Interprofessional Collaboration for Effective Communication in

Integrated Patient Development Records: A Systematic Review

Citra Suraya

1,2,* a

, Tukimin bin Sansuwito

and Aris Citra Wisuda

Faculty of Nursing, Lincoln University College, 47301 Petaling Jaya, Selangor Darul Ehsan, Malaysia

Program Studi Keperawatan, Sekolah Tinggi Ilmu Kesehatan Bina Husada Palembang, Indonesia

Keywords: Effective Communication, Interprofessional Collaboration, Integrated Patient Development Records.

Abstract: Interprofessional collaboration (IPC) involves integrating health professionals with diverse educational

backgrounds into a cohesive team, with the aim of enhancing the quality of healthcare services. This research

aims to identify the types of professions involved in interprofessional collaboration, delineate the components

of effective communication within interprofessional collaboration, understand the elements of collaboration

in its implementation, and identify inhibiting factors in interprofessional collaboration. The chosen

methodology is a Systematic Review design. The findings indicate that the components of collaboration in

implementing interprofessional collaboration encompass cooperation, partnership, coordination, and

decision-making. Inhibiting factors in interprofessional collaboration include attitudes and behaviors,

instances of laziness, forgetfulness, fatigue, differing opinions, and hastiness, leading to ineffective

documentation of integrated patient development records. Integrated patient development records rely on

collaboration among professionals, including doctors, nurses/midwives, support staff, nutritionists, and

others. It is suggested that leaders motivate their subordinates by providing incentives and sanctions.

1 INTRODUCTION

Integrated Patient Development Records form a

crucial component of the stages involved in assessing

the action process. These records are instrumental in

gathering data to determine the success of the service,

with evaluation being a key aspect of the nursing

process (Hickey & Giardino, 2019). During the

evaluation stage, a comprehensive review is

conducted to assess the patient's response to the

actions administered by the collaborative

interprofessional team. Integrating this stage with the

Development records of patients undergoing regular

treatment facilitates the determination of the

effectiveness of the action plan. This evaluation

enables decisions on whether to continue, revise, or

halt the current plan. When implemented effectively,

this approach enhances optimal communication

within interprofessional collaboration (Smith, 2021;

Houston, 2022).

Within the nursing evaluation process, a crucial

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objective is to establish effective communication

between patients and service providers. The ability to

build this communication is a key element influencing

nurses' ease in optimally collecting patient data (Al-

Hussami, 2017). Furthermore, effective

communication in the nursing process serves as an

indicator of patient satisfaction with the provided

services (Harding & Hagler, 2022). Recognizing its

significance, effective communication emerges as a

cornerstone for nurses and other health workers in

ensuring patient safety. Communication that is both

effective and timely, complete, clear, and

comprehensible to the recipient is pivotal in reducing

errors and enhancing overall patient safety (Ministry

of Health Republic Indonesia, 2018).

Interprofessional collaboration (IPC) refers to the

cooperation among health professionals with diverse

educational backgrounds, forming a collaborative

team aimed at enhancing the quality of effective health

services (WHO, 2021). This collaborative framework

encompasses various professionals such as doctors,

286

Suraya, C., Sansuwito, T. B. and Wisuda, A. C.

Interprofessional Collaboration for Effective Communication in Integrated Patient Development Records: A Systematic Review.

DOI: 10.5220/0013671500003873

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 1st International Conference on Medical Science and Health (ICOMESH 2023), pages 286-298

ISBN: 978-989-758-740-5

dentists, nurses, midwives, nutritionists, pharmacists,

and other health workers, all contributing to the

provision of healthcare services for patients (Ku,

2017).

According to Rao (2019), an unintegrated patient

Development evaluation recording system can lead to

inefficiencies between units and other departments

due to repetitive and separate data recording, starting

from registration, through polyclinics, and

culminating in medical records reporting. Conversely,

an integrated nursing evaluation system streamlines

the process, facilitating corrective clinical decisions

for nurses and interprofessional staff when analyzing

and treating patient conditions. In line with the

Hospital Accreditation Committee in Indonesia

(Ministry of Health the Republic of Indonesia, 2019),

integrated nursing evaluation, as part of the medical

record model, serves as a standard for assessing

hospital quality. In practice, hospitals are encouraged

to evolve patient health records into integrated

medical records, with one crucial component being

the implementation of an integrated patient

Development record form.

The completeness of documents in nursing

evaluation supports effective communication through

qualitative and quantitative analysis, an activity that

assesses both the content's completeness and the

quality's consistency in a medical record. The

thoroughness of medical record documents is crucial

as it directly impacts the treatment process and patient

health services (Einarsen & Giske, 2019). This

assertion aligns with Mayang Sari & Fitriyani (2022)

that implementing patient Development records

serves several objectives, including concluding the

nursing action plan, modifying it, and continuing it.

Evaluation, conducted through various stages and

methods, requires nurses to have a comprehensive

understanding and to execute it appropriately for the

optimal functioning of nursing care. Consequently,

the role of nurses is pivotal in coordinating health

services for patients and fostering positive

relationships among professions in hospitals.

2 METHODS

The methodology employed in this study is a

Systematic Review, involving critical and systematic

thinking through the examination and analysis of

various research articles using logical and

argumentative methods. The PRISMA (Preferred

Reporting Items for Systematic Reviews and Meta-

analyses) method serves as the guiding framework for

this study, assisting in the analysis of the literature

obtained. Articles were evaluated for inclusion using

the Critical Appraisal Skills Program (CASP),

specifically applying Duffy's Research Appraisal

Checklist Approach. The research employed the

PICO framework, defining the Problem (P) as

Effective Communication, Intervention (I) as

Interprofessional Collaboration, Comparison (C) as

not applicable, and Output (O) as the role of

integrated patient Development notes.

For the literature search, databases such as Google

Scholar, ScienceDirect, PubMed, Garuda, and

ProQuest were utilized. The search included

keywords like "Effective communication in

interprofessional collaboration" and "integrated

patient Development records." Inclusion criteria

covered articles related to the role of interprofessional

collaboration in the integrated evaluation of patient

Development records, methods used to complete

patient Development records in interprofessional

collaboration, factors influencing effective

communication, and articles in Indonesian and

English published from 2019 to 2023. Exclusion

criteria comprised reviews of direct verbal

communication between professions, reviews of

interprofessional readiness in collaboration, topics

related to community health centers, doctor-patient

communication, and journals displaying only

abstracts or incomplete text. Study selection and data

quality are illustrated in Figure 1.

3 RESULTS

Based on the search results from databases such as

Google Scholar, Garuda, Science Direct, and

ProQuest, 685 articles were initially identified.

Applying filtering criteria, including full text

availability and the publication period of 2019-2023,

refined the search and yielded a total of 183 articles

relevant to the research topic. Subsequently, a

duplication check was conducted on the 183

collected articles, resulting in the identification and

exclusion of 147 duplicates. Following an analysis

based on the specified inclusion and exclusion

criteria, 30 articles did not meet the requirements.

Consequently, the remaining six articles will be

presented in the research results and analyzed in the

discussion section, leading to the formulation of

conclusions and suggestions. The results of data

extraction are presented in Table 1.

Interprofessional Collaboration for Effective Communication in Integrated Patient Development Records: A Systematic Review

287

Google Scholar Pubmed

Garuda

Proquest

n = 685

297 176 79 133

Figure 1. Flowcharts for the results of data extraction are shown in Figure

Table 1: Data Extraction of Research Articles

Author Name

(Year)

Name Journal

(Vol, No)

Title

Method

(Population / Sample)

Research result

(Kusumaningrum

et al., 2019)

Indonesian

Journal of Nurses

and Midwifery.

The

Implementation of

Integrated Patient

Development Notes

in Interprofessional

Collaboration

Practice

A correlational

descriptive design was

employed for this study.

Samples were randomly

selected, resulting in a

total of 47 nurses.

Types of

professions involved in IPC

include doctors, nurses,

midwives, nutritionists, and

physiotherapists.

There is no

communication component in

IPC.

Collaboration

components in implementing

IPC include cooperation,

partnership, coordination, and

joint decision-making.

There are no

inhibitors in IPC.

(Bakhtiar &

Duma, 2020)

Husada

Mahakam: Jurnal

Kesehatan

Implementation of

Interprofessional

Collaboration in

Health Service

Facilities

A qualitative design

with a

phenomenological

approach was employed,

involving participants

such as medical

specialists, nurses,

pharmacists,

Types of

professions involved in IPC

include specialist doctors,

nurses, pharmacists,

nutritionists, and

physiotherapists.

There is no

communication com

onent in

Exclusion

> Last 5 years (n =164)

Not English & Indonesian (n =72)

The title and abstract do not match

the research questions (n =266)

Relating to Author’s topic

(n=183)

Articles identified,

2018

2023

screening

Exclusion

147 was exludeddue to

duplication

Eligibility

Identification of journal contents

and selected (n=36)

Exclusion

30 were exluded based on

inclusion and exclusion

criteria

Included

Articles reviewed, n=6

ICOMESH 2023 - INTERNATIONAL CONFERENCE ON MEDICAL SCIENCE AND HEALTH

288

nutritionists, and

physiotherapists.

IPC.

3. Collaboration

components in implementing

IPC include cooperation,

discussion, coordination, and

decision-making.

4. Factors that

hinder health in IPC are

workload, attitude,

interprofessional

coordination, and

communication.

(Fathya et al.,

2021)

Jurnal

Pendidikan

Kedokteran

Indonesia: The

Indonesian

Journal of

Medical

Education

Implementation of

Interprofessional

Collaborative

Practice in Type B

Teaching General

Hospitals.

A mixed-methods

design was employed,

involving participants

such as medical

specialists, nurses,

pharmacists,

nutritionists, and

physiotherapists.

1. Types of professions

involved in IPC are nurses

and specialist doctors.

2. The communication

components in IPC are trust,

support, empathy, and an

open attitude.

3. Collaboration

components in implementing

IPC include control of power,

field of practice, common

interests, and common goals.

4. Factors inhibiting IPC

are doctors, and the nurse will

discuss if the instructions are

not in accordance with the

scope of nursing practice.

(Abd El Rahman

et al., 2021)

Journal of

Multidisciplinary

Healthcare.

Quality of

Interprofessional

Collaboration;

Development notes

in damage

evaluation and its

impact on

Continuity of

patient care

A correlational

descriptive design was

employed for this study.

Samples were randomly

selected, resulting in 47

respondents.

1. Types of professions

involved in IPC include

midwives, nurses,

physiotherapists, dietitians,

general practitioners, dentists,

specialist doctors, and

pharmacists.

2. There is no specific

communication component

mentioned in IPC.

3. Collaboration

components in implementing

IPC include partnerships,

aspects of cooperation and

coordination, and

interprofessional

communication.

4. Barriers to IPC are

inequality, overlapping

authority, the ratio of patients

to health workers, personal

character, communication

barriers, and lack of

institutional support.

Suéli Regina

Sulzbach, Carla

Argenta, Edlamar

Kátia Adamy,

William Campo

Meschial (2022)

Menoufia

Nursing Journal

Faculty of

Nursing

Menoufia

University

Evaluation of

nursing records

through Quality

Diagnosis,

Interventions, and

Outcomes inpatient

Develo

ment notes

This is a cross-sectional

study using document

analysis, which is part of

the research macro-

project 'Nursing Process

as Care Technology in

the Health Care

1. There is no specific type

of profession mentioned in

IPC.

2. Communication

components in IPC include

empathy, equality, openness,

Interprofessional Collaboration for Effective Communication in Integrated Patient Development Records: A Systematic Review

289

by Interprofessional

Collaboration

Network: Teaching

Interprofessional

Collaboration.' The

sample consisted of 54

respondents.

and support.

3. There is no specific

collaboration component

mentioned in implementing

IPC.

4. There are no specified

inhibitors mentioned in IPC.

(Noviyanti et al.,

2023)

Indonesian

Journal of Health

Information

Management

(IJHIM)

Effective

Communication In

The

Implementation Of

Interprofessional

Collaboration In

The Hospital

This study utilized a

mixed-methods design

involving medical

specialists, nurses,

pharmacists,

nutritionists, and

physiotherapists.

1. The types of

professions involved in IPC

include midwives, nurses,

physiotherapists, dietitians,

general practitioners, dentists,

specialist doctors, and

pharmacists.

2. There is no

specific communication

component mentioned in IPC.

3. The

collaboration component in

implementing IPC involves

partnership and cooperation

towards predetermined goals.

4. The obstacles

to IPC include the ratio of

patients to health workers and

the absence of established

standards.

3.1 Synthesis Results

Based on the results of data extraction, the following

synthesis findings were identified:

a. Understanding the types of professions involved in

interprofessional collaboration in hospitals.

b. Recognizing the components of effective

communication in interprofessional collaboration

in hospitals.

c. Identifying the components of collaboration in

implementing interprofessional collaboration in

hospitals.

d. Understanding the inhibiting factors in

interprofessional collaboration in hospitals.

4 DISCUSSION

4.1 Types of Professions Involved in

Interprofessional Collaboration in

Hospitals

The types of professions involved in IPC are detailed

in several studies, including those by

Kusumaningrum et al. (2019), Bakhtiar & Duma

(2020), Fathya et al. (2021), Suéli Regina Sulzbach,

Carla Argenta, Edlamar Kátia Adamy, William

Campo Meschial (2022), Noviyanti et al. (2023), and

Abd El Rahman et al. (2021). According to

Kusumaningrum et al. (2019), the professions

engaged in IPC include doctors, nurses, midwives,

nutritionists, and physiotherapists. This study

revealed that among the seven respondents, 8.6%

were doctors, 61.7% were nurses, 13.0% were

midwives, 7.4% were nutritionists, and 6.2% were

physiotherapists.

Research conducted by Bakhtiar & Duma (2020)

reveals that the professionals involved in IPC

encompass specialist doctors, nurses, pharmacists,

nutritionists, and physiotherapists. This study

elucidates that the treating doctor plays a crucial role

in determining a medical diagnosis, administering

therapy, making decisions about the patient's

treatment, and deciding when to discharge the patient

from the hospital. In addition, nurses serve as

communicators between health professionals and

facilitate communication between patients and health

professionals. The role of a nutritionist involves

providing nutritional care, offering dietary guidance,

and educating patients about nutrition. Lastly,

physiotherapists specialize in addressing movement

and body function problems.

Research conducted by Fathya et al. (2021)

indicates that the professions involved in IPC are

nurses and specialist doctors. The study reports that

out of 160 respondents, 130 were D3 nurses (81.2%),

19 were S1 nurses (11.9%), and 11 were specialist

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doctors (6.9%). Similarly, in a study by Suéli Regina

Sulzbach, Carla Argenta, Edlamar Kátia Adamy,

William Campo Meschial (2022), the types of

professions engaged in IPC include nurses and

specialist doctors. This study highlights that 82% of

the respondents belonged to the nursing profession,

while 76% were specialist doctors.

Research by Abd El Rahman et al. (2021) reveals

that various professions are involved in IPC,

encompassing midwives, nurses, physiotherapists,

dietitians, general practitioners, dentists, specialist

doctors, and pharmacists. The distribution of

respondents across these professions is as follows: 72

midwives (22.5%), 166 nurses (51.9%), five

physiotherapists (1.6%), six dietitians (1.9%), 15

general practitioners (4.7%), three dentists (0.9%),

33 specialist doctors (10.3%), and 20 pharmacists

(6.3%). Contrastingly, Noviyanti et al. (2023) found

that various professions participate in

interprofessional collaboration, including general

practitioners, specialist doctors, dentists, nurses,

midwives, physiotherapists, dietitians, and

pharmacists.

According to Republic Government Regulation

No. 93 of 2015, a teaching hospital is defined as a

facility that serves as a hub for education, research,

and integrated health services within the realms of

medical and dental education, continuous education,

and various health education initiatives, all

conducted in a multi-professional manner. To

achieve this, the Hospital Accreditation Commission

in MKE (Communication and Education

Management) standard five outlines regulations

pertaining to communication and education

management among health professions. MKE

Standard 5 emphasizes that the communication of

patient care information and outcomes must occur

seamlessly among health professionals working in

shifts. Effective communication between health

professionals is deemed crucial for the smooth

operation of the care process (Ministry of Health the

Republic of Indonesia, 2019).

The World Health Organization (WHO), in both

unspecified past instances and in 2022, has launched

patient safety initiatives with an Interprofessional

Collaboration (IPC) strategy to reduce incidents

causing harm to patients. Both the Institute of

Medicine (IOM) and WHO advocate for health

professionals to collaborate in IPC to enhance health

services (Rørtveit et al., 2020). Ineffective IPC can

negatively impact hospitals, staff, and patients as

service recipients, leading to increased

dissatisfaction and heightened demands from

patients or their families. Adverse incidents arising at

the collaborative practice level are often attributed to

a failure to communicate crucial information among

health workers, particularly doctors and nurses

(Haugen, 2022). The implementation of

interprofessional collaboration in health services

describes a process wherein professionals from

various scientific fields collaborate to provide

holistic and integrated health services, aiming to

achieve healing and well-being for patients (Harding

& Hagler, 2022).

Interprofessionalism is currently a priority in

healthcare (Whelton et al., 2018). Numerous health

professionals endorse interprofessional

collaboration, firmly believing that such

collaboration enhances the quality of care. Over the

past decade, interprofessional health teams have

garnered significant attention, as healthcare delivery

increasingly relies on collaboration, healthcare

provider competency, and knowledge (van den

Heuvel et al., 2022).

In Greece, the importance of Interprofessional

Collaboration (IPC) is outlined in the "Code of

Nursing Deontology" Specifically, Article 12 of the

Code emphasizes that "A nurse must maintain

positive relationships with fellow nurses, doctors,

and other professionals while carrying out their

duties. This involves recognizing and respecting any

differences, always considering the operational

benefits of services." Correspondingly, Section 4 in

Article 21 of the Code of Medical Deontology

highlights that Physicians are expected to promote

respect, nurture positive relationships, and

collaborate with nurses and other personnel in their

practices. This involves acknowledging and

accommodating differences, while prioritizing the

interests of the patient and the efficient operation of

service benefits (Hardy, 2020).

According to the American Nurses Association

(ANA), collaboration is a reciprocal relationship in

which care providers hold the primary responsibility

for patient care within the framework of their

respective fields (Hickey & Giardino, 2019).

Collaborative practice emphasizes shared

responsibility in patient care management, featuring

a mutual decision-making process based on the

education and abilities of each practitioner.

From the perspective of the Department of

Veterans Affairs in the United States, as highlighted

by (Herdman & Heather, 2021), the components of

Interprofessional Collaboration (IPC) encompass

doctors, nurses, pharmacists, psychiatrists, and

technical personnel in health agencies. The

implementation of IPC has been successful in several

countries. The World Health Organization (WHO)

Interprofessional Collaboration for Effective Communication in Integrated Patient Development Records: A Systematic Review

291

noted that, in 2013, five countries excelled in

implementing the IPC concept, namely Canada, the

United States, India, Brazil, and South Africa.

In the 1

edition of the National Standards for

Accreditation of Hospitals (SNARS), specifically in

Part II, Patient Focused Service Standards, it is

outlined that one of the competencies of Care Service

Providers (PPA) is interprofessional collaboration.

This competency is divided into four domains:

values/ethics in interprofessional practice,

roles/responsibilities, interprofessional

communication, and teams and teamwork (Santosa &

Ariyani, 2020). The application of Interprofessional

Collaboration (IPC) in health services is considered

a strategic approach to achieve effective and efficient

quality outcomes. In developed countries, IPC has

become an integral part of health services in

hospitals. The Health Profession Accreditors

Collaborative (HPAC) has also published a guide on

implementing IPC (Ministry of Health the Republic

of Indonesia, 2019).

Therefore, based on the information presented in

the four articles mentioned above, it can be

concluded that the types of professions involved in

interprofessional collaboration include general

practitioners, specialist doctors, dentists, nurses,

midwives, nutritionists, physiotherapists, and

dietitians. Among the five articles, there is one that

does not specify any types of professions involved in

interprofessional collaboration.

4.2 Components of Effective

Communication in

Interprofessional Collaboration in

Hospitals

The effective communication component in IPC is

found in the research of Fathya et al. (2021) and Abd

El Rahman et al. (2021). The components of effective

communication in interprofessional collaboration

consist of several, namely:

a. Believe

The research by Fathya et al. (2021) elucidated

that 77.07% of respondents reported the

establishment of trust when engaging in effective

collaboration.

b. Support

The research by Fathya et al. (2021) revealed that

77.73% of respondents obtained support through

effective collaboration. Additionally, the research

conducted by Abd El Rahman et al. (2021)

explained that the majority of respondents,

specifically 39 individuals, rated their

collaboration as good, constituting 53.8% of the

total.

c. Empathy

Research by Fathya et al. (2021) explained that

the highest score was obtained, namely 80.37%,

with the statement, "Doctors and nurses

understand each other's need for humor in

establishing communication within reasonable

limits. Research by Abd El Rahman et al. (2021)

explains that the majority of 39 respondents rated

empathy as good (64.1%).

d. Open attitude

Research by Fathya et al. (2021) revealed that the

highest score, namely 80.37%, was obtained with

the statement, "Doctors and nurses understand

each other's need for humor in establishing

communication within reasonable limits."

Additionally, research conducted by Abd El

Rahman et al. (2021) explained that the majority

of 39 respondents rated empathy as good,

comprising 64.1% of the total.

e. Similarity

Research by Abd El Rahman et al. (2021)

explained that the majority of 39 respondents

rated similarity as good (66.7%).

Communication is a fundamental clinical skill

that must be consistently, competently, and

efficiently practiced to facilitate the establishment of

trust between medical staff and patients (Singh et al.,

2019). Effective collaboration requires proficient

communication not only within health teams but also

in developing doctor-patient relationships. This

fosters information sharing, delivery of treatment,

and overall patient satisfaction (Mohamadirizi et al.,

2021). Consequently, health services can be carried

out safely and effectively. This principle is also

enshrined in Minister of Health Regulation

1691/MENKES/PER/VIII/2011, where effective

communication is identified as one of the goals of

patient safety. Through strong collaboration among

health professionals in health services, patients can

receive holistic treatment, leading to improved

treatment outcomes and increased patient satisfaction

(Ministry of Health Republic Indonesia, 2018).

In the research conducted by Fathya et al. (2021),

the components of effective communication in

Interprofessional Collaboration (IPC) include trust,

support, empathy, and an open attitude. Specifically,

trust was reported by 77.07% of respondents who

collaborated effectively, support was reported by

77.73% of respondents in effective collaboration, and

empathy achieved the highest value at 80.37%,

particularly with the statement "Doctors and nurses

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292

understand each other's need for humor in

establishing communication within reasonable

limits." However, an open attitude received the

lowest score at 75.54%, particularly with the

statement "Doctors and nurses are able to understand

the patient's psychosocial condition.

Research conducted by Abd El Rahman et al.

(2021) reveals that the components of effective

communication in Interprofessional Collaboration

(IPC) include empathy, equality, openness, and

support. The majority of the 39 respondents assessed

empathy as good (64.1%), equality as good (66.7%),

openness as good (64.1%), and support as good

(53.8%).

This finding aligns with research by

Kusumaningrum et al. (2019), Bakhtiar & Duma

(2020), and Noviyanti et al. (2023), emphasizing the

presence of IPC components in effective

communication. According to Suéli Regina

Sulzbach, Carla Argenta, Edlamar Kátia Adamy,

William Campo Meschial (2022), effective

communication is achieved when the understanding

of the message conveyed by the communicator

matches the understanding of the message by the

communicant. Five general qualities contribute to

effective communication: openness, supportiveness,

a positive attitude, understanding others' feelings,

and equality. Effective communication must also be

based on effective interprofessional relationships

which meet the following requirements:

1) Credibility, in a literal sense, refers to someone

possessing advantages, and it involves the

recipient recognizing the communicator's

competence in the discussed matter. It is

associated with the communicator's attitude or

firm stance, ensuring that the conveyed message

remains unchanged. The conveyed message

typically has a purpose, aiming for positive

change.

2) Context: The conveyed message aligns with the

current needs.

3) Content: The message should be interesting,

engaging, and adaptable to the audience.

4) Clarity: The conveyed message must be clear and

free from multiple interpretations.

5) Continuity and consistency are essential; the

conveyed message should remain consistent and

continuous, adhering to the established topic and

communication objectives.

6) Target capability (the audience's capability),

material, and message delivery techniques are

adjusted to the audience's reception ability to

ensure clarity and avoid confusion.

From the two articles above, it can be concluded

that there are components of effective

communication in interprofessional collaboration,

namely trust, support, empathy, open attitude, and

equality. However, out of the four articles, three

articles did not mention the components of effective

communication in interprofessional collaboration.

4.3 Collaboration Components in

Implementing Interprofessional

Collaboration in Hospitals

The collaboration component in implementing IPC

can be found in the research of Kusumaningrum et al.

(2019), Bakhtiar & Duma (2020), Fathya et al.

(2021), and the research of Abd El Rahman et al.

(2021). The collaboration components in

implementing interprofessional collaboration consist

of several, namely:

a. Cooperation

Collaboration is defined as work carried out

by two or more people working together

across professions to achieve previously

planned and mutually agreed-upon goals. In

hospitals, teamwork has become a necessity

for achieving success in reaching goals (Iula

et al., 2020) Research by Kusumaningrum et

al. (2019) demonstrates a strong correlation

strength with a positive correlation direction,

and research by Bakhtiar & Duma (2020)

indicates that the cooperation aspect has been

well-implemented. Furthermore, research by

Abd El Rahman et al. (2021) reveals that

82.2% of respondents have collaborated

effectively in the cooperation domain.

b. Partnership

A partnership involves collaboration among

various parties, including both government

and private entities, where each participant

serves as partners or colleagues working

together to achieve common goals, fulfill

obligations, and share risks, responsibilities,

resources, capabilities, and profits. Research

by Kusumaningrum et al. (2019) reveals

moderate correlation strength with a positive

correlation direction, while research by Abd

El Rahman et al. (2021) indicates that 67.8%

of respondents had a good correlation.

c. Coordination

Coordination is an activity carried out by

various equal parties to jointly organize or

agree on something and provide information

to each other, ensuring that the process of

carrying out tasks and the success of one party

do not interfere with the other party (Suéli

Interprofessional Collaboration for Effective Communication in Integrated Patient Development Records: A Systematic Review

293

Regina Sulzbach, Carla Argenta, Edlamar

Kátia Adamy, William Campo Meschial,

2022).

Research by Kusumaningrum et al. (2019)

reveals a strong correlation strength with a

positive correlation direction. Additionally,

research by Bakhtiar & Duma (2020) indicates

that the coordination aspect has been

implemented effectively. However, research

by Abd El Rahman et al. (2021) shows that the

coordination domain has the lowest

percentage of good collaboration (66.7%), and

the communication component can influence

this. Therefore, it would be better to improve

communication between health workers in the

team to enhance overall performance.

d. Decision-making

Shared decision-making is the process of

making decisions about patient care actions

based on mutual agreement (Murdiany, 2021).

According to Zamani et al. (2018), the

characteristics of shared decision-making

include: (a) involvement of two or more

participants; (b) collaboration among all parties

to reach an agreement on available treatments;

individuals involved; and (d) reaching a

collaborative agreement for the care to be

carried out and implemented by the Care

Service Provider (PPA).

Research by Kusumaningrum et al. (2019)

reveals moderate correlation strength with a

positive correlation direction, and research by

Bakhtiar & Duma (2020) indicates that the

decision-making aspect has been implemented

effectively.

e. Discussion

Bakhtiar & Duma (2020) conducted research

that demonstrates the successful

implementation of the discussion aspect.

f. Power control

Fathya et al. (2021) research explained that the

control aspect of power received a rating of

76.37%.

g. Practice environment

In their research, Fathya et al. (2021) explained

that the lowest score in this aspect was 75.28%,

as indicated by the statement 'Doctors and

nurses discuss their respective areas of practice.

h. Common interest

In their research, Fathya et al. (2021) explained

that the aspect of shared interests received the

highest score, namely 80.59%. This was

indicated by the statement, 'The nurse asked the

doctor for advice on what might be needed to

strengthen the patient's support system.

i. Common goals

In their research, Fathya et al. (2021) explained

that the aspect of shared goals achieved a score

of 76.83%.

j. Interprofessional communication

Fathya et al. (2021) research on the AITCS II

questionnaire indicates that the communication

component is not analyzed separately but is

integrated into the coordination and partnership

components. According to Singh et al. (2019),

workers collaborate by consistently,

sensitively, and professionally communicating,

as well as demonstrating effective interpersonal

skills." Indicators include:

1) Communicate clearly, comprehensively,

and in a culturally appropriate manner both

orally and in writing.

2) Actively listen to and respect client needs

and concerns.

3) Actively listen to the knowledge and

opinions of all team members.

4) Describes effective working relationships

with clients and team members.

5) Use information and communication

systems effectively to improve client

services.

6) Respect the values, beliefs, and culture of

all parties concerned.

Based on the four articles above, it can be

concluded that the components of implementing

interprofessional collaboration include cooperation,

partnership, coordination, joint decision-making,

discussion, control of power, field of practice,

common interests, common goals, and

interprofessional communication.

4.4 Inhibiting Factors in

Interprofessional Collaboration in

Hospitals

Inhibiting factors in IPC are found in the research of

Bakhtiar & Duma (2020), Abd El Rahman et al.

(2021), and the research of Noviyanti et al. (2023).

The inhibiting factors in interprofessional

collaboration consist of several factors, namely:

a. Workload

Bakhtiar & Duma (2020) research indicates that

individuals bear varying workloads, leading to

suboptimal recording on the Integrated Patient

Development Notes due to excessive workload.

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This is because care service providers (PPA) not

only document patient care but also record

additional responsibilities, such as attending to

patient conditions, conducting doctor visits,

performing surgeries, and so on.

b. Attitude and behavior

Bakhtiar & Duma (2020) research indicates that

the attitudes and behavior of care service

providers (PPA) include laziness, fatigue,

differences in perception, forgetfulness, and

haste, resulting in ineffective documentation of

integrated patient Development notes. The

leader or head of the medical records installation

should motivate subordinates by providing

rewards and sanctions to ensure disciplined

documentation of Integrated Patient

Development Notes. Additionally, the

competency and educational backgrounds of

team members vary; individuals with diplomas

have different competencies from those with

other educational backgrounds, posing an

obstacle if training is not conducted. Hospitals,

particularly the Human Resources Department

(HRD), should pay more attention to medical

record officers, ensuring education aligns with

the Regulation of the Minister of Health of the

Republic of Indonesia Number 55 of 2013

concerning the Implementation of Medical

Recorder Work, where the minimum educational

qualification is a Diploma in Medical Records

and Health Information. Hospital management

should conduct regular training or seminars

related to Integrated Patient Development Notes

documentation to enhance the knowledge and

skills of officers.

c. Inequality

Abd El Rahman et al. (2021) research indicates

that inequality is observed in the existence of

professions whose domains are perceived as

merely supportive to other professions.

d. Overlapping Authorities and the Ratio of

Patients to Health Workers

Research by Abd El Rahman et al. (2021) and

Noviyanti et al. (2023) states that overlapping

actions or authority between health professions

is common in the health sector. This

phenomenon is associated with the unbalanced

ratio of patients to health workers.

e. Personal Character.

Research by Abd El Rahman et al. (2021) and

Noviyanti et al. (2023) state that health workers'

lack of awareness regarding the roles of other

professions in the team creates an obstacle to

collaboration.

f. Common interest

Research by Abd El Rahman et al. (2021) and

Noviyanti et al. (2023) states that several

participants emphasized the significance of

hospital institutional support in promoting

interprofessional collaboration, whether

through policies or facility support. The

absence of hospital institutional support in

formulating policies related to interprofessional

collaboration poses a barrier to its

implementation. Institutional support,

manifested through clear governance,

structured protocols, defined authority

boundaries, administrative support, and shared

operational procedures, serves as a driving

force for fostering interprofessional

collaboration in hospitals. Facilities that support

closer access to team members, such as team

interaction rooms and accessible information

technology for all team members to access

medical records, are believed to enhance

interprofessional communication.

g. Doctors and nurses discuss if what is instructed

is not in accordance with the scope of care

practice.

The nurse communicates to the doctor all the

challenges the patient faces in navigating

treatment options and their consequences.

Additionally, the nurse provides the doctor with

insights into specific areas of care. Furthermore,

nurses emphasize the importance of medical care

when discussing treatment options with patients.

Meanwhile, no inhibiting factors in IPC were

identified in the research conducted by

Kusumaningrum et al. (2019) and Suéli Regina

Sulzbach, Carla Argenta, Edlamar Kátia Adamy,

William Campo Meschial (2022), According to the

Joint Commission on Accreditation of Healthcare

Organizations, medical errors rank fifth among the top

ten causes of death in the United States. The root of

this problem is poor collaboration between health

workers, leading to treatment delays and fatal errors in

operations (Kamil et al., 2020). Additionally,

according to the Australian National Prescribing

Service, 6% of hospital cases result from drug side

effects and treatment errors, both of which arise due

to poor collaboration among health professionals

(Hickey & Giardino, 2019).

Urquhart et al. (2018) explained that 70-80% of

errors in health services result from poor

communication and a lack of understanding among

team members. Effective team collaboration is crucial

Interprofessional Collaboration for Effective Communication in Integrated Patient Development Records: A Systematic Review

295

for reducing patient safety issues. In several large

hospitals in Indonesia, evidence of equal team

collaboration is lacking, and partnerships remain

largely a government discourse. Only 15% of

respondents consider the quality of patient safety,

based on service and communication among health

workers, to be good, as revealed in research conducted

in 40 hospitals across Indonesia. This is evident in the

high number of medication errors in places like

Yogyakarta and Bali, where 1563 cases were reported

in 20 weeks (Craven, 2016). The significant errors in

prescription writing (98.69%) in Indonesia contribute

to pharmacist errors in preparing and providing

information about the medication. From 2015 to 2016,

317 cases of suspected malpractice were reported to

the Indonesian Medical Council (KKI) (Fukada,

2018).

Collaboration between health professionals in

Indonesia is still far from ideal, with overlapping roles

between health professions persisting. One of the

causes of this issue could be a lack of understanding

among health professionals regarding each other's

competence or insufficient communication among

health workers in teamwork and collaboration (Rao,

2019). Improving interprofessional collaboration is

essential to enhance satisfaction among health service

users.

So, it can be concluded from the three articles

above that inhibiting factors in interprofessional

collaboration include workload, attitudes and

behavior, inequality, overlapping authority, the ratio

of patients to health workers, personal character,

communication barriers, and lack of institutional

support. It is noted that doctors and nurses discuss

only when instructed and not within the scope of

nursing practice. Among the five articles, two do not

mention inhibiting factors in interprofessional

collaboration.

5 CONCLUSIONS

1. The types of professions involved in

interprofessional collaboration in hospitals

include general practitioners, specialist doctors,

dentists, nurses, midwives, nutritionists,

physiotherapists, pharmacists, and dietitians.

2. The components of effective communication in

interprofessional collaboration in hospitals

encompass trust, support, empathy, an open

attitude, and equality.

3. Collaboration components in implementing

interprofessional collaboration in hospitals

comprise cooperation, partnership, coordination,

joint decision-making, discussion, control of

power, field of practice, common interests,

common goals, and interprofessional

communication.

4. Inhibiting factors in interprofessional

collaboration in hospitals are workload, attitudes,

and behavior; discussions between doctors and

nurses may occur if instructions are not within the

scope of nursing practice; inequality; overlapping

authority; the ratio of patients to health workers;

personal character; communication obstacles,

and lack of institutional support.

Based on the conclusions above, the suggestions

given are:

1. Communication between health workers in the

team should be improved to enhance overall

performance.

2. The hospital, particularly the Human Resources

Department (HRD), should pay more attention to

the education of medical records officers, with a

focus on achieving a minimum educational

qualification of a Diploma in Medical Records

and Health Information.

3. The leader/head of the medical records

installation should motivate subordinates by

providing rewards and sanctions to ensure

disciplined documentation of Integrated Patient

Development Notes.

4. Hospital management should organize regular

training seminars focused on Integrated Patient

Development Notes documentation to enhance

the knowledge and skills of officers.

ACKNOWLEDGMENTS

The researcher would like to express his gratitude to

the Honourable :

1. Dr. Tukimin bin Sansuwito, as a supervisor who

has provided guidance and advice to make this

research dissertation proposal perfect.

2. Dr. Duke, as a supervisor who has provided

guidance and advice to make this research

dissertation proposal perfect.

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