Reflections on an engaged research approach to understanding patient record-keeping systems in a local clinic in Makhanda

The taking and archiving of accurate record-keeping is an essential part of caregiving in health care. There is extensive evidence that record-keeping systems are affected by systemic problems that impact healthcare provision globally and in South Africa, particularly in public healthcare. Human Factors and Ergonomics (HFE) has been applied in healthcare settings to address these systemic challenges, including those related to record keeping, but not in South Africa. With participation being a critical element of HFE, a Community-Based Participatory Research (CBPR) framework can but has not been used to understand and optimise systems such as those linked to record keeping. This reflection provides an overview of how an HFE approach was applied, using a CBPR framework to understand the challenges affecting patient record-keeping in a clinic in Makhanda. Specifically, it provides insights into how CBPR was applied and reflections on this experience from both the researchers’ and collaborators' perspectives. The importance of patience and flexibility, empathy, constant feedback and consultation and listening to collaborators' and participants' contributions emerged as important lessons. The community collaborator also experienced the process positively, where she emphasised the empowering experience of being able to help guide and facilitate research, which, in turn, revealed challenges that affected the daily running of the clinic. The collaboration using the CBPR approach was a practical framework for applying several HFE approaches to understand the challenges around record keeping.