Policy Manual sample

MDT Home Health Care Agency, Inc. CLIENT’S CLINICAL RECORD FILING SYSTEM POLICY: Client’s clinical records are filed according to assigned clinical’s record numbers. PURPOSE To facilitate convenient and expedited access to client’s clinical record. PROCEDURES 1. The Medical Record Office Clerk files client’s clinical records according to assigned client’s clinical record numbers. 2. Client’s clinical records are retrieved following Confidentiality. The Medical Record Office Clerk: a. Locates the client’s last name on the client completed Client’s Clinical Record Index care in appropriate client’s clinical record index file. b. Obtains the client’s clinical record number from the Client’s Clinical Record Index card/software. c. Locates the client’s clinical record in the Home Health Care Agency’s client’s clinical record files. d. Signs out the appropriate client’s clinical record, including the following information on the sign out card: 1. Date the client’s clinical record was retrieved. 2. Name of the individual who requested that the client’s clinical record be retrieved. 3. The name of the individual who retrieved the client’s clinical record. Home Health Agency Nursing Manual J-28