CONFIDENTIALITY AND PRIVACY BREACHES IN A UNIVERSITY HOSPITAL EMERGENCY DEPARTMENT

Objective: To determine the frequency of visual and auditory confident iality and privacy breaches in a university ED. Methods: A prospective , observational study of medical personnel behavior was performed usin g participant and direct observation techniques. Observations were mad e in a university tertiary referral and trauma center emergency facili ty. Observers recorded auditory and visual confidentiality and privacy breaches in various patient care areas during 1-hour periods, Informa tion collected included patient name or room number, complaint/diagnos is, diagnostic tests, past medical history, and personal information. It was then determined whether a clear identification of the patient's name or face and/or an association to his or her clinical course coul d be made. Results: All members of the health care team committed conf identiality and privacy breaches. Frequency of breaches was dependent on room location and design. Breaches in the triage/waiting area occur red for >53% of the patients. Breaches near the physician/nursing stat ion ranged from 3 to 24 per hour and 1.5 to 3.4 per patient hour. Othe r inappropriate comments also were noted. One hundred consecutive pati ents and family members were interviewed at ED release, with only 2/10 0 having noticed the status board, although neither could recall any s pecific details. Conclusion: Confidentiality and privacy breaches occu r in a university ED by all members of the health care team. The ED ar chitecture and floor plan affect patient confidentiality and privacy.