Automation of Public Health Nurse Reports

Abstract

THE ACCELERATION of change in medical practice places a growing burden on the public health nurse to use the new techniques and procedures that will maintain and improve efficiency, thus enhancing the care of patients. Simplification of administrative tasks frees time for professional responsibilities, and when this benefit can be spread throughout the entire organizational structure of public health nursing, improvements may be significant. The development of a new reporting system for public health nurses in New York State (excluding New York City) is aimed at simplifying and reducing routine paperwork. The system also expedites preparation of reports for various administrative levels and signals important changes in parameters of patient care rapidly and meaningfully. In the New York State system there is but one basic form, used at the staff-nurse level by all participant,s. This form is unique in many respects. Almost every duty or function performed by the public health nurse is recorded on the simplified design, which is more comprehensive than any of the five different forms used previously in the manual data system. Information is recorded by placing lines in designated spaces adjacent to specified printed items (see chart). These marks are made with a standard lead pencil. A single sheet is prepared for each visit and each activity performed during the day. The forms are collected at suitable intervals and mailed to the computer center at Roswell Park Memorial Institute, Buffalo, where forms for the entire State are processed. To ease the burden of scheduling for machine processing, local departments send the completed material at no less than weekly intervals. In some areas where the volume of collected data is unusually high, packages are sent almost daily. Every effort is made to transmit the final material for each month shortly after conclusion of the reporting period so that accurate summaries can be prepared promptly. At the computer center the sheets are processed as received at the rate of approximately 5,000 per day. Each is passed through an IBM 1232 optical mark page reader, a machine which transfers the data recorded on the form to punched cards. No manual key punching is necessary. Incomplete or ambiguous reports are rejected automatically. Obvious errors are corrected at the computer center; other rejects are returned to the nurse for reprocessing. The cards are read by a digital computer (IBM 1401), and the information is stored on magnetic tape. At the conclusion of each month the magnetic tape, containing all reports for the period, is passed through the computer once again, and reports relative to the activity of each nurse are prepared. This information is sent to supervisors in the loca,l health departments through the distribution system of the New York State Department of Health. At this level the utilization varies considerably, depending upon the organizational relationships within the local departments. Usually, the report reaches the individual nurse, providing comparable statistics for monthly planning and scheduling. New personnel can be guided to some extent by reviewing the reports of predecessors in the same assignments. More adequate and realistic distribution of the All the authors are with the New York State Department of Health. Miss Parker is director of nursing services, Albany, Dr. Ausman is executive director, Health Research, Inc., Roswell Park Memorial Institute, Buffalo, and Mr. Ovedovitz is chief, computer study team, Albany.