Integrasi Komunikasi Terstruktur dalam Electronic Medical Record sebagai Upaya Meningkatkan Keselamatan Pasien: Literature Review

Authors

  • ID Iman Nurjaman Universitas Bhakti Kencana Indonesia Author

DOI:

https://doi.org/10.66914/dbkzw181

Keywords:

Electronic Medical Record, komunikasi terstruktur, handoff, dokumentasi keperawatan

Abstract

Keselamatan pasien dipengaruhi oleh efektivitas komunikasi dan dokumentasi klinis. Komunikasi yang tidak terstruktur selama handoff dan dokumentasi berpotensi menyebabkan kehilangan informasi serta meningkatkan risiko kesalahan medis. Penelitian ini bertujuan mengidentifikasi, menganalisis, dan mensintesis bukti ilmiah mengenai integrasi komunikasi terstruktur dalam Electronic Medical Record (EMR) sebagai upaya meningkatkan keselamatan pasien. Penelitian menggunakan metode literature review dengan pendekatan naratif melalui pencarian artikel pada basis data Scopus menggunakan kata kunci yang berkaitan dengan Electronic Medical Record, structured communication, handoff, dan patient safety. Artikel yang dipilih merupakan original research, berbahasa Inggris, tersedia full text, dan diterbitkan pada periode 2020–2026. Sebanyak enam artikel memenuhi kriteria inklusi dan dianalisis menggunakan sintesis naratif. Hasil menunjukkan bahwa integrasi komunikasi terstruktur dalam EMR meningkatkan kualitas dokumentasi, komunikasi antarprofesi, efektivitas handoff, kesinambungan pelayanan, serta mendukung pengambilan keputusan klinis dan keselamatan pasien. Implementasi masih menghadapi kendala berupa keterbatasan pelatihan, beban kerja, variasi kompetensi pengguna, serta faktor organisasi dan teknologi. Disimpulkan bahwa integrasi komunikasi terstruktur dalam EMR merupakan strategi efektif untuk meningkatkan keselamatan pasien dan memerlukan dukungan kebijakan, pelatihan berkelanjutan, serta pengembangan sistem yang berorientasi pada kebutuhan pengguna.

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Published

2026-07-07

Issue

Vol. 2 No. 7 (2026): Sinergi: Jurnal Ilmiah Multidisiplin

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Articles

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Copyright (c) 2026 Iman Nurjaman (Author)

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