Health Information Quality and Patient Safety Performance: A Study at Awet Muda Narmada Regional Hospital
Keywords:
Health information management, Hospital safety culture, Patient safety, Quality improvementAbstract
This study examined the relationship between health information quality management and patient safety performance, identifying significant factors influencing safety outcomes. A quantitative approach was used, with the Hospital Survey on Patient Safety Culture (HSPSC) translated, culturally tailored, and validated for the local setting. The intervention consisted of comprehensive training in information quality, workflow alignment, and the implementation of standardized documentation procedures over 6 weeks. The study was conducted at Awet Muda Narmada Regional General Hospital in West Lombok, West Nusa Tenggara, Indonesia, with a sample size of 92 healthcare professionals, including physicians, nurses, and health information managers. The results demonstrated a 46-point improvement (from 52 to 98 on a 100-point Likert-type scale) in the dimension of "Management Support for Patient Safety," with an average gain of 46 points after the intervention. A paired t-test found a significant difference between pre- and post-intervention scores (p = 0.001), and linear regression confirmed a strong positive relationship between information quality and patient safety (y = 0.86x + 24.15), with a coefficient of determination (R²) of 0.496. The study demonstrates that improving health information quality is associated with better patient safety outcomes. Practical implications include the need to incorporate information technology training, create non-punitive incident reporting systems, and optimize Electronic Health Records (EHR) to foster a stronger patient safety culture in hospital settings.
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Fadahunsi KP, Wark PA, Mastellos N, Gallagher J, Majeed A, Car J. Clinical Information Quality of Digital Health Technologies: Protocol for an International eDelphi Study. BMJ Open. 2022;12(4):e057430. https://doi.org/10.1136/bmjopen-2021-057430
Fadahunsi KP, O’Connor S, Akinlua JT, Wark PA, Gallagher J, Car J, et al. Information Quality Frameworks for Digital Health Technologies: Systematic Review. J Med Internet Res. 2021;23(5):e23479. https://doi.org/10.2196/23479
Setiorini A, Natasia SR, Wiranti YT, Ramadhan DA. Evaluation of the Application of Hospital Management Information System (SIMRS) in RSUD Dr. Kanujoso Djatiwibowo Using the HOT-Fit Method. J Phys Conf Ser. 2021;1726(1):12011. https://doi.org/10.1088/1742-6596/1726/1/012011
Bravi L, Murmura F, Santos G. The ISO 9001:2015 Quality Management System Standard: Companies’ Drivers, Benefits and Barriers to Its Implementation. Qual Innov Prosper. 2019;23(2):64–82. https://doi.org/10.12776/qip.v23i2.1277
Chiarini A. Risk-Based Thinking According to ISO 9001:2015 Standard and the Risk Sources European Manufacturing SMEs Intend to Manage. TQM J. 2017;29(2):310–23. https://doi.org/10.1108/TQM-04-2016-0038
Rahim ASA, Asaad MNM. The Implementation of Iso 9001:2015 to Improve Quality of Service at Pusat Kesihatan Universiti (Pku), Universiti Utara Malaysia(uum). J Technol Oper Manag. 2018;13(Number 2):67–77. https://doi.org/10.32890/jtom2018.13.2.7
Ahmudi, Purwanggono B, Handayani NU. Effectiveness Analysis of ISO 9001:2015 Implementation at Manufacturing Industry. SHS Web Conf. 2018;49:1008. https://doi.org/10.1051/shsconf/20184901008
Wolniak R. Support in Iso 9001:2015. Sci Pap Silesian Univ Technol Organ Manag Ser. 2019;2019(137):247–61. https://doi.org/10.29119/1641-3466.2019.137.16
Pacana A, Ulewicz R. Analysis of Causes and Effects of Implementation of the Quality Management System Compliant With Iso 9001. Polish J Manag Stud. 2020;21(1):283–96. https://doi.org/10.17512/pjms.2020.21.1.21
Nurhasanah N, Wahab S. Analysis of Readiness to Switch Manual Medical Records to Electronic Medical Records to Support the Effectiveness of Outpatient Registration at Muhammadiyah Hospital. Int J Soc Heal. 2024;3(5):304–9. https://doi.org/10.58860/ijsh.v3i5.188
Asyfia A, Zaid -, Mahendika D, Setyowati M. Medical Record Digitization Policy: Overview of the Health Minister Regulation Number 24 of 2022. Cons Sanit J Heal Sci Policy. 2023;1(2):54–61. https://doi.org/10.56855/jhsp.v1i2.227
Wardhana ES, Suryono S, Hernawan A, Nugroho LE. Design and Development of Web-Based Dental Electronic Medical Records According to Ministry of Health Standards. Odonto Dent J. 2023;10:15. https://doi.org/10.30659/odj.10.0.15-23
Ishijima H, Teshima M, Kasahara Y, Miyamoto N, Masaule F, John R. Comprehensive Approach for Strengthening the Management of Regional Referral Hospitals in Tanzania. J Hosp Adm. 2020;9(5):1. https://doi.org/10.5430/jha.v9n5p1
Hu M, Chen W, Yip W. Hospital Management Practices in County-Level Hospitals in Rural China and International Comparison. BMC Health Serv Res. 2022;22(1). https://doi.org/10.1186/s12913-021-07396-y
Ravaghi H, Beyranvand T, Mannion R, Alijanzadeh M, Aryankhesal A, Bélorgeot VD. Effectiveness of Training and Educational Programs for Hospital Managers: A Systematic Review. Heal Serv Manag Res. 2020;34(2):113–26. https://doi.org/10.1177/0951484820971460
Alatawi AD, Niessen L, Khan J. Efficiency Evaluation of Public Hospitals in Saudi Arabia: An Application of Data Envelopment Analysis. BMJ Open. 2020;10(1):e031924. https://doi.org/10.1136/bmjopen-2019-031924
Keen J, Nicklin E, Wickramasekera N, Long A, Randell R, Ginn C, et al. From Embracing to Managing Risks. BMJ Open. 2018;8(11):e022921. https://doi.org/10.1136/bmjopen-2018-022921
Lee SE, Scott LD, Dahinten VS, Vincent C, Lopez KD, Park CG. Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review. West J Nurs Res. 2019 Feb;41(2):279–304. https://doi.org/10.1177/0193945917747416
Musa AK, Aina OM, Opeyemi OP. Perception of Health Information Management Professionals on the Importance of Computer System in Health Information Management in Obafemi Awolowo Teaching Hospital, Ile- Ife, Osun State, Nigeria. Int J Innov Sci Res Technol. 2020;5(7):414–8. https://doi.org/10.38124/IJISRT20JUL353
Stoller JK. Building Teams in Health Care. Chest. 2021 Jun;159(6):2392–8. https://doi.org/10.1016/j.chest.2020.09.092
Chen W-L, Chen J-H. Consequences of inadequate sleep during the college years: Sleep deprivation, grade point average, and college graduation. Prev Med (Baltim). 2019 Jul;124:23–8. https://doi.org/10.1016/j.ypmed.2019.04.017
Sittig DF, Wright A, Coiera E, Magrabi F, Ratwani R, Bates DW, et al. Current challenges in health information technology-related patient safety. Health Informatics J. 2020 Mar;26(1):181–9. https://doi.org/10.1177/1460458218814893
Sharma S V, McPherson H, Sandoval M, Goodman D, Paret C, Mahata K, et al. Design and Framework of a Technology-Based Closed-Loop Referral Project for Care Coordination of Social Determinants of Health. Popul Health Manag. 2024 Dec;27(6):390–6. https://doi.org/10.1089/pop.2024.0129
Yutong T, Yan Z, Qingyun C, Lixue M, Mengke G, Shanshan W. Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review. Int J Integr Care. 2023;23(2):2. https://doi.org/10.5334/ijic.6979
Li E, Clarke J, Ashrafian H, Darzi A, Neves AL. The Impact of Electronic Health Record Interoperability on Safety and Quality of Care in High-Income Countries: Systematic Review. J Med Internet Res. 2022 Sep;24(9):e38144. https://doi.org/10.2196/38144
Tubaishat A. The effect of electronic health records on patient safety: A qualitative exploratory study. Inform Health Soc Care. 2019 Jan;44(1):79–91. https://doi.org/10.1080/17538157.2017.1398753
Idaiani S, Hendarwan H, Herawati MH. Disparities of Health Program Information Systems in Indonesia: A Cross-Sectional Indonesian Health Facility Research 2019. Int J Environ Res Public Health. 2023;20(5):4384. https://doi.org/10.3390/ijerph20054384
Heryawan L. Fast Healthcare Interoperability Resources (FHIR)-Based Interoperability Design in Indonesia: Content Analysis of Developer Hub’s Social Networking Service (Preprint). Jmir Form Res. 2023; https://doi.org/10.2196/51270
Qomariyah S, Sethi R, Izati Y, Rianty T, Latief K, Zazri A, et al. No One Data Source Captures All: A Nested Case-Control Study of the Completeness of Maternal Death Reporting in Banten Province, Indonesia. PLoS One. 2020;15(5):e0232080. https://doi.org/10.1371/journal.pone.0232080
Rubiyanti NS. Penerapan Rekam Medis Elektronik Di Rumah Sakit Di Indonesia: Kajian Yuridis. Magistra Law Rev. 2023;4(02). https://doi.org/10.56444/malrev.v4i02.4167
Rahmasari S. Strategic Planning for Hospital Management Information System (SIMRS) Dental and Oral Hospital (RSGM) Universitas Andalas (Unand) Indonesia. Biosci Med J Biomed Transl Res. 2023;7(10):3620–7. https://doi.org/10.37275/bsm.v7i10.868
Ikawati FR, Haris MS. Challenges in Implementing Digital Medical Records in Indonesian Hospitals : Perspectives on Technology , Regulation , and Data Security. 2024;4(2):1–25.
Christasani PD, Wijoyo Y, Hartayu TS, ... Implementation of Hospital Information System in Indonesia: A Review. Syst Rev Pharm [Internet]. 2021;12(7):499–503. Available from: https://www.sysrevpharm.org/abstract/implementation-of-hospital-information-system-in-indonesia-a-review-82877.html
Hizriansyah. Acceptance Analysis of The Electronic Kohort Information System for Maternal and Child Health (MCH) Using the Technology Acceptance Model (TAM) Method at the Bima City Health Centers. J Sist Inf. 2023;19(1):62–78. https://doi.org/10.21609/jsi.v19i1.1207
Chang J, Jaskula K, Papadonikolaki E, Rovas D, Parlikad AK. Can Blockchain Prevent the Deterioration of Building Handover Information Quality for Higher Education Institutions? Built Environ Proj Asset Manag. 2024;14(4):509–28. https://doi.org/10.1108/BEPAM-08-2023-0152
Hassan E, Yusof ZM, Ahmad K. Factors Affecting Information Quality in the Malaysian Public Sector. Int J Adv Sci Eng Inf Technol. 2019;9(1):32–8. https://doi.org/10.18517/ijaseit.9.1.6385
Weaver SJ, Lubomksi LH, Wilson RF, Pfoh ER, Martinez KA, Dy SM. Promoting a culture of safety as a patient safety strategy: a systematic review. Ann Intern Med. 2013 Mar;158(5 Pt 2):369–74. https://doi.org/10.7326/0003-4819-158-5-201303051-00002
Alotaibi YK, Federico F. The impact of health information technology on patient safety. Saudi Med J. 2017 Dec;38(12):1173–80. https://doi.org/10.15537/smj.2017.12.20631
Titi MA, Baksh MM, Zubairi B, Abdalla RAM, Alsaif F, Amer YS, et al. Staying Ahead of the Curve: Navigating Changes and Maintaining Gains in Patient Safety Culture - A Mixed-Methods Study. BMJ Open. 2021;11(3):e044116. https://doi.org/10.1136/bmjopen-2020-044116
Ali H, Ibrahem SZ, Mudaf B Al, Fadalah T Al, Jamal D, El‐Jardali F. Baseline Assessment of Patient Safety Culture in Public Hospitals in Kuwait. BMC Health Serv Res. 2018;18(1). https://doi.org/10.1186/s12913-018-2960-x
Suganda T, Handiyani H, Rachmi SF, Masyati E, Rahman LOA. An Analysis of Head Nurses’ Nursing Informatics Competencies and Nurses’ Attitudes Towards Patient Safety in Hospitals. Dunia Keperawatan J Keperawatan Dan Kesehat. 2023;11(2):213–26. https://doi.org/10.20527/jdk.v11i2.225
Asan O, Yu Z, Crotty BH. How Clinician-Patient Communication Affects Trust in Health Information Sources: Temporal Trends From a National Cross-Sectional Survey. PLoS One. 2021;16(2):e0247583. https://doi.org/10.1371/journal.pone.0247583
Platt J, Raj M, Kardia SLR. The Public’s Trust and Information Brokers in Health Care, Public Health and Research. J Health Organ Manag. 2019;33(7/8):929–48. https://doi.org/10.1108/JHOM-11-2018-0332
Yuan Y, Lee KS. General Trust in the Health Care System and General Trust in Physicians: A Multilevel Analysis of 30 Countries. Int J Comp Sociol. 2022;63(3):91–104. https://doi.org/10.1177/00207152221085571
Kızılkaya S. El Papel Mediador De La Confianza Del Médico en La Relación Entre La Desconfianza Médica Y La Desconfianza en El Sistema De Salud. Cir Cir. 2024;92(1). https://doi.org/10.24875/CIRU.23000102
Wangkar A. Analysis of the Effectiveness of Integrated Information System Implementation (Case Study: PT Samudera Mulia Abadi Tbk). Eduvest - J Univers Stud. 2023;3(3):524–34. https://doi.org/10.59188/eduvest.v3i3.771
Özturan M, Alacam S, Coskun-Setirek A, Hakyemez TC, Kebapci H, Öztürk E, et al. A Citizen - Centric Integrated Information System Roadmap for Municipalities. J Public Adm Gov. 2017;7(4):175. https://doi.org/10.5296/jpag.v7i4.12093
Lee D, Song M. MEXchange: A Privacy-Preserving Blockchain-Based Framework for Health Information Exchange Using Ring Signature and Stealth Address. Ieee Access. 2021;9:158122–39. https://doi.org/10.1109/ACCESS.2021.3130552
Shahmoradi L, Habibi-koolaee M, Ebrahimi M, Khoy FP, Soltani A. Middleware for the Integration of Hospital Information Systems. Iran J Med Informatics. 2017;6(1):28. https://doi.org/10.24200/ijmi.v6i1.141
Kummer B, Lerario MP, Navi BB, Ganzman A, Ribaudo DS, Mir S, et al. Clinical Information Systems Integration in New York City’s First Mobile Stroke Unit. Appl Clin Inform. 2018;09(01):89–98. https://doi.org/10.1055/s-0037-1621704
Gao X, Yan S, Wu W, Rui Z, Lu Y, Xiao S. ≪p>Implications From China Patient Safety Incidents Reporting System</P> Ther Clin Risk Manag. 2019;Volume 15:259–67. https://doi.org/10.2147/TCRM.S190117
Zhao X, Shi C, Zhao L. Nurses’ Intentions, Awareness and Barriers in Reporting Adverse Events: A Cross-Sectional Survey in Tertiary Hospitals in China. Risk Manag Healthc Policy. 2022;Volume 15:1987–97. https://doi.org/10.2147/RMHP.S386458
Siewert B, Swedeen S, Brook OR, Eisenberg RL, Hochman MG. Barriers to Safety Event Reporting in an Academic Radiology Department: Authority Gradients and Other Human Factors. Radiology. 2018;288(3):693–8. https://doi.org/10.1148/radiol.2018171625
Falcone ML, Stee SK Van, Tokac U, Fish AF. Adverse Event Reporting Priorities: An Integrative Review. J Patient Saf. 2022;18(4):e727–40. https://doi.org/10.1097/PTS.0000000000000945
Dunbar AE, Cupit M, Vath RJ, Pontiff K, Evans N, Roy M, et al. An Improvement Approach to Integrate Teaching Teams in the Reporting of Safety Events. Pediatrics. 2017;139(2). https://doi.org/10.1542/peds.2015-3807
Kiray G, Westcott M, Sagoo MS, Onadim Z, Reddy MA. Genetics versus enviromental factors in pathogenesis of retinoblastoma. Vol. 253, International journal of hygiene and environmental health. Germany; 2023. p. 114121. https://doi.org/10.1016/j.ijheh.2023.114121
Kumar M, Mostafa J, Ramaswamy R. Federated Health Information Architecture: Enabling Healthcare Providers and Policymakers to Use Data for Decision-Making. Heal Inf Manag J. 2017;47(2):85–93. https://doi.org/10.1177/1833358317709704
Niyitegeka C, Uwera T, Korukire N, Sani N, Hakizimana I, Xavier SF, et al. Synchronization of Patient Data Among Health Facilities Through Electronic Medical Records System: A Case Study of Kabgayi District Hospital. Rwanda J Med Heal Sci. 2020;2(3):281. https://doi.org/10.4314/rjmhs.v2i3.12
Dragos K, Magalhães F, Manolis GD, Smarsly K. Cross-Spectrum-Based Synchronization of Structural Health Monitoring Data. 2022;927–36. https://doi.org/10.1007/978-3-031-07258-1_93
Khurshid Z, Brún A De, Moore G, McAuliffe É. Virtual Adaptation of Traditional Healthcare Quality Improvement Training in Response to COVID-19: A Rapid Narrative Review. Hum Resour Health. 2020;18(1). https://doi.org/10.1186/s12960-020-00527-2
Vedel I, Kaur N, Hong QN, Sherif R El, Khanassov V, Godard‐Sebillotte C, et al. Why and How to Use Mixed Methods in Primary Health Care Research. Fam Pract. 2019;36(3):365–8. https://doi.org/10.1093/fampra/cmy127
Bertolino D, Baim-Lance A, D’Aquila E, Coren F, Abraham B. Immediate Initiation of Antiretroviral Treatment: Knowledge, Attitudes, and Practices Among Clinic Staff in New York City. BMC Health Serv Res. 2023;23(1). https://doi.org/10.1186/s12913-023-09896-5
Momplaisir F, Haynes N, Nkwihoreze H, Nelson MN, Werner RM, Jemmott JB. Understanding Drivers of Coronavirus Disease 2019 Vaccine Hesitancy Among Blacks. Clin Infect Dis. 2021;73(10):1784–9. https://doi.org/10.1093/cid/ciab102
Elliott MJ, Ravani P, Quinn RR, Oliver MJ, Love S, MacRae J, et al. Patient and Clinician Perspectives on Shared Decision Making in Vascular Access Selection: A Qualitative Study. Am J kidney Dis Off J Natl Kidney Found. 2023 Jan;81(1):48-58.e1. https://doi.org/10.1053/j.ajkd.2022.05.016
Byrne J-P, Creese J, Matthews A, McDermott AM, Costello RW, Humphries N. ‘…the Way It Was Staffed During COVID Is the Way It Should Be Staffed in Real Life…’: A Qualitative Study of the Impact of COVID-19 on the Working Conditions of Junior Hospital Doctors. BMJ Open. 2021;11(8):e050358. https://doi.org/10.1136/bmjopen-2021-050358
Kang H. Sample Size Determination and Power Analysis Using the G*Power Software. J Educ Eval Health Prof. 2021;18:17. https://doi.org/10.3352/jeehp.2021.18.17
van den Akker OR, van Assen MALM, Bakker M, Elsherif M, Wong TK, Wicherts JM. Preregistration in Practice: A Comparison of Preregistered and Non-Preregistered Studies in Psychology. Behav Res Methods. 2023;56(6):5424–33. https://doi.org/10.3758/s13428-023-02277-0
Sandoval P, Vilaprinyó E, Alves R, Sorribas A. Deciding the Appropriate Sample Size for Clinical Trials: A Complex Interplay Between Power, Effect Size, and Cost. 2024; https://doi.org/10.21203/rs.3.rs-4728662/v1
Ricci‐Cabello I, Saletti‐Cuesta L, Slight SP, Valderas JM. Identifying Patient‐centred Recommendations for Improving Patient Safety in General Practices in England: A Qualitative Content Analysis of Free‐text Responses Using the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS‐PC) Questi. Heal Expect. 2017;20(5):961–72. https://doi.org/10.1111/hex.12537
Won MH, Shin S-H. Mediating Effects of Patient Safety Perception and Willingness to Participate in Patient Safety on the Relationship Between Health Literacy and Patient Participation Behavior Among Inpatients. Front Public Heal. 2024;12. https://doi.org/10.3389/fpubh.2024.1349891
Agbo CC, Mahmoud QH, Eklund J. Blockchain Technology in Healthcare: A Systematic Review. Healthcare. 2019;7(2):56. https://doi.org/10.3390/healthcare7020056
Adnan M, Kalra S, Cresswell JC, Taylor GW, Tizhoosh HR. Federated Learning and Differential Privacy for Medical Image Analysis. Sci Rep. 2022;12(1). https://doi.org/10.1038/s41598-022-05539-7
Shojaei P, Vlahu-Gjorgievska E, Chow Y-W. Security and Privacy of Technologies in Health Information Systems: A Systematic Literature Review. Computers. 2024;13(2):41. https://doi.org/10.3390/computers13020041
Kroes SK, Janssen MP, Leeuwen M van. Evaluating Privacy of Individuals in Medical Data. Health Informatics J. 2021;27(2). https://doi.org/10.1177/1460458220983398
Omaghomi TTN, Opeoluwa Akomolafe N, Chinyere Onwumere N, Ifeoma Pamela Odilibe N, Oluwafunmi Adijat Elufioye N. Patient Experience and Satisfaction in Healthcare: A Focus on Managerial Approaches - A Review. Int Med Sci Res J. 2024;4(2):194–209. https://doi.org/10.51594/imsrj.v4i2.812
Fournier P, Jobin M. Medical Commitment to Lean: An Inductive Model Development. Leadersh Heal Serv. 2018;31(3):326–42. https://doi.org/10.1108/LHS-02-2018-0015
Ahmad A, Chowdhury D. Resistance to Change During Uncertainty-Perspective of Covid-19: An Empirical Investigation Into Resistance Management in the Healthcare Organizations. Rev Appl Socio-Economic Res. 2021;22(2):5–20. https://doi.org/10.54609/reaser.v22i2.79
Mulfiyanti D, Satriana A. The Correlation Between the Use of the SBAR Effective Communication Method and the Handover Implementation of Nurses on Patient Safety. Int J Public Heal Excell. 2022;2(1):376–80. https://doi.org/10.55299/ijphe.v2i1.275
Seo J-K, Lee SE. Effects of Nurses’ Perceptions of Patient Safety Rules and Procedures on Their Patient Safety Performance: The Mediating Roles of Communication About Errors and Coworker Support. J Nurs Manag. 2023;2023:1–9. https://doi.org/10.1155/2023/2403986
Abdi Z, Ravaghi H, Sarkhosh S, Nafar H, Khani S, Letaief M. Patient and Family Engagement in Patient Safety in the Eastern Mediterranean Region: A Scoping Review. BMC Health Serv Res. 2024;24(1). https://doi.org/10.1186/s12913-024-11198-3

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