Keeping records confidential is not tough

Outpatient facilities sometimes struggle with how far they should go to keep records and patient information confidential. According to two accreditation organizations, they often err on the side of caution because maintaining confidentiality is easier than it seems.

For example, outpatient facility directors sometimes mistakenly think they cannot keep open files or they must not use sign-up sheets or white boards that list cases, says Ann Kobs, MS, RN, former director of the department of standards and current sentinel event specialist for the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL.

"I’ve had people tell me they’ve been told to put gates with padlocks across filing cabinets. But it’s not necessary, she explains.

Facility directors also often express concern over the evening cleaning staff having access to files. But this is why you have them sign confidentiality statements, Kobs says. Likewise, facilities may use sign-in sheets that include the patient’s name, the patient’s physician, and the time, she explains.

Also, facilities may use white boards for tracking cases. "Just don’t put the procedure on it, and if the patient says I don’t want my name displayed,’ then they have to leave it off," Kobs says.

The Accreditation Association for Ambulatory Health Care in Skokie, IL, requires facilities to keep unauthorized people from looking at files. And files should be protected while the office is open by having personnel near the files and able to block access, says Cathy Holmgren, RN, MBA, executive deputy director of AAAHC.

"There should be a safe and secure disposal of the records, and if they put records in archives, there should be a confidentiality control over them," she says.

She recalls one case in which an outpatient organization had a policy that all documents older than five years old were destroyed through shredding. "We thought that was over the top, but they said, We’re in a really small community, and we don’t want this information even sitting in a landfill.’ We wouldn’t require that of everybody."