HOSPITAL RECORDS HELP

Institution : Date of Admission : Date of Discharge : Admitted By : Recommending Subscriber : Referring Hospital : Ward : Length of Stay : Case Notes : Patient History : Related Admissions

The databases contain details of children’s admission and stay at each of the hospitals included in HHARP. The information held differs to a certain degree between the hospitals, but there is a core group of fields which occur in all records: the admission and discharge dates, the name of the institution, name of the doctor who admitted the child, the ward admitted to and the length of treatment in the hospital.

Institution

The databases for each hospital in HHARP can be searched individually or as a group by using the drop down list under Institution. The default selection from this list is ‘All Institutions’, which searches across the entire suite of databases.

Date of Admission

The month and year a child was admitted as an in-patient. In the registers the full date is usually given, including year, month and day; searches are restricted to month and year of admission.

Both a Month and Year must be entered and both ‘from’ and ‘to’ boxes must be completed. Select ‘Month’ from the drop down menu and insert Year in full.

Hint

The search works by finding records within a range defined as the 1st day of the month of the ‘from’ date to the last day of the month of the ‘to’ date. To find all admissions in July to September 1868, you search from ‘July 1868’ to ‘September 1868’. If you just want admissions during July 1868, the search would be from ‘July 1868’ to ‘July 1868’.

Date of Discharge

Not searchable. This information was included in the register and is included in the admission record display and the downloadable version of the Results Table. The date of discharge was used to calculate the Length of Stay data.

Admitted By

Many records included the name of the doctor who approved a child’s admission to the Hospital. Admissions can be located for specific doctors by selecting from the drop down menu. As in modern practice, the use of the title Dr implies the practitioner was a physician and the title Mr, a surgeon. The choice of doctor is driven by the institution selected. If you have selected one particular institution for your search only doctors relevant to that institution will be active in the drop down list – the rest will be greyed-out and unselectable. Several abbreviations are used in the registers:

AHS - Assistant House Surgeon
CMO - Consultant Medical Officer
HP - House Physician
HS - House Surgeon
RMO - Resident Medical Officer

Recommending Subscriber

Not searchable. This field contains the names of individuals who supported the hospital in question and sponsored children to be admitted. At Great Ormond Street it was frequently recorded in the registers in the earlier years, but was almost obsolete by the early 1890s, when the practice of requiring patients to have letters (or tickets) of introduction from one of the hospital’s supporters began to die out. At the Alexandra Hip Hospital the information was collected sporadically, and recorded in the applications register rather than the admissions register. It was not included in the Evelina registers. Where available it is included in the display and downloadable formats, as entered in the registers.

Referring Hospital (Alexandra Hip Hospital only)

Many of the children who came to the Alexandra Hip Hospital were referred from other hospitals. This information was recorded in the admissions registers and is included in the Display and Download formats. Although the hospital names have been standardised where possible, the field is not searchable.

Ward

Indicates the ward the patient was admitted to. In some cases a child was admitted to one ward and moved to another, and this is also indicated in the record – the two wards being separated by semi colons. There is an article on Ward Names at Great Ormond Street in the library. At Cromwell House there were two wards, the chronic and surgical ward for children who required nursing care, but were no longer sick enough to occupy valuable acute beds in the main hospital; and the convalescent ward, for children who were truly convalescing. The other two hospitals contained ten wards (Evelina) and nine wards (Alexandra Hip Hospital). The ward field is not searchable but is included in Display and Download formats.

Length of Stay

Records the length of time the child stayed in the Hospital as an in-patient. Although the registers sometimes recorded this statistic, in the database Length of Stay has been calculated from admission and discharge dates.

Search in a range of days.

Patient History

Several fields have been grouped together in the Display format under the title Patient History. Most relate to the Alexandra Hip Hospital only and are only displayed and included in downloads of records for that hospital. These include: Cause of Condition (also included in the Evelina records) which indicates the believed origin of the child’s problem; Condition on Admission (a brief description of the state of the child’s limb on admission); Limb Affected – right, left or both; Duration of Illness before admission (also included in Evelina registers); date of application for admission; and whether fees were paid (and the amount).

A small number of Cromwell House records include information on a patient’s history of childhood diseases and a flag indicating whether or not vaccinated against small pox. It appears in the full record display as a list of childhood diseases already encountered, and a statement that the child has or has not been vaccinated against small pox.

None of the Patient History information is searchable.

Case Notes

A small number of case notes relating to children at Great Ormond Street are available on the website. The case notes were compiled by Dr Charles West, one of the founders of the Hospital for Sick Children and cover the period 1852 to 1874. They represent an opportunity to read in detail about the medical treatment and care given to sick children in the early days of paediatric medicine. The case notes have been scanned and are presented as a series of pdf files, which can be viewed on screen or printed. They are accessed via the admissions record of the child to which they relate.

To locate records with case notes, click on the ‘Has case notes?’ box on the Search Form. This can be used on its own to find all records with case notes, or combined with other terms to find specific case notes.

Hint

As only a very small percentage of records have case notes attached it is advisable to keep any searches for case notes as broad as possible.

Children often made more than one visit to the hospitals, and at Great Ormond Street were transferred between the main hospital and the convalescent home, Cromwell House. Records relating to the same child have been linked together and the list of related admissions is reproduced at the end of the full record display. This list acts as links to the related records, organised in chronological order, so a user can easily follow a child’s progress through the hospital’s various facilities. The implementation of this feature is slightly different depending on the hospital as explained below:

Great Ormond Street and Cromwell House : Patients moved frequently between Great Ormond Street and Cromwell House, as their conditions progressed or they suffered relapses. Records which refer to related admissions (in a contiguous set of admissions) are linked together to enable users to easily follow the children’s admission from start to finish. A list of these related admissions is provided in the record display view (where appropriate) and links from this list lead to other records related to that particular admission. (See John Bartlett, admitted in August 1881, as an example of this – the child was moved seven times between the hospital and the convalescent home.) It is planned later this year to link multiple visits to hospital, so the child’s whole experience of the hospital can be mapped out.

Evelina Hospital : All repeat visits by the same child to the Evelina Hospital have been linked together, and can be navigated using the list of links at the end of each related record, as described above. (See Kate Heritage as an example.)

Alexandra Hospital for Children with Hip Disease : The application and admission records for the Alexandra Hip Hospital have been combined in one database. The two sets of registers do not cover completely comparative periods (the applications cover 1884 to 1894 while the admission registers cover 1867 to 1895) so there is not a one to one relationship between these two sets of records. In addition the application register contains children who were never admitted for one reason or another. These records have been included in the database and will therefore have no corresponding admission. Where applications can be linked to admissions this has been done, and the results will be viewed on screen in the same format as for Cromwell House/Great Ormond Street links. (See Marcus Finkenstein as an example.)