Surprised Not All Hospitals Have All Private Rooms

[NotUrsula]

WHAT?? Where are you? We're required to offer privacy to the patient when THEIR OWN guests are in the room. And there are no patient names posted ANYWHERE in public viewing...

I'm amazed how different HIPAA is treated in different hospitals.

A 500-bed regional medical center in the midwest, a teaching hospital for one of the top 15 US medical schools. According to HHS , putting patient's names on doors is still perfectly fine.

A hospital customarily displays patients' names next to the door of the hospital rooms that they occupy. Will the HIPAA Privacy Rule allow the hospital to continue this practice?
Answer:
The Privacy Rule explicitly permits certain incidental disclosures that occur as a by-product of an otherwise permitted disclosure—for example, the disclosure to other patients in a waiting room of the identity of the person whose name is called. In this case, disclosure of patient names by posting on the wall is permitted by the Privacy Rule, if the use or disclosure is for treatment (for example, to ensure that patient care is provided to the correct individual) or health care operations purposes (for example, as a service for patients and their families). The disclosure of such information to other persons (such as other visitors) that will likely also occur due to the posting is an incidental disclosure.

Incidental disclosures are permitted only to the extent that the covered entity has applied reasonable and appropriate safeguards and implemented the minimum necessary standard, where appropriate.See our section on Incidental Uses and Disclosures. In this case, it would appear that the disclosure of names is the minimum necessary for the purposes of the permitted uses or disclosures described above, and there do not appear to be additional safeguards that would be reasonable to take in these circumstances. However, each covered entity must evaluate what measures are reasonable and appropriate in its environment.Covered entitiesmay tailor measures to their particular circumstances.

http://www.hhs.gov/ocr/privacy/hipaa/faq/safeguards/202.html

 

[indimom]

Wow. We've gone for complete overkill. lol. I wonder if they've gone this far because we're a smaller rural hospital? Everyone knows everyone. So it's not just a name on a door, it's your neighbor, teacher, softball coach?
Either way, I clearly need to read a bit deeper into the policy.

 

[goodstarr]

I work maternity at a very old hospital. When I was first hired, all room were doubles, with two being pay for "privates". Partners weren't ever allowed to stay at night.

Then dads started spending the night if the mom didn't have a roommate (but if she did, some would leave without issue but others would refuse and may be allowed to stay in the room or in our lounge).

Recently, all maternity rooms were made singles, with chairs that convert to sofas. About the same amount of partners stay, but patients are much happier (as well as the staff. These rooms are the same size and used to have two patients, two babies and tons of visitors - plus one or two nurses).

The rest of the medical/surgical rooms are doubles with the exceptions of "paid privates".
We are in a large, major city.

 

[Pea-n-Me]

Difficult as that was, it was much better than the first roommate I had, a schizophrenic older lady who had a serious heart condition. She screamed, threw things, and routinely bit every medical professional who came near her. After two days of that, my DH put on his attorney suit and went to bat for me with the charge nurse. Several hours later, a team of nurses showed up in the middle of the night and rolled me and my things out of there in about 5 minutes flat.

We move people who request to be moved, who are unhappy and/or, as in this case, in an unsafe situation, no matter who requests it, as space allows. Often it occurs at night after patients are discharged and rooms are cleaned.

 

[jen0610]

The 2 hospitals DH was in here local, both had private rooms. The one hospital is older and you can tell they haven't quite gotten around to renovating all the rooms. The other hospital, is brand new and holy cow is it NICE!!!! The rooms are spacious, have nice huge flat screen TV's for the patient, plus a smaller flat screen TV for visitors. Pull out love seat to bed options. Nice recliners. Nice restrooms set up in the rooms. I will say this, the newer hospital, in all the rooms that DH was in, there were the plugs and ports and air valves for a 2nd bed to be there, in case of extreme need for lots of extra beds.

And don't get me started on this hospitals café. You know they have good food, when you are willing to just go to the hospital to get something to eat there.

The hospital out of town that DH was sent to, on the other hand, they are in desperate need for updates. Very few private rooms and most of them haven't been updated unless your in the step down ward from ICU. Very cramped rooms with the 2 beds. The shower is shared between the two adjoining rooms.

And don't get me start on this hospitals café. And it's for all the wrong reasons. When they close for the day at 4 pm, you know it's not going to be a fun trying to eat meals.

 

[morgan98]

I have been a nurse for 21 yrs. In the beginning of my career we had all double rooms. On our cancer floor they were all private. I think about 5yrs into my career all the rooms were all private. I live on Omaha,Ne and we have a huge medical center and a very nice Childrens hospital that are all private as well as all of our other hospitals. You should see the birthing suites. Better than staying at the GF at WDW.

I don't have a horse in this race, but my husband has extensive health care experience and currently visits hospitals across the United States. So this is where some of my background is coming from.

We have several threads on the boards about the cost of Healthcare, insurance, etc. I am not going to argue that the prices for certain drugs and procedures are out of control and that for many health insurance is still a burden. However, newer hospitals and medical facilities are like a four star hotel with private suites, hardwood floors, snacks for guests. These capital costs also are a function of what drives expenses. Of course we want everything to be the nicest, newest, nothing but the best but it does come with a price.

When we compare ourselves to healthcare, say in Europe, in many instances their facilities are nowhere near as luxurious as ours (at least from the three separate hospitals I have seen in the past 10 years visiting relatives in Italy).

People can talk about patience privacy, etc. and I am not saying that is not a concern. However, many of us were born to mothers who shared a plain room in a hospital and we still received good care.

Just some thoughts...sorry for the interruption.

 

[jen0610]

WHAT?? Where are you? We're required to offer privacy to the patient when THEIR OWN guests are in the room. And there are no patient names posted ANYWHERE in public viewing...

I'm amazed how different HIPAA is treated in different hospitals.

A 500-bed regional medical center in the midwest, a teaching hospital for one of the top 15 US medical schools. According to HHS , putting patient's names on doors is still perfectly fine.

http://www.hhs.gov/ocr/privacy/hipaa/faq/safeguards/202.html

The hospital that DH was in that was out of town was a Teaching Hospital on the campus of a university. His name was not only on the door, but also on the big board right there at the nurses station. You had to walk past it to get to and from the rooms to the elevator.

And when the dr's came in, there was no privacy. We heard every discussion that they had with the 4 different room mates that he had over two different stays.

 

[bigbabyblues]

The local hospital I worked for had mostly two-person rooms for adults, but you could request (and pay out of pocket for) a private room, if one was available. ICU, Peds, and Maternity were private.

The hospital we use, which is about an hour away and much larger, has mostly private rooms, but the rooms are very small.

 

[Pooh2]

Our local hospital built a new wing with private rooms for orthopedics but most of the other wings are still shared rooms.
Definitely not fun having to deal with strangers and their guests and noises just a few feet from you when you are feeling awful.

 

[aprilgail]

WHAT?? Where are you? We're required to offer privacy to the patient when THEIR OWN guests are in the room. And there are no patient names posted ANYWHERE in public viewing...

I'm amazed how different HIPAA is treated in different hospitals.

The last names of the patients are on the wall right outside each door- and also on a big board in the nurses station which is right in the hallway. When your room mates Dr comes in they pull the curtain around them and the room mate and then talk like no one else is there- I was visiting a friend recently an knew every issue his room mate had because it was hard not to!

 

[Pea-n-Me]

I don't have a horse in this race, but my husband has extensive health care experience and currently visits hospitals across the United States. So this is where some of my background is coming from.

We have several threads on the boards about the cost of Healthcare, insurance, etc. I am not going to argue that the prices for certain drugs and procedures are out of control and that for many health insurance is still a burden. However, newer hospitals and medical facilities are like a four star hotel with private suites, hardwood floors, snacks for guests. These capital costs also are a function of what drives expenses. Of course we want everything to be the nicest, newest, nothing but the best but it does come with a price.

When we compare ourselves to healthcare, say in Europe, in many instances their facilities are nowhere near as luxurious as ours (at least from the three separate hospitals I have seen in the past 10 years visiting relatives in Italy).

People can talk about patience privacy, etc. and I am not saying that is not a concern. However, many of us were born to mothers who shared a plain room in a hospital and we still received good care.

Just some thoughts...sorry for the interruption.

Thirty one years working in hospitals.

It is about customer service today. Hospitals are in competition with other hospitals for patients, pure and simple. Consumers want to go to the place where they will not only have the best results, but the best experience for themseves and their families. And this goes double for hospitals that are in undesirable locations, like big cities, where there is heavy traffic and expensive parking. So having nice facilities is a must today when there are lots of other choices for consumers.

If patients don't come, those hospitals will close, so it's do or die.

Not sure it's what's driving up health care costs (lots of blame to go around there), but whatever, just wanted to give this perspective from the institution's standpoint.

 

[morgan98]

Thirty one years working in hospitals.

It is about customer service today. Hospitals are in competition with other hospitals for patients, pure and simple. Consumers want to go to the place where they will not only have the best results, but the best experience for themseves and their families. And this goes double for hospitals that are in undesirable locations, like big cities, where there is heavy traffic and expensive parking. So having nice facilities is a must today when there are lots of other choices for consumers.

If patients don't come, those hospitals will close, so it's do or die.

Not sure it's what's driving up health care costs (lots of blame to go around there), but whatever, just wanted to give this perspective from the institution's standpoint.

I absolutely understand that it is all about competition and when my husband was at a community hospital inside the perimeter here is Atlanta, they lost many patients to the "sexier" hospitals in the "nicer" part of town even if the care was not necessarily better.

However, all of these capital improvements are being paid for from somewhere. And waterfalls in lobby's and those types of things are expensive and not really critical to care. Money is finite. We are paying for this too.

 

[Pea-n-Me]

Well maybe people enjoy waterfalls. I know I do.

 

[Pea-n-Me]

In many cases, improvements are not only "nice", but necessary.

Years ago, when many hospitals were built, there weren't computers and technology like there is today. Rooms are crowded with all the technological "stuff" that has to go in there now. Definitely not designed for that in the past, whereas new rooms are. Plus, the family-centered care that I mentioned before. There is evidence-based research that shows that patients do better with their loved ones nearby. So making space for loved ones makes sense for good care. Today. What is seen by some as extravagant is really just a necessity in today's world.

Also, years ago, complementary therapies were also unheard of, but today, they are incorporated into practice and environments. So water features like a fish tank or a waterfall may actually help people lower their stress loads during a hospitalization, therefore it's an expense that makes sense. I don't think it's fair to blame improvements for driving up the cost of care. It's just part of the costs of doing business today.

 

[NFLDERS]

Private for maternity but still shared in the general hospital. I was only in the hospital once for a non-maternity issue and it was a nightmare. Had to have my gallbladder out 6 weeks post partum with my first. I was in the ER for 7 hours in pain before a bed opened up in a room. They finally wheeled me to my room around midnight only to find the other occupants husband sleeping in the bed that was for me. He said since it was empty he was going to make himself at home. I then spent another hour just laying in the bed outside the hallway while they called housekeeping to clean the area again and remake the bed. I was by the window, his wife by the bathroom. He insisted on staying so they gave him a foldout chair/bed which he put at the foot of his wifes bed, completely blocking my access to the bathroom. When I woke him up so I could get to the bathroom at 3 am he was mad at me!

What a moron, and how horrible for you.

 

[Pea-n-Me]

Top Ten Considerations When Renovating Patient Towers

http://mcdmag.com/2014/01/top-10-considerations-when-renovating-patient-towers/#.VhWXB1r3arU

Besides the technology and famiy considerations I mentioned above, they also mention infection control practices, logistics, patient safety concerns, etc - all things that were always important but are of utmost imporance today; actually mandated.

 

[Wendy31]

I think both major hospitals here are all private rooms - at least, whenever I've been in the hospital (3 pregnancies, 2 different hospitals) & whenever I've visited someone, the rooms have all been private.

ER rooms are different.

 

[mjkacmom]

Thirty one years working in hospitals.

It is about customer service today. Hospitals are in competition with other hospitals for patients, pure and simple. Consumers want to go to the place where they will not only have the best results, but the best experience for themseves and their families. And this goes double for hospitals that are in undesirable locations, like big cities, where there is heavy traffic and expensive parking. So having nice facilities is a must today when there are lots of other choices for consumers.

If patients don't come, those hospitals will close, so it's do or die.

Not sure it's what's driving up health care costs (lots of blame to go around there), but whatever, just wanted to give this perspective from the institution's standpoint.

Unfortunately have had a lot of experience with hospitals and medical centers, and yes, customer service is key! Ds12 was taken by ambulance to a pediatric trauma center in a very urban area. However, only a mile or so from the highway, and once inside? Fabulous. And the level of care was outstanding. My moms cancer center is unbelievable, as is the hospital it's attached to. It's moving in the right direction. The problem the staff seem to have is not being able to spend enough time with patients.

 

[MrsJackSparrow4Life]

I work for a hospital and they went private rooms about 5 years ago. The only exception to this is the inpatient behavioral health unit, that had 3-4 beds per room and about 9 rooms.

 

[Pea-n-Me]

Unfortunately have had a lot of experience with hospitals and medical centers, and yes, customer service is key! Ds12 was taken by ambulance to a pediatric trauma center in a very urban area. However, only a mile or so from the highway, and once inside? Fabulous. And the level of care was outstanding. My moms cancer center is unbelievable, as is the hospital it's attached to. It's moving in the right direction. The problem the staff seem to have is not being able to spend enough time with patients.

True, a beautiful facility doesn't do you much good if the staffing ratios are horrible.

Have been on the other side myself, too. Last fall I had a hysterectomy/oopherectomy/salpingectomy/cystoscopy and was supposed to be discharged the same day. Anyway, couldn't pee on my own so had to stay overnight. Was in an "overnight ward" with SEVEN other paitents! And the peachy lady brought up at 2am and placed right next to me was the same one that was obnoxious and swearing at staff hours eariler in post op. Since I was not in my own hospital I was tempted to tell her to... well, never mind. (But I was good and bit my tongue. ) Nurse came in early to take the catheter out. I got up on my own, nobody noticed, peed, then texted my DD to come get me the hell out of there - she was a sight for sore eyes when she rounded the corner with two Dunkin Donut coffees in hand! I really didn't realize that there WERE still wards with SEVEN other people around, who knew! Looking at it that way, I guess one roommate doesn't seem so bad.