PERFORMANCE EVALUATION OF MEDICAL RECORDS DEPARTMENT IN A CORPORATE HOSPITAL
Abstract
The Healthcare Information Management (HIM) Department is crucial in ensuring information accuracy, privacy, and legal compliance in hospitals. Its role is vital for maintaining the integrity of patient data and the quality of healthcare services. A study conducted at corporate hospital in Hyderabad, assessed the performance of the Healthcare Information Management (HIM) Department by reviewing 150 In-Patient medical records. The department demonstrated 100% compliance in risk management, infrastructure, security, and other key areas, though 7 out of 14 measurable standards showed non-compliance. Nurses were identified as the primary source of documentation errors, particularly in the 'Diabetics Booklet'. Despite these issues, the HIM department exhibited a high-performance level, with potential for further improvement through standardization and regular audits.
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