Medical Records Department Planning

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Medical Records Department Planning

Departmental LocationEvery day, many members of the medical staff visit Medical Record department for completion of medicalrecords or for records reference. Proper location of the medical record department and the provision of

proper facilities are essential.

If the medical record department is not staffed 24 hours a day, it should be located within easy walkingdistance from the admitting or outpatient department to ensure that the staff can easily refer files andretrieve records on an emergency basis. Secure surveillance to safeguard medical record information andequipment during non-working hours should also be considered.

Layout: Proper layout of the medical record department adds to its efficiency and attractiveness.

The key considerations in layout are

1. Workflow2. Equipments should be near the user.3. The flow of record work from desk to desk.4. Placing desk side be side in the same direction is said to be the most compact desk arrangement.

5. The records room should not be near the main office entrance. Placing it at the rear end of thedepartment helps to reduce the accessibility of medical records to unauthorized personnel.

6. A supervisor should be placed behind the group of workers he supervises.

Space: Space allocation is determined by departmental services to be provided, equipment and systems to be usedand daily workload. Although services may vary somewhat from hospital to hospital, services and tasks to

be considered in allocating space include the record filing cabins, master patient indexing cabin (manual),coding and indexing desk, correspondence desk, op registration area, admitting and discharging office.However the best guide is the past experience in the particular hospital, or that of a similar institute.

1. Records file maintenance: Record file maintenance includes retrieving, dispatching, receiving and filing methods of records.

a. First, it is important to estimate how many shelves will be required to house an estimated number of patients. As a guide line the following estimate can be used for this study.

b. A 36-inch open shelf file may house on an average75 IP records or 300 OP records.c. To finalize the numbering system used (i.e.) if a unit numbering system is used, adequate space must

be provided on the shelf for growth of records as a result of repeat hospital visits and readmissionsof patients.

d. The number of years the medical records are to be retained in the active medical record room has to


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be determined.

2. Master patient index: Space allocation for master patient index will depend on the type of equipment or system used for immediate identification of current and past patients by name, address and medical record number.

E.g. : the information may be stored on 1 inch by 3 inch or 3- inch by 5 inch cards in upright cabinets.

3. Coding & indexing desk: This desk may be used for medical records, coding forms, and coding books, for compiling disease andoperative indexes manually. If an automated data process mechanism in used, adequate space for systems(computers) must be accommodated on the desk.

4. Correspondence desk:Space for telephone, typewriter or computer and duplicating equipments (stencil or photocopier) will also

be considered.

5. OP registration area: A separate area with a table and system is necessary for the registering clerk to register the new and review

patients visiting the hospital. The number of tables may be decided on estimating the number of patientsvisiting the hospital every day.

6. Admitting and discharge office: The chief function of the admission office is the admission of patient. In addition it is concerned withdischarge, transfer, death and other related information. Hence the admitting office should be located in aquiet section near the entrance in close proximity to the OPD and emergency services on the ground floor and must also be easily accessible from the business, administrative sections and the MRD. The area mayvary from 125-175 5q.ft. It should have two rooms, one for the working area and the other for storing

stationery, forms etc.

7. Billing Process:In many hospitals collection of payment is carried out by the OP registration and admitting and dischargeoffice. This will reduce the number of billing staffs needed for this service. The medical record clerk collects the registration charges and the consulting fees from the patient during the new and reviewregistration process. When a patient needs hospitalization, an advance amount is collected from the patientfor surgery, treatment and medication during the process of admission. During discharge, a final bill is

produced to the patient based on the surgery and the treatment tariff.

Equipments:

In general, equipment needs for the individual hospital medical record department are affected by:

Planning the work environment Part of the planning function is providing employees with the proper work environment. Thisincludes planning for office space and location, office furniture and equipment, and spatialconditioning factors such as lighting, color, sound and air.

Temperature, color and lighting When designing an office layout, the medical record technician should also consider environmentalfactors such as temperature, humidity and ventilation. These factors have been proven to have a


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direct effect on employee productivity and comfort. Recommended means of keeping the air movingin the office include air conditioning, window fans, and ventilators.

The proper use of color is another important consideration in office design. Effective use of color notonly spruces up an office, but also improves working conditions. Psychologically color can affecthuman emotions, senses, and thought processes, as well as individuals ability to relax.

Lighting is another environmental factor, which cannot be over looked. Light sources on the ceilingcan usually provide enough light for the entire office area at a prescribed level of illumination. It isrecommended that the medical record technician consult a lighting expert about the most efficientmethods for obtaining adequate illumination.

Safety & Security Protection from fire: The entire medical record department, especially the filing area of records and X-rays, should be protectedfrom fire by installing fire extinguishers in key areas. Important documents such as medico legal casesshould be preserved in fire-proof cabinets. All electrical cords should be covered to avoid short-

circuiting.

Safety control: Necessary safety measures should be taken for the welfare of both the departmental staff and visitors to thedepartment. Filing shelves and other mechanical equipment devices should be well erected to avoidaccidents.

Infection control: Adequate measures should be taken to protect employees from infections and other diseases. Regular medical checkups and examinations should be available to the staff.

Manpower planning: The manpower planning deals with the personnel requirements according to the bed strength and patientload of the hospital and the job description of the medical record staff.

Formula for calculating number of personal required for MRD.A minimum of two persons for any size of the hospital + 1 personnel for every 100 beds (50-100) + 1 person for every 10 beds.

E.g: Number of staff required for medical record departmentof 100 bedded hospitals =2 + 1+10 = 13.of 500 bedded hospital =2+5+50 = 57.

Categories of Staff for MRD According to Bed Strength.

S.NO. CategoryBed

30 50 100 250 500

1. Medical record officer - - 1 1 1

2. Medical record technician 1 1 2 6 12


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3. Asst. Medical record technician 4 7 10 23 44

4. Other staffs - 1 2 4 7

5. Quality Assurance specialist - - 1 1 1

Grand Total 5 9 16 35 65

Note: The number recommended is optimum, but varies according to workload, record retention policy andother related activities.

Documents

Medical Records Department Planning