Privacy: challenge

Challenge

I am in the H-PHIS room creating a handout on local fibromyalgia resources for patients and it is a busy day in the waiting room. People are starting to browse the pamphlets which we have displayed in two very nice wooden displays along the wall. Small children especially seem to like to run into my room and play with the pamphlets on the bottom row. I will have to think of something more interesting to put there for them to play with.

Today I see the beginnings of what will be a great challenge. My room opens directly onto the waiting room which is good because I am visible and people can feel free to drop in and ask a question or browse pamphlets even when I'm not there. What's not so good is that there is no privacy, either for me when I am working (it can be hard to concentrate when a four-year-old runs in and fake-sneezes on you), or for any person who wishes to ask me to help them find information on a topic that requires privacy. One of the dietitians has to go through my room to get to her office and, while she has put up shades, the glass door and wall do not give her patients much privacy either. How to balance the two? How to make sure that people are welcome to come in and use the service, and that if they need they can have a little privacy?

Picky eaters: case

Case/challenge

Scenario

A young man follows his child into the room and sees a pamphlet he's interested in but we only have the French version displayed. He asks if we have it in English and I pull it out from one of the many boxes I am keeping under the extra desk until we can find someplace to store them. Eventually the plan is to have an extra computer at that desk that patients and their families can use while they wait. The pamphlet is called Feeding your child ages 2-5. The man tells me his daughter is 2 years and 7 months old and a very finicky eater. I offer to see if I can find some other resources. He's nervous about staying in the room with me as he might not hear his name being called. The waiting room is quite animated this morning and a vacuum is being used nearby. I offer to find some information for him and tell him she can pick it up after his appointment.

Resolution

I find a few good resources that will supplement the pamphlet nicely:

From Eat Right Ontario: Picky eaters and serving sizes
From Kids Health: Nutrition & Fitness section
From the BC Ministry for Children and Families: Feeding your toddler with love and good food (pdf)

I print these out and place them handily on my desk for the man to pick up when he leaves. He never returns for them.

Discussion

I'm not sure what to do with the 10 pages or so that I have printed. We have not yet established a procedure for this eventuality but I am now inspired to create one. Some things to consider: a way for patients to be located when they are with me and their name is called; a way to get printed information to a patient in case they forget it (email, fax?); a place to put abandoned printed information that may be used at a later time.

Further resolution & discussion

The following week I decide to try and track down the man and see if he still wants the information. I go to the chief administrator at Herzl to ask if she can suggest how to find the man using only a first name. Medivisit, the clinic's appointment scheduling software, only allows a search using both first and last. She randomly calls one of the team coordinators, who as it happens knows the man we are looking for. I have contact information in my hands within 2 minutes. I call the man and he does still want the information. I leave it with the team coordinator for him to pick up at his next visit. I am very impressed with how well the teams seem to know their patients.

Pediatric MS: case

Case

Scenario

One of the Herzl health professionals (HP) comes to see me while I am working in the library. She has a young patient, a nine year child, who has been diagnosed with pediatric MS. She would like some information for the family.

Resolution

This diagnosis is relatively rare and we are both thinking it may be difficult to find information. As she will be visiting the Montreal Children's Hospital that Friday I suggest they go to the Family Resource Library there, which is excellent, in case they have any special resources on the topic. I tell the HP I will follow up when I am at the Herzl and ask her to write up an InfoRx and leave it for me so that I can fill out a consult.

The next day I call the Family Resource Library at the Children's to see if they do in fact have any special resources on the topic, which it turns out they do not. I decide to do a quick Google search first thing Monday to see what might be out there. I don't normally turn to Google first unless I looking for the US name of a drug before looking it up in a US resource, but this time it seems like the thing to do. I am surprised to see how many excellent resources come up right off the bat:

Search: pediatric multiple sclerosis

Results:

For the health professional:

MS Society of Canada
Hospital for Sick Children Paedetric Multiple Sclerosis (MS) Clinic

National MS Society (US)
Pediatric MS

Quebec chapter of MS Society of Canada


For the patient and family:

MS Society of Canada publications on young persons with MS
Includes an activity book for children with MS, a guide for parents, and answers to FAQ

University of California Children's Hospital
Pediatric MS Center

National MS Society (US)
About MS: Pediatric (Childhood) MS

Children's Hospital of Philadelphia
Neurology: Pediatric Multiple Sclerosis Clinic

National Pediatric MS Center at Stony Brook University Hospital

I also search NOAH (New York Online Access to Health), as well as the default MedlinePlus, to see what they have on the topic. Noah has a couple of links to to the National Multiple Sclerosis Society, ones I have already found, but MedlinePlus does not have anything at all on the topic.

Discussion

(Also see Challenges post for today)

I recently gave a course to hospital staff on using Google wisely and well, and one of the things I made a point of stressing is that Google is just a means to an end. There is a lot of controversy surrounding the use of Google as a diagnostic tool, and especially on its use by consumers to find health information. I believe that *if* you know what you're doing, and more importantly *if* you know how to evaluate what you find, then it can be a really useful, if unreliable, tool for finding information quickly in multiple resources.