Patient records

I had the pleasure of working with the friendliest, motivated and dedicated staff of the CWM Hospital patient record office commonly known as the Medico Legal Office when I was trying to get a medical record of a family member.

My request was handled very professionally despite the very heavy workload that the staff encounters daily.

This little office at the basement houses all the manual patient records and there are wooden shelves that contain the documents installed all around the office and even extend outside the counter area when the visitors are accommodated.

There is a visitors’ sitting bench beside all the files.

Most of the folders were marked as dead folders and I believe it refers to the deceased people.

In the visitors area, it is very easy to pick up the confidential files and such important documents must never be for public viewing and can be subject to theft or vandalism.

The files contain details of a person’s life and the privacy of the patients. It has sensitive details of the cause of death and the medication administrated by the doctors.

I believe there seems to be no policies and procedures for the important documents to be filed, stored, processed, backed up, delivered, and eventually disposed of.

I believe the filing of the hospital manual records must be secured, systematically arranged for easy retrieval by the staff and subject to random audit.

Document security is a highly sophisticated task that requires a facility to be safe, secure and have trained individuals, who handle, retrieve and store documents on behalf of other departments. If documents are not properly packaged and labelled it can be difficult to locate the file and be of inconvenience to all the stakeholders.

I believe the CWM Hospital management team must reconsider their manual storage system with the inventories best practices and procedures.

By looking after the personal files of the patients it will prolong the life of the documents and in some organisation it is mandatory to keep the records for maximum of seven years.

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