Assessing the Usability of Paper-Based Clinical Records for Patient Care in Selected South African Hospitals

Background Paper-based clinical records remain widely used in South African public hospitals despite ongoing challenges related to healthcare information management. There is limited evidence regarding the usability of paper-based clinical records in South African hospitals. Aim This study assessed the usability of paper-based clinical records for patient care in four selected South African referral hospitals. Methods A quantitative cross-sectional record review was conducted in four referral hospitals located in the Eastern Cape and Mpumalanga provinces of South Africa. A standardised questionnaire developed from the Canadian Institute for Health Information (CIHI) Quality Framework was used to assess clinical record usability. The usability dimension comprised four constructs: record accessibility and filing, temporal documentation usability, legibility and readability, and communication usability. A total of 255 clinical records were reviewed. Data were analysed using descriptive statistics, the Kruskal–Wallis test, and Fisher’s Exact test, with statistical significance set at p