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Effective communication is essential for teamwork effectiveness in healthcare, particularly in inpatient units where patient care requires coordination among multiple professionals. Internal data from Hospital X showed that more than 50% of medical incidents in the last two years were related to miscommunication among healthcare workers. In addition, the 2024 employee satisfaction survey reported that workplace communication satisfaction was only 62%, below the hospital target of 75%. This study aimed to examine the influence of effective communication on teamwork effectiveness with interprofessional collaboration as an intervening variable at Hospital X.This study used a quantitative cross-sectional design involving 226 healthcare workers, including doctors, nurses, and medical support staff. Data were analyzed using the Three-Box Method and PLS-SEM. The findings revealed that effective communication significantly influenced teamwork effectiveness both directly and indirectly through interprofessional collaboration. Interprofessional collaboration also acted as a significant mediating variable between communication and teamwork effectiveness. These results indicate that communication is a key foundation for strengthening collaboration and improving teamwork in hospitals. Therefore, hospitals should enhance communication training and interprofessional collaboration programs to improve healthcare quality and patient safety

Hospitals play a strategic role in improving public health through professional, safe, and high-quality healthcare services. In modern healthcare organizations, service quality is not only determined by medical facilities and technology but also by the quality of human resources, particularly healthcare workers who directly interact with patients. This study aims to analyze the influence of authentic leadership on healthcare workers’ performance and hospital service quality. The study employed a quantitative explanatory research design involving 120 healthcare workers in a hospital setting. Data were collected using questionnaires and analyzed through multiple linear regression analysis. The findings demonstrate that authentic leadership has a positive and significant effect on healthcare workers’ performance, with a regression coefficient value of 0.648 and a significance level of 0.000. Furthermore, authentic leadership indirectly influences hospital service quality through healthcare workers’ performance, with an indirect effect value of 0.521. These findings indicate that leaders who demonstrate honesty, transparency, integrity, and interpersonal support are able to create a healthy work environment that enhances healthcare workers’ motivation, responsibility, and professionalism. Consequently, improved employee performance contributes to better hospital service quality, particularly in responsiveness, empathy, and communication with patients. This study highlights that authentic leadership is an effective leadership approach for strengthening healthcare human resources and improving hospital service quality in contemporary healthcare organizations.

The highly competitive healthcare industry in Cirebon poses a significant challenge for Klinik Utama X, especially as a non-BPJS facility. This condition requires a paradigm shift from a provider-centric marketing mix to a patient-centric approach to retain patient loyalty. This study aims to evaluate and formulate the marketing strategy of Klinik Utama X using a comparative 4P (Product, Price, Place, Promotion) and 4C (Customer Solution, Customer Cost, Convenience, Communication) approach based on SWOT analysis. This research used a qualitative descriptive design with purposive sampling, gathering primary and secondary data through in-depth interviews, observations, and document studies. The data were systematically evaluated using Internal Factor Evaluation (IFE) and External Factor Evaluation (EFE) matrices. The findings reveal that the clinic is strategically positioned in Quadrant I, with an IFAS score of 2.53 and an EFAS score of 2.60, indicating strong internal capabilities to seize external opportunities. The recommended aggressive growth strategy involves integrating psychiatric and aesthetic services, penetrating the Business-to-Business (B2B) market through corporate medical check-ups, accelerating digitalization via telemedicine and online queuing, and preparing for BPJS accreditation. The managerial implications suggest that the clinic must prioritize resolving internal human resources and strengthening financial record-keeping systems before investing heavily in medical assets, while actively expanding digital convenience and corporate partnerships to secure short-term financial stability.

The rapid development of digital media has increased the complexity of health information flows and triggered the spread of misinformation, thereby requiring service personnel to be prepared to manage information critically. However, studies specifically examining the relationship between digital media literacy and readiness to handle health hoaxes among non-medical frontliner staff remain limited. This study aims to analyze the relationship between digital media literacy and readiness in handling health-related hoaxes among frontliner staff at RSUD Welas Asih Bandung. A quantitative approach with a survey method was employed, involving 243 respondents selected through a census sampling technique. Data were collected using a Likert-scale questionnaire and analyzed through validity, reliability, and Spearman’s Rank correlation tests. The results indicate that digital media literacy is at a high level, with digital safety (85.2%) and digital ethics (82.3%) as dominant indicators. Readiness in handling health hoaxes is also high, with gathering (78.6%) and planning (76.1%) as the highest indicators. The correlation test shows a positive and significant relationship with a coefficient of 0.794 (p<0.001), indicating a strong association. These findings suggest that improving digital media literacy significantly contributes to enhancing readiness in handling health hoaxes. Therefore, strengthening digital literacy is an important strategy to improve communication effectiveness and healthcare service quality.

The quality of interaction between physicians and patients plays a crucial role in the healthcare system, as it directly affects patient satisfaction. Ineffective communication by physicians may reduce patient satisfaction and increase the risk of complaints and medical disputes. This study aims to analyze the relationship between doctor–patient communication patterns and patient satisfaction in outpatient services. This research employed a quantitative approach with an observational analytic design using a cross-sectional method. The study population included all outpatient patients, with a sample of 110 respondents selected through accidental sampling. The independent variable was doctor–patient communication, while the dependent variable was patient satisfaction. Data were collected using a questionnaire, and analysis was performed using the Chi-Square test with a 95% confidence level. The results showed that the majority of respondents rated doctor–patient communication as good (80.9%) and reported high levels of satisfaction (75.5%). The analysis revealed that among respondents who experienced good communication, 84.3% reported high satisfaction, whereas the proportion of high satisfaction decreased significantly in the groups with moderate and poor communication. In conclusion, there is a significant relationship between the quality of doctor–patient communication and patient satisfaction in outpatient services, where improvements in communication quality are consistently associated with increased patient satisfaction.

This study aims to analyze the marketing strategies of maternal and child healthcare services in hospitals to enhance patient experience, emphasizing a shift from traditional promotional approaches toward the creation of a positive and empathetic patient experience. This research employs a systematic literature review of relevant studies published between 2021 and 2025, with analysis conducted through identification, selection, and thematic synthesis to determine key factors influencing patient satisfaction and loyalty. The findings indicate that the quality of interpersonal interactions and the efficiency of service processes are the primary determinants of patient experience, where factors such as staff empathy, clear communication, reduced waiting times, and well-structured service flows have a greater impact than the technical aspects of medical care. Hospitals should therefore prioritize people- and process-oriented strategies by implementing empathy training, enhancing communication effectiveness, and regularly measuring patient satisfaction, while also integrating digital services, ensuring cost transparency, and developing continuity of care programs to strengthen the patient experience holistically. This study proposes a holistic marketing framework that integrates empathy, efficiency, data-driven personalization, and environmental sustainability, highlighting a shift from a purely clinical orientation to an experiential marketing approach that places human values at the core of a hospital’s competitive advantage.

The healthcare sector is increasingly confronted with a VUCA environment (Volatility, Uncertainty, Complexity, and Ambiguity), requiring hospitals to adopt adaptive, resilient, and innovative strategies. This study aims to systematically review the evidence on smart hospital strategies in responding to uncertainty, particularly in improving service quality, operational efficiency, and patient satisfaction. A systematic literature review was conducted using major academic databases, including Scopus-indexed sources, Google Scholar, and Semantic Scholar, covering publications from 2020 to 2026. Articles were selected based on predefined inclusion criteria focusing on hospital management strategies in dynamic and uncertain environments. A total of 10–15 relevant studies were included and analyzed using thematic synthesis. The findings indicate that key strategies in addressing VUCA challenges include digital transformation (e.g., electronic medical records and telemedicine), adaptive and transformational leadership, agile management approaches, and patient-centered care. Digital technologies significantly improve efficiency and decision-making processes, while agile and adaptive leadership enhances organizational responsiveness and resilience. However, several studies highlight that technological advancement alone is insufficient without integrating humanistic values such as empathy, communication, and trust. In conclusion, the most effective hospital strategies in a VUCA world are those that integrate technological innovation with human-centered care. Hospitals must develop flexible, data-driven, and patient-oriented systems to ensure sustainability and competitiveness in uncertain environments. Future research should focus on longitudinal and experimental designs to strengthen causal evidence and explore the integration of digital systems with humanistic healthcare values.

Rapid global environmental changes, especially due to advances in technology and information, have had a significant impact on various sectors of life, including the health sector. In the context of modern health services, hospitals are no longer just places of healing, but also institutions that are required to provide high-quality services, based on patient safety, and are able to adapt to the dynamics of community needs. This change requires a transformation in human resource management, especially related to the interpersonal and psychosocial competencies of nurses as the spearhead of medical services.Purposes:​ to analyze the effect of effective communication and Assertive Attitude on Nurses' Work Productivity in hospitals, with Work Fatigue as a mediating variable.Methods: This type of research is quantitative, using statistical figures to measure the influence of independent variables on dependent variables. The research design is a cross-sectional study.Results: The results of this study indicate that effective communication, assertiveness, and job fatigue collectively significantly influence nurses' work productivity. Communication and assertiveness positively contribute to job fatigue, which in turn affects productivity. Job fatigue is also shown to be a significant mediator in the relationship between communication and assertiveness on work productivity .Conclusion : The importance of strengthening effective communication as a strategy to increase productivity. Organizations need to design communication systems that support openness, transparency, and clarity of information and culture-based assertiveness training, so that employees can express their opinions appropriately without causing resistance in the team.

Patient safety is often viewed exclusively as the responsibility of clinical personnel. However, administrative errors occurring during the admission process and documentation stages constitute major contributors to medical risk. This study aims to explore the strategic role of administrative staff in strengthening patient safety culture and mitigating medical risks through effective communication coordination. A narrative literature review was conducted extensively using the Scopus, PubMed, and Web of Science databases, covering publications from 2014 to 2024. Data were analyzed using a thematic synthesis approach. The findings identify four main themes: administrative staff as information gatekeepers, the role of health information technologies (HIS/EMR) in bridging communication gaps, collaboration barriers arising from hierarchical structures, and the need for an Interprofessional Shared Governance framework. Administrative accuracy in the early phases of care is proven to be critical in preventing latent errors with potentially fatal consequences. Strengthening patient safety culture requires the integration of administrative staff through cross-departmental training, standardized communication protocols, and non-punitive incident reporting systems. Administrative staff are not merely bureaucratic support personnel but are key actors within the modern hospital patient safety ecosystem.

Effective communication is a key competency for medical professionals, but traditional classroom-based methods in Indonesia face challenges such as limited practice, geographical barriers, and insufficient exposure to diverse patient scenarios. Mobile-assisted learning (MAL) offers a promising solution to enhance medical communication training outside traditional settings. This study investigates the effectiveness of MAL interventions in developing communication skills among Indonesian medical students and healthcare professionals. A mixed-methods approach was used, involving a quasi-experimental design with pre- and post-assessments of communication competence among 180 participants from three Indonesian medical schools. The MAL intervention included a mobile app with video demonstrations, interactive case scenarios, peer feedback, and microlearning modules. Quantitative data showed a significant improvement in communication competence (mean increase of 23.4%, p<0.001), with notable gains in information gathering (28%), relationship building (26%), and patient education (21%). The mobile platform saw high engagement (average of 4.3 sessions/week) and 87% module completion. Qualitative data revealed increased confidence in consultations, improved cultural sensitivity, and better time management. Challenges included inconsistent internet access, varying digital literacy, and resistance from traditional educators. MAL shows potential for improving medical communication in Indonesia, offering flexible, accessible training. Successful implementation requires addressing infrastructure issues, integrating MAL into existing curricula, and training faculty. This study adds to the growing evidence supporting technology-enhanced medical education in resource-limited settings.

Informed consent constitutes a fundamental legal and ethical requirement in healthcare services, ensuring that every medical action is performed with the patient’s full awareness and voluntary approval. In Indonesia, the obligation to obtain informed consent is firmly regulated under the Health Law No. 17 of 2023, the Minister of Health Regulation on Medical Consent, and provisions on medical records. This paper examines the essential role of informed consent as a protective instrument for both patients and healthcare providers within the clinical and legal framework. Informed consent guarantees patients’ rights to information, autonomy, and decision-making, while providing legal safeguards for medical practitioners by documenting the process of explanation, acceptance, or refusal of medical treatment. Proper documentation within medical records ensures accountability, continuity of care, and serves as crucial evidence when medical disputes arise. Medical disputes often stem from dissatisfaction, communication gaps, or misunderstandings about risks inherent in medical procedures. Therefore, informed consent functions not merely as an administrative requirement but as a mechanism for preventing conflict, clarifying responsibilities, and distinguishing unavoidable medical risks from professional negligence. By strengthening the implementation of informed consent, healthcare providers can enhance transparency, improve service quality, and reduce the likelihood of medical litigation.  

This study examines the implementation of social rehabilitation program policies for people with physical disabilities at the Technical Implementation Unit (UPT) Social Rehabilitation Bina Laras Pasuruan under the East Java Provincial Social Service. Using George C. Edwards III's policy implementation model, this research analyses four key variables: communication, resources, disposition, and bureaucratic structure. This qualitative descriptive study employed interviews, observation, and documentation as data collection techniques. The findings reveal that the implementation has been running reasonably well, with clear communication channels established between program implementers and beneficiaries. However, several challenges persist, including limited human resources, particularly professional social workers and medical rehabilitation specialists, as well as budget constraints affecting service quality. The disposition of implementers shows a positive attitude toward policy goals, though the bureaucratic structure requires improvement in coordination mechanisms. The study concludes that while the social rehabilitation program has improved the quality of life for persons with disabilities, optimising policy implementation requires addressing resource limitations, strengthening inter-agency coordination, and enhancing community participation in rehabilitation efforts

This study investigates the clinical handover process as a critical component of patient safety and healthcare service quality in hospital settings. Inconsistent communication, incomplete documentation, and the absence of standardized procedures were identified as major problems contributing to communication failures and potential adverse events. The objective of this research was to develop and test a structured and effective handover model that could improve communication accuracy and documentation reliability among healthcare professionals. A mixed methods design was employed, consisting of a qualitative phase (in-depth interviews, observations, and document analysis) to explore real-world handover practices, followed by a quantitative phase using a pretest–posttest design to evaluate the effectiveness of the proposed model. The study proposes an integrated handover model based on SBAR-IM (Situation, Background, Assessment, Recommendation, Intervention, Monitoring) strengthened by Quality Control (QC) and Mutual Confirmation (MC) mechanisms. The findings demonstrate a significant improvement in handover quality after implementation, with communication scores increasing from 74 to 84.5 and documentation scores improving from 48.3 to 63.0 (p < 0.05). Qualitative results further revealed reduced communication errors, improved clarity of clinical information, and enhanced interprofessional collaboration. This study concludes that the proposed SBAR-IM–based QC–MC model is effective, practical, and suitable for improving patient safety and healthcare service quality in hospital environments.

Human Immunodeficiency Virus (HIV) infection leading to Acquired Immune Deficiency Syndrome (AIDS) remains a global public health issue, with 39 million people living with HIV worldwide in 2022. Although X Hospital in Malang City provides a comprehensive care program, internal data shows a significant level of non-adherence to antiretroviral (ARV) therapy, often in the form of irregular consumption or discontinuation of medication without medical recommendation. This observational study with a cross-sectional approach aims to identify the determinants of ARV non-adherence, involving 81 non-adherent AIDS patients at Hospital X through total sampling techniques. The characteristics of the respondents were dominated by males, highly educated, and working in the non-government sector, with the majority using the ARV regimen TLD, COTRIMOXAZOLE. The results of statistical analysis indicate that all eight determining variables tested show a highly significant positive correlation (p < 0.001) with non-compliance, meaning that the more severe the problems with these factors, the lower the patient compliance. Furthermore, the top five factors showed a very strong positive correlation (r > 0.80) with non-adherence, namely motivation/depression, social support, communication with service providers, treatment costs, and age or routine. These findings underscore that these five key determinants must be a crucial focus in designing and implementing targeted intervention strategies to effectively improve patient adherence to ARV therapy.

Purpose –This article aims to integrate three strategic pillars in strengthening Indonesia's defense human resources (HR), namely Crew Resource Management (CRM) in military medicine, national biological defense, and STEM-based education. Design/methodology/approach –The research used a systematic literature review approach by examining literature from international databases (Elsevier, Springer, Wiley, Taylor & Francis, ACM, IEEE, ScienceDirect, SAGE, DOAJ, JSTOR) and reputable national journals (SINTA, GARUDA, BRIN). The analysis was conducted thematically with normative, empirical, and conceptual approaches. Findings –The study results show that: (1) CRM effectively improves communication, coordination, and decision-making of military medical teams in crisis situations; (2) the establishment of a Biological Defense Agency is urgently needed to address the threat of pandemics, bioterrorism, and transnational biosecurity; and (3) STEM education has been proven to strengthen innovation, adaptability, and the competence of the younger generation of defense personnel. The integration of these three aspects results in the CRM–Bio-Defense–STEM Nexus conceptual framework as the foundation for developing Indonesian defense human resources towards the 2045 vision. Practical implications –This study recommends strengthening national policies through: (1) a STEM-based defense curriculum, (2) CRM training in military medical education and operations, and (3) the establishment of a special biological defense institution as the front line in facing biological threats.Originality/value –This article provides a new contribution in the form of an integrative conceptual model of CRM–Bio-Defense–STEM that has never been studied holistically in the context of Indonesian defense, while also offering a strategic framework for the development of adaptive, innovative, and resilient national defense human resources.

Maritime safety is a crucial aspect and occupies a central position in all maritime operations, especially for Indonesia as an archipelagic country that heavily relies on sea transportation. A lack of knowledge about safety tends to result in material loss, medical issues, and loss of life, demanding extra attention as the number of maritime accidents increases. This study aims to analyze the influence of independent variables on Shipping Safety (Y) at the Tanjung Emas Semarang Port Authority Office (KSOP). The independent variables tested are Crew Resources (X_1), Telecommunication Equipment (X_2), and Pilotage (X_3). Using a quantitative approach with Multiple Linear Regression analysis on 100 respondents (operational staff and captains), the F-test results confirm that X_1, X_2, and X_3 simultaneously have a positive and significant effect on Shipping Safety. Furthermore, the T-test results show that Telecommunication Equipment (X_2) has the highest and most dominant influence compared to other variables in affecting Shipping Safety. The Adjusted R^2 value of 0.619 indicates that 61.9% of the variation in Shipping Safety can be explained by these three factors. This finding provides empirical validation emphasizing the technological imperative in modern port risk management, guiding policies toward prioritizing investment in communication devices to enhance maritime safety performance.

Hypertension, or high blood pressure, is a medical condition characterized by a persistent increase in blood pressure exceeding normal thresholds. The aim of this study was to examine the relationship between coping mechanisms and psychological stress among elderly individuals with hypertension in Meunasah Papeun Village, Krueng Barona Jaya District. This research employed a quantitative design with a descriptive-analytic approach using the Cross-Sectional Study method. The total population consisted of 77 participants, and the sampling technique utilized total sampling. The study was conducted from June 25 to July 16, 2025. Data collection instruments included the Brief Cope questionnaire and a stress questionnaire developed by the researcher, with a reliability value of Cronbach’s alpha P-Value = 0.693. Data analysis was carried out using the Chi-Square test. The study findings revealed a P-Value = 0.503 (>0.05), indicating no significant relationship between coping mechanisms and stress among elderly individuals with hypertension in Gampong Meunasah Papeun. Respondents are advised to maintain emotional stability to prevent psychological stress; although the findings indicate no direct correlation, it remains essential to preserve mental well-being through effective communication, participation in positive activities, and seeking family support. The village as the research site is encouraged to continue developing stress reduction programs through educational and preventive approaches, such as counseling on coping mechanisms for stress and group discussions.

The quality of outpatient services is an essential indicator of hospital performance and patient satisfaction. At Mega Buana Hospital Palopo, patient complaints remain regarding waiting times, limited facilities, and staff communication, highlighting the need for evaluation based on the Ministry of Health Regulation No. 129/Menkes/SK/II/2008. This study aimed to analyze the relationship between human resources, medical staff interactions, service processes, and patient satisfaction with outpatient service quality. This research employed a quantitative design with a cross-sectional approach. A total of 116 patients were selected through accidental sampling. Data were collected using a validated and reliable questionnaire and analyzed using the chi-square test. The results revealed significant associations between human resources (p=0.001), medical staff interactions (p=0.003), and patient satisfaction (p=0.002) with outpatient service quality. The service process, particularly waiting time and queue management, proved to be important factors influencing patients’ perceptions of service quality. Overall, the service quality was categorized as good but not yet fully aligned with the national standards, especially in administrative speed, queue system, and facility comfort. In conclusion, outpatient service quality at Mega Buana Hospital Palopo is influenced by human resources, medical staff interactions, service processes, and patient satisfaction. The findings emphasize the importance of strengthening human resource management, improving the quality of medical staff communication, enhancing queue management, and providing adequate supporting facilities to meet national service standards.

Preoperative anxiety is one of the psychological problems that patients often experience and can affect physiological stability, response to anesthesia, and the postoperative recovery process. High levels of anxiety in patients leading up to surgery can have negative impacts, both physically and emotionally. One of the interventions that can be done to reduce anxiety is therapeutic communication by nurses. Therapeutic communication has an important role in creating a relationship of mutual trust, providing a sense of security, and helping patients understand the medical procedures to be undertaken. However, there are still conditions where therapeutic communication has not been implemented optimally. This study aims to determine the relationship between nurses' therapeutic communication and the level of anxiety of preoperative patients at RSI Pekajangan. The study used a quantitative approach with a correlational design and involved 72 respondents who were selected through purposive sampling techniques. The research instruments included a therapeutic communication questionnaire and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data analysis was carried out using the Spearman Rank test. The results showed that most respondents rated therapeutic communication in the categories of good (81.9%) and moderate anxiety (72.2%). Statistical tests showed a significant relationship between nurses' therapeutic communication and preoperative patients' anxiety levels (p = 0.027) and moderate correlation strength (r = -0.260). The conclusion of this study confirms that therapeutic communication plays a role in lowering patients' anxiety, so it is recommended that nurses improve therapeutic communication skills as part of pre-surgical interventions.

The Intensive Care Unit (ICU) is a specialized unit in a hospital that provides intensive care and close monitoring for critically ill patients. This unit is equipped with advanced medical equipment such as ventilators and hemodynamic monitors, and has a high staffing ratio to ensure optimal care (Smith & Jones, 2020; Brown et al., 2019; Williams & Green, 2021).  The multidisciplinary team in the ICU, including specialist physicians and trained nurses, works together to meet the medical and psychological needs of patients (Taylor, 2022; Miller & Adams, 2018). According to the WHO (2023), 10–20% of hospital patients require ICU care. In Indonesia, ICU patients account for approximately 15% of total hospital patients (Kusuma, 2021). Data from Dr. Moewardi Regional Hospital (RSUD) shows an increasing trend in ICU patients, primarily due to infectious diseases (Ministry of Health, 2021). Meanwhile, in the ICU of Sultan Agung Islamic Hospital (RSI Sultan Agung Semarang), 1,278 patients were admitted between January and October 2024, with the most cases being respiratory failure (143 patients). This study used a quantitative design with a cross-sectional approach. The sample consisted of conscious patients treated in the ICU and met the inclusion criteria, with 71 respondents.  The research instrument used a validated questionnaire to measure family support, therapeutic communication, and anxiety levels. Data analysis was performed using the Spearman test. Based on the Spearman test, the 71 respondents were found to have the following characteristics: the highest age group was early elderly (36.6%), the highest gender was male (64.8%), the highest education level was high school (45.1%), the highest occupation was 80.3%, high family support (74.6%), good therapeutic communication (90.1%), and mild anxiety (59.2%). There is a significant relationship between family support and patient anxiety levels. Furthermore, therapeutic communication also significantly reduced patient anxiety levels in the ICU at Sultan Agung Islamic Hospital, Semarang.