Medical record filing is the organizational process healthcare facilities use to securely store and efficiently retrieve patient health information. Most facilities utilize a numerical system to manage the high volume of records, which provides a more consistent and less error-prone method than alphabetical filing. Straight Numerical Filing (SNF) is the simplest and most foundational of these methods, where records are arranged in strict sequential order based on a unique patient number. This straightforward approach allows personnel to be quickly trained and provides a clear, logical structure for maintaining the physical records. The step-by-step process of assigning a number and physically placing the corresponding file ensures that a patient’s complete history is always found in one single, designated location.
The Mechanics of Straight Numerical Filing
Straight numerical filing involves arranging patient records in exact ascending order, one number following the next, on the filing shelves. For instance, a record with the number 65023 would be physically placed immediately before record 65024, creating a continuous, chronological sequence of numbers within the filing area. This method is also referred to as consecutive filing because the sequence of the records perfectly matches the sequence in which the numbers were originally assigned. The physical filing area is typically composed of open-shelf units, where the arrangement is always from the lowest to the highest number.
When a new patient record is created, it receives the next available number and is placed at the end of the entire sequence on the shelf. This means that all filing activity is concentrated in the area holding the most current, highest numbers. While this simplicity is a benefit, it can lead to congestion if multiple staff members are filing new records simultaneously in the same small section of the shelves. The entire patient chart, which contains all past and current documentation, remains together in one single folder under its unique number.
Assigning and Managing Patient Identifiers
The process of assigning the medical record number happens administratively before the physical record is filed. Healthcare facilities typically use a unit numbering system, which dictates that a patient is assigned a unique, permanent record number upon their very first encounter, whether as an inpatient, outpatient, or emergency room patient. This number is then used for all subsequent visits and treatments, ensuring that all documentation for that individual is consolidated into a single comprehensive record. This unit number is never reused for another patient, even after the original patient is deceased, which maintains the integrity of the record system.
To manage and control the issuance of these unique identifiers, every facility maintains a Master Patient Index (MPI). The MPI is a permanent, alphabetical list of every patient who has ever received care, acting as the administrative control for the numbering system. When a patient registers, staff check the MPI by name to determine if the patient has a pre-existing number, preventing the creation of duplicate records, which are known as overlaps. The MPI is therefore the mechanism that links the patient’s personal information to their unique medical record number, which is necessary to retrieve the physical file.
Locating and Tracking Records
Retrieving a patient’s medical record begins with consulting the Master Patient Index to find the corresponding unique numerical identifier. Once the number is known, staff can proceed to the filing shelves to physically locate the chart, following the strict ascending numerical order of the straight numerical system. Since the records are filed consecutively, a person only needs to scan the numbers on the file folders until they find the exact sequential match.
When a record is removed from the shelf, a formal tracking procedure, known as a “charge-out” system, is immediately implemented. This involves inserting a temporary placeholder, often a brightly colored card or folder called an “out-guide,” into the exact position where the physical record was removed. The out-guide contains information that identifies who has the record, where it was taken, and the date it is due to be returned. This system is crucial because it ensures that the empty space is marked, preventing misfiling errors and allowing the health information management department to track the location of every record outside of the file room at any given moment.