Exploring health workers’ perspectives on factors affecting patient experience in emergency caesarean section response time: a qualitative study in hospitals in Makassar City, Indonesia

Abstract

BACKGROUND: The achievement of an emergency caesarean response time of ≤ 30 min in Indonesia is still far below the target. This can impact the patient experience. This study aims to explore the factors causing delays in emergency caesarean response time and quality improvement strategies to address this issue. METHOD: This qualitative study was conducted in five hospitals in the city of Makassar, Indonesia, from November 2024 to January 2025. The phenomenological approach, along with in-depth interviews, was employed in this research. Data were collected through semi-structured interviews. A total of 14 healthcare workers were interviewed using purposive sampling, consisting of obstetricians, general practitioners, midwives, and nurses, and the data were analyzed using thematic analysis. The inclusion criteria for selecting informants are healthcare professionals who possess knowledge and expertise in the field of emergency cesarean sections, as well as having at least two years of work experience handling patients with such cases in hospitals. RESULTS: This study identifies four main factors that can impact the patient experience in achieving emergency caesarean response time, namely: system factors, patient and family factors, staff factors, and internal hospital policy factors. This study also produces quality improvement strategies to achieve emergency caesarean response times across various health professions, such as the importance of patient and family education, emotional support, the need for comprehensive hospital facilities to ensure the smooth operation of emergency caesarean procedures, the need for periodic performance evaluations of healthcare workers regarding response time achievements and most importantly the availability of documented, socialized, and actively used standard operating procedures by all healthcare workers. CONCLUSION: This study provides a comprehensive understanding of the factors that cause delays in achieving emergency cesarean response times. This can have both positive and negative impacts on the patient experience. Therefore, policy support and commitment from various health professions are essential for the successful implementation of achieving emergency cesarean response times in Indonesia.

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