Question from the Road: Where's the Chart?!!
QUESTION FROM THE ROAD: WHERE'S THE CHART?!!!
I recently conducted a disclosure training seminar for a long-term care provider, which included role playing and discussing scenarios. During one of the role plays, a senior team member, playing the role of upset family member, started pelting her colleagues, who were trying to disclose to her, with the following questions: "Where's my Dad's chart? I want to see the chart! When can I see it? I need to see it....RIGHT.....NOW!!"
The senior team member turned to the crowd (her colleagues) and said that is the one question we get all the time when trying to talk to an upset family or resident. They want to see the chart and see it right now! Her colleagues all nodded in agreement. I'm sure the same is true in all healthcare settings, including hospitals and physician practices. Families want to know, and know....RIGHT...NOW!
What do you do? Of course, there are HIPAA concerns -- is this family member actually entitled to see the chart? Screw up here and you have a different and expensive problem to deal with. Maybe the patient doesn't want his crazy uncle from California seeing his chart. But, if you look like you are stonewalling or hiding the football - "No, you can't see chart...I'm not sure we can give it to you....it would take awhile for us to get the chart to you" and you start creating a different problem. Any perception of stonewalling - real or imaginary - will almost always create the impression with family members that you are monkeying with the chart. It will put a cloud of suspicion over everything you say or do downstream, especially if you later report that the event was NOT caused by error. "Sure, they doctored the chart while they were hiding it from us!" will be the retort.
So, what did we discuss during that role play? What did the group say was the best way to handle this tricky situation?
Short answer: Continue to be proactive while following the law.
If the family member can legitimately prove they are entitled to the chart, turn it over as quickly as possible. Don't play games. Not worth it!
If the family member doesn't have proof they are entitled to the chart, don't use phrases that include words like "no" or "you can't have it" or be off putting in any way. Instead, calmly explain that privacy laws require proof that a family member is entitled to the chart and show them what documents they need to produce, and, if possible, try to assist them. Perhaps provide a small "cheat sheet" citing the law requiring proof (in case they land in a lawyer's office) and what documents are needed to show a family member has a right to see the chart in question. Just as importantly, try to shift the conversation to things you can do right now with service recovery items such as food, transportation, phone calls, lodging, and other forms of immediate help you can provide that shows you do care, you are empathetic, and are trying to help as opposed to be an obstacle. Maybe it's just listening to their problems and acknowleging how upset they are. Keep the conversation going and the relationship alive!
To get help with disclosure training, call Sorry Works! at 618-559-8168 or e-mail firstname.lastname@example.org
Doug Wojcieszak, Founder Sorry Works! PO Box 531 Glen Carbon, IL 62034 618-559-8168