Abstract
Background. Clinical secretaries play a crucial role in documenting and registering hospital services, yet the lack of a clear job description and the mismatch between their educational background and job requirements creates significant challenges.
Methods. This qualitative study was conducted using a descriptive phenomenological approach in 2023 at Imam Reza Medical Research and Training Hospital in Tabriz. A total of 12 inpatient ward secretaries were selected through purposive sampling based on their work experience and relevant knowledge. Data were collected via semi-structured interviews, focus group discussions, and direct observation. Data were analyzed using the Lundman and Graneheim content analysis method. To ensure trustworthiness, the Guba and Lincoln criteria were applied.
Results. Secretaries spent 18-57% of their working time on tasks outside their approved job description. These tasks included documenting nursing procedures, verifying patient identity and insurance, recording consultations in Excel, completing transfer forms, updating patient files, and stamping clinical documents, tasks not officially assigned to their position. The main challenges identified by participants included the absence of a clear job description, excessive workload, lack of tariff allocation, and incongruence between their education and job duties. Such conditions led to increased work pressure, job dissatisfaction, and professional burnout among secretaries.
Conclusion. Performing duties beyond officially defined roles contributes to increased workload, reduced focus on core responsibilities, and greater risk of dissatisfaction and burnout, which may adversely affect both service quality and hospital finances. Developing a formal job description, establishing an official organizational position, and recruiting staff with relevant educational backgrounds are recommended to mitigate these challenges and enhance the quality of services.
Practical Implications. There is a need to revise and clarify the job description of clinical secretaries and establish a dedicated well-defined organizational position. Recruiting staff with relevant qualifications in health information technology or roviding supplementary training courses for secretaries is essential. Reducing the workload and unrelated duties through better task distribution among ward ersonnel is recommended. Implementing these actions may improve the accuracy of service documentation, decrease insurance-related errors, and enhance job satisfaction and productivity.