EVALUATION OF HEALTH RECORDS MANAGEMENT PRACTICES AND THE FUNCTIONALITY OF ARCHIVAL WORKFLOW SYSTEMS AMONG SELECTED HOSPITALS IN MIGORI AND KISUMU COUNTIES, KENYA

Abstract

Effective health records management is essential for efficient healthcare systems. However, outdated infrastructure, limited user integration, and inefficient data retrieval continue to impede healthcare service delivery in Kenyan hospitals, raising the question: to what extent do records management practices predict archival workflow functionality in public hospitals? This study was grounded in Records Management Theory, which conceptualizes records as assets moving through a defined lifecycle creation, use, maintenance, and disposition governed by policies and standards to ensure accessibility, integrity, and accountability. Building on this lens, the study's conceptual framework positions records management practices, retrieval speed and ease, records handling, and archival software use as independent variables predicting archival workflow functionality as the dependent variable, with government policies and standard operating procedures as intervening variables consistent with the theory's emphasis on regulatory oversight across the records lifecycle. The framework further incorporates system reliability, user acceptance, and user requirements, including data confidentiality and security, as dimensions shaping user trust and satisfaction, thereby identifying where adjustments are needed. A cross-sectional survey of 265 healthcare workers at Kisumu and Migori referral hospitals, sampled proportionately across professional cadres using Slovin's formula, tested these relationships using descriptive statistics, chi-square tests, and logistic regression. Findings showed generally favorable standard operating procedures compliance (64.4%), retrievability (57.8%), and software evaluations (65.1–73.1%), alongside strong support for system modernization (87.9–91.5%), though user feedback integration remained moderate. Regular disposal of outdated records, a core lifecycle stage under Records Management Theory, was significantly associated with workflow functionality (χ²=33.25, p=0.032), while standard operating procedures compliance (OR=1.52, p=0.045) and user-friendly, secure archival software (OR=1.84, p=0.011) emerged as significant predictors, affirming the theory's premise that structured, policy-governed management of records across their lifecycle drives system functionality. These results underscore the need to modernize archival workflow systems, strengthen data security, and deepen user participation. The study recommends standardized, automated archival workflows supported by ongoing capacity building and routine system reviews in Kenyan public hospitals.