Daniel J. Weissburg (dweissburg@ucsd.edu) is Chief Compliance and Privacy Officer and Marilyn L. Shanks-Dizard (mshanksdizard@ucsd.edu) is Senior Privacy Analyst at UC San Diego Health in La Jolla, CA.
An observer may be defined as an individual who visits a hosting healthcare entity for a set period of time, under that entity’s supervision, to shadow patient care and/or clinical operations. Observers may witness patient care, but observers are not authorized to participate in patient care. This article offers guiding principles behind a tailored observer program designed to allow an entity to host visiting observers while also safeguarding the entity and patients by putting proper policies and protocols in place.
Consider the following scenario
Seventeen-year-old Sarah looks around the crowded waiting room as she patiently awaits her opportunity to observe her uncle, the chief of surgery. Sarah is excited to observe, because she is attending college next year, and she is interested in studying to become a surgeon. While she waits, Sarah feels the energy of the bustle of the surgical staff. In the distance, she sees a slender man in a white coat rushing down the hall and two nurses quickly typing away at work stations. Over the rustling of magazines, Sarah hears her name called. A nurse in blue scrubs, with a stethoscope loosely tossed around her neck, greets Sarah and escorts her to the procedure room. “I am one step closer to my future,” Sarah thinks as she slips into her assigned scrubs and proudly displays her “observer” ID badge, front and center.
The care team files into the operating room. Sarah sits quietly in the corner observing without receiving a second glance. The surgery begins, and the care team works together in perfect harmony. “How fascinating,” Sarah thinks. Suddenly, between two nurses, Sarah sees the patient’s removed spleen in the physician’s hands. With the mindset of any typical 17-year-old, Sarah is determined to share this unbelievable experience with her online friends. With the same agility and accuracy as the surgeon, Sarah whips out her phone and captures a picture of the operation. The splenectomy ends quickly, and the care team departs without acknowledging Sarah.
As Sarah walks to her car, she giddily posts her picture on social media, which, for an employee, would be a terminal offense. Looking at the picture, Sarah revels in the fact that the spleen is in full display over the patient’s unconscious body. “My friends at school are not going to believe this!”
