Category 1. Institutional, organizational and management aspects | |
Aspects in need of improvement | Suggestions |
• The management of space is prioritized when building health centres. • Operability is prioritized over confidentiality. • To solve high workloads, decisions are made that conflict with confidentiality, for instance: • Signature of prescriptions by administrative personnel. • Administrative personnel triage the most urgent cases. | • To sign an individual confidentiality form for access to the information necessary to provide healthcare. • To define and disseminate the levels of access to Electronic Medical Records. • To define functions and responsibilities of employees. • To analyse infringements of confidentiality. • To assume responsibility in situations of infringement of confidentiality. • Strategies to request referrals and tests in agreement with confidentiality requirements. |
Category 2. Facilities | |
Aspects in need of improvement | Suggestions |
• Low quality of building in healthcare facilities, even in the most recent. The management of space is prioritized when building health centres. • Rooms are not soundproof. • In the waiting rooms and doctors’ offices you can listen to the conversations of professionals and patients. • The lack of an office to give confidential information is commonplace. | • To guarantee that the new facilities comply with confidentiality requirements. • To design the interior of health centres to comply with confidentiality requirements. Separate entrances for users and personnel. • Exclusive areas for personnel. |
Category 3. Confidentiality , Information Systems and Electronic Medical Records | |
Aspects in need of improvement | Suggestions |
• Confidentiality gets lost when information is shared with other professionals. • Everybody can access the Electronic Medical Records. • The current medical records do not guarantee confidentiality. • Electronical medical records are very useful, but I’m not sure what happens then with confidentiality. • Many people has access to the information on referrals. • The patient might feel unprotected. | • To open clinical records only with the agreement of the patient. • To define and disseminate levels of access to the Electronic Medical Records. • To sign an individual confidentiality form for access to the information necessary to provide healthcare. • To register when the clinical records are accessed. • To improve confidentiality in the management of documents with clinical data. |
Category 4. Training and raising awareness on confidentiality for health workers and society at large | |
Problems identified | Suggestions |
• There is no training on confidentiality. • Errors occur due to lack of knowledge. | • To inform workers on the legal implications of violating confidentiality. • Training in schools and universities and for all CIH professionals. • Campaigns of training and social awareness on confidentiality. |
Category 5. Confidentiality as a cross professional competence in the CIH | |
Aspects in need of improvement | Suggestions |
• Confidentiality is not observed. • We hear comments on patients and colleagues in corridors. • Confidentiality is violated during informal conversations between colleagues. • There is gossiping on confidential information. • Some professionals access more information than they require. • A brief medical history is taken at the entrance of A&E. Information, even about severe diagnostics, is sometimes delivered along corridors. • Relatives are given information at the door of the ward. | • Be clear on behaviours that violate confidentiality. • Improve attitudes and manners. • Do not give information on corridors or places that do not provide any privacy. • Do not give information by phone. • Inform the patient and ask if it is ok to have residents or medical students during the visit. • Leave time for the patient-doctor relationship during ward rounds. |
General opinions | Positive experiences |
• Confidentiality is a problem of difficult solution. • It is an unresolved issue. • It is everybody’s right and responsibility. • Confidentiality is the responsibility of professionals. • Information should be given in private, with enough time for the patient, relatives and the professional in charge to voice their concerns. • Confidentiality has limitations when individual rights are in conflict with social rights. | • I look for those areas in the waiting room that guarantee confidentiality. • I do not raise my voice. • Family members generally accept that I cannot give information to them. |