FORMS CONTROL

Just as forms design is not a random process, form control should not be
haphazardly performed either. Forms control encompasses the following objectives :

1. To ensured the efficient design and constructions of forms and their

integration into all phases of the information processing system.
2. To develop and maintain proper specifications for the economical production
and usage of needed forms.
3. To educate and assist operating personnel in designing their own forms when
consistant with the aims and controls of the forms control program.
4. To stop the origination of useless forms, to combine form which serve
similar needs, to eliminate unneeded forms, and to create additional forms
when such addition serves the information processing system better than
combined forms.
5. To provide an effective brake on the natural inclination of personnel to
change existing forms at whim.

In a paperenvironment, forms control includes : forms inventory, form

identification, ongoing review and revision (forms analysis), and purchasing. In a
computerized system, data element inventory takes the place of forms inventory and
programming logic takes the place of forms identification. Purchasing applies only to
special forms of paper (e.g., OCR) input orv output.

Forms Inventory

If a (paper) forms control program does not exist, the first step in implementing
such a program is to obtain an inventory of all forms. This inventory should then be kept
up to date at all times. A forms inventory includes a forms history file and subject / title
file.

A form history file provides a complete picture of each form in the organization
from development of current status. It should be arranged according to the numbering
system used to identify forms, which should be as simple as possible.
 A form history file can be set up by establishing a folder for each form and filing
by form number. Each folder should eventually contain the following :

 A copy of the current edition of the form and any previous editions.
 Drafts showing significant stages of development and pertinent correspondence.
 A copy of the directive authorizing use of the form.
 The original request for approval of the form and any requests for revisions
indicating the names of all units using the form and the rate of use.
 Evidence relating to the official final approval for the printing or reproduction
and issuance of the form.
 A record of all actions taken on the form, including a cross-reference to the
subject/title file.

The forms history file should be periodically reviewed and updated. Folders on
discontinued or obsolete forms should be removed forms the active file on a timely
basis, appropriately annotated, and placed in a aeparate discontinued history file for
such time as required by the organizations’s records retention schedule.

A forms subject/title file provides the mechanism by which forms dealing with
related subject matter are brought together. One copy of each forms is classified by
purpose and placed in a subject/title folder.

The main purpose of the subject/title file are to :

 Avoid the creation af a new form when an existing form could be revised to
serve the need.
 Detect those forms which might be eliminated or which might be eliminated or
which might be consolidated with similar forms.
 Identify forms which should be analyzed and redesigned for simplication and
uniformity of format, nomenclature, item sequence, spacing, size, and so forth.
 Generate studies of forms in relation to the systems and procedures used

The subject/title file is not an easy file to develop because of the many possible
subject headings that could be assigned to some forms. However, one subject heading,
producing as many cross-reference cards as necessary to tie the subjects together and
facilitates location of the form. It is the best type of control file to use when making an
analysis og the organization’s forms. Maintenance of the forms subject/title file may be
facilitated by using database software on a micro computer.

Identification

Forms control requires that all forms be appropriately titled and identifield, as
previously described. Form identification is usually a number issued sequentially and
prefixed or suffixed by a code for the originating department or section. As an example,
the identifying line of the first form generated by the Jewish Hospital of Michigan
would appear as follows for a new form back printed ; the front side numbered; the
originating department Medical Records with a code number of 10; and the edition date
January 1990:

0001a-10 01/90 MRD Copyright 1990 JHM

It is recommended that when a form is back prnted (printed on both sides), or if

the form comprises several pages, the primary form number (the sequential number)
should have as its last character alowercase alphabetic character, such as an “a” to
represent the first page and a “b” to represent the reverse side of the form or the next
page, and so forth.

For forms used in an automated environment, one may wish to identify each one
b assigning the computer program number that will be receiving the data input.
Facilities may wish to use computer-readable identification, such as bar coding, on
forms that will be scanned into an optical imaging system. Computer readable
identification allows the scanner to auto matically index the type of form, thus speeding
the process and eliminating the need for manual indexing of the form.

A Form Control Register is essential for the proper control of form numbers
issued, as weel as for other identifying information. It can be maintained either manually
or by computer. The register should include information on : form number, title, form
size, edition date, revision data, and originating department.
 Serial numbering of forms is another form of identification. It is advisable to
number forms only when a high degree of control is required, such as admitting forms,
purchase orders, etc. Much time can be wasted if the numbers are not used properly. A
special forms control log is required to track the usage of serially numbered forms.

Forms Analysis

Ongoing review and revision of forms is the critical step in forms control. Forms
analysis should begin by fact finding a process which provides complete information
about the form. Because (parts of) forms can become obsolete without the person
preparing the form even being aware of it, it is important to regularly review forms, not
just when the supply runs out or when a change is requested.

Some of the reason which prompt an analysis of form are : the existence of
operational problems such as backlogs, bottle necks, unusual time lags, repetition, or
numerous errors; areas suggested by top management for potential savings and
improvement; and suggestions made by the operating staff. Another reason why health
information managers are taking fresh looks at the forms in use in their facilities is to
prepare for computerization, especially optical imaging. Completely revising paper
forms and controlling their numbers can be a multiyear process and is often a first step
toward automation.

The forms analysis process may be aided by issuing a regular forms

questionnaire to all users. A forms questionnaire to all users. A forms questionnaire in it
self is a form which serves as a management tool; providing a written reference for
cross-sectioning information (especially where there is more than one user of the form
or where there are several related forms). The questionnaire may be completed by the
users, or used by the forms analyst as an interview guide. Remember, as a form itself,
the questionnaire needs to be reviewed periodically to insure that it is asking the
questions relating to new requirements or new methods of handling forms :
 Manuals, regulations, or directives which describe functional responsibilities and
procedures that relate to the forms under study.

 Forms History File and Forms Subject/Title File

 Completed forms which shows the types of errors made in completing the
forms
 Organizational charts which show the relationships of the department
responsible for the form to other departments

Fact confirmation is the second step in forms analysis where the fact about a
form are summarized and presented to the users for their examination and verification.
For example, one users may indicate that certain data being collected is no longer being
used. However, another user, or the person initially filling out the form, may have need
for the data.

Challenging the form by getting the user to think about each item in terms of its
own merit and its cost is the next step.

Some question to ask include: is the form necessary at all, does it really serve its
stated purpose, are there forms already in the system that show the same data or at least
enough of the data to serve the stated purpose, does the form produce meaningful data
for other aspects of the system, what would be the consequence if the form did not
exist? If the form is necessary, a forms flowchart (figure 4) can be used to analyze the
distribution of the form and/or its copies. Are all the copies necessary, does each copy
serve the stated purpose, does the recipient of each copy have authority to take action
based on data appearing on the copy-if not-why does that person get a copy, and if a
copy is for information proposes, would it be cheaper to refer to a permanent copy in a
central file? On the other hand, there may be too few copies which result in recipients
making costly photocopies. If the form and all copies are necessary, is all data
necessary? In addition to the overall merit of the form and its distribution, the concent
of the form should be analyzed. Does each item serve the stated purpose, what would be
the consequence if individual data items were ommitted, can they be reduced or
eliminated?
 Forms analysis also includes review of specifications and elements of design
relating to paper, link, punching, etc. A checklist is of great value here. Each health care
facility should develop its own checklist of standart forms design considerations,
spelling out hospital policy on titles, copies, hole punching, and so forth.

It is exremely rare that a form exists as an isolated document. Almost always it

exists as one of several forms which are interdepedent. So, item analysis or
rearrangement of data may not fully result in cost reductions. A multiform analysis or
data frequency chart (Figure 5),may be helfpul in identifying forms which may be
combined.

Purchasing

The purpose of from control are the proper design of from to ensure the
collection of needed information with maximun efficiency, elimination of obsolete
froms, consolidation of froms to minimize duplication of effort, and minimization of
printing costs. The essential ingredient in forms control is to have unbreakable rules
backed by administration and medical staff. These rules should include a means of
controlling the source of ordering and printing. The prchasing department and print shop
should operate with an unequivocal statement that no form can be ordered, reordered, or
changed without the approval of the appropriate forms committee chairperson or
delegated representative (often the health information gractitioner ). Without strong
control, mass confusion can result. The health care facility may wish to have a request
for new or revised form(figure 6) to initiate the forms analysis necessary to create or
changed a form.

In order to lay out the proper form design, it is important to know the quantity of
forms to be ordered, because the methods if reproduction govern the form design.
 It is usually sufficient to order a six-to twelve-month supply of form, depending
on the discount and the storagespace available. If the form is subject to critical changes
within a short period of time, one may wish to order a smailer suppty. A standard form
should be used for stocking, printing, and ordering forms.

Certain types of from take longer to produce than others. Enough lead time
(from the date the order is placed to the date of delivery) must be allowed to achieve the
desired implementation date. Below are estimated time periods for the reproduction of
just a few types of froms. These estimates can vary based on locality and the season in
which the froms are to be reproduced :

Single-part froms (up to 11” x 17”) 2 2 to 3 weeks

Single-part froms (over 11” x 17”) 3 to 4 week

Tags and envelope 4 to 8 weeks

Carbon-interleaved snap-out froms 8 to 12 weeks

Continuous froms 10 to 15 week

Some printers will make arragements to warehouse froms and make drop
shipments as they are needed. This method enables one to take advantage of the lower
cost per thousand that is available as the size of the order is increased. A good deal of
foresight must be exercised to be assured that a heavily used froms will be able to
endure for a year or more without any changes in design or construction.

SUMMARY

Froms analysis and control are the management tools of data communication.
Whether a from is a specially designed piece of paper for a manual system, the format of
computer screen, the logical presentation of data elements in a computer evironment, or
a computer printout, froms design is important to ensure effective data collection and
dissemination. Al though froms control is needed primarily for paper froms,
consideration must also be given to computer programming logic and printout
management. Forms design and control require a defined purpose and coordinated
effort. The health information practitioner lends forms forms exertise as well as
knowledge of the information flow within a health care facility to the design of forms
that will reduce direct costs as well as indirect costs of headling and processing. Well-
designed forms are the key to efficient and effective data communication, which
contributes directly to the productivity of all members of the health care team and
ultimately to quality patient care.

STUDY QUESTIONS

1.Explain the statement that computer data communication are not “form-less”.

2. identify design rules for data collection forms.

3. Identify the five components of paper forms.

4. What contruction consideration must be made for paper forms?

5. Dscribe the evolution of forms with respect to computerization

6. What are the objectives of a forms control program?

7. What are the components of a forms control program?