ABSTRACT
The study examined electronic health records management practices and service delivery of employees of Babcock University Teaching Hospital. The study employed the survey design and the purposive sampling technique to select 450 staff across management, senior and junior level. A well-constructed questionnaire, which was adjudged valid and reliable, was used for collection of data from the respondents. The data obtained through the administration of the questionnaires was analyzed using the Pearson correlation analysis.
The results revealed that: electronic health records management practices prevalent at Babcock University Teaching Hospital is potent. Challenges of service delivery by employees of Babcock University Teaching Hospital is potent. There is positive and significant relationship between electronic health records management practices and service delivery (r=0.772; p<0.05).
The study hereby concluded that Electronic health records management practices have significant influence on service delivery of the employees in Babcock University Teaching Hospital. The study suggested that; The hospitals need to fully utilize electronic health records management practices to save retrieval time; The hospital need to use electronic health records management practices for business processes improvement; The hospitals need to upgrade and use the existing servers as a storage media for complete electronic patient records keeping; They need to make available disaster backup for recovery in case it is affected by disaster like fire and water.
CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Service delivery is an important activity within any organization. It defines who the organization is and promotes its corporate image. It shows the level of satisfaction the customers within the organization have. According to Ejumudo (2009) service delivery, has become the focus of increasing managerial attention and represents a major portion of economies of the world’s developed countries is at the heart of organizational performance, whether in the public or the private realm. Pyrene (2015), citing Arries, Ebin and Newman (2008) assert that service delivery has become an increasingly important concern of public healthcare services. Service delivery can be seen or is evident in the way the hospital employees respond to their patients, their courtesy, how reliable and confident they are, and even the care they offer to patients. Service delivery in a hospital entails the total health care given to a patients that visits the hospital, right from the time of registration to the time of actual treatment.
Arries and Newman, (2008) define service delivery as the consistent and accurate services provided to patients, it is the performance of the health personnel, and the motivation and assurance a patient derive from a health care treatment. Service delivery is a multiphase interactive action which coincide with the dimensions of excellence, assurance of competence, attentiveness, dissemination of information by staff and flexible helpfulness that add valuable meaning to the users.
Johnston and clark (2005), state that service delivery is all about the customer service and effectiveness. Effectiveness in customer service implies doing the right things which is measured using indicators like customer satisfaction, this can be seen or is evident in speed, service quality, timing and reactions. A service becomes effective when it is valid to its users or consumers, it is also noticed that whenever service providers meet and exceed their customer’s expectations, then the customer is satisfied. Service delivery is a component of a business or any organization which defines the interactions that exist between service providers and clients where the providers offers a service whether it is in form of information or a task and the clients finds value or losses value as a result. Therefore, service delivery is an a continuous act of providing or rendering services to customers, where the customers are either satisfied or dissatisfied with the services rendered, this can be evident in their reactions or expressions.
Good service delivery provides clients with an increase in value. Good service providers work to clearly define the content of services, the roles and responsibilities of the customers and users, the roles and responsibilities of the service providers and set service quality expectations as well as availability and timeliness (Servicefutures.com, 2016). Service delivery can be found in many different professions, company structures and organizations, such as medical hospitals. Each profession has its own set of standard service delivery practices that are followed. Service delivery provides a framework where services are defined and levels of service support are agreed upon.
Pyrene (2015), says that records management is vital to service delivery within any organization and any record that is misfiled or lost is likely to delay the service delivery and hence dent the image of the service provider. In this view, Alexander and Harding (2003) also noted that hospitals in most countries remain an important source of critical health care services, providing both basic and advanced care for the people. Hospitals are often the provider of last resort for those who are critically ill and poor.
In today’s world, information is key. It plays an important or major role in the society and organizations. Hence, the need to preserve that information in the form of records. The International Standard Organization (ISO) 15489-1(2001), define records as information created, received, and maintained as evidence, and information by an organization or person, in pursuance of legal obligations or in the transaction of business needed to deliver the right services to their clients. Records on its own has so many definitions but relating to this research it can be defined as a permanent written communication that document information relevant to a client’s health care management. It is also the clinical, scientific and legal document relating to the nursing care given to an individual or patients. These records provide the employees with the right amount of information needed to deliver the right services to their clients Luthuli, (2017).
Asunmo and Yaya (2016), define records as recorded information, irrespective of form or medium, received or created and maintained by establishments in pursuance of their legal or statutory obligations or record keeping of any kind. Records could comprise of paper, books, computer print-out and any other machine readable records. They also noted that efficient and effective records management must begin with the establishment and implementation of records management program.
Lungile and Trywell (2017) note that records support accountability, security, integrity and comprehensiveness and are critical to effective service delivery to the community. If records are not properly managed, health service may be affected in a negative way. An important element of records management is that records are created and kept so that they can be made available to their intended users whenever required. An essential element in record registration is giving the record a unique that sets it apart from all other records within a records management system.
In the same view, Maniric, (2015), pointed out that without complete recording there is no evidence to prove that care was provided to the patient. Therefore, good nursing practice requires detailed record-keeping that is comprehensive, timely and accurate. On the other hand, poor record-keeping not only undermines patient care but makes the nurses more vulnerable to legal claims which arise from breakdown in communication that results from incomplete or inadequate records
Electronic health records management involves the management of all patient’s records which are stored electronically or in a digital format. They are repositories of information that concerns the health status of individuals the information contained in these records or patients file have a full or complete information about the client’s health history which includes allergies, surgeries, treatments etc. Mathai, Shiratudin and Sohel, (2017).
Ojo and Popoola,(2015) define electronic health information management system as a massive and integrated information system that supports the comprehensive information requirements of patient, including clinical ancillary and even financial management, which could be seen as only one instance of a holistic health information system. Furthermore, they stated that electronic health information management system can or will bring about an increase in digitization which makes the management of comprehensive medical records from patient’s information to diagnostic care and prescription less stressful and straight forward process.
Mathai, Shiratudin and Sohel (2017), observed that properly designed electronic health records systems eliminate the need to take down transcriptions on paper and can well organize physician workflows resulting in increased efficiency and productivity. The use of electronic health records systems has helped the healthcare providers with the better exchange of laboratory results, scans reports and improved communication method with patients. A well-implemented health care system will reduce the inefficiencies, and promote a better health care.
1.2 Statement of the problem
Service delivery within the Babcock university teaching hospital is important and can affect the rate at which patients visit the hospital. Lack of effective health records management practices affects the retrieval of patient’s records. Ondieki (2017) posited that most often, hospital employees render poor services or struggle to render good and timely services due to lack of effective records management which leads to long waits by patients. In the struggle to retrieve patient records which have been stored using paper based systems, the patients continue to wait for hours without any success. The researcher observed that the service delivery of the employees of Babcock University Teaching Hospital has been relatively slow. This is related to the aspect of managing the health records of their patients.
Danso, (2015), state that an effective management of hospital records is a critical factor in providing capacity for hospitals’ efficiency, accountability, transparency, information security and also good governance. As records management becomes more and more demanding and very vital activity within any organization, how to preserve them too becomes a problem, because managing paper based records requires a lot of work. Hence there is a need to investigate how electronic health records management practices can influence service delivery of employees in Babcock University Teaching Hospital (BUTH).
1.3 Objective of the study
The general objective of this research is to find out the influence of electronic health records management practices on service delivery by employees of Babcock University Teaching Hospital. The specific objectives of the research are to:
- Access patients’ perception of service delivery by employee of Babcock University Teaching Hospital.
- Find out electronic health records management practices prevalent at Babcock University Teaching Hospital.
- Investigate the influence of electronic health record management practices on service delivery by employee of Babcock University Teaching Hospital
- Find out the challenges of service delivery of the employees of Babcock University Teaching Hospital.
1.4 Research questions
- What are patients’ perception of service delivery of employees in Babcock University Teaching Hospital?
- What are the electronic health records management practices prevalent at Babcock University Teaching Hospital?
- What are the challenges of service delivery by employees of Babcock University Teaching Hospital?
1.5 Research hypothesis
The following null hypothesis was formulated to guide the study and will be measured at 0.05 significance level
H01. Electronic health records management practices have no significant influence on service delivery of the employees in Babcock University Teaching Hospital.
1.6 Scope of the study
This study will focus on electronic health records management practices and service delivery of employees of Babcock University Teaching Hospital (BUTH), Ilishan Remo, Ogun State, Nigeria. The study will be limited to Babcock university teaching hospital and the participants of the study will be health personnel of Babcock University Teaching Hospital (BUTH) such as Doctors, Nurses, Dentists, Pharmacists, Laboratory scientists, Health Record officers, Radiographers, and Laboratory technologists and patients of Babcock University Teaching Hospital.
1.7 Significance of the study
This study is important for many reasons. It will cast more light on the importance of electronic health records management practices in Babcock University Teaching Hospital. And also come up with a frame work that will provide guidelines for Babcock University Teaching Hospital on electronic health records management practices. The study will influence the medical personnel on proper records management practices and also adequate training for records keeping. The study will also help to identify the challenges hospital personnel face in use and management of electronic health records management and also help them understand how electronic health records management practices can influence and affect service delivery. The study will also provide empirical, theoretical and conceptual framework, which will contribute to the existing knowledge in other related fields. The outcome of this research would help to identify ideal methods of managing electronic health records.
1.8 Operational definition of terms
Records: This can be defined as any document or recorded information which is created, received and maintained by health personnel of Babcock University Teaching Hospital.
Records management practices: This refers a range of activities which an organization perform or carry out to properly manage its records. The key activities include records creation, use, storage, maintenance, retrieval and disposal.
Electronic health records: This is an electronic store of patient’s health records, which are created, stored, managed and controlled by health personnel at Babcock University Teaching Hospital.
Service delivery: This is the act of providing or rendering services to patients who visit Babcock University Teaching Hospital.
