fbmj.v4i1.19882

Authors

Diaz Alifarizki Zuvarcan Universitas Adhirajasa Reswara Sanjaya (ARS University), Indonesia
Dasrun Hidayat Universitas Adhirajasa Reswara Sanjaya, Indonesia
Mira Veranita Universitas Adhirajasa Reswara Sanjaya, Indonesia

DOI:

https://doi.org/10.31949/fbmj.v4i1.19882

Abstract

Clinical communication failures and low patient involvement are the primary causes of patient safety incidents in hospitals. The asymmetrical communication in the inpatient wards of RSUD Dr. Moewardi potentially reduces patient understanding, particularly in chronic cases involving high-risk therapies. This study aims to explore the implementation of a structured communication system based on Shared Decision-Making (SDM) and to measure its impact on enhancing patient understanding (health literacy) and strengthening personalized-care-based patient safety. This study employs a Mixed Methods Sequential Exploratory design. The qualitative exploratory phase involves in-depth interviews with 11 informants (healthcare professionals, head nurses, and patients/families) to investigate the implementation of communication and its barriers in the field. These findings serve as the foundation for developing quantitative instruments, which will be distributed to 96 healthcare professionals using a proportionate stratified random sampling technique. The data will be analyzed using inferential statistics to evaluate the effects and mediation among variables. The results are expected to demonstrate that health literacy significantly mediates the impact of structured communication on patient safety. The implications of this study are projected to provide a strategic foundation for hospital management to reconstruct bedside handover and educational guidelines, making them more personal and participatory to prevent Adverse Events (AEs).

Keywords:

Structured Communication, Shared Decision-Making, Patient Safety, Health Literacy, Personalized-Care, Hospital, Structured Communication, Shared Decision-Making, Patient Safety, Health Literacy, Personalized-Care, Hospital

Downloads

Download data is not yet available.

References

Azyabi, A., Karwowski, W., & Davahli, M. R. (2021). Assessing Patient Safety Culture in Hospital Settings. International Journal of Environmental Research and Public Health, 18(5), 1–36. https://doi.org/10.3390/IJERPH18052466

Coughlin, S. S., Vernon, M., Hatzigeorgiou, C., & George, V. (2020). Health Literacy, Social Determinants of Health, and Disease Prevention and Control. Journal of Environment and Health Sciences, 6(1), 3061. https://pmc.ncbi.nlm.nih.gov/articles/PMC7889072/

Creswell, J. W., & Plano Clark, V. L. (2018). Designing and Conducting Mixed Methods Research (3rd ed.). SAGE Publications.

Fadhilah, K. M., Hidayat, D., & Rohendi, A. (2025). ANALISIS KEMUDAHAN DAN PENERIMAAN PENGGUNAAN REKAM MEDIS ELEKTRONIK (RME) DI INSTALASI RAWAT JALAN RSUD DR. SOEDONO MADIUN : TECHNOLOGY ACCEPTANCE MODEL. JURNAL PENELITIAN TERAPAN KESEHATAN, 12(1), 23–33. https://doi.org/10.33088/JPTK.V12I1.971

Gunawan, R., Arief, Y. S., & Kusnanto, K. (2022a). Analysis of factors affecting the implementation of patient safety incident reporting in Indonesian hospitals. Jurnal Ners, 17(1), 55–62. https://doi.org/10.20473/jn.v17i1.32567

Liu, C., Wang, D., Liu, C., Jiang, J., Wang, X., Chen, H., Ju, X., & Zhang, X. (2020). What is the meaning of health literacy? A systematic review and qualitative synthesis. Family Medicine and Community Health, 8(2). https://doi.org/10.1136/FMCH-2020-000351

Liu, Y., Yang, Y., Jia, C., Shi, Z., Liu, Y., Yang, Y., Jia, C., & Shi, Z. (2024). The Application Progress of Swiss Cheese Model in Safety Management of Nursing Care. Journal of Biosciences and Medicines, 12(12), 402–410. https://doi.org/10.4236/JBM.2024.1212032

Made, D. S. I., Hidayat, D., & Santoso, B. (2025). Mixed Methods Exploratory Study: Analisis Penerapan Budaya Keselamatan Pasien. ProHealth Journal, 22(2), 96–112. https://doi.org/10.59802/PHJ.2025222184

Miloslavich, P., Bax, N. J., Simmons, S. E., Klein, E., Appeltans, W., Aburto-Oropeza, O., Andersen Garcia, M., Batten, S. D., Benedetti-Cecchi, L., Checkley, D. M., Chiba, S., Duffy, J. E., Dunn, D. C., Fischer, A., Gunn, J., Kudela, R., Marsac, F., Muller-Karger, F. E., Obura, D., & Shin, Y. J. (2018). Essential ocean variables for global sustained observations of biodiversity and ecosystem changes. Global Change Biology, 24(6), 2416–2433. https://doi.org/10.1111/GCB.14108

Montori, V. M., Ruissen, M. M., Hargraves, I. G., Brito, J. P., & Kunneman, M. (2023). Shared decision-making as a method of care. BMJ Evidence-Based Medicine, 28(4), 213–217. https://doi.org/10.1136/BMJEBM-2022-112068

Najihah, N. (2018). BUDAYA KESELAMATAN PASIEN DAN INSIDEN KESELAMATAN PASIEN DI RUMAH SAKIT: LITERATURE REVIEW. Journal of Islamic Nursing , 3(1), 1–8. https://doi.org/10.24252/JOIN.V3I1.5469

Sawyer, K. E., & Opel, D. J. (2024). Shared Decision-Making in Pediatrics. Pediatric Clinics of North America, 71(1), 39–48. https://doi.org/10.1016/j.pcl.2023.08.001

Scheibler, F., Geiger, F., Wehkamp, K., Danner, M., Debrouwere, M., Stolz-Klingenberg, C., Schuldt-Joswig, A., Sommer, C. G., Kopeleva, O., Bünzen, C., Wagner-Ullrich, C., Koch, G., Coors, M., Wehking, F., Clayman, M., Weymayr, C., Sundmacher, L., & Rüffer, J. U. (2024). Patient-reported effects of hospital-wide implementation of shared decision-making at a university medical centre in Germany: a pre-post trial. BMJ Evidence-Based Medicine, 29(2), 87–95. https://doi.org/10.1136/BMJEBM-2023-112462

Spatz, E. S., Krumholz, H. M., & Moulton, B. W. (2016). The New Era of Informed Consent: Getting to a Reasonable Patient Standard through Shared Decision Making. JAMA, 315(19), 2063. https://doi.org/10.1001/JAMA.2016.3070

Veranita, M., Birowo, A., & Mirawati, L. (2023). Strategi manajerial dalam upaya mempertahankan retensi dokter spesialis: Studi kualitatif di Rumah Sakit Islam Pati. KJPKM (Kawanad Journal of Public Health), 1(1), 1–10.

Waddell, A., Lennox, A., Spassova, G., & Bragge, P. (2021). Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review. Implementation Science : IS, 16(1), 74. https://doi.org/10.1186/S13012-021-01142-Y

Wiegmann, D. A., Wood, L. J., Cohen, T. N., & Shappell, S. A. (2022). Understanding the “Swiss Cheese Model” and Its Application to Patient Safety. Journal of Patient Safety, 18(2), 119. https://doi.org/10.1097/PTS.0000000000000810

Yanti, K. J., Hidayat, D., & Widjaja, Y. R. (2024). TINGKAT EFISIENSI PENGGUNAAN SISTEM REKAM MEDIS ELEKTRONIK DI RSUP DR. KARIADI SEMARANG. Journal of Social and Economics Research, 6(2), 682–703. https://doi.org/10.54783/JSER.V6I2.670