THE FACTORS MILITATING AGAINST EFFECTIVE DOCUMENTATION IN HEALTH DELIVERY SYSTEM (A CASE STUDY OF LAGOS STATE TEACHING HOSPITAL
This study examinesThe Factors Militating Against Effective Documentation in Health Delivery System. Faced with the problem of inadequate manpower and financial resources to properly integrate modern technology into the healthcare systems in Nigeria has reduced productivity of personnel in the healthcare sector of Nigeria, the study was guided by the following objectives;to find out if there are proper documentations of health delivery system in Lagos State Teaching hospital; to investigate the impacts of effective documentation of health delivery system in Lagos State Teaching Hospital; to identify factors militating against effective documentation in the healthcare sector.
Concerning methodology, the study employed descriptive and explanatory design, questionnaires in addition to library research were applied in order to collect data. Primary and secondary data sources were used and data was analyzed using statistical package which was presented in frequency tables and percentage. The study findings revealed that there little or no proper documentation of health delivery system in Lagos State Teaching Hospital. This has reduced the efficiency of healthcare workers in the organization. Key recommendations from the study are; Information Technology should be integrated into the health delivery systems of every hospital in Nigeria. This will reduce wastages and improve efficiency in the health care sector of Nigeria.
Table of Contents
CHAPTER ONE 4
1.1 BACKGROUND OF THE STUDY 4
1.2 STATEMENT OF THE PROBLEM 6
1.3 OBJECTIVES OF THE STUDY 6
1.4 RESEARCH QUESTIONS 7
1.5 STATEMENT OF THE HYPOTHESIS 7
1.6 SIGNIFICANCE OF THE STUDY 7
1.7 SCOPE OF THE STUDY 8
1.8 LIMITATION OF THE STUDY 8
CHAPTER TWO 12
LITERATURE REVIEW 12
2.1 INTRODUCTION 12
2.2 WHAT IS HEALTHCARE DOCUMENTATION? 14
2.3 Essential Principles of Healthcare Documentation 19
2.4 Effects of Patient Documentation on Health Care 24
2.5 The factors militating against effective documentation in health delivery system 36
2.6 Interventions to enable access to health services 42
CHAPTER THREE 60
RESEARCH METHODOLOGY 60
3.1 Research Design 61
3.2 The Study Area 61
3.3 Population of the Study 61
3.4 Sample Size and Sampling Techniques 61
3.5 Sources of Data Collection 63
3.6 Instrument for Data Collection 64
3.7 Validity of Research Instrument 65
3.8 Reliability of the Instrument 65
3.9 Administration of the Instrument 66
3.10 Method of Data Analysis 66
3.11 Decision Rule 66
CHAPTER FOUR 67
PRESENTATION AND ANALYSIS OF RESULTS 67
4.1 Demographic Information of the Respondents 68
4.2 Answers to the Research Questions 72
4.3 Research Hypothesis 76
CHAPTER FIVE 78
SUMMARY, CONCLUSION AND RECOMMENDATIONS 78
5.1 Summary 78
5.2 Conclusion 79
5.3 Recommendations 81
1.1 BACKGROUND OF THE STUDY
Health care delivery systemis the process of meeting the health care needs of people, institutions, and resources and other target populations. There are numerous health care delivery systems globally.However, nations design and develop the health delivery system which isin accordance with their needs and resources. The essential health systems consist of primary healthcare which is the health system which consist of planning and distribution of health care needs among market participants and public health care system which is the effort of governments, trade unions, charities, religious organizations, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. Health care planning and distribution is evolutionary rather than revolutionary.
The World Health Organization defines health systems as a system consisting of all organizations, people and actions directed at promoting, restoring or maintaininghealth. This includes efforts which influence health determinants and health-improving activities. A health system encompasses publicly owned facilities which delivers personal health services, health insurance organizations, a mothers care for a sick child at home; vector-control campaigns,efforts of private health care providers; behavior change programmes, occupational health and safety legislation. It also takes into consideration inter sectoral action by health staff, such as enhancing the ministry of education to promote female education which facilitate the growth of good health.World Health Organization (2000).
Documentation of health care delivery system plays a significant role in providing the needed information regarding the evaluation and treatment of health care services and communicating same to third-party payers. Documentation guidelines serve as the standard for many other insurance plans.Documentation also provides relevant clinical information. It is essential that the documents note and reports are clear, legible and that it efficiently conveys all of the essential information required for clinical management and reimbursement. The study seeks to proffer an appraisal of the factors militating against effective documentation in health delivery system. A case study of Lagos state teaching hospital.
1.2 STATEMENT OF THE PROBLEM
The challenge facing documentation relates to certain factors inadequate skilled manpower, lack of efficient technology, lack of financial resources to adopt modern technology which promote effective documentation, lack of information technology skill among others . Consequently the problem confronting the study is to appraise the factors militating against effective documentation in health delivery system. A case study of Lagos state teaching hospital.
1.3 OBJECTIVES OF THE STUDY
The Main Objective of the study is to appraise the factors militating against effective documentation in health delivery system. A case study of Lagos state teaching hospital; The specific objectives include:
i. To find out if there are proper documentations of health delivery system in Lagos State Teaching hospital.
ii. To investigate the impacts of effective documentation of health delivery system in Lagos State Teaching Hospital.
iii. To identify the factors militating against effective documentation of health delivery system in Lagos state teaching hospital.
1.4 RESEARCH QUESTIONS
i. Are there proper documentations of health delivery system in Lagos State Teaching hospital?
ii. What are the impacts of effective documentation of health delivery system in Lagos State Teaching Hospital?
iii. What are the factors militating against effective documentation of health delivery system in Lagos state teaching hospital?
1.5 STATEMENT OF THE HYPOTHESIS
Ho1: There is no significant factor militating against effective documentation in health delivery system.
1.6 SIGNIFICANCE OF THE STUDY
The study proffers an appraisal of the factors militating against effective documentation in health delivery system. A case study of Lagos state teaching hospital. It provides relevant data for the effective formulation and implementation of policies to enhance the realization of envisaged objective.
1.7 SCOPE OF THE STUDY
The study proffers an appraisal of the factors militating against effective documentation in health delivery system. A case study of Lagos state teaching hospital.
1.8 LIMITATION OF THE STUDY
The study was confronted with logistics and geographical factors.
1.9 DEFINITION OF TERMS
HEALTH CARE DELIVERY SYSTEM DEFINED
World Health Organization defines health systems as a system consisting of all organizations, people and actions directed at promoting, restoring or maintaininghealth. This includes efforts which influence health determinants and health-improving activities. A health system encompasses publicly owned facilities which delivers personal health services, health insurance organizations,amother’scare for a sick child at home; vector-control campaigns, efforts of private health care providers.
HEALTH CARE PROVIDERS DEFINED
Healthcare providers consist of those institutions or individuals which provides healthcare services.
Education is viewed as the process of inviting truth and possibility. It is the wise, hopeful and respectful cultivation of learning undertaken in the belief that all should have the chance to share in life.
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High performing health systems are critical to address key health challenges faced by Member States in the European region, such as changes in disease burden and population dynamics, in governance and funding mechanisms, and in technology and clinical management practice. Against this background many countries have significantly invested in strengthening the primary care level including the development of home-based care programmes. At the same time, hospitals remain essential for the delivery of complex acute specialised care. Hospitals form an important part of health spending and play an important role in shaping public perception of the performance of countries’ health systems, and, thus, their political visibility. The World Health Organization (WHO) acknowledges that due attention must be given to all levels of care as well as the integration and coordination of functions and care mechanisms to meet the challenges of an ageing population, with increasing expectations of service quality and safety and with the ability to access these services nationally and through cross border care. Work in this field in the European context is closely linked to the global initiative started by WHO headquarters in identifying key questions to be addressed by the global hospital agenda within the wider context of coordinated care. Experiences from various countries and regions of the world can be used to initiate a review of the place, role and function of hospitals within changing health systems, to support all Member States in the challenging process to remodel their hospitals appropriately and to build capacity to support health care delivery reform. The workshop ‘Modern health care delivery systems and the role of hospitals’ aimed to contribute to moving a step further on the road to better integration and coordination of health care service delivery, through
• Reviewing the current situation in relation to hospital and health system reforms across the region, including the patient choice perspective
• Creating a shared understanding of current state of healthcare delivery systems and their capacity and willingness to address change
• Sharing stakeholders experiences and best practice models, both theoretical and applied, in search of optimised solutions to increase health care delivery performance
• Identifying unanswered questions, gaps in our knowledge and areas where further research is needed • Agreeing on priority areas for future work
• Developing a roadmap for action led by WHO Europe with stakeholders to support Member States in these areas for the coming two years.