Patient Bill of Rights
Rationale: Patients may feel overwhelmed at times with the healthcare system. Patients can feel as if they are being taken advantage of. It is important to inform the patient that they do have rights, and are protected at every step of the way. The patient bill of rights in the United States is a federally protected set of laws that offer people the ability to select the physician of their choice, have confidential treatment that protects their records and information, refuse any medical treatment they do not want, the right to be completely informed about their current condition, the right to informed consent, receive complete disclosure of their insurance in laymen terms that are easily understood, and a number of other rights are included as well. In the event that a patient is having trouble understanding their rights, patient advocates are either available in the facility you work at or in a nearby city, and should be able to help them navigate the more complicated portions of the law.
Rationale: Not all examinations are without risk. Venipuncture is relatively risk free, it may need to be repeated if you miss a vein, but generally the worst that can happen is some bruising from hematoma. However, if a patient is going to be taken to surgery or another type of invasive examination, there is an extensive amount of paperwork that needs to be accounted for. Arguably, the most important form for the patient is the informed consent. This details the risks behind the exam, and the expected outcomes. Physicians typically inform the patient about complex procedures and surgeries. But, depending on the physician, the medical assistant may be responsible for informing the patient about the procedure and obtaining the proper consent. But, the informed consent may be revoked at any time by the patient after the document has been signed. This protects the patient so that they have an opportunity to rethink their choices at any time and make a selection that leaves them comfortable.
Consolidated Omnibus Budget Reconciliation Act
Rationale: The right to health care is a subject of much debate in the United States at the present. There have been many attempts by the government to produce a lasting and all-encompassing law that will protect its people in this way. However, at this present time, there are only a few laws and systems that work in concert to provide those without insurance the medical protection they need. Medicaid and Medicare are two government provided services that honor health care to those of meager financial situations or ages above 65, among other things. COBRA, or the Consolidated Omnibus Budget Reconciliation Act, is a federal regulation set in place that hold medical institutions responsible and liable for refusing to provide care for those that cannot afford it. The organization EMTALA, Emergency Medical Treatment and Active Labor Act, requires that Medicare-participating hospitals screen and/or attempt to transfer anyone in an emergency medical condition.
Rationale: Just because a patient visits an urgent care, hospital, even an emergency room, does not mean that the patient must submit to the care of that institution, as long as they are of sound mind. This right also protects the patient in another capacity. If the patient is not of sound mind, they cannot refuse the care being provided by the physician. This does take some judgment on the side of the physicians, and legally can be a sticky slope, which is why extensive amounts of paperwork must be filled out if this becomes an issue. A patient can be considered to be in an altered mental status if they are under the influence of alcohol or drugs, and if they have received some type of brain trauma or have been diagnosed with a mental illness. In the event of life-ending situations, a DNR clause can be placed in a patient’s chart. DNR stands for Do Not Resuscitate. However, these stipulations must be made while the patient is lucid, and in their right mind.
Health Insurance Portability and Accountability Act
Rationale: The Health Insurance Portability and Accountability Act of 1996, also known as the HIPAA Privacy Rule, gives patients federal protection over their medical records, personal information, and any other details that are given during their stay in a medical facility. However, it does allow disclosure of that same medical information as long as it pertains directly to the patient care of the individual being treated. This is one of the most sensitive areas of any medical professional’s job. You must be constantly aware of how you are talking about your patients, and where you are talking about them. You should always respect the privacy of the patient. For example, the patient confides in you a personal, embarrassing story about the origin of their condition. And, thinking it is funny, you share this story with a co-worker. This is in a direct violation of the privacy act, and is usually punishable by immediate termination from your position.
Rationale: Medical malpractice is considered professional negligence that is determined as being the source of harm that befalls a patient thru lack of knowledge, skill, or experience. Medical malpractice is one of the primary reasons that physicians, hospitals, and medical personnel all carry with them a substantial amount of insurance coverage. It is an area of healthcare that is a worst case scenario, but these circumstances to come up. This is one of the main reasons why we must always stay up-to-date on all of our professional skill sets so that we never endanger the patient. All medical facilities have a moment during examinations and procedures called a “time out”. This requires that everyone stop what they are doing, and reassess the current situation before proceeding with the patient’s care.
Rationale: There are many laws that protect the privacy of the patient, and demand confidentiality of the medical professionals providing treatment for the patient. But confidentiality, as with most things in the medical field, has its limitations. Those limitations arise whenever the health and well-being of the patient has been called into question. If the patient is at risk of harming themselves or others, it is the obligation of the medical professionals to contact law enforcement, regardless of how the information came into play. Child abuse is an extremely critical subject in all medical facilities, especially emergency rooms. All suspected child abuse cases must be reported immediately, or you as the medical professional could stand to face criminal charges. If patient information must be released, the appropriate documentation will need to follow it expressing what circumstances allowed its transferral.
Protected Health Information
Rationale: In the modern day and age, a majority of the patient information obtained is either converted to or entered in a digital fashion. This includes everything from lab results, prescriptions, to diagnostic imaging and patient histories. HIPAA protection extends itself to the digital age with a special acronym, PHI. PHI stands for Protected Health Information. PHI stands for any patient information recorded in any form for the health of the individual by any health system, at any time. This modification to the HIPAA laws was critical to giving the people the protection of their personal information in any capacity. There are unique sets of protection that must be installed to protect against piracy of such private information. It is a current struggle of modern medical institutions to continue upgrading these safeguards to optimize the protection of their patients.
Rationale: There are circumstances that arise in the care of a patient where their restraint is required to protect the patient from themselves. The most common circumstance is when a patient has been intubated or is currently receiving intravenous medications. If the patient is in a state of altered mental status, they may not be totally aware of what they are doing at any moment. If they are to regain consciousness, and begin pulling out tubes and lines, this would drastically compromise the care they are receiving. If restraint is required, physicians must sign off on a restraint necessity form on a regular basis, and the patient’s status must be reviewed with each update. If those forms are not updated, or if the physician is not made aware of the restraint, a substantial lawsuit could be waiting for the hospital. False imprisonment is the concept of restraining an individual without a patient’s previous consent or without medical justification.
Rationale: Abandonment is considered the unethical withdrawal of care without appropriate transfer or discharge of a patient. Physicians have the right to choose which patients that they will treat, however, they can be held liable if something happens to the patient if they do refuse. Because of this, the physician must make every attempt to offer optimal care for priority patients, such as those in emergency situations. If the physicians find themselves in a situation that cannot house another patient, such as a full emergency room, then they must contact another medical facility to find boarding for the patient. That being said, once the physician has accepted the responsibility of caring for the patient, that treatment cannot be transferred until the patient no longer has the illness or malady they were diagnosed with.