EVALUATION OF CONSTRAINTS FACING SERVICE DELIVERY HEALTH INFORMATION PRACTITIONERS

1.1 Introduction

Health information management is the process of organizing, tracking and maintaining paperwork for patients in clinics, doctors’ offices and hospitals. this industry also involves analyzing the paperwork and communicating with doctors to ensure that patients are treated properly, given appropriate medication and treatment. Electronic Health Information (EHI) is defined as an electronic version of a patient’s medical history including key administrative clinical data relevant to that person’s care and have emerged as a promising tool to improve health care quality (Bjarnadottir, et al., 2017). Research indicates that EHIs can improve documentation, thereby increasing the accuracy and completeness of patient data. This improves health care providers’ ability to appropriately diagnose and treat their patients (Bowles et al., 2016).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

In the past few decades, the healthcare field has had an increasingly global technological advancement. One prime example of this is the Electronic Health Information (EHI). It is an essential platform that evolved rapidly over a short period of time to serve as a way to use and communicate health information (Garcia, 2020). It is used all around the world as a way to communicate health information across various health care professionals, track a patient’s progress, and trend laboratory results to ultimately enhance patient outcomes through safety and quality of care (Garcia, 2020).

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 coincides 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.

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. Electronic health records management involves the management of all patients’ 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 et al., 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.

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Evaluation of Constraints Facing Service Delivery Health Information Practitioners in Medical Reception Service.

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1.3 Statement of Problems

Investigation revealed that the service delivery 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.

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 evaluate the Constraints Facing Service Delivery Health Information Practitioners in Medical Reception Service in Takum Local Government Taraba State.

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1.4 Aim and Objectives of Study

The aim of the study is to evaluate the Constraints Facing Service Delivery Health Information Practitioners in Medical Reception Service. In achieving this aim, the following specific objectives were laid out as follows:

1. To investigate the effect of medical records keeping in continuity of patient care;
2. To examine the importance of trained health record professionals in health information management department;
3. To emphasize the problematic impact on the quality of health care service delivery in hospitals under the study area;
4. To identify and examine the constraint faced on health record keeping in the area under study; and
5. To investigate the effect of the constraints on the problems encountered by the health professionals in the area under study.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Are there constraints faced on health record keeping in the area under study?
• What is the effect of medical records keeping in continuity of patient care?
• What is the importance of trained health record professionals in health information management department?
• What is the problematic impact on the quality of health care service delivery in hospitals under the study area?
• What is the effect of the constraints on the problems encountered by the health professionals in the area under study?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: Health Information Practitioners practices have no significant influence on service delivery of the employees in the area under study.
• H1: Health Information Practitioners practices have significant influence on service delivery of the employees in the area under study.

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1.7 Significance of Study

This study is important for many reasons. It will cast more light on the importance of electronic health records management practices. And also come up with a frame work that will provide guidelines 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 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. It 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.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The scope of the research is focused on the Evaluation of Constraints Facing Service Delivery Health Information Practitioners in Medical Reception Service using Takum Local Government Taraba State as a case study.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Research material: availability of research material is a major setback to the scope of the study.
4. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
5. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Operational Definition of Terms

Constraints: A state of being restricted confined prescribed bound, constraints can also being regarded as challenges or problem.

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: It refers a range of activities which an organization performs or carried out to properly manage its records. The key activities include records creation, use, storage, maintenance, retrieval and disposal.