How to cite:
Terra Amalia, Ria Angraini. (2021) Review of Inactive Medical Record
Destruction Activities at Hermina Hospital Palembang Year 2021.
Journal Eduvest. 1(9): 976-981
E-ISSN:
2775-3727
Published by:
https://greenpublisher.co.id/
Eduvest – Journal of Universal
Studies
Volume 1 Number 9, September
2021
p- ISSN 2775-3735 e-ISSN 2775-3727
REVIEW OF INACTIVE MEDICAL RECORD DESTRUCTION ACTIVITIES AT
HERMINA HOSPITAL PALEMBANG YEAR 2021
Terra Amalia, Ria Angraini
Piksi Ganesha Polytechnic Bandung
E-mail: [email protected], riaangarini2609@gmail.com
ARTICLE INFO ABSTRACT
Received:
August, 26
th
2021
Revised:
September, 14
th
2021
Approved:
September, 16
th
2021
Various methods and systems used to improve the quality of
the management and storage of medical record files, one of
which is to reduce the volume of archives that have no use
value, to reduce archive buildup and create better and more
efficient storage space, making it easier for officers to carry
out their duties search and expedite the patient's treatment
process. This study uses a qualitative type of research, with a
descriptive method. The data collection in this study used the
interview and observation (checklist) method. The population
in this study were officers of the medical record work unit at
Hermina Hospital Palembang in 2021. Based on the research,
it can be concluded that the retention of inactive medical
record files in 2021 is being carried out by medical record
officers and the destruction of inactive medical record files
has not been carried out because constrained by the COVID-
19 pandemic, there are officers who carry out WFH (Work
from Home) along with service hours. At the Hermina
Hospital in Palembang, the standard operating procedure
(SOP) regarding the destruction of inactive medical record
files at the Hermina Palembang hospital already exists, but
has not been implemented is 0.000 <0.05, it can be concluded
that it is accepted, meaning that there is a difference in
scores between before and after being treated with water
Terra Amalia, Ria Angraini
Review of Inactive Medical Record Destruction Activities at Hermina Hospital
Palembang Year 2021 977
tube media.
KEYWORDS
Retention, Destruction, In-Active Medical Record Files
This work is licensed under a Creative Commons
Attribution-ShareAlike 4.0 International
INTRODUCTION
According to the Minister of Health No. 269/MENKES/PER/III/2008 medical
records are those that contain records and documents regarding patient identity,
examination, treatment, actions and other services that have been provided to patients
(Kholili, 2011).
Apart from being a means of communication between service providers, medical
record files also have many other benefits (Rokhim, 2020), as stated in the Minister of
Health Regulation No. 269/MENKES/PER/III/2008 article 13, regarding the use of
medical record files such as:
a. Health maintenance and patient treatment
b. Evidence in law enforcement
c. Education and research needs
d. Funding basis
e. Health statistics
Based on Permenkes No. 269/MENKES/PER/III/2008 article 8 paragraph 1 which
contains "Medical records of inpatients in hospitals are kept for at least 5 (five) years
from the last date the patient was treated or discharged", paragraph 2 which contains "
After the time limit of 5 (five) years as referred to in paragraph (1) is exceeded, the
medical record can be destroyed, except for the summary of discharge and approval of
medical action", paragraph 3 which contains "The summary of discharge and approval of
medical action as referred to in paragraph (2) must kept for a period of 10 (ten) years
from the date the summary was made”, and paragraph 4 which contains “Storage of
medical records and summary of discharge as referred to in paragraphs (1) and (3) is
carried out by officers appointed by the head of the service facility. health services”, the
hospital health service provider is obliged to periodically reduce and destroy medical
record files for at least 5 years from the year the last time the patient was treated.
According to (Kamil, Putra, Erawantini, & Muna, 2020) states that medical record
management education is related to medical record management, including assembling,
coding, indexing, filling, and retention and destruction. Retention officers already have
medical record education qualifications, so officers from medical records can direct and
assist other officers if they are confused in carrying out medical record retention
(Apriliani, Muflihatin, & Muna, 2020). This is in accordance with Masauty's 2018
research which states that the education aspect is an integral part in determining the best
way to start the behavior change process, with education the wider the increase in
knowledge, this will become the basis for officers to better understand their duties as
responsibilities.
The USG (Urgency, Seriousness, Growth) method is a way to determine the
priority order of problems by paying attention to the urgency, seriousness, and the
possibility of the problem growing bigger. USG (Urgency, Seriousness, Growth) is one of
the tools to arrange the priority order of problems to be solved. How to determine the
level of urgency, seriousness, and development of the problem by giving a score of 1-5.
According to Santoso (2017) states that the USG (Urgency, Seriousness, Growth) method
Eduvest – Journal of Universal Studies
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978 http://eduvest.greenvest.co.id
to prioritize problems is carried out by observation and interviews with officers. Problems
that have the highest total score are priority problems.
Based on the preliminary survey that has been carried out, the destruction of
medical record files at the Hermina Palembang Hospital in 2019 has been carried out.
Destruction of medical record files has been carried out since 2015 in stages, starting
from selecting files that have entered the eradication period, then directly destroying files
that meet the criteria for destruction.
The purpose of this study was to determine the process of destroying inactive
medical record files at the Hermina Palembang hospital in 2021, to determine the
standard operating procedure for the destruction of medical record files at the Hermina
Palembang hospital to determine the selection process for active to inactive files, to find
out which inactive medical record files were still available useful.
RESEARCH METHOD
This research use descriptive qualitative methods. Qualitative research method is
a research method based on the philosophy of postpositivism, used to examine the
condition of natural objects, (as opposed to experiments) where the researcher is the key
instrument, data collection techniques are carried out by triangulation (combined), data
analysis is inductive/qualitative, and the results of qualitative research emphasize
meaning rather than generalization (Sugiyono, 2019). This type of research uses a
qualitative approach to determine the review of medical record file destruction activities
at the Hermina Hospital Palembang in 2021.
The population of this study were 3 medical record officers in the filling unit of
Hermina Palembang Hospital in 2021. The sample of this study was the head of medical
records and 3 medical records officers in the filling unit of Hermina Palembang Hospital
in 2021.
RESULT AND DISCUSSION
A. Research Results
1. The process of destroying inactive medical record files at Hermina Hospital,
Palembang in 2021
Table 1 Destruction of Inactive Medical Record Files at Hermina Hospital
Palembang
No.
Observation
Yes
No
Description
1.
Retention
Retention activities at Hermina
Hospital Palembang are being
implemented
2.
Extermination
The extermination activities at the
Hermina Hospital in Palembang
have not been carried out because
they are constrained by the
COVID-19 pandemic and the
shortage of staff
Based on the results of observations and interviews conducted with medical record
officers at the Hermina Palembang hospital that the retention of inactive medical record
files in 2021 is being carried out by medical record officers and the destruction of inactive
Terra Amalia, Ria Angraini
Review of Inactive Medical Record Destruction Activities at Hermina Hospital
Palembang Year 2021 977
medical record files has not been carried out because it is constrained by the COVID-19
Terra Amalia, Ria Angraini
Review of Inactive Medical Record Destruction Activities at Hermina Hospital
Palembang Year 2021 979
pandemic Covid-19. This makes there are officers who carry out WFH (Work from
Home) and are constrained by the shortage of medical record officers.
2. Standard Operational Procedure for Destruction of Medical Record Files at
Hermina Hospital Palembang
Table 2 Standard Operational Destruction Procedures
No.
Observation
Yes
No
Description
1.
SOP (Standard
Operating Procedure)
regarding destruction
There is already a Standard
Operating Procedure (SPO)
which is still based on the
regulations of the Hermina
Palembang hospital and has
followed the eradication
policy based on Permenkes
269 article 8 of 2008.
Based on the results of observations and interviews conducted with medical record
officers at the Hermina Palembang hospital that the standard operating procedure (SOP)
regarding the destruction of inactive medical record files at the Hermina Palembang
hospital already exists, but has not been implemented due to the covid-19 pandemic.
3. Medical Record File Selection Process Active to Inactive
Based on the results of observations and interviews conducted with medical record
officers at the Hermina Hospital in Palembang, the selection process for medical record
files from active to inactive is carried out by looking at the patient's last treatment, which
is 5 years from the last date the patient was treated at the Hermina Hospital. Palembang.
The implementation of retention activities begins by sweeping the medical record
files from the alphabet A to Z, this is done after hours of service at the Hermina Hospital
in Palembang. Constraints in the process of selecting medical record files from active to
inactive are:
1. By time because it coincides with the time of service hours.
2. It is difficult to know when the patient's last date of treatment was, so it had to be
checked one by one.
3. Actually, it can be checked through computerized history when the last date for
treatment was the data can be withdrawn, but at Hermina Hospital Palembang it
was not biased because it did not have a good application.
4. Knowing Inactive Medical Record Files That Are Still Valuable
Based on the results of observations and interviews conducted with medical record
officers at Hermina Hospital Palembang, in-active medical records that are still of value
that are not destroyed are informed consent sheets or medical consent sheets, HIV case
sheets and research and education sheets.
B. Discussion
1. The process of destroying inactive medical record files at Hermina Hospital,
Palembang in 2021
According to the Ministry of Health of the Republic of Indonesia in 2006
concerning Guidelines for the Implementation and Procedures of Hospital Medical
Terra Amalia, Ria Angraini
Review of Inactive Medical Record Destruction Activities at Hermina Hospital
Palembang Year 2021 981
Records in Indonesia Revision II, destruction is a process of physically destroying
medical record archives whose functions and use values have ended. Total destruction
must be carried out by burning, chopping or recycling, so that the contents and shape
cannot be recognized.
Based on the results of observations and interviews conducted with medical record
officers at the Hermina Palembang hospital, it can be concluded that the inactive medical
record file retention activity in 2021 is being carried out by medical record officers and
the destruction of inactive medical record files has not been carried out because it is
constrained by the COVID-19 pandemic. -19 has made there are officers who carry out
WFH (Work from Home), along with the time-of-service hours and are constrained by
the shortage of medical record officers.
2. Standard Operational Procedure for Destruction of Medical Record Files at
Hermina Hospital Palembang
Procedures are procedures, rules and guidelines in the implementation of a job.
Procedure is the development of professional standardization and policies that have been
previously established, whether in the form of laws, ministerial regulations, minimum
service standards and others. Each hospital has a different procedure for storing medical
record files tailored to the needs of their services.
Based on the results of observations and interviews conducted with medical record
officers at the Hermina Palembang hospital, the standard operating procedure (SOP)
regarding the destruction of inactive medical record files at the Hermina Palembang
hospital already exists, but has not been implemented due to the Covid-19 pandemic.
3. Medical Record File Selection Process Active to Inactive
Inactive medical records, files that have been keep a minimum of 5 years in the
medical record work unit at the hospital starting from the last date the patient was served
at a health service facility or 5 years after death.
Based on the results of observations and interviews conducted with medical record
officers at the Hermina Hospital in Palembang, the selection process for medical record
files from active to inactive is carried out by looking at the patient's last treatment, which
is 5 years from the last date the patient was treated at the Hermina Hospital. Palembang.
4. Knowing Inactive Medical Record Files That Are Still Valuable
Archival assessment is an activity to evaluate the use value of the information
contained in the archive. The results of the archive assessment are that it will be known
archives that have permanent use value that must be stored forever, and archives of
temporary use value that can be destroyed immediately or at a later date (Suraja, 2006).
Based on the results of observations and interviews conducted with medical record
officers at Hermina Hospital Palembang, in-active medical records that are still of value
that are not destroyed are informed consent sheets or medical consent sheets, HIV case
sheets and research and education sheets.
CONCLUSION
Based on the research, it can be concluded that the retention of inactive medical
record files in 2021 is being carried out by medical record officers and the destruction of
inactive medical record files has not been carried out because constrained by the COVID-
19 pandemic, there are officers who carry out WFH (Work from Home) along with
service hours. At the Hermina Hospital in Palembang, the standard operating procedure
Eduvest – Journal of Universal Studies
Volume 1 Number 9, September 2021
980 http://eduvest.greenvest.co.id
(SOP) regarding the destruction of inactive medical record files at the Hermina
Palembang hospital already exists, but has not been implemented.
At the Hermina Hospital in Palembang, the selection process for medical record
files from active to inactive is done by looking at the patient's last treatment, which is 5
years from the last date the patient was treated at the Hermina Hospital Palembang. The
implementation of retention activities begins by combing through the medical record files
from the alphabet A to Z, this is done after hours of service at the Hermina Hospital in
Palembang.
At the Hermina Hospital in Palembang, inactive medical records that are still of
value that are not destroyed are informed consent sheets or medical consent sheets, HIV
case sheets and research and education sheets. At the Hermina Hospital in Palembang, the
file transfer from active to inactive has not been carried out and has not been destroyed
due to the covid-19 pandemic so that some medical record officers at Hermina Hospital
do WFH (Work from Home) and the officers are focused on carrying out patient service
activities.
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