Pa ge 1 Pa ge 44 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. Pa ge 45 https://journals.e-palli.com/home/index.php/ajase Am. J. Appl. Stat. Econ. 3(1) 44-50, 2024 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. Pa ge 46 https://journals.e-palli.com/home/index.php/ajase Am. J. Appl. Stat. Econ. 3(1) 44-50, 2024 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). Anecdotal evidence from most public health facilities Pa ge 47 https://journals.e-palli.com/home/index.php/ajase Am. J. Appl. Stat. Econ. 3(1) 44-50, 2024 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 Pa ge 48 https://journals.e-palli.com/home/index.php/ajase Am. J. Appl. Stat. Econ. 3(1) 44-50, 2024 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 Pa ge 49 https://journals.e-palli.com/home/index.php/ajase Am. J. Appl. Stat. Econ. 3(1) 44-50, 2024 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. Pa ge 50 https://journals.e-palli.com/home/index.php/ajase Am. J. Appl. Stat. Econ. 3(1) 44-50, 2024 Aremu, H. B. (1999). Health Records Management 1 & 11 Ilorin: Decency printers & sanitation LTD. Ayilegbe, B. K (2008). The essence of documentation in health care institution, Kano: Debisco printing press. Ayilegbe, B. K. (2015). The Dynamics of Patients’ Discharge Summaries. Kano: Debisco printing press. Benjamin, B. (1980). Medical Records. Edinburgh: Churchill Livingstone. Federal Ministry of Health (1996). National Health Information Management Information System (Health Facility Summary Forms). Lagos: FMOH Publication. Geoffrey, Y. (1999). Managing Hospital Records. London: International Record Management Trust. Huffman, E. K. (1994). Health Information Management (10th Edition). Berwyn: physicians’ Record Company. Lippincott, W, and Wilkins. (2006). Steadman’s Medical 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 Publications.