Accreditation

Tip of the Week: Four tips for guarding paper records

Accreditation Connection, June 13, 2005

Although some hospitals have already gone electronic, there are still plenty of organizations that rely on paper records.

Sgt. Stephen Butler, a detective with the Indianapolis Police Department who has also worked as a security consultant for hospitals, suggests the following four tips for guarding paper records:

1. If clinicians or billing workers handle paper with patient information on it, make sure they protect these records

"Keep those papers locked up," Butler says. "Don't leave them lying out for the general public or cleaning crews. At the very least, put paper records in a file drawer."

From the perspective of a would-be thief, it is far easier and quicker to steal patient information from someone's desk than to risk being caught snooping through a filing cabinet, he says. Along those lines, double-check how and when you lock doors. Consider external entries as well as doors to areas within the building.

2. Shred patient records before disposing of them

"Shred, shred, and shred--that's the simple answer," says Butler. "Saturate the environment with these shredders. Make it simple and brainless."

"You can buy a shredder for less than $50," he says. It's much harder to glean patient information from medical documents once a machine slices them up. Two areas that hospitals trip up on with shredding are worker training and ongoing monitoring.

For example, some sites use large bins to store paper awaiting the shredder. Train workers to keep those bins locked, because an open container may invite a thief. Someone must frequently empty the bins, because if they're too full, people will simply stack documents next to them, which defeats the purpose, Butler says.

Security officers, maintenance workers, and housekeepers can check on these items as they make their rounds and report problems to the appropriate personnel.

3. Conduct background checks on employees who will handle patient information

Although they may be a big upfront expense, background checks are a worthy effort, Butler says.

"I highly suggest using reputable background investigations before hiring someone," he says. "You get what you pay for. You don't find swans in the sewer."

4. Security measures apply to patient information

When you review your hospital's building-security plan, you'll find that these concerns also affect the hospital's ability to protect patient records. Butler suggests asking your self the following questions:

  • What types of locks do you use (such as keys, key cards, keypads, combination locks, proximity-card locks,  biometrics-controlled locks)?
  • Does every external door feature a lock?
  • Are there entries that don't have locks? Why?
  • Do you know where the locks are installed? Is there an accurate diagram with this information?
  • Do loading docks have secure entries? If they are open, is an employee always present?
  • How do you determine authorization for access to sensitive areas after hours?
  • Who has access after hours and for what purposes?
  • Are any locks on timers for after-hours control?
  • How do you control access to stairwells and elevators?
  • Besides locks, what other steps does the hospital take for security (such as cameras and security officers)?
  • Do you have adequate protection for internal high-risk areas (such as the laboratory, pharmacy,  medical-records room, computer room, and data closets)?

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