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Table 6 Analysis of the Value “Confidentiality”. Worker’s comments in the Code of Ethics

From: The workers opinions have a value in the Code of Ethics: Analysis of the contributions of workers in virtual Forum Catalan Institute of Health

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.