St. Randall Private Hospital’s Primary Filing System

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Executive Summary

This report aims to advise the management of the hospital on the best strategies for improving its primary filing system. The hospital needs to move from its current straight numerical filing system to a terminal digit filing system. It gives the necessary steps and the cost the hospital will incur in putting up a new filing system.

Introduction

Saint Randall’s Private Hospital is experiencing a major problem with its filing system. Its filing system is smaller compared to the number of medical records it can accommodate. The total storage capacity has a deficit of approximately 40%. Also, the wooden shelves on the shelves are very old and in need of a major renovation. As a result of these problems, several OH&S concerns have developed among many people.

Missing records and wrongly filed information have developed into a common issue at the hospital (Koch, 1969). Therefore, this paper gives the best recommendations regarding the best strategies for the conversion of the hospital’s filing system from the current straight numerical to the terminal digit filing system. The terminal digit filing system is a numerical system, which effectively maximizes organization by enabling even distribution of patient records across the HIS.

AHIMA is an organization whose main objective is to educate, provide resources and instruments to transmit information on health and professional practice (AHIMA, 2009). This organization provides solutions to all the problems that HIMs face.

Conversion

Conversion from numerical filing to terminal digit filing will involve changes to not only the paper medical record but integrated hospital IT systems also. Primarily a terminal digit, otherwise known as a UR number develops for each existing patient. This situation comes about through various patient management systems, so it is crucial to determine whether or current PMI can do this, if not we will need to incorporate new patient management software into the hospital.

Also, new patient UR numbers should be added to already existing hospital software as the primary source of identification. The front cover of the paper-based record will have to change to help in the filing. Policy for patient wristbands will require a review as wristbands now need to have the patient UR number present on the band. Finally, HIS staff will need to be trained on how to use terminal digit filing systems (Cooper, 1993).

Health Record Covers

The front cover of the paper-based record will need to be changed, meaning that each existing record will need to be re-jacketed with new file covers. The new file jackets will be color-coded in 10 different jackets, each color coinciding with a block of files depending on the last two digits of the terminal digit. A black band will be placed around the side of the file to indicate the two middle digits of the terminal digit. The front cover will have a label indicating the patient UR number/ terminal digit as well as a brand sticker on the top right-hand corner (Cooper, 1993).

Equipment

The MRA will also need to buy spare color-coded covers to use when the current ones start wearing and tearing. Buying them in advance saves them the time they would spend looking for covers. They will also need to buy stickers to use in the coding of the files. The stickers are very important since they are the ones that carry the terminal codes for each record. They are, usually, on the spines of the files. Therefore, the management needs to set aside enough money for these items to save on time and future escalation of prices (Cooper, 1993).

Space

I will use the space adjacent to the current primary store to house the shelves temporarily. Creating makeshift shelves using chairs and tables ensures that people continue accessing the files without any disturbance. Apart from moving the shelves slowly, people working on this project will utilize this space in ensuring that they do not disrupt the normal functioning of the hospital regarding accessing the files (Anythingfiling.com, 2014). This area can also accommodate three to four other shelves. Therefore, it will be a very useful resource when expansion will be necessary for the future. It will serve both as an interim accommodation space for the shelves and as an extension area.

Staff

Four clerical officers will be working during the morning shift while the HIS personnel and the other three clerical officers will work during the evening shift. The company will pay the extra money for overtime. The contractor will design the shelves, and the other workers will provide the labor for the real development of the shelving units. They will also empty and re-file the shelves. Also, the clerks will be responsible for the changing of the coding style. They will change the codes from straight numeric to terminal digit coding. The contractor will help supervise the clerical workers during the day while the HIS personnel will be in charge at night. Each of the clerical staff will earn approximately $36,000.

Patient Care

To ensure that the process does not interfere with access to a medical record, the hospital will take several measures. For example, they will limit other activities such as outpatient clinics; record requests for research purposes, and staff leave records, not in the file during the conversion period. On the other hand, the contractor should ask his workers to build the shelves in sessions. They should transfer files from sections of shelves as soon as they build their replacements. In case doctors need the files, they can look for them on new or old shelves. The builders can also put tables and chairs in the extension space to serve as make-shift shelves. People will access their files from this point without any disturbance (Www2.archivists.org, 2014).

Updating Documentation

The Saint Randall’s Private Hospital has to update the corporate documentation of policy and procedure manual for terminal digit filing. The purpose of the policy is to identify the standard and expected outcome for the terminal digit filing system. Every staff that performs filing tasks is required to follow the procedure manual.

Staff Training

The clerical staff will require training on how to build the shelves. Many of them have never worked in such jobs. Health officers must learn the methods of handling people who are rigid to change. Handling such people requires:

In-service training programs for the employees
Unrestricted communication between health records officers and other employees
An all-inclusive plan for change
The hospital should facilitate and support the employees after and before the planned change
Negotiating and agreeing with employees about changes in their working conditions

Budget

Item	Cost of an individual item	The total cost of the items
Labour (11 weeks)	$9000 (per week)	$99000 (11 weeks)
Procurement of materials		$150000
Stickers	$5	$500
Training	$100	$800
Miscellaneous		$500

Conclusion

Converting straight numeric filing style to terminal digit style is an involving process. It requires lots of labor and time. It also requires lots of money to pay for labor and other important equipment. The conversion of Randall’s Private Hospital, the contractor, ensures a smooth transition from the straight numeric to the terminal digit filing system.

References

American Health Information Management Association. (2009). Terminal Digit Filing Toolkit. Web.

Anythingfiling.com. (2014). Analysis of terminal digit filing. Web.

Cooper, H. (1993). One MRA’s experience in converting alphabetical filing to terminal digit. Australian Medical Record Journal, 23(2), 57-59.

Koch, G. (1969). A class of covers for finite projective geometries which are related to the design of combinatorial filing systems. Journal of Combinatorial Theory, 7(3), 215-220.

Www2.archivists.org,. (2014). Terminal digit filing | Society of American Archivists. Web.

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