CALL ME BY YOUR NAME. Protected patient: Reflections on removing the patient's name in Patient Safety

Romera, A.; Garrido, A.; Lema, M.; Contreras, A.M.

doi:10.1016/j.redare.2019.02.005

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Protected patient: Reflections on removing the patient's name in Patient Safety" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "350" "paginaFinal" => "351" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Romera, A. Garrido, M. Lema, A.M. Contreras" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Romera" "email" => array:1 [ 0 => "andreilla111@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Garrido" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Lema" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A.M." "apellidos" => "Contreras" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Médico Adjunto, Servicio de Anestesiología, Reanimación y Terapéutica del Dolor del Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Abogada, Legalex Abogados, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding authors at: C/ Rodríguez San Pedro 72. CP, Madrid, 28015, Spain, Tel.: +606642609 /915430966" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "CALL ME BY YOUR NAME. Paciente protegido: reflexiones sobre lo que implica privar del nombre propio para la Seguridad del Paciente" ] ] "textoCompleto" => "We are writing to you in our capacity as Safety Auditors in Anaesthesia, to comment on the safety implications derived from a name. These issues arise from 2 critical incidents in twin paediatric patients whose identity had been voluntarily concealed by their legal guardian, and who were identified by the terms protected, protected followed by a case history number. The case history number written on the wristband did not correspond to either patient, but to his brother. In both cases, the surgical check list had been completed correctly,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> except for the part where the patient's name should be filled in. The patients, with incorrect case history numbers, underwent surgical procedures. They were not injured, but the potential for injury (surgery, diagnoses and wrong medical treatments) is unquestionable.The analysis of this incident is complex, and requires some clarifications:- Patients admitted to hospital are usually identified by means of 3 details: full name, date of birth and sex. This system is very effective, not only because of the synergy of the three details (it is almost impossible for 2 patients to coincide in each and every one of these categories), but because these data are personal. Private. Unique. They belong to the patient more than any other identification code ever can. Thus, if a patient is assigned a name that is not theirs, he or she will, in most cases, be easily spot the mistake and thus prevent the medical error.- Although only common in 3 specific scenarios – cases of mistreatment, persons of public interest, hospital employees – all patients admitted to the hospital have the right to request that their identity be concealed. In this regard, they are protected by the Spanish Data Protection Act 15/1999, and Organic Law 3/2018, which calls for the protection of the fundamental rights of individuals, especially their honour and personal and family privacy. To this end, the Spanish health system has created so-called Anonymisation Procedures, which allow personal data to be processed so that the information obtained cannot be associated with identifiable persons, including the replacement of the individual's name with a generic code. In our hospital, this code is protected, protected. The process of anonymisation begins in the Admission Service. There, the patient is attended by a doctor, who is in charge of replacing his or her name with this generic code, and linking this to a unique case history number.The very concept of Modern Safety Culture is based on the paradigm that healthcare procedures can cause injury. This incident, however, is a unique example of a new reality: some of the measures taken by the Health System to protect patients can make them more vulnerable.The reality is that an individual's name is a safety barrier. One of the best, in fact.The right of an individual to conceal their identity is also a safety barrier. We would like to emphasize that both doctors and patients must be informed of the difficulties inherent in this paradoxical situation. The aim of our letter is twofold: to raise awareness of this situation in both patients and doctors. With regard to patients, we suggest including an informed consent clause in the Request For Anonymisation form that is handed in to the Admission Service. This should inform patients that, by concealing their identity, they waive their right to one of the Health System's safeguards against medical errors. This consent clause should also specify that the Health System will thereafter assign them a new name: the case history number. This number will be the only means of identifying the patient, and it will therefore be their responsibility to know and verify it when requested. We, the treating doctors, must also perform meticulous, repeated identity checks, as an additional safety net, thereby showing that we are aware of the alienation inherent to an identification code, and conscious of the fact that a number will never identify a patient as perfectly as their own name.FundingNone declared.Conflicts of interestNone declared." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "Reference" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Romera A, Garrido A, Lema M, Contreras AM. CALL ME BY YOUR NAME. Paciente protegido: reflexiones sobre lo que implica privar del nombre propio para la Seguridad del Paciente. Rev Esp Anestesiol Reanim. 2019;66:350–351." ] ] "bibliografia" => array:2 [ "titulo" => "Reference" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO guidelines for safe surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Alliance for Patient Safety" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "World Health Organization" "editorialLocalizacion" => "Geneva" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006600000006/v1_201905290656/S2341192919300915/v1_201905290656/en/main.assets" "Apartado" => array:4 [ "identificador" => "66474" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006600000006/v1_201905290656/S2341192919300915/v1_201905290656/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300915?idApp=UINPBA00004N"]

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Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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Vol. 66. Issue 6.

Pages 350-351 (June - July 2019)

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