ED Patients in the Hallway

[dingerzz, BSN, RN, EMT-P]

I work in a busy ED. However, we are frequently full and this causes some patients in their beds to be lined up in the hallway. Are there any HIPAA issues in doing this? It's bad enough that these patients have no privacy and their dignity is decreased. But, I was wondering if there may be HIPAA/privacy issues in doing this.

[Dobieb2009]

We have had to do this too. I liken it to double bedded rooms. Is an admission interview private when there's a pt in the other bed? We used to pull the "magic" curtain, and pretend they couldn't hear. They also see one another as they go to the bathroom, or testing. One way we treated at least the privacy problem was to have curtains installed outside the nurses station, where we parked the pt's. No good answer; haven't had any HIPPA complaints

[Rose_Queen, BSN, MSN, RN]

Here's a quote from a previous thread about this issue:

Rock ... paper ... scissors ... EMTALA beats HIPAA? OK, I'm being silly, but ...

In all seriousness, you do what you gotta do to treat the patient. In my ED if it's between 9:30am and midnight, I can virtually guarantee that all our beds are full. Newly arrived patients who cannot wait *must* be juggled, and that means using any and every available hallway space. No more nor less a HIPAA issue than any curtained area, a chair area, a semi-private inpatient room, a pre-op holding area, PACU or open ward-style ICU environment. Or the open concept floor plan I've seen in a distressing number of dentists' offices ... (don't get me started).

The gilded age of all patient care areas being truly private may yet appear on the horizon, but it's certainly not here yet.

Considering that there are many instances of shared rooms, curtained bays, and other areas where patients do not have their own room, this may not be much different. After all, if it were truly an issue, it would not be permitted to happen at all by regulatory agencies.

[iluvivt, BSN, RN]

No it is not a violation of.HIPAA. You do not want to impede quality care so it must be done at times. You do however, want to think about some safeguards that are specific to each situation. Try and minimize incidental exposure by talking softly, be careful with computer screens and other paperwork that can be seen by others and use of privacy screens.I would also limit the visitors allowed in when the ED is that packed.