Reflections on an engaged research approach to understanding patient record-keeping systems in a local clinic in Makhanda

Authors

DOI:

https://doi.org/10.21504/ajhece.v1i2.2497

Keywords:

Community-based Participatory Research, Human Factors and Ergonomics, Patient record-keeping, Healthcare

Abstract

The taking and archiving of accurate record-keeping is an essential part of caregiving in health care. There is extensive evidence that record-keeping systems are affected by systemic problems that impact healthcare provision globally and in South Africa, particularly in public healthcare. Human Factors and Ergonomics (HFE) has been applied in healthcare settings to address these systemic challenges, including those related to record keeping, but not in South Africa. With participation being a critical element of HFE, a Community-Based Participatory Research (CBPR) framework can but has not been used to understand and optimise systems such as those linked to record keeping. This reflection provides an overview of how an HFE approach was applied, using a CBPR framework to understand the challenges affecting patient record-keeping in a clinic in Makhanda. Specifically, it provides insights into how CBPR was applied and reflections on this experience from both the researchers’ and collaborators' perspectives. The importance of patience and flexibility, empathy, constant feedback and consultation and listening to collaborators' and participants' contributions emerged as important lessons. The community collaborator also experienced the process positively, where she emphasised the empowering experience of being able to help guide and facilitate research, which, in turn, revealed challenges that affected the daily running of the clinic. The collaboration using the CBPR approach was a practical framework for applying several HFE approaches to understand the challenges around record keeping.

References

Aceves-González, C., Rodríguez, Y., Escobar-Galindo, C. M., Pérez, E., Gutiérrez-Moreno, B., Hignett, S., & Lang, A. R. (2021). Frontiers in human factors: Integrating human factors and ergonomics to improve safety and quality in Latin American healthcare systems. International Journal for Quality in Health Care, 33, 45–50. https://doi.org/10.1093/intqhc/mzaa135 DOI: https://doi.org/10.1093/intqhc/mzaa135

Berger, M., & Scott, P. (n.d.). There is more to the record than meets the eye: an analysis and application of SEIPS 2.0 for health and care records. https://doi.org/10.31219/osf.io/7fzt4 DOI: https://doi.org/10.31219/osf.io/7fzt4

Bizimana, E., & Bimerew, M. (2021). Knowledge, attitudes and barriers of nurses on benefits of the quality of patient record-keeping at selected public district hospitals in Burundi. International Journal of Africa Nursing Sciences, 14. https://doi.org/10.1016/j.ijans.2020.100266 DOI: https://doi.org/10.1016/j.ijans.2020.100266

Blijleven, V., Koelemeijer, K., Wetzels, M., & Jaspers, M. (2017). Workarounds emerging from electronic health record system usage: Consequences for patient safety, effectiveness of care, and efficiency of care. JMIR Human Factors, 4(4). https://doi.org/10.2196/humanfactors.7978 DOI: https://doi.org/10.2196/humanfactors.7978

Bourke, L. (2009). Reflections on doing participatory research in health: Participation, method and power. International Journal of Social Research Methodology, 12(5), 457–474. https://doi.org/10.1080/13645570802373676 DOI: https://doi.org/10.1080/13645570802373676

Britz, P. M. (2018). Medical Record Keeping in South Africa: A Medico-Legal Perspective. https://doi.org/http://hdl.handle.net/2263/67924

Brown, N. (2022). Scope and continuum of participatory research. International Journal of Research and Method in Education, 45(2), 200–211. https://doi.org/10.1080/1743727X.2021.1902980 DOI: https://doi.org/10.1080/1743727X.2021.1902980

Bunting, J., & de Klerk, M. (2022). Strategies to Improve Compliance with Clinical Nursing Documentation Guidelines in the Acute Hospital Setting: A Systematic Review and Analysis. In SAGE Open Nursing (Vol. 8). SAGE Publications Inc. https://doi.org/10.1177/23779608221075165 DOI: https://doi.org/10.1177/23779608221075165

Burgess-Limerick, R. (2018). Participatory ergonomics: Evidence and implementation lessons. In Applied Ergonomics (Vol. 68, pp. 289–293). Elsevier Ltd. https://doi.org/10.1016/j.apergo.2017.12.009 DOI: https://doi.org/10.1016/j.apergo.2017.12.009

Carayon, P. (2006). Human factors of complex sociotechnical systems. Applied Ergonomics, 37(4 SPEC. ISS.), 525–535. https://doi.org/10.1016/j.apergo.2006.04.011 DOI: https://doi.org/10.1016/j.apergo.2006.04.011

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14–25. https://doi.org/10.1016/j.apergo.2013.04.023 DOI: https://doi.org/10.1016/j.apergo.2013.04.023

Corrigan, P. W., & Oppenheim, M. (2024). The power of community-based participatory research (CBPR). Psychiatric Rehabilitation Journal, 47(1), 2. DOI: https://doi.org/10.1037/prj0000568

Costa-Black, K. M., & Arteberry, C. (2020). The social value of Participatory Ergonomics from a practitioner’s perspective. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 64(1), 919–923. https://doi.org/10.1177/1071181320641219 DOI: https://doi.org/10.1177/1071181320641219

Dalymiya, V. (2007). Unraveling Leadership ‘Relational Humility’ and the Search for Ignorance. In P. Hershock, M. Mason, & J. Hawkins (Eds.), Changing Education Leadership, Innovation and Development in a Globalizing Asia Pacific (pp. 297–322). Springer. DOI: https://doi.org/10.1007/978-1-4020-6583-5_13

DeJonckheere, M., Lindquist-Grantz, R., Toraman, S., Haddad, K., & Vaughn, L. M. (2019). Intersection of Mixed Methods and Community-Based Participatory Research: A Methodological Review. Journal of Mixed Methods Research, 13(4), 481–502. https://doi.org/10.1177/1558689818778469 DOI: https://doi.org/10.1177/1558689818778469

Dul, J., Bruder, R., Buckle, P., Carayon, P., Falzon, P., Marras, W. S., Wilson, J. R., & van der Doelen, B. (2012). A strategy for human factors/ergonomics: Developing the discipline and profession. Ergonomics, 55(4), 377–395. https://doi.org/10.1080/00140139.2012.661087 DOI: https://doi.org/10.1080/00140139.2012.661087

Glen, P., Earl, N., Gooding, F., Lucas, E., Sangha, N., & Ramcharitar, S. (2015). Simple interventions can greatly improve clinical documentation: a quality improvement project of record keeping on the surgical wards at a district general hospital. BMJ Quality Improvement Reports, 4(1), u208191.w3260. https://doi.org/10.1136/bmjquality.u208191.w3260 DOI: https://doi.org/10.1136/bmjquality.u208191.w3260

Goveia, J., Van Stiphout, F., Cheung, Z., Kamta, B., Keijsers, C., Valk, G., & Ter Braak, E. (2013). Educational interventions to improve the meaningful use of Electronic Health Records: A review of the literature: BEME Guide No. 29. Medical Teacher, 35(11). https://doi.org/10.3109/0142159X.2013.806984 DOI: https://doi.org/10.3109/0142159X.2013.806984

Haines, H., Wilson, J. R., Vink, P., & Koningsveld, E. (2002). Validating a framework for participatory ergonomics (the PEF). Ergonomics, 45(4), 309–327. https://doi.org/10.1080/00140130210123516 DOI: https://doi.org/10.1080/00140130210123516

Heshu, M. Z. P. (2020). Makhanda: reflections of past, present and future. Journal of Indigenous and Shamanic Studies, 1(1), 25-28.

Hignett, S., Carayon, P., Buckle, P., & Catchpole, K. (2013). State of science: Human factors and ergonomics in healthcare. Ergonomics, 56(10), 1491–1503. https://doi.org/10.1080/00140139.2013.822932 DOI: https://doi.org/10.1080/00140139.2013.822932

Homb, N. M., Sheybani, S., Derby, D., & Wood, K. (2014). Audit and feedback intervention: An examination of differences in chiropractic record-keeping compliance. Journal of Chiropractic Education, 28(2), 123–129. https://doi.org/10.7899/jce-13-29 DOI: https://doi.org/10.7899/JCE-13-29

IEA. (2000, May 25). What is Ergonomics (HFE)? https://iea.cc/about/what-isergonomics/what-is-ergonomics/ Accessed: 10 November 2024.

Irvine, P. M. (2021). From Grahamstown to Makhanda: Urban frontiers and challenges in a post-apartheid city. In South African Urban Change Three Decades After Apartheid: Homes Still Apart? (pp. 163-177). Cham: Springer International Publishing. DOI: https://doi.org/10.1007/978-3-030-73073-4_10

Israel, B., Eng, E., Schulz, A., & Parker, E. (2013). Methods for community-based participatory research for health.

Jossey-Bass. Karsh, B. T., Waterson, P., & Holden, R. J. (2014). Crossing levels in systems ergonomics: A framework to support “mesoergonomic” inquiry. Applied Ergonomics, 45(1), 45–54. https://doi.org/10.1016/j.apergo.2013.04.021 DOI: https://doi.org/10.1016/j.apergo.2013.04.021

Key, K. D., Furr-Holden, D., Yvonne Lewis, E., Cunningham, R., Zimmerman, M. A., Johnson-Lawrence, V., & Selig, S. (2019). The continuum of community engagement in research: A roadmap for understanding and assessing progress. Progress in Community Health Partnerships: Research, Education, and Action, 13(4), 427–434. https://doi.org/10.1353/cpr.2019.0064 DOI: https://doi.org/10.1353/cpr.2019.0064

Khunlertkit, A., & Paine, L. (2015). A Human Factors Approach for Root Cause Analysis: A Case of Duplicate Medical Record Number. Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 4(1), 156–161. https://doi.org/10.1177/2327857915041022 DOI: https://doi.org/10.1177/2327857915041022

Luthuli, L. P., & Kalusopa, T. (2018). The management of medical records in the context of service delivery in the public sector in KwaZulu-Natal, South Africa: the case of Ngwelezana hospital. South African Journal of Libraries and Information Science, 83(2). https://doi.org/10.7553/83-2-1679 DOI: https://doi.org/10.7553/83-2-1679

Mahomed, O., & Asmall, S. (2015). Development and implementation of an integrated chronic disease model in South Africa: lessons in the management of change through improving the quality of clinical practice. International Journal of Integrated Care, 15. http://www.ijic.org DOI: https://doi.org/10.5334/ijic.1454

Martinez-Vargas, C. (2022). Democratising participatory research: Pathways to social justice from the global south. In Democratising participatory research: Pathways to social justice from the global south. Open Book Publishers. https://doi.org/10.11647/OBP.0273 DOI: https://doi.org/10.11647/OBP.0273

Marutha, N. S., & Ngoepe, M. (2017). The role of medical records in the provision of public healthcare services in the Limpopo province of South Africa. SA Journal of Information Management, 19(1). https://doi.org/10.4102/sajim.v19i1.873 DOI: https://doi.org/10.4102/sajim.v19i1.873

Mayosi, B., & Benatar, S. (2014). Health and Health care in South Africa- 20 Years after Mandela. The New England of Medicine, 317(14). https://doi.org/10.1056/NEJMsr1405012 DOI: https://doi.org/10.1056/NEJMsr1405012

Minkler, M. (2005). Community-based research partnerships: Challenges and opportunities. Journal of Urban Health, 82(SUPPL. 2). https://doi.org/10.1093/jurban/jti034 DOI: https://doi.org/10.1093/jurban/jti034

Mutshatshi, T. E., Mothiba, T. M., Mamogobo, P. M., & Mbombi, M. O. (2018). Recordkeeping: Challenges experienced by nurses in selected public hospitals. Curationis, 41(1). https://doi.org/10.4102/curationis.v41i1.1931 DOI: https://doi.org/10.4102/curationis.v41i1.1931

Norris, B. J. (2012). Systems human factors: How far have we come? In BMJ Quality and Safety (Vol. 21, Issue 9, pp. 713–714). https://doi.org/10.1136/bmjqs-2011-000476 DOI: https://doi.org/10.1136/bmjqs-2011-000476

Nhemachena, A., Mlambo, N., & Kaundjua, M. (2016). The notion of the “field” and the practices of researching and writing Africa: towards decolonial praxis. Africology: The Journal of Pan African Studies, 9(7), 15-36.

Ohuabunwa, E. C., Sun, J., Jean Jubanyik, K., & Wallis, L. A. (2016). Electronic Medical Records in low to middle income countries: The case of Khayelitsha Hospital, South Africa. African Journal of Emergency Medicine, 6(1), 38–43. https://doi.org/10.1016/j. afjem.2015.06.003 DOI: https://doi.org/10.1016/j.afjem.2015.06.003

Okaisu, E. M., Kalikwani, F., Wanyana, G., & Coetzee, M. (2014). Improving the quality of nursing documentation: An action research project. Curationis, 37(1). https://doi.org/10.4102/curationis.v37i1.1251 DOI: https://doi.org/10.4102/curationis.v37i1.1251

Omodan, B. I., & Dastile, N. P. (2023). Analysis of participatory action research as a Decolonial research methodology. Social Sciences, 12(9), 507. DOI: https://doi.org/10.3390/socsci12090507

Parajón, L., Hinshaw, J., Sanchez, V., Minkler, M., & Wallerstein, N. (2021). Practicing Hope: Enhancing Empowerment in Primary Health Care through Community-based Participatory Research. American Journal of Community Psychology, 67(3–4), 297–311. https://doi.org/10.1002/ajcp.12526 DOI: https://doi.org/10.1002/ajcp.12526

Pezaro, S., & Lilley, L. (2015). Digital voice recorders – A conceptual intervention to facilitate contemporaneous record keeping in midwifery practice. In Women and Birth (Vol. 28, Issue 4, pp. e171–e176). Elsevier. https://doi.org/10.1016/j.wombi.2015.04.008 DOI: https://doi.org/10.1016/j.wombi.2015.04.008

Pirkle, C. M., Dumont, A., & Zunzunegui, M. V. (2012). Medical recordkeeping, essential but overlooked aspect of quality of care in resource-limited settings. International Journal for Quality in Health Care, 24(6), 564–567. https://doi.org/10.1093/intqhc/mzs034 DOI: https://doi.org/10.1093/intqhc/mzs034

Rosen, R. (2023). Participatory research in and against time. Qualitative Research, 23(3), 597–613. https://doi.org/10.1177/14687941211041940 DOI: https://doi.org/10.1177/14687941211041940

Schmittdiel, J. A., Grumbach, K., & Selby, J. V. (2010). System-based participatory research in health care: An approach for sustainable translational research and quality improvement. Annals of Family Medicine, 8(3), 256–259. https://doi.org/10.1370/afm.1117 DOI: https://doi.org/10.1370/afm.1117

Shepherd, A., & Stammers, R. (2005). Task Analysis. In J. Wilson & N. Corlett (Eds.), Evaluation of Human Work (3rd ed., pp. 129–158). CRC Press. DOI: https://doi.org/10.1201/9781420055948.ch6

Shepherd, E., Hoyle, V., Lomas, E., Flinn, A., & Sexton, A. (2020). Towards a humancentred participatory approach to child social care recordkeeping. Archival Science, 20(4), 307–325. https://doi.org/10.1007/s10502-020-09338-9 DOI: https://doi.org/10.1007/s10502-020-09338-9

Telleria, J. (2021). Development and Participation: Whose Participation? A Critical Analysis of the UNDP’s Participatory Research Methods. European Journal of Development Research, 33(3), 459–481. https://doi.org/10.1057/s41287-020-00287-8 DOI: https://doi.org/10.1057/s41287-020-00287-8

Tola, K., Abebe, H., Gebremariam, Y., & Jikamo, B. (2017). Improving Completeness of Inpatient Medical Records in Menelik II Referral Hospital, Addis Ababa, Ethiopia. Advances in Public Health, 2017, 1–5. https://doi.org/10.1155/2017/8389414 DOI: https://doi.org/10.1155/2017/8389414

Van Eerd, D., Cole, D., Irvin, E., Mahood, Q., Keown, K., Theberge, N., Village, J., St. Vincent, M., & Cullen, K. (2010). Process and implementation of participatory ergonomic interventions: A systematic review. Ergonomics, 53(10), 1153–1166. https://doi.org/10.1080/00140139.2010.513452 DOI: https://doi.org/10.1080/00140139.2010.513452

Vaughn, L. M., & Jacquez, F. (2020). Participatory Research Methods – Choice Points in the Research Process. Journal of Participatory Research Methods, 1(1). https://doi.org/10.35844/001c.13244 DOI: https://doi.org/10.35844/001c.13244

Wallerstein, N., Duran, B., Minkler, M., & Foley, K. (2005). Developing and Maintaining Partnerships with Communities. In B. Israel, E. Eng, A. Schulz, & E. Parker (Eds.), Methods in Community-Based Participatory Research for Health (1st ed., pp. 31–51). Jossey-Bass.

Wegner, L. (2013). Missing medical records: an obstacle to archival survey-research in a rural community in South Africa. South African Journal of Physiotherapy, 69(2). https://doi.org/10.4102/sajp.v69i2.24 DOI: https://doi.org/10.4102/sajp.v69i2.24

Wilson, J. (2014). Fundamentals of systems ergonomics/human factors. Applied Ergonomics, 45(1), 5–13. https://doi.org/10.1016/j.apergo.2013.03.021 DOI: https://doi.org/10.1016/j.apergo.2013.03.021

Wong, R., & Bradley, E. H. (2009). Developing patient registration and medical records management system in Ethiopia. International Journal for Quality in Health Care, 21(4), 253–258. https://doi.org/10.1093/intqhc/mzp026 DOI: https://doi.org/10.1093/intqhc/mzp026

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2024-12-11

How to Cite

Kingwill, K., Todd, A., Davy, J., & Pama , S. (2024). Reflections on an engaged research approach to understanding patient record-keeping systems in a local clinic in Makhanda. African Journal of Higher Education Community Engagement, 1(2), 1-25. https://doi.org/10.21504/ajhece.v1i2.2497