Prediction of active filing shelf in medical record unit-General hospital Dr. H. Soewondo Kendal 2020 – 2024

General hospital Dr. H. Soewondo Kendal is a local government hospital. Improving medical support services, especially the quality of medical record archiving services, is essential to maintain the quality of hospitals in the context of good hospital standards. This study aims to predict the need for archive shelves between 2015-2019. The type of research used is descriptive with accidental sampling technique. Patient medical records were collected using a systematic sampling technique. The observation results showed that the average thickness of medical record documents was 0.85 cm based on measurements on 30 samples of medical record documents. The hospital has 48 shelves with 5 sub-shelves on each shelf. The length of the available archives is 525 cm and by 2024 a total of 37 shelfs will be needed. Modeling results based on linear regression equations have decreased medical record documents since 2015-2019 y = 782.9x +30636. However, the linear regression validation for the cumulative medical record documents for 2015-2019 shows an increase based on the regression equation y = 28439 x + 1112.2, therefore it is necessary to immediately save the medical record document in an active state. The conclusion delivered by Dr. H. Soewondo Kendal does not need an additional archive shelf, but it does require inactive document storage.


Introduction
Regulation of the Minister of Health (Permenkes) RI Number. 749a / Menkes / Per / XII /1989 states that every health service facility is required to have an outpatient and inpatient medical record unit. [1] A medical record is a file containing notes and documents about the patient's identity, examination results, medication that has been given, and other actions and services provided to patients [2].
Processing of medical record document data which is closely related to the process of filing medical record documents. [3] Filing is a unit in the medical records department that is responsible for the storage, retention, and destruction of medical record documents. The filing unit is tasked with providing complete medical record documents so that it can facilitate the tracking of patient information data if needed at any time [4].
Unit Filing is responsible for the storage of medical record documents. The speed of taking medical record documents in the filing section also affects the service to patients. Fast and precise service with the support of existing facilities in the filing section, such as the availability of storage shelfs that are easily accessible by officers to make it easier to retrieve medical record documents, the availability of sufficient shelves for patient medical record documents stored in active medical record filing documents so that patients will serve quickly. [5] The frequency of entry and exit and the increase in medical record documents makes it necessary to predict the availability of ideal storage shelfs. Medical record documents that are stored on storage shelfs are not always kept in a long storage time, the document shelf will be full and not sufficient anymore so that it needs document retention 5. If the filing space capacity is solid, it is necessary to sort the files that are already in the inactive category. Overcrowded shelves can complicate and slow down the process of storing and retrieving files, besides that, dense storage tends to be cluttered and damaged [6].
Based on the survey results at the general hospital Dr. H. Soewondo Kendal, the number of shelfs owned by the public hospital is 68 shelfs with each shelf having 5 sub-shelves with a centralized storage system, namely the storage of patient medical records in one place, both polyclinic visit records and notes while a patient is treated [7].
The numbering system used is the Unit Numbering System. This system only provides one medical record number for outpatients, inpatients, emergency patients, and newborns.
The medical record document structuring system uses the Digit Filing Terminal system, which is a system of synchronization by aligning medical record document folders based on the sequence of medical record numbers in the last two group numbers.

Methods
The type of research used is descriptive research with the method of observation [8]. The data collected in this study is to measure the dimensions of the document storage shelf including the length of the sub shelf, the width of the sub shelf and the height of the sub shelf. In addition, it also measures the dimensions of medical record documents which include the length, width and thickness of the document. The average thickness of medical record documents is based on measurements of 30 samples of medical record documents and the number of medical records from 2020 to 2024. When the research was carried out from August 2017 to October 2017. The place of research was carried out at the Filling Unit, medical records department, Dr. H. Soewondo Kendal. The population in this study was 30 samples of medical record documents and the number of medical record documents from 2020 to 2024, medical record file storage shelfs totaling 48 shelves with 5 sub-shelves on each shelf and the available filing length was 525 cm, while the sample used is a medical record document filling unit.
Sampling Techniques, outpatient medical record document shelves were taken by accidental sampling, namely, sampling was done by taking data that happened to exist at the time of the study. Meanwhile, the patient's medical record files were taken using systematic sampling [9].
The research variables observed were the average patient visit, the average thickness of the medical record file, the number of medical record file storage shelfs, the size of the medical record file storage shelf and the shrinkage of medical records [10].

Shelf Dimensions
The General Hospital Dr. H. Soewondo Kendal has 2 types of shelves, namely iron shelves with a combination of wood and metal shelfs (gray) with the total number of shelfs is 48 and each shelf has 5 sub shelfs.

Medical Record Documents
The measurement results of the patient's medical record documents, dimensions of medical record documents, namely length: 34.5 cm, width: 25.5 cm and the average thickness of medical record documents is 0.85 cm obtained from 30 samples of medical record documents from the total population: 141,437 documents medical records. The following is a table of the number of additional medical record documents [11].

Retention
General Hospital Dr. H. Soewondo Kendal in 2015 to 2019, no retention was carried out due to constraints on the required costs. Arrangement of inactive medical record documents is calculated from at least the last 5 years from the date of the patient's last treatment. The goal is to reduce the burden of storing and storing assessment activities for the use of medical records for later preservation and destruction. [12].
Prediction of Number of Medical Record Documents for 2020 to 2024. In determining the prediction of the number of medical record documents from 2020 to 2024, it can be calculated by calculating the average number of additional medical record documents for new patients in the previous 5 years from 2015 to 2024.

Available File Length
In determining the need for archive shelves, it is necessary to know the length of the records available in one shelf so that the shelf needs to be predicted can be known. [13].

Required Filing Length
The required data filing length can be calculated by reducing the number of medical record documents in a certain year by the number of medical record documents stored then multiplying by the results of the file expansion. [14] General Hospital Dr. H. Soewondo Kendal in 2019 has not conducted retention so that more and more medical record documents are stored on the archive shelf.
Based on the results of measuring the thickness of 30 medical record documents, it was found that the average thickness of medical record documents was 0.85 cm. (Table 5)

Needs document shelf medical records
Determination of the need for filing shelfs in 2020 to 2024 can be calculated based on the number of additional new patient medical record documents in 2015 to 2019 which are then calculated to obtain the required filing length data and available filing lengths, so that in calculating the shelf requirements for calculation results the required filing length divided by the available filing length [15].

Discussion
This has not been implemented due to constraints on costs, it is feared that it will cause a buildup of medical record documents so that the number of shelf needs will also continue to increase.  Linear regression validation for cumulative medical record documents in 2015-2019 showed an increase (y = 28439 x + 1112.2), therefore retention is needed immediately so there is no accumulation of medical record documents.

Conclusion
The results of calculations and analysis at the General Hospital Dr. H. Soewondo Kendal does not require additional shelf filing, but retention of inactive medical record documents must be carried out immediately so that there is no accumulation of medical record documents so as not to disturb medical record officers in carrying out archiving tasks.