Bradley Hall A/B
Thursday July 12, 2012
Managing records in South African public healthcare institutions – a critical analysis
The healthcare sector in South Africa has evolved over several centuries into a very sophisticated network of institutions in the public and private sector. Most citizens of the country use the services provided by the public sector. While there are many opportunities to study different aspects of healthcare service provision in the public sector, it would seem that there is a dearth of studies that look specifically at the management of records and even fewer looking in the health sector specifically. In South Africa, there are have been eight masters or doctoral dissertations that were limited to five of the nine provinces of the country. Additionally the studies were limited to certain subjects such as completeness of records, impact of records on quality of healthcare as well as confidentiality and privacy. While the studies covered different aspects of records management within the country, they remained fragmented in their approach to the subject. This study seeks to investigate, in a holistic manner, the management of health records in public healthcare institutions in the country. Outside South Africa there have been there have been almost four dozen dissertations within the last three decades that have looked at the subject of records management in healthcare institutions.
This study is a critical analysis the management of records in public healthcare institutions in South Africa. This entails an understanding of the key challenges faced by public sector healthcare institutions in South Africa. The study explores possible interventions drawing from experiences in Africa and around the world and has three basic aims.
First, it assesses the legislative, policy and regulatory framework within which records are managed in public healthcare institutions in South Africa. Second, it assesses the extent to which public healthcare institutions in South Africa are managing records effectively. Lastly, it identifies appropriate records management interventions at both policy and operational level in order to assist the management of records in healthcare institutions. These interventions are drawn both from research data collection processes as well as gleaned from experiences from other nations based on literature review processes.
The study engages a research methodology that uses three datasets for analysis and for each, an appropriate research tradition, either positivist of interpretivist is used. Dataset 1 is primary data, obtained by data collection by the doctoral student. Dataset 2 is data that was collected over the course of several years by an organisation known as COHSASA and made available to the researcher for analysis. Dataset 3 is data that was collected by a different researcher, who wished to remain anonymous, and was made available to the researcher.
The presentation will provide a brief overview of the study and, if permission is granted, share a video presentation on the challenges of managing health records in South Africa obtained from one of the interview respondents during the course of data collection.
Listen to the People: How the voices of those being studied can change both the researched and the research. 1
This presentation examines the research experience of working with people with early stage Alzheimer’s disease to create, capture and use records in a way that supports their memory and identity. There are various techniques for the creation of autobiographical records in the context of doing life story work particularly as used by health professionals. Even though there is much anecdotal evidence to the effectiveness of these activities there is a gap in the research with regards to what it means to create these records and just as importantly how they can be used and managed.
The Storyline Project is a qualitative study with an interpretivist approach. It uses grounded theory, a small cohort of in-depth case studies and open interviews to listen and learn from the people affected. In turn it is this ‘conversation’ that allows both the research and the theory to evolve in what is an iterative process.
This presentation reports on what it has meant to undertake sensitive research where there is a high impact factor for both researcher and participant. It provides insight into the challenges and reality of designing research methods so that they can respond and adjust to unique contexts. These findings around research as a practice will be explored in light of their influence on archival research.
1 Caulfield School of Information Technology, Monash University, East Caulfield, VIC Supported by Alzheimer’s Australia Research Postgraduate Scholarship in Dementia