Hospital Records and Record-Keeping, c. 1850-c. 1950, Part II: The Development of Record-Keeping in Hospitals

Abstract

Before the latter part of the nineteenth century, documents created in the course of business were predominantly manuscripts.Records were kept by officers who combined record-keeping duties with other responsibilities.Hand labour and the integration of record-keeping with administrative functions and medical practice were the most important common features of record-keeping in all types of hospital.The administrative and medical records in hospitals were always kept separately.'This basic separation did not change in the period under examination.However, between c. 1900 and 1945 the preparation of both administrative and medical records and the organization of the offices responsible for keeping these records underwent significant changes. Record-Keeping in Hospitals before c. 1900Generally, the main office of the hospital clerk, secretary, or superintendent kept the official books of record and the documentation associated with the administration of the institution.'There was a variety of organizational arrangements in the administrative offices of the selected voluntary hospitals.At the Royal Marsden Hospital, the Secretary was responsible for the day-to-day management and, until 1870, the paperwork was done by two clerks under the Secretary's direction.At the London Hospital, the House Governor, Secretary, and Steward, each with clerical assistants, handled daily administration, committee work and the keeping of financial and registration records.In Ontario's selected voluntary hospitals, a superintendent with part-time clerical help carried on the administrative duties of the main ~f f i c e .~In the public authority hospitals in both areas, the medical superintendent was ultimately responsible for both the administrative and medical records, but the two functions were quite distinct and the records never mixed.4At the Springfield Hospital, the Steward kept the financial records and stores accounts and at the Kingston Psychiatric Hospital, the Bursar assumed similar responsibilities under the supervision of the superintendent.