Ask Me Help Desk - Hipaa publication

I work for an oncology office and we asks patients families to wait in the waiting room while their family member gets treatment.
We have on patients spouse who insists on standing next to the treatment chair.
When asked to wait in the waiting room he bad mouths the practice to everyone in ear shot.
Is there a publication that can deal with this in layman's terms so the patients and their families can understand?

Quote:

Originally Posted by KATZ5

I work for an oncology office and we asks patients families to wait in the waiting room while their family member gets treatment.
We have on patients spouse who insists on standing next to the treatment chair.
When asked to wait in the waiting room he bad mouths the practice to everyone in ear shot.
Is there a publication that can deal with this in layman's terms so the patients and their families can understand?

I don't think you can control what people say - sounds like he has his own problems but if your policy is no one in the treatment room but the patient, then that's the policy. Perhaps the Office Manager should speak to him but depending on his mind set that will only make things worse. Perhaps anger is his way of handling things.

I don't know how you would better explain your policy -

Of course it is not Hippa that he can not be with his spouse if the spouse wants him in the treatment room for basic exams. In fact in some cultures and religions, they may even have speciific rules who has to be there.

There is nothing to stop him from speaking his view point, and believe me, if my wife wanted me in the room with her and you said I could not, I would say you wouldhear more.

So it is just your office policy based on your companies view point and rules, no law. If he is too loud, you can ask him to leave and most likely lose your patient as a customer.

First of all it's HIPAA, not HIPPA...

Second of all, any person can be with the patient provided that consent is given. If the wife has given consent then there is no reason that the significant other, whether it be a spouse or friend, should NOT be permitted while the patient is undergoing treatment.

HIPAA forbids the healthcare provider, and or any medical personel treating a patient, divulge information regarding the care, treatment, and/or finances. It has NOTHING to do with support.

As a cancer patient myself I can tell you I would be highly upset, and possibly report to the medical board of my state, if I could not have my support system by my side during my treatment. Cures are all about support as well as medical treatment. Your company is depriving patients of their support system. This is terrible business, and in all honesty should be reported to your local medical board.

I'm sorry, but I take this personally. When I went through chemo, my 4 year old daughter (at the time, she is now 14) was one of my support systems... she was allowed at my side at all times, as a matter of fact, she was allowed to flush my INT with Normal Saline. So should any other family member.

Your company is not violating HIPAA laws, but they are impeding the recovery of the patients they treat.

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JudyKayTee disagrees: My husband is a dialysis patient - no one is allowed in the dialysis room when the procedure is being performed.

You can disagree Judy, but as a dialysis is a little different than chemotherapy.

Our dialysis centers do not allow family members either. Dialysis is a completely different animal from chemo. While it is frightening in it's own right, there are some major risks that can be associated when family members are present as dialysis is considered more invasive than chemo.

Patients on chemotherapy span all age groups, more so than dialysis. Patients are frightened for their lives, they are afraid they will get sick with each treatment, afraid to lose their hair... the list goes on.

Family and good support systems are imperative during chemotherapy as cancer affects the whole family, not just the patient. Family's are afraid for their loved loss of hair, loss of functioning, not to mention the possible threat of loss of life.

It is helpful to the support system (family, loved ones, etc) to be with the patient during chemo, it not only makes the patient more comfortable, but eases the burden on the loved ones if they can share in the experience... ask questions... be recognized.

The cancer treatment center I went to during my chemotherapy encouraged loved ones to come with the patient during chemo as many cannot drive themselves home after the treatment. My oncologist felt that it is best to treat the entire family as a unit, rather than the patient as a number.

Sounds like he needs a new oncologist. My mother's oncologist encourages adult family/friend participation (no one under 12). They provide pillows and blankets for the long chemo's and there is always a sandwich and cookie trolley going 'round. They have a lending library of paperbacks. They make a great effort of putting people at ease rather than isolating them. Perhaps it is time your office took a long, hard look at their policies.

Em, your mother's treatment team sounds just like mine! They made an exception and let my daughter go with me when she was only 4 due to my type of cancer. I had breast cancer and they allowed her (as well as all of the doctors (surgeons, GP, reconstructive surgeons)) as my form of cancer may very well effect her later in life. They were of the belief that if she saw that I was comfortable and if she was exposed and not afraid, then if she were ever to get breast cancer it would not be as frightening for her.

I am a cancer survivor and now work in an Oncology practice as well. J_9, it sounds like you had a fantastic doctor and I'm glad for that.

I can relate to the OP, however, because our clinic institutes a similar policy. While it may not be specific to HIPAA (I'm not sure), we institute it because we've simply grown beyond capacity. We're an outpatient clinic with two treatment rooms full of 25 recliners that patients sit in (next to each other) to receive therapy. Our nurses are stuck using small stools to sit next to their patient. We have 6 offices within our practice and they are all equally busy as we receive at least 30 new referrals a week. Our first timers or difficult patients are permitted to have loved ones with them. "Veterans" are asked to keep loved ones in the lobby.
This may sound cruel, but its will the best intentions I can assure you. Overall, the patients tend to sleep and loved ones sit bored, using chairs our patients need. Some have even gotten violent when asked to vacant a chair for a patient. Some have taken pictures on their phones of OTHER patients and emailed them... as in "hey sis, look who's having chemo with me... our neighbor Sue!"

When our patients complain that someone's guest is disturbing or embarrassing them, what are we left to do besides ask them to leave? In general, we "ask" that people obide by what our office sees fit for the patient area. There isn't just one patient back there, but many, we have to look out for. Sure there are exceptions, but overall if we allowed guests for every patient, we'd literally have over 75 people in a small area.

Our reasons for keeping the treatment area free of "extra bodies" are these.
1. Privacy of others. Violations such as picture phones, loud talking, etc. (We had a man "hiding" treatment from his wife until a guest of another patient barged in and recognized him as her neighbor... and told his wife... after yelling "Hey Mr. John Doe!" across the entire treatment area.) It may seem strange, but many of our patients are intensely private and we can't violate their wishes, even if it means hiding from their spouse)
2. close quarters involving dangerous drugs
3. high traffic in too small an area (we're working on a move to a better place)
4. Safety of guests. Children especially are not welcome in our area. Toxic drugs, syringes, needles, IV poles, walkers, Biohazard material, etc... we can't risk them running into or grabbing something.
5. Safety of staff. To mix chemo drugs, etc. we try to minimize distractions under the hood as much as possible.
6. Quite, relaxed moods. We try to maintain a peaceful environment as many people seem to benefit from this.
7. Codes. We frequently have codes where 911 must be called. The fewer people in the immediate area the better. Since we're outpatient, we don't have private areas to treat and when a patient codes, they cannot be moved out of the main treatment room chairs safely until EMS arrives.

Again, let me emphasize that I agree support is probably THE most important thing to a patient. However, some situations do not allow for that support to sit right next to them for that specific duration of time. While we do allow exceptions, or short visits, most of our guests realize that they're asked to wait in the lobby for the safety of their loved one, themselves, and our staff as well. In our particular area, this is what's best.

But, back to the OP's question:
KATZ,
I don't believe there is anything specific in layman's terms. You might want to talk to your office manager and outline reasons like I did above. Its possible that you could print your own forms to include in patient teaching packets outlining the concerns your office has with visitors.
Before each new patient gets chemo, we have a "teaching visit" where they sit with a nurse educator and learn about the regimen specific to their doctors orders. In the packet, we include company policies, privacy information, etc. If you don't have something similar in place, it might be a good idea.

To sum up here it is not a HIPAA violation to have someone in the treatment room with the patient's consent or at their request. It would be a HIPAA violation if the patient did NOT want the person there since that would force the caregiver to give information to a third party.