We appreciate the work done by Dhamanti et al in their paper titled “Health Workers” Perspective on Patient Safety Incident Disclosure in Indonesian Hospitals.1 Congratulations to the authors for providing information on healthcare workers’ perceptions regarding open discussion practices of adverse events that may harm patients during care.

The study conducted by Dhamanti et al aimed to investigate the views of healthcare staff in Indonesian hospitals regarding open disclosure of patient safety incidents. The study found that the level of open disclosure practices was good, but most participants were confused about the difference between incident reporting and incident disclosure. Other findings revealed that important factors in incident disclosure were effective communication, the type of incident, and the characteristics of patients and their families.1 However, there were other factors influencing incident disclosure, such as ethical awareness and the perception of patient safety culture among nurses working in hospitals. Examples of cultural perceptions include promoting a culture of education, understanding, and practicing basic ethical values that need to be fostered together by the government, society, healthcare institutions, and healthcare professionals to enhance patient safety culture.2

The study conducted by Dhamanti et al used a mixed-methods explanatory sequential design, utilizing separate quantitative and qualitative data and integrating the results in the interpretation phase to achieve a comprehensive and in-depth understanding and validation.1 The chosen methods were appropriate, but we would like to recommend for future research to utilize the Patient Safety Guide for Primary Care (PSG-PC), which is the first guideline developed collaboratively by multidisciplinary healthcare sciences for primary care. The guide is designed to enhance patient safety by addressing international and national priorities. This method can provide insights on communication, understanding roles and responsibilities, and how to develop partnerships between patients and healthcare providers to actively engage patients in patient safety.3

In conclusion, we appreciate the findings obtained by the researchers, highlighting that open disclosure is a new concept for healthcare professionals in Indonesia. When implemented effectively, it can help address issues such as lack of knowledge, policy support, and training that support patient safety in hospitals.1 Therefore, we recommend that hospital organizations and nurses make efforts to implement systematic and sustainable quality improvement programs, manage education throughout the organizational structure, promote a cooperative team working culture, and enhance healthcare workforce development. Additionally, it is important to promptly implement legislation to protect healthcare professionals, ensuring that nurses feel legally protected when openly expressing complaints regarding unethical professional practices based on their ethical awareness.2

The author reports no other conflict of interest in this communication.

1. Dhamanti I, Sholikhah V, Semita IN, Zakaria N, Guo H-R, Sholikhah V. Health workers’ perspective on patient safety incident disclosure in Indonesian hospitals: a mixed-methods study. J Multidiscip Healthc. 2023;16:1337–1348. doi:10.2147/JMDH.S412327

2. Kim Y, Lee E. The relationship between the perception of open disclosure of patient safety incidents, perception of patient safety culture, and ethical awareness in nurses. BMC Med Ethics. 2020;21(1):1–9. doi:10.1186/s12910-020-00546-7

3. Morris RL, Ruddock A, Gallacher K, Rolfe C, Giles S, Campbell S. Developing a patient safety guide for primary care: a co-design approach involving patients, carers and clinicians. Heal Expect. 2021;24(1):42–52. doi:10.1111/hex.13143