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American Journal of  Applied 
Statistics and Economics (AJASE)

Effect of  Sorting and Arrangement of  Patient Health Records in Health Records
Department of  Cottage Hospitals Bojude and Malam Sidi in Kwami L.G.A. Gombe 

State, Nigeria
Usman M.1*, Sani A.1, Alhassan M.1, Auwal R. H.1

Volume 3 Issue 1, Year 2024
ISSN: 2992-927X (Online)

DOI: https://doi.org/10.54536/ajase.v3i1.2002
https://journals.e-palli.com/home/index.php/ajase

Article Information ABSTRACT

Received: November 29, 2023

Accepted: January 01, 2024

Published: January 03, 2024

The study focused on the effect of  sorting and arrangement of  patient health records in 
the health records department of  Cottage Hospitals Bojude and Malam Sidi Gombe State, 
Nigeria. The study population for this research work comprised Health Record Officers/
Managers, Health Records Technicians, and Health Records assistants working in the two 
health records departments of  Bojude and Malam Sidi. The study adopted a descriptive 
survey design to reduce the effects of  sorting and arranging patients’ health records in the 
selected hospital. The population comprised One Hundred (100) respondents with a self-
designed structured questionnaire and was validated to establish its reliability; the researcher 
personally administered the questionnaire. Data collected were analyzed using Epi-Info 
software (Epidemiology Information) version 3.5, and the results were presented in simple 
analysis form to reveal the respondents’ views based on objectives. The study found that 
sorting and arranging patients’ health records negatively affect patients and hospitals. 
Moreover, all health institutions should be mandated to employ qualified and trained Health 
Information Personnel to maintain the ethics of  the Health Information Management 
Department so that their knowledge in managing patients’ health records will assist in 
reducing the error of  miss sorting and arrangement of  patient health records. Also, the 
management of  the hospitals should provide manpower, meaning trained medical records 
personnel, enough space, and adequate carbonate shape and lightening for proper filing 
equipment and suitable filing for the health records department to reduce the misfiling of  
patients’ health records.

Keywords

Arrangement, Health, Information, 
Record, Patient

1 Gombe State College of  Health Science and Technology Kaltungo, Nigeria
* Corresponding author’s e-mail: othman1064@gmail.com

INTRODUCTION
The health information management department in each 
hospital is the backbone of  the facility and one of  the 
most important works that health information managers 
normally do is to sort patient case notes/folders in the 
hospital at every central library for filling. However, some 
other hospital fails to achieve their goals through the 
improper sorting and arrangement of  patient case folders 
because they lack trained personnel (Aremu, 1999). This 
research work is going to figure out the problem in the 
hospital, we all know that if  memory forgets the record 
will remember things that have happened over centuries 
so the health information management department is in 
charge of  the records or backbone in the hospital, and 
is very important to employed qualified staff  that will 
handle the record, so that will last for so many years. 
In this case, we will look into the brief  history of  the 
health information management department and the 
heroes that contribute to the work.  The origin of  the 
health information management department began some 
decades back, in the past twenty-nine century BC the 
record was established on the patient bed and the person 
who started the record was Thoth. This was done to 
continue the treatment of  patients; this great man was 
an Egyptian and he lives for Sixty-one (61) years with his 
greatness he sorts out the patient record and arranges 
them on each patient’s bed. Sorting and arrangement of  

patient case folders have been a very huge work that the 
health information management department has to battle 
with and the staff  posted on this unit must be serious 
to avoid lost or missing patient case folders (Huffman, 
1994).

Color-Code Your Filing System
Visual markers, such as colored tabs, can save you time 
when browsing for documents. You can use different 
colored folders for your various types and subtypes of  
documents. Some folders include label tabs in various 
colors. With either of  these options, you can create a 
color-coded key to keep track of  the color (Lippincott & 
Wilkins, 2006).

Assigned to the Document Category
Labeling your document categories can help you quickly 
identify your intended folder. Some folders come with 
paper to make your labels. You can either hand-write 
the labels or print out a sheet of  typed labels all at once. 
You can further optimize your labeling system by using 
different colored pens or ink that match your color-coded 
key. Highlighters can also be used on black text to color 
code the label. Label makers can also allow you to quickly 
print out single-label stickers. This tool is especially 
helpful when labeling a filing shelf  or cabinet, or if  you 
need to replace current labels with new ones.



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Dispose of  Unnecessary Documents
Creating an organized filing system can help you find ways 
to reduce the amount of  paperwork you store. Recycle 
no longer relevant documents to reduce clutter, or shred 
them for extra security. Consider placing a small recycling 
can or a dedicated basket for documents you want to 
shred near your desk. Regularly disposing of  unnecessary 
files and documents can help keep your workspace.

Statement of  the Problem 
The main purpose of  this research is to find out whether 
the hospital employed qualified staff  for the Department 
of  Health Information Management and how the staff  
sorted out the patient’s case folders and also arranged 
them to avoid miss filling folders in the cottage hospital 
Bojude and Cottage hospital Malam Sidi.
This research work has been carried out by a person who 
has been urged to research the topic of  the sorting and 
arrangement of  patient case folders toward better health 
information management practice in Cottage Hospital 
Bojude, Gombe State. Despite what the government is 
doing to the hospital, most of  the staff  and the hospital 
management are not stable with their work. This has 
resulted in many medical errors that have led to death 
and some medical problems. This research work has 
vast importance to the hospital but looking at the 
issue critically the hospital needs to know the patient 
confidentiality. Now the question is do the hospital 
maintain good confidentiality? If  not, what will be the 
problem? How will this problem be tackled in what way 
will this project be useful to the hospital? These are some 
of  the issues the research will consider throughout.

The Objective of  the Study 
i. To find out whether the two hospitals employed the 

right personnel at Cottage Hospital or not.
ii. To find out whether the health information 

management department staff  knows how to sort and 
arrange patient case folders at Cottage Hospitals. And;

iii. To know the method of  sorting and arrangement of  
patient case folders in Cottage Hospital.

Research Questions  
i. Does the hospital have qualified staff? 
ii. Do the two Cottage hospital staff  know the sorting 

and arrangement of  patients’ case folders? 
iii. Does the health information management 

department apply the method of  sorting and arranging 
patient case folders at the HIM Department?

Significances of  the Study 
This research work is very important to the health 
information management department in general hospital 
Kaltungo and other health professionals and to patients 
because the recommendation of  this study may guide the 
hospital at large as well as the people who come in contact 
with the hospital care most especially those who come 

for follow up the case. When patients’ case folders are 
arranged precisely and also kept or filled in a prescribed 
manna according to the hospital will not cause stress to 
both the patient and the staff. There will be no errors or 
missing patient case folders.
This research work is very important to the health 
information management department in the general 
hospital Bojude and Malam Sidi’s recommendation of  this 
study may guide the department of  health information 
management and the hospital at large as well as the 
Ministry of  Health and the community. The sorting and 
arrangement of  patient case folders toward better health 
information management practice has been the most 
important work that health information managers are 
battling with in every hospital both private and public 
sector this work was found to be stressful to those staff  
posted in the unit and has found to be the first stage 
taking for filling of  the patient case note. Sorting and 
arrangement of  patient case folder are important because 
they try to figure out the missing folders or doubling 
hospital number and make sure is corrected before being 
filled into the shelves or cabinet together with the tracer 
card.

Definition of  Terms 
The terms are defined for the research work and they are 
used throughout the research work.

Health 
Is defined as the physical social and mental well-being of  
an individual without mainly the absence of  disease or 
infirmity.
 
Information 
Means the data that has been processed 

Sorting
Means the act of  picking up something or patient case 
folders to fill 

Arrangement
Means placing something in a prescribed manna according 
to the hospital or is the act of  placing a patient’s case 
folders in a prescribed manna for filling. 

Management
Means to maintain the available things that you have, i.e., 
organized, controlled, and leading. People or resources 
and a particular board e.g., the management board of  the 
health record office. 

Patient
Means anybody who is seeking medical attention. 

Folders
Means the booklet that is given to a patient in the hospital 
most especially when his/she is admitted to the hospital. 



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Record
Can be defined as the creation of  information received 
and maintained as evidence-based, information by 
organizations or persons in pursuance of  legal obligations 
or the transaction of  business content (i.e., information 
data).

Medical Records
Means the data of  a patient’s e.g., examination, treatment, 
and other health records of  the patient. The terms 
medical record, health record, and medical chart are used 
somewhat interchangeably to describe the systematic 
documentation of  a single patient’s medical history and 
care across time within one particular health care provider.

Health Information Management
Health information management (HIM) is information 
management applied to health and health care. It is the 
practice of  analyzing and protecting digital and traditional 
medical information vital to providing quality patient 
care.

Review of  Literature
This chapter focuses on the topic such as the explanation 
of  the topic and the people who also talk about the topic 
or related topics with their books or journals (Related 
Literature) author’s name book published year of  
publication. This topic also captures some importance of  
sorting and arrangement of  patient case folders and the 
materials used in sorting and arrangement of  patient case 
folders with the appropriate method.

Conceptual Issues 
The concept of  sorting and arrangement of  patient case 
folders in the hospital the sorting and arrangement of  
patient case folder toward better health information 
management practice have been the most important 
work that health information managers are battling with 
in every hospital both private and public sector this work 
was found to be stressful to those staff  posted in the unit 
and has found to be the first stage taking for filling patient 
case note. Sorting and arrangement of  patient case folder 
are important because it’s tried to figure out the missing 
folders or doubling hospital number and make sure is 
corrected before being filled into the shelves or cabinet 
together with the tracer card.

Module for Sorting Patient Case Folder 
If  a numerical record-identified system is used, then 
numerical sorting is also done, there are two main 
systems of  sorting the patient record and arrangement 
accordingly:

a. Straight numerical sorting and arrangement of  
patient case folder and;

b. Terminal digits of  sorting and arrangement of  
patient case folder. 
This method reflects the exact Chronological order of  
the creation of  records and the Importance of  proper 

sorting and arrangement of  patient case folders for 
quality filling the proper sorting and arrangement of  
patient case folders led to good filling, and the proper 
filling of  patient medical records ensure easy retrieval 
and contribute to decreasing patient waiting time at the 
hospital and ensures the continuity of  care.

Health Information and Evidence 
Health information as evidence is one of  the critical blocks 
of  the health system strengthening. Health information 
systems cannot be ignored since health policies and 
planning in any country are mostly dependent on correct 
and timely information on various health issues. Health 
facilities throughout the world keep consistent records of  
patients/clients. These medical records are normally kept 
confidential and in confined places such as record units 
or offices. This medical record is a chronologically written 
account of  a patient’s examination and treatment that 
includes the patient’s medical history and complaints, the 
physician’s physical findings, the results of  the diagnostics 
test and procedures, and medications and therapeutic 
procedures (Murphy et al., 1999)

Organizing and Storing Your Medical Record
There are different ways to organize your medical records. 
To help figure out what works best for you, talk to other 
cancer survivors about what they have done, or visit a 
local office supply store to see what sort of  organizers 
are available. Here are a few options: Use a filing cabinet, 
3-ring binder, or desktop divider with individual folders 
Store files on a computer, where you can scan and save 
documents or type up notes from an appointment store, 
record online using an e-health tool; certain online 
records tools may be accessed, with permission by 
doctors or family members organize your records by 
date or by categories, such as treatments, tests, doctors’ 
appointment, etc. (Osundina, 2004).

How to Organize Documents
The following steps can guide you in sorting, categorizing, 
and storing your physical paperwork and help you design 
an effective filing system: Separate documents by type:

1. Use chronological and alphabetical order.
2. Organize the filing space.
3. Color-code your filing system.
4. Label your filing system.
5. Dispose of  unnecessary documents.

The situation of  Medical Records Filling
As attendance in healthcare facilities increases with time, 
the volume of  medical records becomes a big challenge 
to health facility management. This is no different in 
Ghana. Of  late most of  our public health facilities are 
confronted with filling out medical records, especially 
with the introduction of  the national health insurance 
scheme which brought in its wake the introduction of  
new folders and NHIS identification cards (ID cards). 
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indicates that facilities are saddled with old and new 
folders for outpatient and inpatient departments as well 
as a sizeable number of  patients having more than two 
folders due to mainly to filling or forgetting their ID cards 
when visiting the facility. In 2010 the School of  Public 
Health, University of  Ghana, during an annual summer 
short course in improving management for public Health 
Interventions (IMPHI), several district health directors 
identified missing filling and multiple patient folders as 
major problems in their facilities. This paper reports the 
result of  an intervention in the medical records filling 
system of  a municipal hospital in Ghana.

Method of  Filling System 
Centralization Method of  Filling
system this method the patient health records are 
maintained at the central library or the record is 
maintained in one unit.

Decentralized Method of  Filling
system this method of  filling system the patient health 
records are maintained by the various units or clinics in 
the hospital.

Causes of  Miss Filling
1. Poor handwriting 
2. Heavy workload 
3. Lack of  trained medical record personnel 
4. Lack of  a conducive environment 
5. Inadequate electricity

Commentaries and systematic reviews of  the study 
indicate concerns about how technology affects caring, 
both positively and negatively. While there are many 
controversies on how to interpret these measurements 
exist. (AHIMA, 2003) and (Aremu, 1999) state that caring 
cannot be operationalized and therefore quantitative 
studies are not suitable, while (Ayilegbe, 2008) states that 
it can be operationalized and so quantitative methods are 
appropriate.

Information Technology Scales for Health Record 
Many instruments have been used to assess health 
information managers’ attitudes toward technology, 
however, they were noted to be inconsistent with the 
results of  studies and/or did not report reliability or 
validity (Ayilegbe, 2015).

Quality and Health Information Technology 
In the year 2000, the Institute of  Medicine (IOM) released 
a report focusing on patient safety estimating that 44,000 
to 98,000 people die in U.S. hospitals annually as a result of  
medical errors. Many of  these errors involve medications 
in a subsequent report, the IOM identified IT as one of  
the four critical forces that could significantly improve 
healthcare quality and safety (AHIMA, 2003).
Perception on sharing of  anonymized health records, 
perhaps 10 except for more recent studies that examine 
patients’ perception about consent to health information 

used for other than their care (Benjamin, 1980). In 
connection to this, (Geoffrey, 1999) investigate the 
divergence of  perception among patients toward different 
types of  Personal Health Record (PHR) systems, including 
paper-based, personal computer-based, memory devices, 
portal and networked PHR, which are in the increasing 
order of  technology advancement (FMOH, 1996).

METHODOLOGY
Research Design 
A descriptive survey is used for the study. This research 
work is designed to provide systematic information about 
a phenomenon.

Research Population 
The target population used in this study was the total 
number of  staff  working at the Cottage Hospital Bojude 
and Malam Sidi. Who were found to be 150 workers in 
the research sample the health record personnel and other 
health professionals from different units in soliciting 
information? The staff  from all units in respect to the 
hospital.
 
Sample Size and Sampling Techniques 
One Hundred (100) respondents were selected from the 
two-cottage hospital, and sharing fifty in each hospital 
questionnaires were distributed to them. The information 
obtained was based on the roles of  documentation, 
sorting, and arrangement in health care services at 
record department sampling techniques (simple random 
sampling) used in selecting the respondents for this 
research.

Study Area
The Cottage Hospital Bojude and Cottage Hospital 
Malam Sidi in Kwami Local Government Area in Gombe 
State of  Nigeria. Its headquarters are in the town of  
Mallam Sidi, Kwami is bounded in the east by Lake Dadin 
Kowa. The postal code of  the area is 760. The population 
of  Kwami in the 2006 census is 195,298. The study area 
is Cottage Hospital Bojude and Cottage Hospital Malam 
Sidi in Gombe State, which was established as the facility 
that renders medical services in both areas of  the state 
and the country at large.  The two cottage hospitals 
were established in 2007 by the state government it 
renders medical services in the state and the nation, and 
each hospital has a fifty (50) bed capacity, the hospital 
renders the General medical and surgical hospitals, 
health care, and social assistance, child day care services, 
community food and housing, and emergency and other 
relief  services, continuing care retirement community 
and assisted living facilities for the elderly, home health 
care services, individual and family services, medical and 
diagnostics laboratories, nursing care facilities (skilled 
nursing facilities).

Geographical Location
Kwami LGA has a total area of  1,787 square kilometres 



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and lies on the banks of  Lake Dadinkowa, the area 
witnesses two major seasons which are the dry and the 
rainy seasons. The average temperature in Kwami LGA 
is 32 °C.

Instruments for Data Collection 
The instrument used for this study is a questionnaire. 
A structured questionnaire used for data collection is 
divided into two sections:

1. Section ‘’A’’ Personal data
2. Section ‘’B’’ The factors that affect the sorting and 

arrangement of  patient case folders. 

Method of  Data Analysis 
The researcher used a questionnaire for easy and 
capturing information, the data collection for this study 
was analyzed by using the frequency distribution table 
and percentage scale.

RESULTS AND DISCUSSIONS
This table shows that male is the highest number of  
respondents with 65% while female has 25%.
Table two shows that workers with an age of  26- 40 have 

the highest percentage which is 56% and the others have 
the lowest percentage this shows that those with the age 
of  26- 40 are the highest respondents.
Table three shows that married ones have the highest 
response which is 45% and the singles have 39%while the 
widows and divorce have 16%.
Table four shows that the highest number of  respondents 
are those with a national diploma with 45% and 40%from 
a professional diploma then 15% those with other degrees.
Table five show that the hospital lack qualified health 
information managers No has the highest percentage 
which is 65% and yes has 35%.
Table six shows that the staff  all know the method of  
sorting and arrangement of  patient case folders yes has 
the highest percentage which is 70% and no, has 30%.

Table 1: Gender of  the respondent?
Respondents Frequency Percentage%
Male 65 65
Female 35 35
Total 100 100

Source: Field survey, 2022

Table 2: Age of  the respondents?
Respondents Frequency Percentage%
18-25 34 34
26-40 56 56
41-60 10 10
Total 100 100

Source: Field survey, 2022

Table 3: Marital status of  the respondents?
Respondents Frequency Percentage%
Single 39 39
Married 45 45
Widow and divorce 16 16
Total 100 100

Source: Field survey, 2022

Table 4: Educational qualification of  the respondents?
Respondents Frequency Percentage%
Health Assistance 45 45
Professional Diploma 40 40
Other Degrees 15 15
Total 100 100

Source: Field survey, 2022

Table 5: Does Cottage Hospital have qualified Health 
Information Managers?
Respondents Frequency Percentage%
Yes 35 35
No 65 65
Total 100 100

Source: Field survey, 2022

Table 6: Are the staff  aware of  the methods of  sorting 
and arrangement of  the patient case folders?
Respondents Frequency Percentage%
Yes 70 70
No 30 30
Total 100 100

Source: Field survey, 2022

Table seven shows that the hospital is not organizing a 
seminar or workshop for their staff  for more training No 
has the highest percentage which is 60% while yes is 40%.
Table eight shows that the hospital doesn’t provide a 
conducive environment for health information managers 
No has the highest percentage which is 70% while yes 
has 30%.

Table 7: Does the hospital organize seminars and 
workshops for more training for their staff ?
Respondents Frequency Percentage%
Yes 40 40
No 60 60
Total 100 100

Source: Field survey, 2022

Table 8: Does the hospital provide a conducive 
environment for the health information department?
Respondents Frequency Percentage%
Yes 30 30%
No 70 70%
Total 100 100 %

Source: Field survey, 2022



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Table nine shows that the hospital assists the department 
at any stage because yes has the highest percentage which 
is 80% while No is 20%.
Table nine shows that the hospital assists the department 
at any stage because yes has the highest percentage which 
is 80% while No is 20%.

This study provides information about sorting and 
arranging patient case folders and proper filling, filling 
situations of  medical records filling, and types of  filling 
systems. The instrument used where the self-administered 
questionnaire was typed and printed out one hundred 
(100) copies of  the questionnaire were administered 
to the staff  that is working in Bojude and Malam Sidi 
Cottage Hospital. The data collected for this study were 
grouped according to the research from the various 
items asked in the questionnaire and analyzed by using 
descriptive statistics.

CONCLUSION
The result of  the study revealed that missing sorting 
out an arrangement of  patient health records will have 
negative effects on patients and hospitals, the hospital 
management should find ways to introduce seminars 
and workshops for their staff  for more training. They 
should be strong laws guiding the patient case folders 
to avoid miss sorting, arrangement and miss filling, and 
other complicating issues in the Health Information 
Management Department. Government should employ 
qualified health professionals that will run the activities 
of  the Medical Records Unit without any challenges or 
problems. The government should provide a conducive 
environment for the health information department and 
hospital as large.

RECOMMENDATIONS
Given the significant and negative effects that miss 
sorting and arrangement of  patient health records have 
on patients and hospitals, the following recommendations 
are hereby made for both two hospitals:

1. All health institutions should be mandated to employ 
qualified and trained Health Information Managers 
to manage the Department of  Health Information 
Management so that their knowledge in the management 
of  patient health records will assist in reducing miss 
sorting and arrangement of  patient health records. 

2. The management of  the hospitals should be 
informed of  their responsibilities in providing trained 
personnel, adequate filing equipment, and a suitable filing 
environment for the health records department because 
the above-mentioned factors contribute to the miss 
sorting and arrangement of  patient health records in the 
two health institutions. 

3. Health Information Managers should maintain a 
high level of  decorum and concentration when filing 
patients’ records in the health records library. 

4. A good tracer system should be put in place by 
Health Records Officers to track the movements of  
patients’ case notes in the hospital. 

5. Patients’ health records should be computerized to 
aid quick and timely retrieval of  patients’ information.

REFERENCES 
Ahima. (2003). the complete medical records in a hybrid 

disclosure. Practice brief. Retrieved from www.ohima.org. 

Table 9: Is there any way that the hospital assists the 
Department of  Health Information Management? 
Respondents Frequency Percentage%
Yes 80 80
No 20 20
Total 100 100

Source: Field survey, 2022

Table 10: Does the hospital encounter any problems in 
sorting out patient case folders?
Respondents Frequency Percentage%
Yes 45 45%
No 55 55%
Total 100 100 %

Source: Field survey, 2022

DISCUSSION 
At this point, the researcher has categorically stated the 
results and findings gotten from the respondents as it has 
been interpreted above. Therefore, the researcher obtained 
information through a questionnaire administered to the 
cottage hospitals Bojude and Malam Sidi. 
Table one shows that male has the highest percentage of  
65% while female has 35%, table two shows that those 
aged 2-40 have the highest percentage which is 56%, 
while those with age 18-20 have 24% and those 41-60 
have 10%, table three shows that the married ones are 
the highest respondents with 45% while the singles have 
39%, and widows and divorce have only 16%, table four 
shows that those with national diploma have the highest 
frequency and percentage of  45% and professional 
diploma is 40%, those with BSc has 15%.
The hospital doesn’t have qualified health information 
managers, because, according to the respondents, it 
shows yes has 35% and those answering No has 65%. 
This shows that the Department of  health information 
management lacks qualified staff. And also, the hospital 
doesn’t have a conducive environment for the health 
information management department according to the 
response. The researcher found a load of  problems 
encountered while sorting out and arranging patient 
case folders. The hospital, don’t organize seminar or 
workshops for the staff.

Summary
The research was conducted on “Assessment of  the 
sorting and arrangement of  patient’s case folders towards 
better health information management practice at 
Cottage Hospital Bojude and Cottage Hospital Malam 
Sidi, Gombe State.



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Aremu, H. B. (1999). Health Records Management 1 & 
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Ayilegbe, B. K. (2015). The Dynamics of  Patients’ 
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Benjamin, B. (1980). Medical Records. Edinburgh: 
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Federal Ministry of  Health (1996). National Health 
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Geoffrey, Y. (1999). Managing Hospital Records. London: 

International Record Management Trust. 
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Dictionary. Baltimore: A Wolters Kluwer Health 
Company. 

Murphy, G., Mary Alice, H., and Kathleen, W. (1999). 
Electronic Health Records: Changing the vision. W. 
B. Saunders Company. 

Osundina, K.S. (2004). Principles and Practice of  
Health Records Management. Ilesa: K. S. Osundina 
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