A filing system is a plan or method of arranging documents in a prescribed order.

The purpose of filing documents is to enable a quick retrieval of complete information whenever it is required.

Requirements of a good filing system

Simplicity-The filing method must be easy to understand and simple to operate.

Easy access-Documents should be easily identified and located to enable speedy pulling and filing.

Security-Documents should be safely kept and well preserved. o Tracer system-The whereabouts of documents removed from the storage must be known.

Neatness and flexibility-Completeness is needed with regard to both convenient filing and cost of storage space, but the filing system must also provide ability to expand and contract according to future need.

Economy-It should be economical in terms of equipment and operation.

There are four common methods of filing patient records used in health facilities

Alphabetical

Chronological

Geographical

Numerical

Alphabetical filing is a very commonly used method for filing in general.

Advantages

It does not need a supporting index because it is either applied to names or subjects.

Only valuable to health facilities with small quantity of records.

It does not function satisfactorily in large institutions because of its inflexibility.

Examples of alphabetical filing system are, Abdallah, followed by Bakari, then Charles

Chronological filing means filing in time order.

It is used in combination with another method.

Letters for example are usually filed alphabetically according to name or subject and within each group in date order.

Various documents are arranged according to type (clinical notes, reports).

Documents of the same type are then filed in date order.

Chronological filing works satisfactory when used for waiting lists and follow-up systems.

Example of chronological filing system is, those patients who are expected to be admitted on 14th February 2010, Abdallah/14, Bakari/14, Charles/14. The 14 is a filing position in filing waiting list.

The waiting list is having filing position from 1 up to 31 according to dates.

Geographical filing is based on geographical units like countries, regions, and town.

Very often it is used in combination with other method.

It is a satisfactory method for example in business companies where filing according to places and customers is needed.

Geographical filing is not suitable for filing medical records.

Like chronological filing this method used in combination with other method of filing.

It can be used for follow-up systems.

Examples of geographical filing system are o Temeke district: 00-00-01/Temeke, 00-00-02/Temeke, 00-00-03/Temeke. (Filing is done in shelves identified for Temeke district).

Kinondoni district: 00-00-04/Kinondoni, 00-00-05/Kinondoni. (Filing is done in shelves identified for Kinondoni district).

Numerical and alphabetical filing systems are the most commonly used.

Unlike the alphabetical method, numerical filing cannot work alone.

If a number is not known there must be ways of finding it.

Numerical filing must be supported by an alphabetical index.

Different techniques can be applied when filing numerically.

Medical records are usually filed according to numbers.

Three types of numerical filing systems which are commonly used by health facilities are: o Straight numerical filing system (example: File number 1, 2, 3, 4, 5 ……) o Terminal digit filing system (example: File number 00-00-01, 00-00-02…)

Middle digit filing system (example: File number 00-01-00, 00-02-00, …)

Health facilities register patients by giving them hospital numbers and file the patients’ medical records according to these numbers.

Types of Numbering Systems

Serial numbering system

In serial numbering the patient receives a new number each time he or she is admitted or treated as a new out-patient case.

This means that if a patient is admitted three times he or she gets three different numbers and his medical records are filed in three different places.

Unit numbering system

This system is based on the principle that the patient (not the disease episode and a

patient) is the unit and that all notes on one individual patient are kept in one file.

When the patient comes to the hospital for the first time, either as an out-patient or an in-patient, he or she is given a hospital number.

This is a permanent number and is going to remain his for all subsequent attendances no matter how many times and how many departments he or she will visit

Serial unit numbering system

This numbering system is a combination of the serial and unit numbering systems.

The patients are given numbers according to the principle of serial numbering.

Each time a patient receives a new health facility number his previous record is brought forward and filed under the latest number.

A unit record is thus created.

When the older record is brought forward some type of tracer card should be left in its place indicating the new number

Annual numbering, monthly numbering

When serial numbering is used the series of numbers should continue.

It is quite common in Tanzania to begin new series each year or even each month and to distinguish the series by a letter and by the last two calendar year digits or the digits for month and calendar year (Example: F 2345/78, M 6789/4/78).

Filing Procedure for Patient Records

Auditing of patient documents o Critical checking, if there is missing documents from the clinics/departments

Editing of patient documents o Arrange documents in a systematically order, for example from registration sheet to discharge summary

Sorting of patients’ file

Arrange files in a sequence order, from the smallest number to the largest one.

It facilitates speed in filing

Filing of patients’ file

Insert files in the shelf according to the patient registration number or the alphabetic order of their names