Effects of Improper Documentations of Health Records
CHAPTER ONE
Objective of the study
- To ascertain the importance of records management practice to health staff.
- To identify the state of records management practice at health facilities.
- To assess how record management affects the quality of health service delivery at the various health facilities.
- To assess the availability of capacity for electronic records management in terms of human resources in the various health.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
What is record Management Practice?
The International Organisation for Standardization describes a record as “information created, received and maintained as evidence by an organization or person in the transaction of business, or in the pursuance of legal obligations, regardless of media. Such evidence comprises things such as tax returns, educational certification, birth certificates among others. Records management is thus, “the professional practice or discipline of controlling and governing what are considered to be the most important records of an organisation from the time such records are conceived through to their eventual disposal. This work includes identifying, classifying, prioritizing, storing, securing, archiving, preserving, retrieving, tracking and destroying of records” (ARMA, 2013). Kennedy and Schauder (1998:8) define records management as “an organisational function of managing records to meet operational business needs, accountability requirements and community expectations”. According Kemoni and Ngulube (2008:297), records management is defined as the unit of the organisation assigned with the function of managing records in order to ensure that the organisation is able to comply with business operational needs, meet community needs and properly account to the citizens. On the other hand, Place and Hyslop (1982:4) view records management as a “process of controlling organisational information from creation through to its final disposition”. The driving force of all the above definitions is that records management operate records from formation to discarding. The records should still be fashioned to sustain and fully record all business, legal, fiscal, social and historical requirements. Records management refers to the management or control of records in different formats, which are hard-copy files, correspondence, disks, maps, memoranda, microfilm, papers, photographs, recordings, reports and tapes. This ensures that records are easily accessible, retrievable and properly classified. Webster, Hare and Julie (1999:285) cite the definition of records management from Ricks and Gow (1988:20) as “the systematic control of recorded information from creation to final disposal”. Records management is the systematic control of an organisation’s records, throughout their life cycle, in order to meet operational business needs, statutory and fiscal requirements, and community expectations. Effective management of corporate information allows fast, accurate and reliable access to records, ensuring the timely destruction of redundant information and the identification and protection of vital and historically important records (National Archives of Scotland).
CHAPTER THREE
RESEARCH METHODOLOGY
INTRODUCTION
In this chapter, we described the research procedure for this study. A research methodology is a research process adopted or employed to systematically and scientifically present the results of a study to the research audience viz. a vis, the study beneficiaries.
RESEARCH DESIGN
Research designs are perceived to be an overall strategy adopted by the researcher whereby different components of the study are integrated in a logical manner to effectively address a research problem. In this study, the researcher employed the survey research design. This is due to the nature of the study whereby the opinion and views of people are sampled. According to Singleton & Straits, (2009), Survey research can use quantitative research strategies (e.g., using questionnaires with numerically rated items), qualitative research strategies (e.g., using open-ended questions), or both strategies (i.e., mixed methods). As it is often used to describe and explore human behaviour, surveys are therefore frequently used in social and psychological research.
POPULATION OF THE STUDY
According to Udoyen (2019), a study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitutes of individuals or elements that are homogeneous in description.
This study was carried to examine effects of improper documentations of health records. Selected hospital in Lagos form the population of the study.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
INTRODUCTION
This chapter presents the analysis of data derived through the questionnaire and key informant interview administered on the respondents in the study area. The analysis and interpretation were derived from the findings of the study. The data analysis depicts the simple frequency and percentage of the respondents as well as interpretation of the information gathered. A total of eighty (80) questionnaires were administered to respondents of which only seventy-seven (77) were returned and validated. This was due to irregular, incomplete and inappropriate responses to some questionnaire. For this study a total of 77 was validated for the analysis.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
Introduction
It is important to ascertain that the objective of this study was to ascertain effects of improper documentations of health records. In the preceding chapter, the relevant data collected for this study were presented, critically analyzed and appropriate interpretation given. In this chapter, certain recommendations made which in the opinion of the researcher will be of benefits in addressing the challenges of effects of improper documentations of health records
Summary
This study was on effects of improper documentations of health records. Three objectives were raised which included: To ascertain the importance of records management practice to health staff, to identify the state of records management practice at health facilities, to assess how record management affects the quality of health service delivery at the various health facilities and tassess the availability of capacity for electronic records management in terms of human resources in the various health. A total of 77 responses were received and validated from the enrolled participants where all respondents were drawn from selected hospitals in Lagos. Hypothesis was tested using Chi-Square statistical tool (SPSS).
Conclusion
To conclude, health facilities have not engaged records management practice critically enough even though patients’ records are needed for effective decision making and providing quality health care. Patients’ health records are mainly kept manually with insufficient storage space and personnel to guarantee good record management practice.
Recommendation
To advance records management practice, there is the need for engagement of professionally and competently qualified health information personnel and biostatisticians as for all health facilities.
- The health facilities should provide their records management staff with training, courses and workshops to cover the capacity of professional management of digital or electronic records.
- The privacy and confidentially of patients’ health records must be fully promoted respected by all.
References
- ARMA International. “Glossary of Records and Information Management Terms, 3rd Edition” http://archive.arma.org/standards/glossaryw2/index.cfm?
- Aziz S and Rao MH. Existing Record Keeping System in Government Teaching Hospitals in Karachi.J. Pak. Med. Assoc. 2002; 52(4): 163 – 74.
- Benfell, P. (2002). An integrated approach to managing electronic records. Records Management Journal, (12)3: 94-97.
- Bhana, P. (2008). The Contribution of Proper Record Keeping Towards Auditing and Risk Mitigation: Auditor General’s Perspective, Corporate Executive: Office of the Auditor-General, 10 November.
- Danquah JB, Appah EK, Djan JO, Ofori M, Essegbey IT and Opoku S. Improving Recordkeeping For Maternal Mortality Programs, Kumasi, Ghana. The Kumasi PMM Team. Int. J. Gynaecol. Obstet. 1997; 59(2): S149 – 55.
- Davidson, E.J. (2000). Analyzing genre of organisational communication in clinical information system. Information Technology and People, (13)3:196-209. Edwin AK. Don’t Lie but Don’t Tell the Whole Truth: The Therapeutic Privilege – Is it Ever Justified? Ghana Med J. 2008 December; 42(4): 156– 161.
- Ghana Health Service Patients Charter http://www.ghanahealthservice.org/aboutus.php?inf=Patients%20Charter . Accessed online on 17th September, 2011.
- Johnston, G.P. and Bowen, D.V. (2005). The benefit of electronic records management systems: a general review of published and some unpublished cases. Records Management Journal, (15)3:131-140.
- Kemoni, H. and Ngulube, P. (2008). Relationship between records management, public service delivery and the attainment of the United Nations Millennium Development Goals in Kenya. Information Development, (24)4:296-306.
