How to Optimize Integrated Patient Progress Notes: A Multidisciplinary Focus Group Study in Indonesia

Hajjul Kamil,1 R Rachmah,1 Elly Wardani,1 Catrin Björvell2 1Nursing Leadership and Management Department, Faculty of Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia; 2Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SwedenCorrespondence: Elly WardaniNursing Leadership and Management Department, Faculty of Nursing, Universitas Syiah Kuala, Banda Aceh, IndonesiaEmail ellywardani@unsyiah.ac.idIntroduction: Hospitals in Indonesia are obligated to implement Integrated Patient Progress Notes (IPPNs), also known as the “Catatan Perkembangan Pasien Terintegrasi”. A progress note contains the entire interaction between patients and health professionals, including physicians, nurses, pharmacists, dietitians, and physiotherapists. However, since the first launch in 2012, obstacles and problems in completing this integrated documentation remains nationwide.Aim: The objective of this investigation was to identify health professional’s perspectives on obstacles and problems using IPPNs and facilitators that may optimize their use.Methods: Five focus group discussions (FGDs) involving 37 participants took place. All FGDs were recorded, translated, and transcribed verbatim. A thematic analysis was used to interpret the data.Results: The thematic analysis of the material revealed three main categories for each of the two topics; Topic 1. Perceived problems hindering integrated documentation: lack of supervision, competence, workload; topic 2: perceived strategies to optimize integrated documentation: organizational support, joint practices, integrating technology with IPPN.Conclusion: The results indicate that health professionals see the importance of using IPPNs but only if implemented with educational and organizational support and that the use of an electronic patient record may be more effective than a paper record. To continue the implementation of IPPNs, it is suggested that it is preceded by educational and organizational support.Keywords: integrated documentation, Indonesia, patient report, safety, service quality