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, Taiwan

Correspondence: Inge Dhamanti, Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, 60115, Indonesia, Tel +628 2336099800, Email [email protected]

View the original paper by Dr Dhamanti and colleagues

This is in response to the Letter to the Editor

Dr. Laoh’s interest in our research is greatly appreciated. Thank you for highlighting significant factors influencing incident disclosure, such as ethical awareness and the impression of patient safety culture among hospital nurses, which we did not uncover in our study’s findings. We believe that ethical awareness will lay the groundwork for all health workers, not only nurses. Meanwhile, the safety culture will provide a supportive environment for all health staff to disclose incidents. Both are required in the Indonesian hospital system.

Thank you also for recommending that future studies employ the Patient Safety Guide for Primary Care (PSG-PC). Although the guidelines are helpful for increasing collaborations to enhance quality of care by improving communication and building partnerships between patients and health-care providers, they do not focus on incident disclosure. Rather, we advised using NHS’s Being Open Policy,1 which provides a thorough approach to implementing open policy.

To summarize, like you, we strongly believe that feeling safe to disclose an occurrence is the most important factor; therefore, establishing a policy that protects health workers and is supported by an organizational structure will accelerate and improve the adoption of open disclosure within our health care system.

The authors report no other conflicts of interest in this communication.

1. NPSA. London: being open: saying sorry when things go wrong; 2009. Available from: https://www.hsj.co.uk/download?ac=1293677. Accessed May23, 2023.

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