Emerald Insight 1

7/25/2019 Emerald Insight 1

1/9

Records Management JournalFiling systems

HEATHER WALKER

Article information:

To cite this document:HEATHER WALKER, (1996),"Filing systems", Records Management Journal, Vol. 6 Iss 1 pp. 51 - 58Permanent link to this document:http://dx.doi.org/10.1108/eb027086

Downloaded on: 29 November 2015, At: 02:03 (PT)

References: this document contains references to 0 other documents.

To copy this document: [email protected]

The fulltext of this document has been downloaded 982 times since 2006*

Users who downloaded this article also downloaded:

(1984),"Filing and storage", Facilities, Vol. 2 Iss 12 pp. 6-8 http://dx.doi.org/10.1108/eb018738

P.S. WALKINS, (1953),"FILING AND STORAGE OF REPORTS", Aslib Proceedings, Vol. 5 Iss 4 pp.335-340 http://dx.doi.org/10.1108/eb049495

Thomas W. Jackson, Stephen Smith, (2011),"Retrieving relevant information: traditional file systemsversus tagging", Journal of Enterprise Information Management, Vol. 25 Iss 1 pp. 79-93 http://dx.doi.org/10.1108/17410391211192170

Access to this document was granted through an Emerald subscription provided by emerald-

srm:434496 []

For Authors

If you would like to write for this, or any other Emerald publication, then please use our Emeraldfor Authors service information about how to choose which publication to write for and submissionguidelines are available for all. Please visit www.emeraldinsight.com/authors for more information.

About Emerald www.emeraldinsight.com

Emerald is a global publisher linking research and practice to the benefit of society. The companymanages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as wellas providing an extensive range of online products and additional customer resources and services.

Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of theCommittee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative fordigital archive preservation.

*Related content and download information correct at time of

download.
http://dx.doi.org/10.1108/eb027086http://dx.doi.org/10.1108/eb027086


2/9

Stud y Gu ide

F i l i ng sys tems

HE THER W LKER

BSTR CT

This study guide should start with an explanation of what I mean by filing sys

tems. Whether one is referring to the filing of records on a shelf or the filing

order of papers within a record, both are filing systems and both are organised

differently. To cover filing systems in a comprehensive way, therefore, we not

only have to discuss both of these systems but also the numbering and organisa

tion of records or papers that allow them to be filed and retrieved.

Drawing on examples from the health service, this study guide will cover

the following topics:

num bering systems

filing within a record

me thod s of filing

filing of a record with in a filing sys tem

tracing records within the filing system

It is important to emphasise the importance of a well organised and main

tained filing systems without which many businesses and organisations

could not function efficiently.

Records Mana gement Journal vol. 6 n o. 1 April 1996 pp. 51-58


3/9

Records Managem ent Journal

vol. 6 no. 1

1.

NUMBERING SYSTEMS

Within the health service there are at least four different numbering sys

tems with several variations on these. The number is issued as a unique

identifier to all patients attending a hospital. This number is kept on both

the computer and the manual record. The different types of systems used

include:

alphabetical

straight numerical

date of birth

numerical with year or alpha prefix

a. Alphabetical

This is the most commonly used system and most readily understood. It

is still used in the health service in small departments particularly Acci

dent and Emergency and Maternity as it easily understood and easy to

maintain for a small number of reco rds. It may also be important to allow

easy access to non-records staff out of office hours and an alphabetic

system requires the retriever to know only the patient s name.

b. Straight Num erical

This system starts with the issue of a unique number, usually number 1,

for each patient registered and is used up to the issue of 999 999. After

six digits the number becomes difficult to remember when filing. This type

of system relies on an index to enable retrieval of records and is usually

used for the main hospital filing system.

c. Date of Birth

This num bering system uses the patient s date of birth as the six digit

number with alpha characters from the surname used to differentiate

records within the same date of birth. This method can be used either in

a simple sequential or a terminal digit filing system (see section 4).

d. Num erical With Prefix

This system is similar to straight numerical but with a prefix added either

when the number would become larger than six digits or to indicate the

date of the registration year. This system allows the records to be sorted

by year of registration, so the number of new records added to the system

can be m onitored. For records that are no longer current, the year of reg

istration can be used to identify those records that can be destroyed or

microfilmed once the agreed retention period is passed.

52


4/9

April 1996

Filing systems

2

FILING WITHIN A RECO RD

The medical record contains a large variety of papers that may or may

not be standard documents and vary considerably between hospitals. An

attempt to standardise these documents in the health service was made by

the Tunbridge Committee

1

in 1961 which recom men ded:

the classification of records acco rding to their likely pe

riod of relevance.

retention periods for doc um ents.

the use of international paper sizes.

the unit system of record -keepin g - one patient one record.

the use of shelves for filing as an alternative to cabine ts.

the formation of a perm anen t body to act as a point of

reference for changes in medical record-keeping.

the use of standard forms.

guid ance on paper quality.

The report from this committee was final ly published in 1965 as The

Standardisation of Hospital Medical Records

2

. Some of i ts recommenda

tions were introduced, although no permanent body was ever formed. The

next influential report on medical records keeping did not come until 30

years later when the Audit Commission chose medical records as a sub

j ec t fo r one o f i t s na t iona l s tu d ie s . The re com m end a t io ns o f t he

report

3

regarding record-keeping were as fol lows:

a sing le main filing area or library

impro ved content within a single set of notes

culling of contents

a clear medical record architecture

colou r coding of records

a closed filing area or library

The record used in the health service is an A4 manila folder for hospitals

or trusts and an A5 (Lloyd George) envelope for GP records.

3 MET HO DS OF FILING DOCUM ENTS W ITHIN A FILE OR

R E C OR D

There are two main methods of filing documents within a file or medical

record:

loose filing of papers in a pocket or cove r

fixed papers with a clip or a tag

53


5/9

Records Managem ent Journal vol. 6 no. 1

Within these two methods there are a variety of ways in which the docu

ments or papers can be organised:

chronological

by med ical/surgical speciality

by type of docu men t

Many health records are organised into sections to allow similar docum ents

to be kept together. The four main sections are:

identification and adm inistration section

clinical notes

investigation and test results

correspondence

Other types of documents are filed within the record although their place

may not be clear. An alternative system would be to use coloured divid

ers to create many more sections and allow the classification to become

much wider.

4.

F I L I N G O F R E C O R D S

There are several ways to file records. Some of the more common ones

used to file medical records are:

sim ple sequential

term inal digit

alphabetical

mixe d sequen tial/terminal digit

a. Simple Sequential

Records are filed in ascending numerical order with the growth of the file

at one end of the system. This system is suitable for straight numerical

numbering, numerical with a prefix, and date of birth systems.

The disadvantages of this system are that the growth of records is at one

end of the system which means that records have to be culled and moved

back every year. It also means that all new records are at one end of the

system which, in a medical records filing system, may cause congestion

as the activity in a medical records filing system is generally with new

records as these belong to new patients.

b. Terminal Digit

The filing area is divided into 100 equal sections or filing bays/shelves

numbered from 00 to 99. The last two digits of a record number are the

5


6/9

April 1996

Filing systems

terminal digits and indicate into which section the record should be filed

so,

for example, record number 123456 would file in bay/shelf 56. W ithin

each of these sections the remaining digits, 1234 in this example, are used

for filing sequentially. In very large systems the shelves or bays may be

further subdivided into another 100 sections or into 10 sections and the

middle digits filed accordingly.

The advantages of this method are that it allows for filing equally w ithin

the system, with new records spread throughout the area. So, 100 new

records issued consecutively would each have a different terminal digit

and would therefore be filed within a different filing bay.

This method is suitable for straight numerical and date of birth number

ing systems; it is particularly useful for large filing systems in hospitals

as new records are spread throughout the system and access is easier to

maintain.

Terminal digit filing is not, however, suitable for use with mobile shelv

ing as simultaneous access to shelves in different rows would be very

difficult.

c. Alphabetical

Alphabetical filing is the most commonly used system and most readily

understood. It is still used in small departments in the health service,

particularly Accident and Emergency and M aternity. Rules have to be clear

as different spellings of names and hyphenated names can lead to filing

difficulties.

The advantage of this method is that only the pa tient s name is needed to

access the system although this may be, therefore, unsuitable for highly

confidential records e.g. genito-urinary medicine clinics.

d. Mixed Sequen tial/Terminal Digit

This system usually results from two filing areas being available, one

known as secondary storage. Records are filed in a terminal digit order

within the main system but, when culled to the secondary storage, are filed

in sequential order usually due to the more limited space or the use of

mobile shelving.

Within all of

these

systems the use of colour coding may assist in the filing

of records. A colour is allocated to each number from 0 - 9 using col

oured tape. The different coloured tape is then used to represent the ter

minal digit or year of registration and attached to the spine or edge of the

record. This means that all the records with the same terminal digit will

have the same coloured tape on the cover making it easier to file and to

identify misfiles.

55


7/9

Records Managem ent Journal

vol. 6 no. 1

5 TRACING OF RECORDS

Within any filing system there needs to be some method of retrieving the

records. In the health service this would be known as a Master Patient

Index and is now usually held on a computer. Likewise, the records

removed from a file have to be traceable. This can also be done by com

puter, using a tracking system, or alternatively using a manual system

relying on tracer cards. There are four types of tracing systems:

personal tracers

common/temporary tracers

library tickets

bar coding/medical record tracking

a. Personal Tracers

Created with the record a personal tracer contains the unique identifica

tion number and the patients name. The movement of the record is added

to the tracer card and this is retained within the filing system when the

record is removed. Once the record is returned to the file the tracer is

replaced within the record. This type of tracer contains the history of a

record s movements.

b. Com mon or Temporary Tracer

This tracer is used only when the record is removed from the filing sys

tem. Details of the reco rd s destination are added to the tracer and once

the record is returned to the file, the tracer card is removed and the entry

deleted.

c. Library Ticket

The record contains a small card containing the record number and name

of the patient. When the record is removed from the file the details of the

borrower are added to the card and the card is filed in an alphabetical

index. The difficulty with this type of tracer is that as there is no record

within the filing system itself and two places have to be searched by

anyone wishing to borrow the record. Once the record is returned the card

is reinserted in the front of the record.

d. BarCoding/Record Tracking

The unique record number can be bar-coded and this can be scanned when

the record is removed from the filing system and the details of the trans

action recorded on the computer system. The advantage of this method

of tracing is that a list can be produced from the computer system giving

information on the location of records and, therefore, preventing

56


8/9

April 1996

Filing systems

unnecessary searching in the filing system for a record that has already

been removed. A study of this system at a large teaching hospital proved

that enough clerical staff time could be saved to pay for the introduction

the bar coding system.

6. CONCLUSION

This study guide has described the essential elements of records filing

systems w ith reference to currently used manual filing systems within the

health service. The future of filing systems within the health service though

may be very different with the introduction of patient-held records,

including smart cards, document image processing and the electronic

patient record.

Patient held records have already been tried for small groups of patients

such as diabetic and obstetric patients. This allows patients to carry a small

amount of medical information with them, although a duplicate of this

record will be maintained at the hospital or clinic.

Document image processing involves archiving paper records onto opti

cal disks and can, with the use of word processing facilities in clinics and

wards linked to the central record database, create a paper free environ

ment. However, before hospitals move to the paperless office the manual

systems have to be well organised and efficient as the electronic record

will not solve efficiency and organisation problems. The hospital record

may in the future be transformed into a computerised record but before

this can happen the difficulties with legality and cost of this type of sys

tem have to be overcome. It is unlikely this will happen within the next

ten years so we should continue to maintain and improve the present

systems because without them the hospital, as indeed any other business,

could not function.

References

1. Great Britain. Ministry of Health Central Health Services Council.

Standing Medical Advisory Committee. The standardisation of

hospital medical records: report ofthesub-committee. Chairman Pro

fessor RE Tunbridge. HMSO, 1965. p. 36-37.

2. Ibid.

3. Great Britain. Audit Commission. Setting the records straight: a study

of hospital medical records. HMSO, 1995

57


9/9

RecordsManagement Journal

vol. 6 no .1

B i b l i o g r a p h y

1. Techn icians Handb ook. IHR IM, 1995.

2.

Great Britain. M inistry of Health Central Health Services Coun cil.

S t and ing Medica l Advi sory Commi t t ee . The s t anda rd i sa t ion o f

hospital medical records: report of the sub-committee. Chairman Pro

fessor RE Tunbridge. HMSO, 1965.

3 . Great Britain. Audit Comm ission. Setting the records straight: a study

of hospital medical records. HMSO, 1995.

Author

Heather Walker is a Senior Consultant with CHKS Ltd, providers of a national

comparative database service of health service information. She originally joined

the health service as a management trainee and worked for seven years in medi

cal records management posts in the north west of England. She then moved to

the Health Services Management Unit, Centre for Health Informatics at the Uni

versity of Manchester where she was Fellow in Health R ecords and in 994joined

CHKS Ltd.

HeatherWalker 9 HatcheryClose AppletonThorn Wa rrington Cheshire. WA 4

4TF.

58

Documents

Emerald Insight 1