Unit of competency Outline

Date retreived
22/07/2026 9:57 PM AWST

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Maintain patient records

Maintain patient records

Unit of competency
National Code
BSBMED303
State Code
AUI77
TGA Status
Current
DTWD Status
Approved
Current Release Number
2.00
Current Release Date
14/01/2016
View on TGA
State Implementation and Classification
Approved Date
15/09/2015
Field of Education
080901 - Secretarial And Clerical Studies
Original Release Date
15/09/2015
Nominal Hours
40
Description
This unit describes the skills and knowledge required to maintain patient records within an existing medical records management system, under the supervision of a senior receptionist or practice manager.It applies to individuals who apply a broad range of competencies in various medical administration contexts. They are skilled operators who are expected to exercise discretion and judgement in accessing and maintaining patient records while fully respecting patient privacy and the confidentiality of their details.No licensing, legislative, regulatory or certification requirements apply to this unit at the time of publication.
Notes
Elements and Performance Criteria
1. Identify and clarify own role and procedures for patient recordkeeping
  • 1.1 Determine own role and responsibilities within patient recordkeeping system through consultation with relevant personnel or via organisational policy and procedures manual
  • 1.2 Access documented procedures for patient recordkeeping system and read for understanding
  • 1.3 Seek clarification with relevant personnel of unclear or ambiguous procedures
2. Access patient records
  • 2.1 Gain access to patient records to facilitate patient visit
  • 2.2 Check currency and accuracy of patient demographic and personal details
  • 2.3 Create new records according to enterprise protocols
  • 2.4 Check records following patient visits, for practitioners’ instructions related to follow-up action
  • 2.5 Store patient records according to organisational policy and procedures
3. Help maintain records
  • 3.1 Make required checks of patient records
  • 3.2 Carry out archiving of patient records as required
  • 3.3 Transfer patient records to another health facility upon appropriate request for patient information
4. Monitor and review own role
  • 4.1 Monitor and review own role and responsibilities in maintaining patient records to identify opportunities for improvements to system and own work practices
  • 4.2 Make recommendations to relevant personnel for improvements to the established procedures and processes for maintaining patient records
No information
No information
Replaces
State Code National Code Title Type
D0837 BSBMED303B Maintain patient records Unit of competency