This prevented the patients in the waiting room overhearing conversations taking place behind the reception desk. Reception desk was small and separated from the waiting room by a window which the receptionist closed each time they had seen a patient. Receptionist rarely asked the name of the patients, they did not ask for more information than was needed. There was a bell to ring for attention at both the reception desk and the dispensary which prevented patients from waiting at the reception desk for long periods of time. Patients were allocated a coloured number card on arrival. Receptionist's initial contact with patient/queuing area The patient asked the receptionist for a repeat prescription and informed the receptionist of both forename and surname. The practice nurse announced both the forename and surname when calling for a patient on four occasions. The receptionist asked the patient what was wrong and said that they would put them down for a visit and cancel their appointment. The patient then informed the receptionist the reason for their visit. This became apparent when they sounded surprised and asked if they were alright. The patient informed the receptionist that they had an appointment to see their GP and the receptionist seemed to know the patient. In this case the patient initiated the conversation and seemed to be comfortable talking to the receptionist about their condition. The receptionist informed the patient that they had not received the results of the test but would let them know when they had. was able to hear the concerns of the patient and there was one other patient present in the waiting room who would have been able to hear what was being said. They mentioned both their surname and address. (P4)Ī patient enquired about a set of test results and told the receptionist the condition they were enquiring about. The receptionist asked for the name telephone number of the patient and repeated them both. The patient informed the receptionist that they were there to see the nurse at 10.30 am the receptionist asked the patient for their name and the patient then responded with ‘haven't you got it down?’ The receptionist then said that they had to ask. Reasons for the appointment, name, address/phone number, date of birthĮxamples from the original observational field where patient-identifiable information was revealed during person-to-person interaction Reception and medical staff initiated (face-to-face) Type of interaction taking place when patient-identifiable information was disclosed Anonymised data were fed back to each practice. Processes and environment were analysed in the same way. The numbers of each type of patient-identifiable information disclosure were located in the data. Observational statements were themed using template analysis. New observational data were added to the schedule as they emerged. Sketches and notes were made on the location of reception systems and the physical environment. The tick box schedule covered aspects of personal and medical data separately for telephone and face-to-face interactions and context. Patient identifiable-information overheard was recorded for each patient, the latter anonymised as a case number. These were systematically logged into a pre-piloted data collection schedule. The researcher who was unknown to practice staff sat in the waiting room making observations during each ‘field’ visit.įield notes recorded details of confidentiality breaches, including instances where the patient's name was revealed in case this was linked to other information later. In al cases they chose not to disclose the specific time of the visit. Practice visits were organised in advance with the practice manager who was responsible for informing and obtaining agreement from all practice staff. Invitations were posted to practices following a presentation to practice managers. The nature of waiting rooms meant that the researcher was regarded by patients as ‘one of them’, transposing the observer into a participatory and covert role. The reception staff, although aware of the research, did not know the date or time of the visit. This was an ethnographic observational study the observer was overt and non-participatory. 3 Therefore, for the purpose of this study breaches of confidentiality were taken to mean anything that revealed more than the patient's name. The Caldicott Committee review of patient identifiable information stated, ‘all items of information which relate to an attribute of an individual should be treated as potentially capable of identifying patients and hence should be appropriately protected to safeguard confidentiality’.
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