Question

Identify if each of them is a problem or not, and if so, suggest what could be done to fix that problem.

Application Exercise: File Room Improvements

You are the new RHIT whose responsibility includes supervision of the file room in the HIM department in a small 78 bed rural hospital. Your supervisor has asked you to evaluate the file room, list any problems and their effect on the efficiency of the department, and make any recommendations to resolve the problems.

You have the following information: Generally, the department runs smoothly but lately there have been several complaints about “lost” records. There are six employees in the department. One employee has the primary responsibility of filing and locating records; however, two of the other employees always have to help because there is just too much for one person to do. This works okay because the two employees that help out usually have some extra time at the end of their shift.

Specific information about the department:

1. Straight numeric filing is used.
2. There is easy access to the files by all hospital personnel, especially on the night shift.
3. There is a manual charge-out system (i.e. use of out guides and sign-out slips) but the system isn’t usually used.
4. There are two specialty clinics every week. Usually the records are requested when the patient arrives.
5. The last audit of the files was two years ago.
6. One employee has major responsibility for filing but two others help almost every day because the volume is increasing.

Identify any problems and recommend how you would resolve them. Prepare answers including the personnel that would be needed to resolve the problem areas and how each of the above points should be addressed.

Answer 1

The people having easy access to files, use of the now outdated manual charge-out system , understaffing and unplanned specialty visits are creating some problems.

It is recommended that the files must not be easily accessible by everybody either during the day or night shift. This will lead to irresponsible practices and loss of patient files as evidenced by some recent incidents. Staff should not be allowed access to the files without recording the request and permission. Their entry time and exit time, and accessed filer numbers must be noted and recorded in both (day and night ) shifts. The manual charge-out system must be replaced with electronic one and until its implementation is carried out, the present system must be strictly followed.

For specialty clinics, as these are all planned visits their name and required files must be asked and collected from the concerned department and files for the same are sorted collected well before the patient's arrival. This will prevent last-minute hurry and confusion. Instead of one, two employees must equally share the major responsibility of filing and they must ensure that both of them never take leave/absent on the same day. Other employee's help in filing during the increased volume time must be supervised properly.

Departmental audits should be conducted quarterly as many files are missing from the department. As the quality of the department improves and achieve the standard level the audits can be conducted yearly.