A resident physician is on her way to morning signout after her overnight shift and gets into an elevator crowded with nurses and other hospital staff members. The medical student on the team gets on the elevator and asks the resident how her shift went. During the conversation, the student is careful not to mention the patient's name, asking, "Did the patient in Room 232 get her CT scan?" Which of the following is the most appropriate response to the student?

Question

A resident physician is on her way to morning signout after her overnight shift and gets into an elevator crowded with nurses and other hospital staff members.  The medical student on the team gets on the elevator and asks the resident how her shift went.  During the conversation, the student is careful not to mention the patient's name, asking, "Did the patient in Room 232 get her CT scan?"  Which of the following is the most appropriate response to the student?

Quizplus · Accepted Answer

Physicians have an ethical responsibility to protect patient confidentiality, including during interactions with other healthcare team members in public places and non-medical settings. In situations where discussion of patient's healthcare information may be overheard, it is prudent to avoid discussing any information regarding potential patients. Physicians should maintain strict standards of confidentiality in any public setting, including in the presence of other health care professionals not involved in the patient's care. In this case, although the medical student has not used the patient's name, the room number can easily be connected to the patient by anyone who may overhear, thereby violating the patient's privacy under the Health Insurance Portability and Accountability Act (HIPAA). The most advisable course of action is to defer the conversation to a more appropriate and private setting outside the elevator. (Choice A) Although this statement is correct, publicly admonishing the student is not the best approach. Discussing the matter privately during signout is preferred. (Choices B, C, E, and F) These responses violate patient privacy as they acknowledge that the patient received a CT scan. Disclosing information about a patient's hospital course in a public setting, even if the patient's name is not discussed, is inappropriate. Educational objective: Physicians must be cautious about discussing protected patient health information in public places, including public settings within the hospital, even with other medical personnel. Conversations regarding patients should be deferred to a later time when a more private setting can be arranged. __________ References: Confidentiality breaches in clinical practice: what happens in hospitals? (http://www.ncbi.nlm.nih.gov/pubmed/27590300)

A Resident Physician Is on Her Way to Morning Signout