sharing news over the phone

[kat82]

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Hi all-
How do you go about sharing bad news about a patient over the phone? We have had quite a few deaths recently and this issue keeps coming up. Specifically with trauma and/or unidentified victims of trauma.

Regarding death:
When a family member calls, I will usually share all of the bad news if they are too far to come to the hospital (ie, out of state). If they are within range of the hospital they usually will come in on their own and I'll share the news in person. What do you do when the family member is within driving range but wants to know over the phone?

Regarding other serious illness:
I will more willingly share over the phone with family/friends the patient is in serious condition and ask them come to the hospital for more information (unless they can't then I'll share more detail if I trust it is a close family member)

Regarding unidentified victims of trauma:
I usually defer to the police until the patient is identified. We had a recent death where it took hours to officially ID the body. There was a slew of family members at the hospital wanting to know if it was their loved one that had died. After speaking to legal we were told we could allow them to see the patient if we believed in good faith it was their loved one.

What are the laws regarding sharing health info over the phone? All I have found so far is this:
http://www.hhs.gov/hipaa/for-indivi...-my-health-information-with-family/index.html

 

[Arcan57]

I think most of us do some variation on your approach. If they can come to the hospital then I wait to tell them. If they insist on knowing prior to coming, I'll confirm that they're not currently driving and inform them of the death. If the patient isn't dead then I'll give general impression of condition and make them either come in or get the info secondhand from someone that can come. Haven't had to deal with unidentified trauma pt recently but would probably turf to police for ID.

 

[WilcoWorld]

My understanding is that in most states if the patient has the ability to grant permission than you should ask. However, if the patient can not grant or withhold permission than it is assumed that you may give basic information (e.g.: he's in the ICU and he's alive) to somebody on a phone claiming to be a family member.

 

[EM Junkie]

I had to tell a guy over the phone that his ex wife and kid were dead after an MVA with an impaired driver, and his other kid was going to the PICU with a non survivable head trauma. He was in Africa on business. We had the kid's uncle in the ED "pave the way", and ensured dad was in a safe place before we told him, but we had to tell him. The worst part of it was the third kid from the wreck came in hours later by ground ambulance as a trauma transfer. She was wearing a seatbelt and had no injuries. The other kids were unrestrained.