Professional placement is a vital component of a pupil’s experience. It is where learning opportunities are available for students to undertake practice under supervision. Professional placements have a positive effect on students’ ability to integrate theory to practice.

Professional placement is a vital component of a pupil’s experience.


You can add anything that you think it is important for any question.
You can find all answers below the questions (only read the answers and write in your own words – to avoid plagiarism – because I collect these answers from web and friends)
Free plagiarism
Please, this paper very important for me so do your best on it.
4 references only.

INTRODUCTION ( 150 words) please, do not use (First, second, etc ) you can add anything that you think it is important for this introduction.

Professional placement is a vital component of a pupil’s experience. It is where learning opportunities are available for students to undertake practice under supervision. Professional placements have a positive effect on students’ ability to integrate theory to practice. It is essential to conduct this type of practice for several reasons. Firstly, quality placement experience is considered to be part of effective education. Secondly, patients and the public need to have the highest performance from health care professionals. Lastly, it builds knowledge and experience in order to prepare senior students for professional practice The aim of this report is to highlight King Khalid University Hospital (KKUH). The focus will lie particularly on the Health Information Management Services (HIMS) Department. The 45 placement objectives will be discussed, analysed and considered.

1. Hospital location, relevant history, specific points of interest. Maximum of one page. ( Almost 250 words)

2. Describe the type of hospital and services or facilities available. Include the number of beds, average daily occupancy, annual separations, day cases, emergency and outpatient occasions of service. ( 200 words)

This information to answer question 1 & 2

In year 2014, statistics
Patients admitted 44,879
Patients Discharged 44, 863
Avg, Daily Census 653
Avg, Occupancy Rate 84
Avg, Length of Stay 4.6
Number of Operations 7,435

No, of Visits in A&E 156,398
NO, of Outpatients Visits 367,853
King Khalid University Hospital (KKUH) is in the central of Riyadh city.
Established in 1982.
The second and biggest educational hospital in Riyadh city, Saudi Arabia.
KKUH provides many services for researchers and trainees.

And it was limited in its infancy on the complex outpatient clinics, and then evolve with time to work with a capacity of 950 beds and 20 operating room, and a separate building for clinics featuring 161 examination room in addition to other facilities. It also has a full-service hospital in the medical laboratory services and radiology and pharmacy.

King Khalid University Hospital on an estimated area of 80,000 m 2, to reach the absorptive capacity of the hospital inpatient beds to 1,200 beds, as part of the ongoing development projects taking place in the city medical facilities in the field of educational services and medical.

In 1982, a dedicated university hospital was opened and was named King Khalid University Hospital. This facility is an 950 bed facility with all general and subspecialty medical services. It contains a special outpatient building, more than 20 operating rooms, and a fully
equipped and staffed laboratory, radiology, and pharmacy services in addition to all other supporting services.
The hospital provide primary, secondary care services for Saudi patients. It also provides tertiary care services
to all Saudi citizens on referral bases. All care is free of charge for eligible Saudi patients including medications.

Free health services, vital to any society, are offered by King Khalid University Hospital (KKUH), which possesses highly qualified consultants, carefully chosen physicians, and the finest nursing staff and general personnel possible. KKUH possesses the most current technological equipment, and annually serves the needs of a host of ambitious students at the College of Medicine.

KKUH has several specialized departments like:
• Medical Imaging (Radiology)
• Laboratory
• Nursing Department
• Rehabilitation
• Anesthesia
• Pharmacy
• Infection Control
• Clinical Physiology Department
• Physiotherapy


3. Obtain a copy of the health service organisational chart showing the lines of responsibility. Discuss the reporting structure, especially pertaining to the Health Information Management Service. Include advantages, disadvantages, issues, review, plans for future change if applicable (Around 270 words). (See attachment)

The HIMS department plan is attached in the appendix.
The Hospital organisational chart is important for all staff.
All staff must have access to the organisational chart.

The organization chart can be defined as the level of employee involvement in decision-making through teamwork. In addition, it helps to bring groups of people together in order to perform efficient and proper functions. It is essential to determine the relationship between functions, positions, responsibility and authority to do particular tasks.
If you look at attached an organisation chart (Chart 1) you would notice variety of departments are listed on the chart with evident reporting structure. However, it does not encompass Health Information Management Service.

The patient information manager position is shared amongst two health information managers who report to the executive director. The Coders and the freedom of information officers report directly to the managers of patient information. There are three deputy health information managers who oversee the inpatient and outpatient clerical staff. One of the deputy managers is employed full time and two of the deputy managers work part time, therefore share the vacancy.
The main advantage of the organisation structure is that relative to the size of the hospital and the number of staff in other secondary hospitals there are an adequate number of staff at KKUH. This reduces stress related to work overload and increases efficiency as tasks may be distributed amongst the employees. The current weakness of the organisational structure is related to varying roles amongst clerical staff such as the inpatient and outpatient clerical staff. This poses a problem in circumstances where there are clerical staff shortages and staffs are required to cover positions within the different clinics, due to the limited training the staff will not be able alternate between the positions.
4. Obtain a copy of the Health Information Management Service organisational chart. Discuss the reporting structure, justifying any advantages or disadvantages to the structure (250 words ). (See attachment)

The HIMS organisational chart is attached in the appendix.

The HIM’S organisational chart is important for all staff.
All staff must have access to the organisational chart to understand their responsiblites, enhance the workflow, …, … etc
Shows clear reporting structure – employees know who to report to, who to contact when there is an issue that needs resolving or a question that needs to be answered.

Advantages are clear lines of communication, clear lines of authority, and clear areas of responsibility. In an organized hierarchy, people are encouraged to communicate with the level directly above or below them, which keeps other levels clear of communication “clutter,” leading to more efficiencies and providing easier communication with familiar levels and people. The clear lines of authority are very important, because personal relationships and other factors tend to muddy these if there is no organizational chart.
A chart also lets people know what their functions and responsibilities are, which keeps everyone in an organization on track, doing what he or she is supposed to be doing.

Disadvantages of having an organizational chart include a loss of flexibility, possible difficulties in lateral communication, and a significantly decreased exchange of ideas, although a matrix structure can alleviate some of these problems, while creating others. When people have assigned roles and responsibilities, they might have a tendency to never think about pitching in to help in another areas, for example, and assigned work is completely confined, although it might be better served by going outside the chart’s limits. A rigid structure can hinder lateral communication, with no clear means of one department communicating with another, which can lead to difficulties when things go wrong, or even when they don’t. This lack of communication also can mean that ideas among departments are not exchanged, with many missed opportunities for improvement in a company.

5. Outline the key functions and scope of the Health Information Management Service (Around 160 words).
Please write at least 10 functions.

The HIMS department will enhance the workflow and to provide high quality services for patients at KKUH.
There are many of functions and responsibilities of the HIMS. The important include and not limit to:
? Maintains confidentiality of patient information at all times.
? Maintenance of computer patient administration system (eSIHI) and other information systems.
? Release confidential patient information to authorized Health Care Professionals external to the Hospital.
? Provision of medical records and other relevant material for approved research, audits clinical review and education.
? Development and implementation of the Quality Improvement Program to ensure that both patient care and Health Record Management Service comply with established standards. This includes assessing the medical record content as well as medical record services.
? Supply morbidity statistical data
? Provide clerical, secretarial and reception services throughout various units and department in the Hospital.
? Collection of departmental and hospital-related performance indicators.
? Provide advice, where appropriate, to other Hospital departments on medical record related matters.
? Allow classification of diseases and procedures for inpatient admissions using international Classification of Diseases and Health Related Problems, 10th Revision Australian Modification (ICD-10-AM).
6. Read the job descriptions of the Manager and senior supervisors within the Health Information Management Service. To gain an understanding of the scope of each position.
• List and briefly document each position.
• Discuss the roles and duties with the staff concerned.

(Around 10 points for each position) (For all questions, around 1100 words)

Manager of HIMS
? Create and maintain policies and procedures related to health information
? management.
? Oversee all activities in the HIMS including admission and discharge, medical record service, non-admitted service, freedom of information, central secretarial service, health information system support
? Improve quality of care in evaluating and meeting customer needs.
? Improve performance management to help increase work performance.
? Ensure availability of technology in order to have accurate and secure health information.
? In charge of the financial operation of the HIMS.
? Ensure the HIMS is meeting KKUH’s policies and patients’ needs.
? Attend internal and external committees in regard to health information.
? Provide training and support in regard to health information.
Deputy Manager of HISM

• Provide assistance and support to the HIMS Manager in strategic planning, financial and material resources.
• Evaluate the HIMS policies and procedures and discuss them with the Manager and coordinators.
• Provide consultation and advice to health care professionals regarding health information.
• Ensure safety is adopted in the HIMS and comply with occupational safety.
• Provide statistical information that helps to evaluate and develop performance.
• Organize and perform training programs related to health information.
• Responsible for training health information management students.
• Perform any duties as required.
• Manages the operational aspects of the Health Record Management Service (HRMS) in KKUH to ensure an efficient and effective service.
• Provides administrative support to the HRMS Manger including physical and human resource requirements and health information professional issues.
• Provides advice to the Manager in developing and reviewing HRMS policies and procedures.
• Co-ordinates and directs section Coordinators and Senior Staff in the design, implementation, monitoring and evaluation of continuous quality improvement related to the Service.
• Ensures consistency in the application of HRMS policies, standards, procedures and systems, and provides appropriate training and development for staff to comply with the standards.
• Provide professional advice to KKUH staff (nursing, medical, allied health, administrative) with regard to design and review of the patient health record and associated forms and systems.
• Provide strategic advice to senior hospital management on confidentiality, privacy and legal matters / issues concerning patient information.
• Develops and contributes to the development and implementation of an electronic health record and document management strategy and systems for KKUH and wider health sector.
Manager of Medical record department

Job Summary:

2.1 The organization and management of all Areas/Sections of the department (MRD).

2.2 The organization and management of all types of progressive meetings and
solution of the problems relating to the necessities of Medical Records Department with the Deputy Medical Director.

2.3 The organization and management of all types of progressive meetings and

solution of the problems relating to the medical documents, physicians, nurses and other necessities with the Deputy Medical Director.
2.4 The organization and management of all types of progressive meetings and

solution of the problems relating to the medical documents, physicians, nurses and other necessities with the Director of Medical Director.
2.5 The organization and management of all types of progressive meetings and

solution of the problems relating to the medical documents, nurses and other
necessities with Nursing Director or his/her designee under the supervision of
Deputy Medical Director.
2.6 The organization and management of all types of progression and solution of the problems relating to medical documents and other necessities with all Medical Departments under supervision Deputy Medical Director.

2.7 The organization and management of all types of progression and solution of the problems with Non-medical departments relating Medical Records Department.

2.8 The formulating and updating of department’s Policy & Procedure relating to the department requirements in liaison with the other departments of the hospital under the command of Deputy Medical Director. These reviews are to be done periodically depending upon the necessity.

3.1 Responsible for the overall administration of the Medical Record Department.

3.2 Ensure that confidentiality of patient records is maintained by the department.
3.4 Design and establish training program for students from other institutions.

3.5 Participate on various hospital committees such as Medical Records Committee and Represent department interests.

3.6 Responsible for long term planning of department functions, staffing and equipment needs.

3.7 Evaluate performance of staff reporting to Director.

3.8 Evaluate the quality and effectiveness of medical record services.

3.9 Assure that department policies and procedures are accurate and up to date.

3.11 Ensure that working environment is safe.

3.12 Assist in recruiting qualified personnel

Assistant Manager Medical records

Duties and Responsibilities:

3.1. Serve as Acting Director in absence of the Director.

3.2. Provide in service education for all staff in allocated areas, with an emphasis on cross-training between the different areas.

3.3. Participate in formulating and revising policies and procedures.

3.4. Provide statistical and other reports on a regular basis, as required by Administration, The Medical Staff etc.

3.5. Assign such duties as deemed necessary to the staff and re-assign duties in the event of staff absence.

3.6. Maintain a working relationship with the staff in the clinical areas, so as to minimize problems in patient care.

3.7. Report any unsolved or impending problems to the Director of Medical Record department.

3.8. Maintain a daily list of missing medical records and any other problems.

3.9. Participate in the evaluation of staff performance.

3.10. Plan and assign vacation of the staff in file room.

3.11. Maintain confidentiality of patient’s records.
3.12. Take care of equipments in the department.

3.13. Maintain equipment in proper working order.

3.14. Demonstrate awareness of safety in the department.

3.15. Re-assign staff to cover for unplanned absences.

3.16. Undertake counseling activities as necessary.

3.17. Prepare staff schedule including vacation coverage.

3.18. Supervise students when assigned.

3.19. Other duties as assigned.

File room supervisor
Duties and Responsibilities:

3.1. Confirm to the departments and hospital’s policies and procedures.

3.2. Organize daily activities in the filing area and to maintain an even distribution of work through-out the day.

3.3. Assign such duties as deemed necessary to the staff and re-assign duties in the event of staff absence.

3.4. Prepare a monthly work schedule for staff.

3.5. Maintain a working relationship with the other File room supervisor and together coordinate the activities of all three shifts.

3.6. Maintain a working relationship with the staff in the clinical areas, so as to minimize problems in patient care.

3.7. Report any unsolved or impending problems to the Director of Medical Records department.

3.8. Maintain a daily list of missing charts and any other problems.

3.9. Participate in the evaluation of staff performance.

3.10. Plan and assign vacation of the staff in file room.

3.11. Maintain confidentiality of patient’s records.

3.12. Take care of equipments in the department.

Coordinator of Admission discharge office
1- Coordinates the application and data entry process to ensure efficiency
2- Coordinates activities related to admission of patients in hospital or other medical facility: Confers with physicians, and nursing, housekeeping, transport, and other staff members to coordinate and schedule admission of patient.

3- 3) Prepares records of admission, transfer, and other required data.

4- 4) Notifies departments of patient’s admission.
5- Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and jcaho standards.
6- Monitors admitting trends by maintaining various categories of statistical data for utilization within internal reporting systems.
7- Enhances patient care delivery system by implementing admissions function interface with the nursing and professional staff
8- Serves and protects the hospital community by ensuring adherence to professional standards, hospital policies and procedures, federal, state, and local requirements
9- Reviews clerical work of interviewers and other personnel.
10- Communicate with Emergency department all the day.
Manager of Emergency department

1- Responsible about ED in front of Medical Director & Hospital Director
2- Coordinate work in ED, manpower distribution, staff relation to other hospital staff (like soci al worker, security etc.) public and administration, staff emergency & vacation leaves (ED Doctor), problem solving
3- Assess ED work, staff practice, and try to formulate & implement ways to improve the department).
4- Acts as ED controller in disaster condition
5 . Helps ED staff in difficult decision making.
6 . Implement to the ED staff every policy.
7 . Supervise medical trainee practice in ED.
8 . Admission right (to referral ROD).
9 . Supervise ambulance policy its working condition and readiness.
10 . Ensure that registration of patient and issuing ED form for all emergency patient attending for care.
11 . Ensure that completing patient personal data
12 . Care of filing system and movement of reports & ED statistic making.
13 . Ensure and checking the processes for ED admission

Supervisor of Physician dictation room
Duties and Responsibilities:

3.1 Scrutinize for deficiency of the completed files received from the Processing Unit.

3.2 Update deficiency regarding discharge summaries and medical reports.

3.3 Liaise with the medical staff for completion of their medical records.

3.4 Supervisor in this unit should liaise with the Supervisor of Main Filing Section to pull the pending files (if any) of the doctors (request lists) for
completion of records.

3.5 Once updated information is available and deficiency is filled, medical records against the medical staff is being deleted for processing of vacation and clearance is provided.

3.6 Coordinate with physicians intending to conduct a research. All physicians are requested to fill the form (find attached form) with the Consultant’s Name or Department Head’s approval. The form is to be presented to the Director of Medical Records for approval to the get the disease Code and for pulling the files from the Main Filing Section.

3.7 Files after collection of data for research by the Physicians are to be returned back to the Main Filing Section.

3.8 The Supervisor/ clerk of this unit should inform all the Physicians about their pending files and remind them as well to complete their records.

7. List the committees on which the Manager and other senior staff are members. Include position held; function of the committee; how often meets; if internal or external. Suggested activity: Attend a relevant committee meeting and read the terms of reference. (350 words)
The health information managers and deputy managers appear in various internal and external committees. Often the internal committees identify issues within the patient information service department at KKUH and develop an action plans to address the departmental concerns. The external committees serve as forums to discuss issues, policies and procedures related to the management of health information management at a broader level and involve representative panel members from other government owned hospitals and the department of health.

External committees
1 Health Information management committee- The committee members meet every two months with members from the Department of Health , they discuss issues relevant to the management of health information. Recent committee meetings have discussed new electronic health record projects. The meeting is usually attended by one of the patient information managers.
2 Computer systems committee-The deputy managers attends this committee meeting held monthly at health information network. The committee discusses issues related to computer systems such as new functions or upgrades, bugs in topaz or merits and possible solutions for downtime and other problems that arise.

Internal meeting
Department meeting- bi-monthly meeting attended by the deputy managers, mangers of patient information, clerical supervisor and freedom of information officer to discuss the issues across the department and possible solutions. Some of the issues discussed in the internal meeting included quality, reviewing an orientation pack provided to all new staff, setting new planner goals and discussing the implementation of a new staff satisfaction survey .

1. Health record clerk meeting- bi-monthly, meeting with all the health record clerks to discuss any suggestions/ issues staff may have.

2. Clinical coding meeting-bi-monthly , meeting with all the clinical coding staff and mangers of patient information service to discuss issues or new coding procedures( as per HMDS reference manual)

3. Ward clerk meeting- held yearly
4. Quality – discuss new implementations and activities in relation to meeting the accreditation standards. The meeting occurs during accreditation period, the manager of patients information is the departmental representatives.

8. Obtain a floor plan of the Health Information Management Department. If no plan is available, prepare one either on paper or electronically. Discuss the Department in terms of design, workflow, the impact these have on staff and the availability of storage space. Suggested activity: Undertake an ergonomics review of this area: consult with staff and make recommendations for any improvements. (Around 570 words).

Ground floor: Main Room Filing area, Checking Area with for 4 medical records Professionals, reception 2 clercks,

First floor (Level 1): all offices, another reception to deal with receive and to send the file to wards or nurses,

Second floor (Level 2): Alternative storage for inactive files or expired files, scanning medical records,
At KKUH, the HIMS department has been designed to optimize space while providing the best arrangement for the rapid achievement of tasks. HIMS department plan, to some extent, is communicated to all KKUH staff as HIMS is one of the most important areas of the hospital and because of that the policy of hospital is intended to provide a guideline for all Hospital staff regarding the correct handling of confidential information. The departmental plan takes into account that HIMS information is contained in paper medical record and information contained on computer systems.

Despite these efforts, according to staff, the area where medical records are stored now is not efficient enough for record filing requirements of KKUH. There is inadequate space to file the health records in the filing area. Some files were placed on the ground; others were filed on the top of shelves. The current store which has been used for some time, is too small, which has forced the department to store their records in alternative and distant areas. According to the staff, this is time consuming especially looking for specific record and leads to work which is demanding and involves the timetabling of task outside general office hours. Thus, staff are required to be working there during working hours and after hours. Another one of the problems which the department faces is the need for offsite storage. This requirement means additional procedures and additional time both in sending and collection of data. These procedures most of the time affect patient’s health care quality and efficiency.

There are two location for medical record department. One of them is in the outpatient building, near from medical record department, and all workers there is male. Another one is in medical record department and all workers is female and this is will help for workflow in the HISM department.
The male worker will receive patient’s request and then contact with female worker to start to supply the medical report for patients.

The elevator inside medical record department is not working since 2013 and this is will not enhance the workflow. All staff use the stair inside the department or the elevator which is outside the department when they need to send any files to level one (Manager or deputy manager, processing, coding, dictaction, medical report, loose report, secretary, repair areas and reception of medical record department).

The elevator will serve all staff on ground floor and level 1 and 2 and they do not need to open the door on ground floor for all time. When they fix elevator they will enhance the privacy and security of patients’ information.
The door, which is located on the first floor is closed all day and all staff must have access from Safety and Security Department. On the other hand, the door, which is located on the ground floor is open in the morning and evening time and some patients walk in the medical records department.
This violates the regulations and legislation in the hospital and causes loss of privacy and the confidentiality of patients’ information.

9. Review occupational health and safety issues within the Health Information Management Service. What legislation is involved? Comment on any hazards (real and potential) and the measures in place to limit these and comply with regulations (e.g., safety representative positions, fire exits and drills, pest control, equipment etc.). (Around 550 words)
Occupational Health & Safety (OHS) protects workers from hazards and ensures safe and healthy working conditions.

Under legislative requirements the patient information service managers have the responsibility of providing a safe and healthy environment to all employees, eliminating hazards as much as possible and ensuring that Occupational Health and Safety (OHS) are incorporated across the department. For example, all new employer at KKUH must attend the orientation programs which include information related to OHS.

Employees are responsible for protecting their own health and safety, and that of patients, colleagues and the public by identifying and reporting hazards, reporting incidents/accidents, using personal protective equipment supplied or required and complying with established safer work practices, procedures and reasonable instructions.
Regarding the hazards within the HIMS workplace, staff informally interviewed made reference to the physical risks. These hazards were relating to the filing and storing of numerous patients’ medical records, and are managed day to day by the Medical Records Officers in the Medical Records Office (MRO). The use of trolleys and other support devices is governed by setting policy.
There are no Fire extinguisher in the Main Filing Room in Medical record department at KKUH. Also, there are no ventilation and staff cannot open the windows.

In my view, the HIMS Department should perform internal audits by safety staff. I did not see any first aid. Therefore, it is mandatory to determine the first aid needs of the workplace and put together first aid kits and establish a protocol to check and replace them regularly. The OHS can be enhanced by rewarding departments that follow and adapt the OHS regulations. I would encourage the HIMS manager to perform sample emergency response plans in order to increase risk awareness.
To promote safe work practices and to ensure that a safe work environment is maintained for employees who install, repair, or maintain energized electrical equipment.
Departments and units that use portable or stationary electrical equipment, appliances, flexible cords, or adapters must ensure the equipment and operation is safe by properly inspecting, maintaining, and using the equipment in accordance with the manufacturer’s recommendations and all applicable codes, standards, and policies.
Smoking in prohibited in the Medical Records Department to prevent fire or disaster.

In the event of fire in the department, employees should close all the doors as they leave.

The first person/staff receiving news of the fire shall report it to:
All fire protection doors must be kept closed at all times.

Fire extinguisher must be located in an easily accessible place.

In the event of a public disaster, the Director of the department shall call in for active duty support. Staff would work at whatever level of duties are assigned and once released from the disaster would report back to the Director, Medical Records Department for further instructions.
Staff are oriented about the importance of preventing fire or disaster.

All staff are sent for training to the Fire Safety Department in rotation and are certified (given a certificate of participation).
Safety: Alert employee to hazard associated with the work area (ladders, stepstools, etc).
Fire & Evacuation: Educate employees of the procedure and to go through the fire control program.

10. Identify and discuss the operating hours of the department. In terms of resourcing and allocation of duties, describe how the after-hours shift differs from a day shift. How is security managed for staff? (300 words)

There are three shifts for medical record department staff.
Morning shift: from 7:30 Am to 3:30 pm.
Manger of Medical record Department, her Deputy, all staff in dictation, processing, coding, losse report, transcription, checking, main filing areas staff are working in the morning shift as well as secretary and reception clerks. Also, medical report staff are working in the morning.

The second shift is from 3:30 pm to 11:30 pm.
In this period of time, the health medical record professionals and clerks file and pulling all files from and into the shelves.
There are seven persons for filing and six persons for pulling all files for patients using a lists of appointment and for files which are requested for emergency department. Also, there are one clerk for answering the phone. Before filing files into the shelves, All staff must use eSIHI to confirm that they received the file from all wards and to know the location of the file in the future and to reduce all misfiling errors.

The third shift is from 11:30 pm to 7:30 am. There are only one clerk and one medical record professional.
Main Filing Room supervisor maintain a working relationship with the other File room supervisor and together coordinate the activities of all three shifts.
11. Review a Health Information Management Service roster for either a fortnight or a month. Discuss issues that needed to be considered when preparing a roster, whether a fixed or rotating roster is in place and describe how annual leave, sick leave and public holiday coverage is managed. (300 words)

Rostering at KKUH is every month and the responsibility of medical record supervisor who arrange and organise the working times for all staff in that area. Before supervisor starts preparing the roster, many issues have to be considered. One of the most important things is that the annual leave schedule which illustrates any employee who has applied for leave, review the contracts, organise sick leaves and pay attention to special requirements. When rostering is in place the supervisor has to make sure that all employees rotate around all tasks in order to allow others to work in different duties as well as different shifts.
if a staff member is currently working in pulling files for outpatient clinic, the next month the same staff will be placed in different task in order to perform multiple tasks and not to cause any inconvenience to the staff of being long time working in pulling files and so on for the rest of the staff.
Annual leave:
Staff requesting annual leave are to view the annual leave roster to see if the time they are requesting is available.
Peak periods such as school holidays or Christmas time are approved based on fairness, where past annual leave is reviewed. The annual leave will then be granted to staff that had the least leave time in the past.

In the case of absent staff, through sick leave or annual leave, the coordinator must call in staff from different shifts who do not have duty already for that given day. The staff member is asked if they are prepared to cover this position. Generally, staff will indicate their desire for additional shifts to the coordinator.

12. Identify any performance appraisal tools utilised by the Health Information Manager. How often are reviews undertaken with staff? (150 words)

Annual performance appraisals (Form 523) are a tool that is used to measure the performance management. The purpose is to measure skills, knowledge and attitudes in relation to certain objectives as well as to encourage the employees to perform well and develop their performance. Furthermore, the HIMS Department becomes familiar with what type of training is needed and if the staff requires refresher training.

Performance Management will be undertaken for all Health Record Service staff and will be conducted by immediate Supervisor. Supervisors are responsible for filing and checking the forms annually with the deputy manager and send copy to HRM Department.
13. Identify what employment Award/s (certified agreements, EBAs) apply to the Manager and staff within the HIMS. Summarise what the Award states in relation to leave entitlements.

You do not have to answer this question (13).
14. What professional development opportunities are offered to staff in the HIMS? What is coordinated centrally and what is organised by the Department? (100 words)
HIMS staff members are able to attend any of the following learning and development sessions or courses free of charge: medical terminology, ethical decision-making; communication skills; leadership training; Occupational and health safety, performance management; project management; recruitment and selection; training and selection; workplace aggression and violence. All staff must complete the electronic form through the website and submit it to Deanship of Skills Development in Blok 26.

15. Identify and describe the process for recruiting and selecting new staff. What are the end of employment procedures? (Around 500 words)

Plz, write almost half page and mention:
There are to kinds of job at KKUH (Full time and part time).

Canadiates must fill the application form of recruitment.
The requesting department department head fill and sign the competency form.

Important: You can find the answer for this question through reading the the procedures below. I think all recruiting and select new staff at KKUH as others hospitals or companies.

Procedures for Advertising vacancies & Candidate nomination

The requesting department department head fill the competency form

Candidate nomination

16. Describe and discuss the filing and storage of health records addressing the following:
• filing system (centralised; decentralised)
• storage locations on site and their relationship to the HIMS
• type of filing (terminal or middle digit; other system)
• colour coding
• management aids to workflow (e.g., alert stickers, instruction forms)
• storage equipment (including shelving units, trolleys, step-stools)
• overall efficiency of the current system. (700 words for question 16)

This answer below related to KKUH but you can add anything (ideas, …). Storage and equipment are the almost the same in a lot of hospital.

Only dental department kept its patients’ records in the dental department.
The Main Filing Room is located in the groud floor and its size not enough.

There are more than 570,000 files filed in the Main Filing Room and in the Level 2. Active files is located in the Main Filing Room, but there are many active and inactive files in Level 2. All files that kept in main filing room is for the last five years (From 2011 to 2016).
According to the supervisor of medical record, the number of requisition of files is reduced after implementation of eSIHI.

The location of the Main Failing Room is near from Emergency Department, outpatient building and wards and this is will help workflow.
In terms of storage space, there is inadequate space to file the health records in the Main filing area. Some files were placed on the ground; others were filed on the top of shelves. In the main filing room, there is no ventilation and staff cannot open the windows and no fire extinguishers. There is no dust in main filing room. One the other hand, a lot of dust in the storage area in Level 2.
The existing space is enough between the filing shelves to allow space for a trolley and a person to walk between the shelves to file and retrieve records. However, all shelves are full with records, which has led to the filing many record in Level 2.
Trolleys are used to push the records around for filing of the records and for usage outside medical record department. The size of trolleys is good for usage inside the elevator. Stools are located around the filing area for reaching files on the higher shelves. In main filing room, there are three rolling and 11 non-rolling step stools have been provided to staff. In Level 2, there are only 4 step stools and one scanning machine and only one scanner.
There are enough trolleys with different sizes in main filing room.
There are a variety of stickers utilized to assist with efficient workflow. Alerts such as drug and medical are placed on the file to inform health care providers if the patient has an allergy or needs medical attention.

• storage locations on site and their relationship to the HIMS
Files after arrival to the main filing area from different locations, viz. emergency
room (Adult and Pediatrics), wards, clinics, research and physician dictation room and coding, etc. They would be updated in the file tracking system in the computer. Segregation is done and medical record files are ultimately filed by the assigned staff according to the terminal digits in the main file room.

Large central room consists of large shelves where all patient files are kept, numbered in lead color for easy availability and access. Equipped with computer and telephone devices through which communication is maintained with other department(s) in the hospital.

A medical record system is organized to render service to the patient, medical staff and the hospital administration. The primary purpose for which a medical record department exists in a hospital is to give service in support of good patient care.

Printing of the appointment list is done by terminal digits through theSIHI; the list is then divided in between the staff available according to the terminal digits for easy distribution of medical record files. After completion of pulling from the main filing area, staff is advised to look out for the charts according to the tracking (in the shelves of doctors, inactive filing area, physician dictation Male and Female, Coding and processing, etc.).

The files are then segregated according to the list of Doctors, Clinics, Wards, Admission Wards and cancellation is done in case of duplication of appointment.
The files are then dispatched through the file tracking system (HIS) to their respective locations.

17. Alternate storage methods in use: (500 words)
• describe the media used: location and equipment required
• scanning or filming procedures (include updating procedures)
• levels of access
• reasons for use: when brought back to hard copy

KKUH stores all records older than 2007 off-site, and older than 2011 as inactive files in Level 2. This is due to the lack of available filing space within in the medical record department. In terms of alternate storage methods in use, there was microfiche, which stopped in 1998. There are also one scanner to scan files who are working in Level 2. His productivity is only to scan 25 files.
KKUH service stores all records older than December 2007 off-site, including all older volumes. This is due to the lack of available filing space within in the medical record department. All records are stored at Level 2 and there are new and few shelves for the new files in Main Filing Room area. According to the staff, these shelves for a new files for patients who visit emergency department and doctors and clerks use eSIHI since May 2015 so these files only include two papers (ID copy and patient information form). According to the staff, they need to scan these files and destroy all papers but they waiting the approval from CEO.

Records are prepared by attaching a barcode to the cover of the health record.
Location Media:

The Health Record Management Service is located on level 2.

The Health Record management Service has been divided into active and inactive areas.

The current primary or active filing area is located on level 2 Block A. This area contains approximately 2 years worth of current medical records the medical records are filed in Terminal digit order.

Medical records within the secondary storage are those of inactive patients, and are also filed in Terminal digit order on static shelving.

Multiple Volumes of a patient’s medical record and deceased patient medical records are stored off site

Levels of Access:

The first step in a patient’s administration at KKUH is through The Patient Adinistration system – eSIHI. Authorized staff access is required to access this initial computer system.
After this, for tracking files, a Medical Record Information Tracking System (MRITS)is currently used to quickly inform staff the location of a patient’s medical record. This system is protected with a password which only relevant HIMS personnel have. In addition to this, the Medical Records Store’s entry is protected with a code, which only relevant HIMS staff know. Overall the level of access, based on observation, appears to be sufficient.

Storage and Security :

The department, to which the permanent loan of health records is granted, shall be responsible for ensuring that there is an area suitable for record storage and that this area can be securely locked when no-one is in attendance.
The Health Record Management Service should be kept secure at all times, with only authorised staff being permitted to enter the Department. Employees of the Department have a responsibility to ensure that unauthorised persons do not enter the Department.
When transporting health records, whether internally or externally, Hospital employees have a responsibility to secure health records to ensure confidentiality. When transporting single records, it is advised that records be enclosed in a non-transparent envelope e.g. internal mail envelope.
Health records must not be left in unsecured areas where there is the potential for unauthorised access.
18. If applicable, discuss off-site storage of health records. Justify the reason; location; cost; issues involved. The preparation for sending records off site; transport to the area, procedure for requests – urgent and non-urgent. 300 words

Due to a lack of space on the KKUH it has become necessary to use off-site storage to store health records that are rarely used.

KKUH has two of site storages, one of them is in Blok 62 (200 meters from Medical Record Department MRD) and another one is in a big room in nurses residence building( 430 meters away from MRD). All files in offsite storage into boxes and all boxes with barcode.
The preparation for sending records off site is well-organized at KKUH. When a given patient has not come to the KKUH for about four years, their medical record will be identified. This is the first step. The second step with regards to the preparation for sending records off site is that the identified document is located and instructions are inputted into the system. This enables staff to be able to locate the document. The third step is the packing of the patient medical record. This step involves sending a list of the files number by computer to the store, putting it in the box and then sending it off site under the supervision of a medical record supervisor to Building 62.

All of the health records have a barcode and the correct MRN was printed on the front of the cover.
If the patient comes to the hospital for treatment and his or her file location is offsite or researchers need the file, the health providers have to request the file from MRD if not urgent by calling receptionist or by contact directly with Manager of Medical record or supervisors if urgent. For ‘urgent’ Medical Records, the delivery is promised within one day while or non-urgent documents are promised delivered within two days.
19. Discuss the main tracking or tracer system used by the Health Information Management Service. If applicable, address alternative media and off-site storage tracking systems as well. 150 words

Main tracking system is used.

The old Patient Health System used in KKUH is called Health Information System HIS (for offsite storage, inactive (inactive files for patients who not coming to hospital from 2009 and need the possessing now to scan them) and expired files (expired files for who died) that is in level 2. There are also many files in the Blok 62 and in the basement floor in the care parking building and many of these files are scanned)

The new one is (Electronic System for Integrated Health Information) eSiHi (eSiHi is electronic medical record) and two hospital use eSiHi – KKUH and KAUH.
(an internal name for Cerner Millennium® called eSiHi, or Electronic System for Integrated Health Information was announced).

King Khalid University Hospital (KKUH), a 950 bed hospital and King Abdulaziz University Hospital (KAUH), a 200-bed hospital. The contract was executed between KSU and Saudi Health Information Systems (SHIS),

20. Describe the process of internal and external health record transportation. Include destination; confidentiality measures, who conveys and mode of transportation. 250 words
Before sending and after receiving files, all files are recorded on the eSIHI to avoid misfiling errors.
Medical record clerks always collect files from wards at 1:30 pm. All wards has a specific and safe drawers for medical records.
In the comments field is placed who the record is going to, eg Name of doctor or ward.
It is essential that care is taking to maintain patient confidentiality when medical records are being transported. The primary mode of health record transportation is by the medical record clerk. The Clerks will transport records throughout the hospital to the required departments. Records can also be collected by those requiring them. When carrying health records the patient’s name and any other confidential information should be shielded from view. Records should be placed face down and out of reach to the public.

All wards staff can use eSIHI to request any files and medical record receptionist then will see the requestion list through the system, eSIHI.
Sometimes, nurses come to the receptionist to take the file. In this case, nurses must write his or her name in the form and sign. The form contains medical record number, name of receiver, name of ward and the receiver’s signature.

21. Describe procedures and issues associated with loose reports. Include: (Around 230)
• how technology has affected the area of reporting and storing reports
• any specific requirements (e.g. doctor’s signature to ensure the report is sighted)
• the flow of reports (movement between service points, urgent need, number of copies generated)
• filing procedure for all storage areas.

If a UMRN is not noted on the form the patient’s information is entered into eSIHI and the appropriate UMRN is found and written on the loose paper. The number of loose filing is counted and entered onto a stats sheet. The loose papers are then sorted into UMRN order by terminal digit number and put into the loose filing bays for filing.
All reports must be signed by doctors before placed into the medical record. If forms are not signed the record should be placed into the bays for signing.
3.1 Patient’s name and medical record number to be checked before filing any loose material.
3.2 Patient’s name and medical record number must be in English on all loose reports.

3.3 Pick up loose material from the distribution and sorting slots.

3.4 Arrange loose material in terminal digit order.

3.5 Locate and pull the chart for which there is loose report.

3.6 Open chart and check patient’s name and medical record number on the file and see whether they match the name and number on loose material.

3.7 Stick all loose reports to an authorized order.

3.8 File today’s Loose material by appropriate chart order.

3.9 If the chart is not available. Loose material must be placed in the plastic envelope and file it where the exact position of charts should be.

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *