HIPAA Regulatory Alert

Privacy hindered by not-so-private hospital rooms

Despite increasing demand for privacy surrounding health information, North American hospitals lag behind European counterparts when it comes to one of the most visible impediments to privacy — multibed hospital rooms.

"Considerable attention is paid to the privacy of health information, yet multibed rooms do not provide such privacy," wrote the authors of a recent paper published in the Journal of the American Medical Association.1

According to Michael E. Detsky, MD, and Edward Etchells, MD, both of the University of Toronto, single-bed hospital rooms were recognized as the ideal setting for patient care early in the last century; however, while patient safety, dignity, and privacy have gained attention in hospital medicine, multibed rooms have remained.

Besides providing privacy, the authors suggest, single-patient rooms inhibit the spread of nosocomial infection and reduce the need for in-hospital transfers; on the other hand, they point out, one patient per room means more walking and time for hospital staff, and new construction costs are inherent in converting from multipatient rooms to single-patient rooms.

Nonetheless, the privacy protection afforded by a private room is demanded by a health care system that prizes patient privacy.

"Patients may not share sensitive medical history, such as sexual practices or illicit drug use, in a room where strangers can listen," Detsky and Etchells wrote. "Discussions about life-sustaining treatment or a serious diagnosis with a poor prognosis are inappropriate with other parties present when separated only by curtains."

While North American hospitals lag behind, for example, in French hospitals, which have designed single-patient rooms as standard for hospitals for the last 20 years, single-patient rooms are becoming standard in new construction of medical/surgical wards and obstetrical units.

"Single-patient rooms are permanent physical features that potentially could improve safety and patient satisfaction without the need for ongoing staff training, audits, or reminders," the authors conclude.


1. Detsky ME, Etchells E. Single-patient rooms for safe patient-centered hospitals. JAMA 2008;300:954-956.