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ary children's pain service in the world. Its primary staff is composed of
anesthesiologists, psychologists, nurses, and physical therapists. Annu-
ally, 2,000 children (in-patients and outpatients) are treated for postoper-
ative pain and pain associated with cancer. The patient records and
shadow patient files of the service are computerized and never purged.



RECORD SERIES IDENTIFIED FOR PRESERVATION IN THE ARCHIVES

All functions:

• Department annual reports (published in "Reports of the
Departments"; currently have 1976-1992)

• Department chief's correspondence files

Patient Care:

• Clinical Competence Committee minutes

• Quality Assurance Committee minutes

• Pain Treatment Service brochures



DEPARTMENfT OF ANESTHESIA DOCUMENTATION PLAN 233



• Pain Treatment Service pain management protocols

• Pain Treatment Service patient handouts (e.g., on pediatric cancer
pain)

Education

• Annual syllabi of review courses

• Calendar of daily lectures and seminars (issued monthly)

• Education Committee minutes

• Educational manuals for trainees (produced by each division)

• Fellowship Selection Committee minutes

• Staff, resident, and fellow lists

• Trainee and staff file

Research

• Pain Treatment Service correspondence file

• Research Committee minutes

• Staff bibliography (in department's annual reports)

Health promotion

The department does not engage in health promotion activities

Other

Photographs of staff and fellows (taken annually)
Final budget performance reports
Main Operating Room
Anesthesia Laboratory
Pain Service



DOCUMENTATION PLANNING: A METHODOLOGY FOR SPECIALIZED
APPLICATION

The documentation plan for Children's Hospital Anesthesia Department is
an application of the documentation planning process to a particular
department in a specialized hospital. The plan is not meant to be a plan for
all anesthesia departments in all hospitals, but illustrates the documenta-
tion planning processes of analysis (institutional, interinstitutional, and
field) and selection (at the function/activity, department/program, and
record series levels). The process was designed to be translated to other
hospital organizational units and to the other institutions and organiza-
tions composing the U.S. health care system.

On an even more general level, the documentation planning process
can be applied to institutions and organizations outside of the U.S. health
care system, such as state or local government institutions, arts organiza-



234 DOCUMENTATION PLANNING AND CASE STUDY



tions, and labor organizations. To develop documentation plans for insti-
tutions or organizations that are not part of the U.S. health care system,
archivists will first need to develop field analyses, such as this book
provides for health care, for the larger systems of which these other
institutions and organizations are a part.



NOTES

1. "Institutional" may also be read as "organizational" throughout this chapter.

2. Documentation planning is an intrainstitutional approach to selection;
documentation strategy is an interinstitutional approach. See Helen Willa
Samuels, "Who Controls the Past?" American Archivist 49 (Spring 1986):
109-24. It is my belief that if documentation strategies are possible, they are
only so after the institutions involved have formulated documentation plans.

3. In some cases it may also be appropriate to examine the community context.
For example, when documenting a hospital in a large urban setting, it is
important to compare the hospital to others in and around the city.

4. Functions may be subdivided into subfunctions or activities as the case
requires. For example, in this book health care delivery has been divided into
patient care and health promotion in an attempt to emphasize health
promotion, which otherwise might not be appropriately documented.

5. Cynthia G. Swank, "Organizational Culture and Its Role in the Creation,
Survival and Use of Records: A Case Study" (Paper delivered at the Bentley
Historical Collections Symposium, July 1990).

6. The idea of core documentation is adapted from the library world's concept of
core collection. See, for example, Samuels, "Who Controls the Past?" 1 13-14.

7. Invoices for office supplies and other "housekeeping" records, for example,
are not significant record series for the purpose of documentation planning.

8. See Judith E. Endelman, "Looking Backward to Plan for the Future:
Collection Analysis for Manuscript Repositories," American Archivist 50
(Summer 1987): 340-53. Endelman's approach could be adapted to an
institutional archives.

9. It took me seven or eight hours from start to finish to devise the
documentation plan for the Children's Hospital Anesthesia Department.

10. The Children's Hospital: 1869-1939 (no publisher, n.d.), 9.

1 1. "Independent" is the operative word. Many hospitals are affiliated with a
university, and their research funding is reported as part of the research
funding of the parent institution.

12. The six are Beth Israel, Brigham and Women's, Children's, New England
Deaconess, Dana-Farber Cancer Institute, and Joslin Diabetes Center.

1 3. Children 's World: Year in Reviev^' 1991, 5.

14. All statistics in this section are taken from Listing of Freestandinc] Children's
Hospitals in the United States compiled by the National Association of Children's
Hospitals and Related Institutions (NACHRI). NACHRI's source was the 1991



NOTES 235



edition of the American Hospital Association Guide to the Health Care Field which
was based on the American Hospital Association's 1990 annual survey.

15. It should be noted that Nancy McCall and Lisa Mix, editors of Designing
Archival Programs to Advance Knowledge in the Health Fields (Bahimore: Johns
Hopkins University Press, 1994), recommend that preserving material for
biomedical research purposes be a primary function of health-related
archives; however. Children's Hospital was not ready to commit the
necessary resources.

16. For an excellent discussion of the secondary uses of official patient records
and appraisal considerations for patient records, see Joel D. Howell,
"Preserving Patient Records to Support Health Care Delivery, Teaching, and
Research," in Nancy McCall and Lisa Mix, eds.. Designing Archival Programs to
Advance Knowledge in the Health Fields (Baltimore: Johns Hopkins University
Press, 1994).



APPENDIX A



Selected Landmarks in the History of
Health Care in the United States



1756 Oldest U.S. hospital, Pennsylvania Hospital (Philadelphia),

founded.

1760 First physician licensing statute enacted in New York City.

1765 First medical school in the United States, Medical School of
the College of Philadelphia, founded.

1 766 First colonial, later state, medical society founded in New
Jersey.

1772 New Jersey act regulating medical practice; colonial, later

state, board of medical examiners adopted by New Jersey.

1790s Local boards of health organized in Baltimore, Boston,

Philadelphia, and New York City.

1798 Marine Hospital Service established by Congress. (Now the

U.S. Public Health Service.)

1 805 First formally organized medical library founded in Boston.

1812 New England Journal of Medicine precursor founded. (Now

the oldest U.S. medical journal.)

1836 Library of the Surgeon General's Office established,

forerunner of the National Library of Medicine.

1842 First use of ether anesthesia by Crawford Long, M.D., in

Georgia.

1846 First public demonstration of ether anesthesia at the
Massachusetts General Hospital, Boston.

1847 American Medical Association founded.

1851 Female Medical College of Pennsylvania (Philadelphia)

founded, world's first medical college for women.



237



238 SELECTED LANDMARKS IN THE HISTORY OF HEALTH CARE



1855 First state health department established in Louisiana.

1861 First voluntary health association, the Civil War Sanitary

Commission, founded in New York City.

1872 American Public Health Association formed.

1873 First three U.S. schools of nursing founded, in Boston, New
Haven, and New York City.

1879 National Board of Health established, first organized

medical research program of the federal government.
1881 American Red Cross founded by Clara Barton.

1887 Charles Mayo, M.D., and his sons established a practice in

Rochester, Minnesota, that evolved into the first large
medical group practice, the Mayo Clinic.

1891 National Confederation of State Medical Examining and
Licensing Boards founded.

1892 Anti-Tuberculosis Society of Philadelphia founded.

1893 Johns Hopkins University School of Medicine founded;
offered first formal progressive clinical education of
physicians.

1896 X-ray technique used in the United States.

1899 American Hospital Association founded.

1901 Rockefeller Institute for Medical Research founded; first
American institute devoted wholly to biomedical research.

American Medical Association reorganized as a federation
of state medical societies.

1902 Parke, Davis & Company (Detroit) began first American,
commercially operated research laboratory.

1906 Pure Food and Drug Act passed; became the basis for

federal regulation of foods and drugs.
1910 Abraham Flexner's report, "Medical Education in the

United States and Canada," published, changing the shape

of medical education.

1913 American College of Surgeons founded.

1917 First medical specialty board formed, American Board of
Ophthalmology.

1918 First federal grants given to states for public health services.

1929 Blue Cross started at Baylor University (Dallas, Texas).

1930 National Institute of Health (NIH) created, (now called
National Institutes of Health)

1935 Social Security Act passed.

1937 Health Service Plan Commission organized. (Later called
the Blue Cross Commission.)

National Cancer Institute of NIH established.

1938 Federal Food, Drug, and Cosmetic Act passed, increasing
drug regulation.



APPENDIX A 239



1942 First health maintenance organization formed. Kaiser

Permanente Health Plan. Rhode Island became first state to
enact a health insurance law.

1 944 Public Health Service Act passed, extending to all NIH

institutes the authority to award research grants to
nonfederal agencies.

1946 Hill Burton hospital planning and construction legislation

passed to improve population/bed ratios, especially in rural
areas.

Blue Shield Medical Care Plan organized. (Later called the
Blue Shield Medical Care Commission.)

1946 Communicable Disease Center established in Atlanta,

Georgia. (Now called Centers for Disease Control and
prevention.)

1950 National Science Foundation established.

1951 Joint Commission on Accreditation of Hospitals formed.
(Now called Joint Commission on Accreditation of
Healthcare Organizations.)

1953 Department of Health, Education, and Welfare established

as a cabinet level agency. (Now the Department of Health
and Human Services.)

1962 Amendments to the Food, Drug, and Cosmetic Act passed,
which empowered FDA to specify testing procedures for
evaluating new drug applications.

1963 Health Professions Educational Assistance Act legislated to
support medical schools and health-related educational
institutions.

1964 Nurse Training Act legislated to support nurse training.
National Library of Medicine began MEDLARS, the first
computerized system for searching medical literature.

1965 Medicare (medical health insurance for citizens over 65)
and Medicaid (medical assistance program for the indigent)
legislation passed.

Regional Medical Programs Act passed, establishing
regional cooperation in health care planning.

1966 Allied Health Professions Personnel Act legislated to
support training of allied health workers.

1968 Health Manpower Act legislated to support training health

professionals.

1970 Occupational Safety and Health Act (OSHA) passed,

regulating health hazards in the workplace.

National Institute of Alcohol Abuse and Alcoholism
established.

1972 Social Security Act Amendments passed, creating

professional service review organizations.



240 SELECTED LANDMARKS IN THE HISTORY OF HEALTH CARE



1973 Health Maintenance Organization Act passed, providing
funding for model HMO projects.

1974 National Institute on Aging established within NIH.

1975 Rhode Island became first state to enact a catastrophic
health insurance program.

1976 Health Care Financing Administration established.

1981 Acquired immunodeficiency syndrome (AIDS) first
recognized.

1982 Health Resources and Services Administration established.
Orphan Drug Aa passed.

Professional Standards Review Organizations transformed
into Peer Review Organizations.

1983 Diagnosis-related groups (DRGs) instituted as method of
Medicare reimbursement.

1987 FDA adopted rule allowing release of experimental drugs

(e.g., azidothymidine) to individuals with AIDS and other
serious diseases.
Source: Data from Joellen Beck Watson Hawkins and Loretta Peirfedeici Higgins,
Nursing and the American Heatlh Care Delivery System (New York: Tiresias,
1982), 58-60; Theodor J. Litman and Leonard S. Robins, Health Politics and
Policy (Albany, N.Y.: Delmar, 1991), 395-41 1; and Florence A. Wilson and
Duncan Neuhauser, Health Services in the United States (Cambridge, Mass.:
Ballinger, 1985), 289-91.



APPENDIX B



Health-Related Discipline
History Centers



The following list of repositories collecting manuscripts in various fields
within the history of health care is meant to be used to devise cooperative
collecting arrangements and to locate appropriate respositories in which
to house collections. Institutional archives are not listed.

Anesthesiology

Wood Library-Museum of Anesthesiology

515 Busse Highway

Park Ridge, IL 60068-3189

708/825-5586

Dentistry

American Dental Association

Archives

211 East Chicago Avenue

Chicago, IL 60611

312/440-2642

University of Pennsylvania

School of Dental Medicine

Library

4001 Spruce Street A 1

Philadelphia, PA 19104

215/898-8978



241



242 HEALTH-RELATED DISCIPLINE HISTORY CENTERS



Dermatology

Dermatology Foundation of Miami
Tape Studio and Library
480 Casuarina Concourse
Coral Gables, FL 33143
305/667-3224

Family Medicine

American Academy of Family Physicians

8880 Ward Parkway

P.O. Box 8418

Kansas City, MO 641 14

816/333-9700

Gerontology

Syracuse University Gerontology Center
Brockway Hall
Syracuse, NY 13210
315/423-3335

Health — Connecticut, Bridgeport

Bridgeport Public Library
Historical Collections
925 Broad Street
Bridgeport, CT 06604
203/576-7417

Health Care

InterStudy

Library — Information Center

5715 Christmas Lake Road

P.O. Box 458

Excelsior, MN 55331

612/474-1176

Yale University

Sterling Memorial Library

Manuscripts and Archives

120 High Street

Box 1603A Yale Station

New Haven, CT 06520

203/432-1749



APPENDIX B 243



Health Care — Alabama

JCMS — UAB Health Sciences Archives
901 18th Street South
Birmingham, AL 35256
205/933-8601

Health Care — Texas

University of Texas Health Science Center at San Antonio

Library — Special Collections

7703 Floyd Curl Drive

San Antonio, TX 78284

512/691-6271

Health Care Administration

Center for Hospital and Health Care Administration History

American Hospital Association

840 North Lake Shore Drive

Chicago, IL 60611

312/280-6258

Health Sciences — California, especially San Francisco

University of California

Library and Center for Knowledge Management

Special Collections and University Archives

San Francisco, CA 94143-0840

415/476-8112

Health Sciences — Michigan

Historical Center for the Health Sciences
715 North University, Suite 6
University of Michigan
Ann Arbor, Ml 48 1 04- 1 6 1 1
313/996-9443

History of Medicine — Arkansas

University of Arkansas for Medical Sciences
History of Medicine Division/Archives
Library/Slot 586
Little Rock, AR 72205
501/686-5980



244 HEALTH-RELATED DISCIPLINE HISTORY CENTERS



History of Medicine — Connecticut, Hartford

Hartford Medical Society

Library

230 Scarborough Street

Hartford, CT 06105

203/236-5613

History of Medicine — Illinois (Chicago)

University of Illinois at the Medical Center

Library of the Health Sciences

Archives and Special Collections

1750 West Polk Street

P.O. Box 7509

Chicago, IL 60680

312/966-8977

History of Medicine — Los Angeles

University of California — Los Angeles

Biomedical Library

History and Special Collections Division

12-007 Center for the Health Sciences

Los Angeles, CA 90024

213/825-6940

History of Medicine — Maryland

Medical and Chirurgical Faculty of the State of Maryland

Library

1211 Cathedral Street

Baltimore, MD 21201

301/539-0872 x215

History of Medicine — Missouri

St. Louis Metropolitan Medical Society
Oak Knoll Park
Clayton, MO 63105
314/726-2888

History of Medicine — Nebraska

University of Nebraska
Medical Center
Library of Medicine
42nd and Dewey Avenue
Omaha, NE 68105
402/559-7091



APPENDIX B 245



History of Medicine — New England, especially Boston

Francis A. Countway Library of Medicine

Special Collections

10 Shattuck Street

Boston, MA 02 11 5

617/732-2171

History of Medicine — New Jersey

University of Medicine and Dentistry of New Jersey

Special Collections and Archives

G. F. Smith Library

30 12th Avenue

Newark, NJ 07103

201/456-6293

History of Medicine — New York

The New York Academy of Medicine Library
Malloch Rare Book and History of Medicine Room
2 East 103rd Street
New York, NY 10029
212/876-8200

New York Hospital — Cornell Medical Center

Medical Archives

1 300 York Avenue

New York, NY 10021

212/746-6072

History of Medicine — Ohio (Southwestern)

University of Cincinnati

Libraries

Archives and Rare Book Department

Blegan Library — Room 808

Cincinnati, OH 4522 1 -0 1 1 3

513/566-1959

History of Medicine — Ohio (Western Reserve)

Cleveland Health Sciences Library
Historical Division
1 1000 Euclid Avenue
Cleveland, OH 44106
216/368-3648, 3649



246 HEALTH-RELATED DISCIPLINE HISTORY CENTERS



History of Medicine — Pennsylvania (esp. Philadelphia) and the U.S.

College of Physicians of Philadelphia
Historical Collections
19 South 22nd Street
Philadelphia, PA 19103
215/561-6050

History of Medicine — Rhode Island

Rhode Island Medical Society

Library

106 Francis Street

Providence, Rl 02903

401/331-3208

History of Medicine — South Carolina

Medical University of South Carolina

Health Affairs Library

Waring Historical Library

80 Barre Street

Charleston, SC 29401

803/792-2288

History of Medicine — Texas

Texas Medical Association

Memorial Library

1801 North Lamar Boulevard

Austin, TX 78701

512/477-6704

University of Texas Medical Branch

Moody Medical Library

History of Medicine and Archives Department

Galveston, TX 77550

409/761-2397

History of Medicine — Texas, Harris County and Houston

HAM-TMA Library

Texas Medical Center

1 133 M. D. Anderson Boulevard

Houston, TX 77030

713/797-1230 xl39



APPENDIX B 247



History of Medicine — United States

American Philosophical Society

Library

105 South 5th Street

Philadelphia, PA 19106

215/440-3409

National Library of Medicine
History of Medicine Division
Bethesda, MD 20894
301/496-5963

Smithsonian Institution

National Museum of American History

Department of History of Science and Technology

Division of Medical Sciences

AHB 5000

12th Street and Constitution Avenue, N.W.

Washington, DC 20560

202/357-3270

University of Kansas Medical Center
College of Health Sciences and Hospital
Clendening History of Medicine Library
Rainbow Boulevard at 39th Street
Kansas City, KS 66103
913/588-7040

History of Medicine — Wisconsin

Medical College of Wisconsin

Todd Wehr Library

8701 Watertown Plank Road

P.O. Box 26509

Milwaukee, WI 53226

414/257-8302



Hospitals



Center for Hospitals and Health Care Administration History

American Hospital Association

840 North Lake Shore Drive

Chicago, IL 60611

312/280-6258



248 HEALTH-RELATED DISCIPLINE HISTORY CENTERS



Internal Medicine

American College of Physicians

Archives

4200 Pine Street

Philadelphia, PA

215/243-1200

Microbiology

Center for the History of Microbiology
Albin O. Kuhn Library and Gallery
University of Maryland-Baltimore County
Baltimore, MD 21228
301/455-3601

Military Medicine

Armed Forces Institute of Pathology
Armed Forces Medical Museum
Otis Historical Archives
Alaska Avenue and 14th Street, N.W.
Washington, DC 20306
202/576-2334, 2341, 2348

Neurology

Archives of Neurology

American Association of Neurological Surgeons

22 South Washington Street

Park Ridge, IL 60068

708/629-9500

Nursing

Nursing History Archives

Mugar Library

Boston University

771 Commonwealth Avenue

Boston, MA 022 15

617/353-3696

Center for the Study of the History of Nursing
University of Pennsylvania
Nursing Education Building/S2
Philadelphia, PA 19104
215/898-4502



APPENDIX B 249



Oncology Nursing Society
501 Holiday Drive
Pittsburgh, PA 15220-2749
412/921-7373

Nutrition

Vanderbilt University
Medical Center Library
Special Collections
Nashville, TN 37232
615/322-0008

Obstetrics and Gynecology

American College of Obstetrics and Gynecology

Historical Collection

409 Twelfth Street, S.W.

Washington, DC 20024

202/638-5577

Ophthalmology

Foundation of the American Academy of Ophthalmology

Department of Ophthalmic Heritage

655 Beach Street

P.O. Box 6988

San Francisco, CA 94101-6988

415/561-8500

Otolaryngology

American Academy of Otolaryngology — Head and

Neck Surgery

Department of Archives and History

1 Prince Street

Alexandria, VA 22314

703/836-4444

Pediatrics

American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60009
708/981-4722



250 HEALTH-RELATED DISCIPLINE HISTORY CENTERS



Pharmacy

American Institute of the History of Pharmacy

Pharmacy Building

University of Wisconsin

Madison, WI 53706

608/262-2894

University of Pennsylvania

Van Pelt Library

Edgar Fahs Smith Collection in the History of Chemistry

3420 Walnut Street

Philadelphia, PA 19104

212/898-7088

Physical Therapy and Rehabilitation

Abbott-Northwestern Hospital Corporation

Sister Kenny Institute

800 East 28th Street

Minneapolis, MN 55407

612/874-4312

Plastic Surgery

Columbia University Health Sciences Library

Special Collections

701 West 168th Street

New York, NY 10032

212/305-7931

Psychiatry

American Psychiatric Association Archives
1400 "K" Street, N.W.
Washington, DC 20005
202/682-6017

Public Health

University of Minnesota
Libraries

Social Welfare History Archives
101 Walter Library
117 Pleasant Street, S.E.
Minneapolis, MN 5 5445
612/624-6394



APPENDIX B 251



Women in Medicine

Medical College of Pennsylvania

Archives and Special Collections on Women in Medicine

3300 Henry Avenue

Philadelphia, PA 19129

215/842-7124

Radcliffe College

Arthur and Elizabeth Schlesinger Library on the History of Women in

America

10 Garden Street

Cambridge, MA 02138

617/495-8647, 8648



INDEX



AAHC (Association of Academic Health Cen-
ters), 137, 138
Academic health centers
archival/records management programs

at, 140-141
role of, 137-140
Accreditation
defined, 122, 124
of hospitals, 26, 27

of instructional programs, 15, 117, 125-
129
Administration for Children and Families, 5,

48
Administrative foundation, 218-219
Advertising, 192

Agencies, health. See Health agencies
Agency for Heahh Care Policy and Research,

5, 51, 54
Agenq' for Toxic Substances and Disease

Registry, 5
AMA. See American Medical Association
Ambulatory care facilities, 4, 36-37

listed, 15
American Dental Association, 1 52
accreditation functions of, 162
archival/records management programs

at, 171, 172
certificate and degree programs of, 117
JCAHOand, 166
legislative lobbying by, 162
American Heart Association, 9, 151, 152,
154, 155



archival/records management programs

at, 171, 172-173
case study of, 168-171
American Hospital Association, 17
annual statistical summary of, 1 38,

212
archival/records management programs

of, 171, 172
health insurance and, 197
in-service education by, 165
JCAHOand, 166
legislative lobbying by, 162
planning defined by, 27
teaching hospital defined by, 32-33
American Medical Association (AMA), 1, 8,

152
accreditation of educational facilities by,

15, 117, 125-126, 128
archival/records management programs


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