Is it appropriate to check on pts?

Specialties Emergency

Published

I was just wondering if you think it's appropriate to call a unit/hospital where you sent a pt from the ED to see how they are doing. Does anyone here do this?

I work in a LTC facility and we will call the ER to find out if they have been admitted and if so what for. Then we document in the patients nurse notes. But that is usually the only info we ask for and are able to get. If we ask more than that, they tell us it violates the HIPPA rules/regs.

Specializes in Med/Surg, Ortho.

I think calling is not necissarily appropriate but paying a visit to the patient is not out of line. Then its the patients decision as to how much or if any information is offered. If the patient was transferred to another facility then a QI member needs to do the calling.

As far as LTC goes,, i understand that they are concerned about a resident but call the family,, dont call the hospital floor for updates or information. 9 out of 10 you wont get anything from the nurse who has to stop what they are doing to go answer your call. I really dont have time, and you know that you wont get information. Or better yet,, call the patient if they can talk to you, they will speak with you and it would mean more to them if you called them instead of telling me to tell them you called.

Specializes in CT ,ICU,CCU,Tele,ED,Hospice.

i don't believe its a hippa violation as long as you were involved in the persons care.in my er we often transfer pts .usually the md will call ten let staff involved know how pt made out .i don't see a problem with that .as far as a nurse calling me i would answer briefly how pt is stable not stable alert or not diagnosis and whether being admitted .simple.

Specializes in Emergency.
I feel it is inappropriate to ask for medical information. I often find it annoying when I am working on the floor and nurses from the sending facility are calling throughout the day to check on the status of a patient. I usually will redirect them to case management.

I am somewhat puzzled by your response. I will admit that one of the drawbacks of working in the ED is you don't always know how your patients end up. Either we send them to the floor, the OR or cath lab, or we send them to a higher level of care facility.

I don't need to know the details of your care for them, but simple, concise answers regarding stability are appreciated.

We have often spent alot of time saving someone's life and perhaps bonding with a family. I do think about these people after a shift is over. It doesn't happen with all of my patients, but it does happen.

Continuity of care, cooperation between staff and facilities, and simple human decency shouldn't be annoying.

My sister was very sick last summer & went to our state's university hospital. While they were trying to diagnose her, she was cared for a by a wonderful nurse. She took her to her varoius tests & even held her up while she was given a mamogram. She is the kind of nurse I hope to be one day.

After a diagnosis was made she ended up in cardiac ICU & later another ICU. That nurse stopped in every couple days to check up on Jeanne & her family even though she no longer was her concern. It was so appreciated. Before leaving the hospital, 2 months later, they stopped on her floor to tell her Good-bye. It's a act of kindness that none of us will forget.

Dixie

Specializes in Emergency & Trauma/Adult ICU.
I think calling is not necissarily appropriate but paying a visit to the patient is not out of line. Then its the patients decision as to how much or if any information is offered. If the patient was transferred to another facility then a QI member needs to do the calling.

As far as LTC goes,, i understand that they are concerned about a resident but call the family,, dont call the hospital floor for updates or information. 9 out of 10 you wont get anything from the nurse who has to stop what they are doing to go answer your call. I really dont have time, and you know that you wont get information. Or better yet,, call the patient if they can talk to you, they will speak with you and it would mean more to them if you called them instead of telling me to tell them you called.

Seriously ... you want the LTC staff who cares for the pt., and will care for them again after they're discharged from the hospital, to get their info from the patient's family???

Wow.

Why would you not pass on info to the professionals who also care for the patient? I don't understand. You will eventually call report back to them when the patient is discharged ...

I'm just not understanding where some feel the HIPAA violation lies? We're talking about professionals who have been involved in the patient's care following up on the patient's condition.

Specializes in Nephrology, Cardiology, ER, ICU.

I have to say I've been on both sides of the fence: I worked 10 years in a level one tertiary care facility and rec'd calls freq from transferring facilities and pre-hospital personnel. It is NOT a HIPAA violation when these people have cared for the pt - its just continuance of care and also provides a QI/QA evaluation too.

Now...that I work in outpatient chronic hemodialysis, I do send people to the ER and even directly admit them. Most of the time it is no problem for me to receive information per the phone. However, I have had instances where I called and was told that they couldn't provide me with info because of HIPAA. I promptly called Risk Management at the hospital involved and they reviewed HIPAA with staff and now there is no longer an issue.

I was an EMT when the big push for HIPAA was initiated. The understanding of the regulations was so poor that there were times when we would bring a patient into the ER, leave, return a few minutes later with information we wanted to add or a bottle of pills someone had put in their pocket at the scene and forgotten to turn over, and had the desk person say, "I can't confirm or deny that Mr. X is a patient here."

"What do you mean, you can't confirm or deny. We just brought him in."

"I can't confirm or deny that Mr. X is a patient here."

"Well, here is a bottle of meds belonging to Mr. X. If he should happen by, you might want to see that he gets them."

Sheesh.

HIPAA.

If I answer the phone, and am told that you are so-and-so from X LTC, I cannot verify that you are who you state you are.

Once my patient transfers back to you, chart copies will be sent back with your resident (and care management will have spoken to your DON) and then you can follow up on QI.

For all I know, there are nasty family issues afoot with my patient, and a family member without POA is impersonating the LTC staff. When HIPAA first went into effect and was all over the news, we had a patient and their relatives try to get info out of us by any means. It was obvious they were looking to file a lawsuit, and since then, I don't give out any info to someone I haven't called. I'll be happy to call your facility back on the number I find in the phone book, but other than that? Nope.

Specializes in Med/Surg, Ortho.

thanks shark. You said it all. I am in the same situation and not every patient that goes to the hospital goes back to the LTC they left. Sometimes for very good reasons. So i dont give any info on the phone,, they can call the patients POAHC.

Specializes in Rotor EMS, Ped's ICU, CT-ICU,.
I was an EMT when the big push for HIPAA was initiated. The understanding of the regulations was so poor that there were times when we would bring a patient into the ER, leave, return a few minutes later with information we wanted to add or a bottle of pills someone had put in their pocket at the scene and forgotten to turn over, and had the desk person say, "I can't confirm or deny that Mr. X is a patient here."

Sheesh.

I agree that HIPAA was grossly misunderstood and mis-applied in it's infancy, often against the tenets of BASIC common sense.

I worked as a paramedic for several years before becoming an RN, and would occassionally transfer a patient out of the local ED to a tertiary center, and on a couple occassions the transferring RN would hand me a sealed envelope, and would freak out when I would tear the envelope open right in front of her, citing HIPAA privacy.

I couldn't believe that I would actually have to explain that I was going to care for the patient in the back of the MICU enroute to the hospital, and needed to not only be aware of all relevant details of this patient's condition, I also needed to ensure that the proper transfer paperwork was completed according to EMTALA.

Maybe she thought all I was going to do was load the patient in the back and then sit up front with my partner eating chicken sandwiches and jamming out to Tobey Keith on the way. One nurse actually said to me, "none of the other paramedics seem to have a problem with this," to which I replied, "because you intimidate them...fortunately you don't intimidate me."

HIPAA was intended to facilitate a more efficient transfer of patient data, but for several years it created more problems than it solved.

I can only imagine if that same clerk or nurse came out to the EMS charting room and asked if you had the patient's medication or an additional bit of info and you said, "I cannot confirm or deny that I transported that patient to this hospital!"

Some people take HIPAA too far. It is not a violation to verify that someone is in your unit, and the basic condition-----unless the pt or family requests otherwise.

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