Medical records clerk came into work while on leave and checked relative's records
This instalment of You Make the Call features a hospital employee who overstepped a hospital’s boundaries of confidentiality.
Lori Priest was a health records clerk working in the medical records department of a hospital run by the Saskatchewan Association of Health Organizations in Lloydminster, Sask. She was originally hired in 2005 and joined the hospital in 2007. As part of her job, Priest signed a code of confidentiality that recognized the “right to total privacy” for clients, residents and patients. The records department had similar confidentiality rules of which she was made aware of when she started work.
On July 17, 2008, Priest went on maternity leave, about two weeks before the baby was due. A few days later, on July 22, Priest learned that her husband’s cousin had been in a serious car accident and had been transported to Saskatoon for major surgery. She was asked to relay news of the accident to the cousin’s grandfather.
On the way to the grandfather’s, Priest stopped by the cousin’s home and saw a bag of his bloody clothes. This rattled her and she dropped in to the medical records department.
Once in the department, Priest saw the cousin’s medical chart on a desk and started reading it. Two co-workers told her she shouldn’t be looking at the information but Priest continued to read. One said their manager, who was out of the office, would be upset if she knew, but Priest said the manager wasn’t around.
When the manager returned to the office a week later, she heard about the incident and conducted an investigation. She met with Priest, who acknowledged she had come in and read the chart to see if there was anything she hadn’t already been told by the family. She claimed she had already read the chart by the time anyone told her to stop.
The hospital decided to terminate Priest’s employment for a breach of confidentiality and a violation of the Saskatchewan Health Information Protection Act, which it considered gross misconduct that fell outside its policy of progressive discipline. It called another meeting with her on Aug. 19, 2008. At the meeting, Priest presented a lengthy letter of apology that explained she was under emotional stress because of the accident, health issues from her pregnancy and her brother’s upcoming wedding and she wasn’t thinking clearly. She pointed out she had no previous discipline and the family wouldn’t have had a problem with her checking the information. She also claimed other workers in the department often checked various medical charts without punishment and should also be held accountable.
You Make the Call
Should Priest have been fired for violating the confidentiality rules?
OR
Was dismissal too severe under the circumstances?
If you said dismissal was too severe, you’re right. The arbitration board recognized the violation of the hospital’s confidentiality rules and health information protection legislation was very serious and Priest was aware of the rules. It also found her “unprovoked, intentional, premeditated act” of walking into the health records department while she was on leave to do so was “troubling.” In addition, the board felt Priest didn’t show sincere remorse: Though she apologized, she also deflected part of the blame on the hospital not holding others accountable for similar misconduct.
However, the board found Priest’s motivation was to assist family in a time of need, there was no evidence of harm to the patient and it was for a limited purpose. This allowed for some variation in the consequences for her misconduct.
