“Record Rockers” Compiling All Records into Main Filing System

NAME OF HEALTH DEPARTMENT: Scotland County Health Department

PROJECT TITLE: “Record Rockers” Compiling All Records into Main Filing System

Danielle Wilkins & Lisa Lundy
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Project Overview

Project Aim:      
Scotland County Health Department aims to streamline services through updating our record retrieval system, in order to improve timeliness of and our patient satisfaction with the registration process of all health department programs. This is important because results from our patient satisfaction survey indicated 49% of clients were displeased with their wait time for services.  Often this increased wait time is due to our antiquated filing system, which currently includes both numeric and alpha files.  This project will help improve patient satisfaction with our registration process as well as our staff satisfaction with our filing system.  We will complete this project by December 2011.  We will achieve this by using QI methods we learned in the Public Health QI 101 and by reviewing our current filing system.


  • Increase patient satisfaction with the registration process by 12% from baseline.
  • Increase staff satisfaction with the retrieval process by 80% from baseline.
  • Increase record retrieval capabilities by 80% by upgrading the current record filing system.
  • Decrease time taken for record retrieval by 80% from baseline.

Project timeframe:
November 2010 to December 2011

How was the need for the project determined?
Based on poor patient satisfaction surveys regarding extensive wait time for delivery of services; this was due to numerous places to search for records and the high volume of records to search through since archiving had not been done in decades.

Areas for Improvement and Change Ideas Implemented

Improvement 1
File records daily into central files.  Records had been left in baskets, offices and carts creating a very difficult retrieval process with multiple search locations.  We took (1) type of record, ie Family Planning Charts and filed them into central filing to determine if retrieval was more efficient.  Then we took our STD records and filed them into central filing (these had been kept in rolling carts), we created a spreadsheet for the R.N. to use to track open cases.  Then we did the same with our Child Service Coordinator records.  We met a lot of resistance initially from staff but later gained acceptance and retrieval time was faster.  We filed over 600 records back into central filing.

Improvement 2
Outcard Usage.  Outcards were not being used for every record-pull, thus creating a difficult search for charts.  We set up a special area to sign out records using outcards and for shelving requested records and returning records.  This was a simple and beneficial change that addressed several issues.  This process has worked well and we have had positive feed-back from staff.

Improvement 3
Archive records with no activity for 10 years or more.  This requires a hands-on involvement to manually review each record.  Archiving had not been done in decades thus creating numerous records to search through.  We started with numerical charts and reviewed chart by chart, shelf by shelf from zero on and are still in the process.  We then will review alpha charts from a to z and finally miscellaneous records from a to z.  This is an ongoing project with no definitive completion date due to cut in staff by (3) management support employees to date.

Improvement 4
We created an archived records storage room by using an office vacated by previous office manager.  In order to use the space we had to 5-S it.  This task was huge and involved the whole team and we shred over a ton of trash!  We had a truck come and get old furnishings and office supplies for surplus storage.  We purchased bankers boxes to store the archived files in and stacked them in the storage office.  We moved lots of furniture and cabinets to other areas and organized our supply cabinet and shelves.  We relocated our immunization records to another room.


Overall Improvements

  • All records are located in one central filing area and are much easier to locate.
  • The front end support team is able to locate records more efficiently thus creating a better patient flow.
  • Designated work areas have helped to create a more productive environment.

Lessons Learned:

  • Don’t select a project too large to do for the first QI Project. 
  • Start with something measurable and obtainable within a reasonable time frame. 
  • Select a team consisting of employees from different departments (not all the same dept). 
  • Include members who think “outside of the box”, who can add fresh concepts and put input into the project.
  • Include active team players- who will be willing to participate in the project. 
  • Understand ahead of time that most people are resistant to change, even for a good cause, and be able to overlook negativity and reach your goals anyway.

Programs supported by:

BlueCross BlueShield of NC FoundatoinThe Duke Endowment

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