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Int J Qual Health Care. 2009 Aug;21(4):253-8. doi: 10.1093/intqhc/mzp026. Epub 2009 Jul 2.

Developing patient registration and medical records management system in Ethiopia.

Author information

1
Johns Hopkins Medicine International, Johns Hopkins University, Baltimore, MD, USA.

Abstract

QUALITY PROBLEM:

In low-income countries, medical record management is often lacking. We sought to evaluate the impact of an inexpensive business process re-engineering project on the accessibility and completeness of patient information and on physician satisfaction.

DESIGN:

Pre-post intervention study during 2006-07, using time-motion studies, medical record audits and physician surveys.

SETTING:

A rural hospital in Ethiopia.

PARTICIPANTS:

Medical record personnel, hospital administrators, clinical staff.

IMPLEMENTATION:

We implemented a hospital-wide patient registration and medical records re-engineering process, which included a simple, custom-made computer database to manage patient information, standardized medical records forms and processes and enhanced human resource management efforts.

MAIN OUTCOME MEASURE:

s) We measured medical records accessibility and completeness, and physician satisfaction.

EVALUATION:

Medical record accessibility and completeness and physician satisfaction improved significantly (P < 0.05) based on pre- and post-intervention comparisons. The success rate of retrieving the proper medical record number for returning patients improved from 14 to 87% (P < 0.01); time to locate medical records decreased from 31.2 sec per record to 15.7 sec per record (P < 0.01); the percentage of complete medical records increased from 6.5 to 45.7% (P < 0.01). Physician satisfaction with the medical records system was significantly higher after the intervention (P = 0.02).

LESSONS LEARNED:

Our findings indicate that a well-organized medical record management system can be effective in improving patient information accessibility and completeness in hospitals in low-income countries despite the lack of resources. Longer follow-up is required to assess the sustainability of the hospital improvements accomplished.

PMID:
19574294
DOI:
10.1093/intqhc/mzp026
[Indexed for MEDLINE]

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