ASSESSING THE DIMENSIONS OF HOSPITAL RECORDS (MEDICAL RECORDS) IN DELIVERING QUALITY OF SERVICE TO PATIENTS

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Significance of Record-Keeping:
Of late, the process has been made more scientific and albeit easier because we find computers playing an incremental role in managing the records, it is pertinent that you realize the instrumentality of record-keeping. However, medical record is an important primary tool in the practice of medicine because (Huffman,2001)  stressed that the whole idea " behind it is to provide better care of the patient through careful recording of every detail having to do with his/her case. The medical record is the, who, what, why, where, when, and how of the patient care during hospitalization. The following are the significant of hospital records;

1.Quality decision making: it was agreed with this view that sky is the limit to quality purgation and sky is the limit even for achieving a stage of perfection. Of course, you have subjective knowledge and based on that you are in a position to manage hospitals in a right fashion.

2. Evaluation of Performance is possible: Records in a true sense narrate the contribution of different department and section. The performance of an individual or a team can be gauged with the help of records.

3. Making possible a comparative analysis: If an organization want to remain number one or at the top, it is pertinent that you not only know about yourself but also come to know about your competitors. It is in this context that we find hospital helping you in making comparative analysis of the performance of leading and internationally acclaimed hospitals and healthcare organizations.

4. Internal control is possible: The record keeping if managed and monitored in a right fashion helps an organization in channelizing the internal control. Since you have come to know the points, stage, reasons for the mistakes committed earlier, it is easier for you to be vigilant so that the employees don’t repeat the same.” Prevention is better than cure.

5. Operational efficiency is increased: The hospital records substantially help you in increasing the level of efficiency of not only the personnel but also the equipment, instruments, plants and machines, instrument used in the process.

Methodology
This shows how the study was conducted using the very right methods.  To ensure that all aspects of this descriptive research were analyzed significantly before drawing relevant conclusions, both quantitative and qualitative approaches were employed. The sample size used for the study was 60. The researchers employed systematic sampling for the study. Systematic sampling is a type of probability sampling method in which sample members from a larger population are selected according to a random starting point and a fixed periodic interval. The total population was 123 and the target sample was 60, thus 123/60=2.05 so every 2nd person in the population stands the chance of being selected.

S/N

THEMATIC

ITEMS

PROPORTION (100%)


1.


Age


(A) 18-23

(B) 23-28

(C) 33-38

(D) 43-48

(E) 53 And Above


25

25

15

15

20


2.


Gender


(A) Male

(B) Female


36.7

63.3


3.


Years Worked


 (A) 0-1year        

(B) 1-2years       

(C) 2-3years

(D) 3-4years      

(E) 5years And Above 


13.3

5.0

21.7

21.7

38.3


4.


Department


(A) Nursing        

(B) Admission Office   

(C) Medical Record


51.7

16.7

31.7


5.


System For Storing And Keeping Records


(B) TD Record

(C) Both


48.3

51.7


6.


Difficulty In Filing And Creating Records


(A) Strongly Agree

(B) Agree

(D) Disagree,  

(E) Strongly Disagree


18.3

43.3

31.7

6.7

Table 4.1 (Field survey, 2018)

From the table above, the Age categories of the respondents range from 18-28, recording the highest percentage of 25% of the entire age category.
Majority of the respondents were females 63.3%. Respondents were asked years they’ve worked with the organization, majority of them have worked more the 5years representing 38.3%.
Nursing department was majority of the respondents recording 51.7%. However, the researchers wanted to know which system was adopted for record keeping in the organization, majority said both manual and technology were used representing 51.7%. Respondents agreed that, filing, indexing, cataloguing and creating records was a challenging task.

Table 4.2 The most challenging dimension of medical records keeping

Rank

1st

2nd

3rd

4th

5th

Total

Creating the Records

(26x1)

(15x2)

(9x3)

(6x4)

(4x5)

127

Retaining the Records

(21x1)

(18x2)

(11x3)

(6x4)

(4x5)

134

Administering the Records

(24x1)

(18x2)

(8x3)

(6x4)

(4x5)

128

Destroying the Records

(16x1)

(14x2)

(8x3)

(9x4)

(13x5)

169

Submitting the Records

(13x1)

(11x2)

(15x3)

(11x4)

(10x5)

174

The above table shows the dimensions of medical records the most challenge to the least challenging. The first rank was given the lowest number (1) and the least challenging attribute was given the highest number (5). The total lowest score shows the first most challenging. The results of the rank order were as follows; Creating records, administering the records, destroying the records and submitting the records. 


Model


R


R Square


Adjusted R Square


Std. Error of the Estimate


Change Statistics


R Square Change

F Change

df1


df2


Sig. F Change


1


.657a


.432


.375


.94442


.432

7.602

5


50


.000

a. Predictors: (Constant), Legal documents, Performance evaluation, Quality decision making, Operational efficiency, Internal control
b. Dependent Variable: Patients Satisfaction


TABLE 4.4 ANOVAb


Model


Sum of Squares


df


Mean Square


F


Sig.

1

Regression


33.903


5


6.781


7.602


.000a

Residual


44.597


50


.892


 


 

Total


78.500


55


 


 


 

a. Predictors: (Constant), Legal documents,  Performance evaluation, Quality decision making, Operational efficiency, Internal control    b. Dependent Variable: Patients Satisfaction

The Multiple regression coefficient R from the table recorded (.657) high and excellent level of prediction. Whilst R2 (.432), signifiers percentage of variations in the dependent variable that was interpreted by the independent variables. Technically, the independent variables gave details of 43.2% of the variations in the dependent variable. Thus, 43.2% of the disproportion (variance) in Patients satisfaction was accounted for Legal documents, Performance evaluation, Quality decision making, Operational efficiency, Internal control. It explicitly shows how close the data were. The Adjusted r-squared was 37.5% which spell out an increase and a preferred goodness-of-fit statistic.

 


TABLE 4.5 Coefficientsa


Model


Unstandardized Coefficients


Standardized Coefficients


T


Sig.


Collinearity Statistics


B


Std. Error


Beta


Tolerance


VIF


1


(Constant)


.062


.477


 


.129


.898


 


 


Quality decision making


.372


.135


.303


2.760


.008


.942


1.061


Performance evaluation


.381


.140


.296


2.726


.009


.961


1.041


Internal control


.162


.111


.174


1.453


.152


.796


1.257


Operational efficiency    


-.186


.111


-.183


-1.670


.101


.951


1.052


 Legal document


.409


.140


.347


2.932


.005


.810


1.234

a. Dependent Variable:  Patients Satisfaction

b. Statistical significance
The ANOVA table above, the F-ratio where F(5, 50) =7.602, p < .0005 (i.e., the regression model was  good and was fit for the data significantly). From the Coefficients Table 4.4 there was no presence of multicollinearity. Since the VIF values, from the above table ranges from 1.042 to 1.257 were less than rule of thumbs 4, 5, and 10. Therefore the presence of multicollinearity in this model was corrected.

Conclusions
It was observed that majority of the respondents were youth from the Age categories of 18-28, whilst majority of the respondents have worked with the health institution for 5years and above. However the study was more focused on the medical records; but it was found that majority of the respondents were nursing showing that they work more with patients records than any other department. It was found that both manual and technological driven system of keeping records was adopted. The result indicated that filing, indexing, cataloguing as one of the dimensions of records was very difficult to do. Administering the records was the next most challenging dimension, followed by destroying the records and submitting the records was the least challenging. It was also observed that patient satisfaction was depended on, Quality decision making, Legal documents, Performance evaluation, Operational efficiency and Internal control. When all the aforementioned parameters increase it simultaneously increases the satisfaction of patients. The significance and the effective role of medical records ensure continuity of care and patients satisfaction.  It was also identified that, patients file, lab reports, X-ray, Doctors notes makes up the medical records, and admissions, discharge summaries, and day-to-day care procedures are forms(core form and diagnostic form). Most patients do not give the right information about their medical history which tends to be a very challenging. In conclusion, the medical records department is to care for the accuracy in maintaining records properly as it will assist in the timely production of the data, fact sheet and right time of retrieval. It was recommended that indexing or cataloguing should be more innovative and simple within time limit, so that the required papers or records are easily made available to the concerned person. Health records should be properly maintained to gauge the performance of health professionals and effective comparative analysis.

REFERENCES
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6.Haux, R (2006) Health information systems past, present, future. Int J Med Inform 75:268 281
7.Huffman, K.E (2001) Medical Record Management (9thEd.) New York, NY: Claredon Press.
8.John R. McGibony (1952). Principles of Hospital Administration. New York: Putnam publications.
9.Kumar R& Goel SL.(2002). Management of Hospitals. Vol 4. New Delhi: Deep & deep publications.
10.Natrajan Sangeeta (2010). Hospital Supportive Services. India:Excel Books publishers
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