Over the weekend, Arizona Rep. Gabrielle Giffords was upgraded from “critical condition” to “serious condition.” More good news came from Giffords’ husband, Mark Kelley, who recently spoke about the amazing progress the congresswoman has made since she was shot in the head by accused gunman Jared Loughner on Jan. 8.
Apart from responding to commands, doctors reported Saturday that they removed Giffords’ breathing tube and replaced it with a tracheotomy tube in her windpipe. The good news the media enjoyed most was Kelly’s comment to Diane Sawyer that Giffords “spent 10 minutes giving me a neck massage.”
So is the difference between critical and serious condition a breathing tube? Or is it a neck rub?
It’s hard to say.
Ann Cisnerios, the public affairs representative at Tucson’s University Medical Center, where Giffords is being hospitalized, told The Daily Caller that “critical condition” means that “vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.”
Cisnerios said UMC takes its cue on the designations from the American Hospital Association’s guide regarding the disclosure of patients’ conditions.
The AHA’s guidelines, however, are just suggested guidelines.
No hospital is required to follow AHA’s guidelines and its intentionally vague recommendations concerning the one-word descriptions (which, in order of improvement, are: Critical, Serious, Fair, Good, and Undetermined). Policies for individual hospitals can — and do — vary.
Hospitals, however, do have to follow rules set by the Heath Insurance Portability and Accountability Act of 1996. Privacy regulations in HIPAA,”govern privacy standards for healthcare information.” These regulations “expressly permit hospitals to release the patient’s name [and] general condition … unless the patient has asked that the information not be released,” according to the AHA’s eight-page guide.
Obviously, patients’ attending physicians are the ones who make the condition assessments. The incredibly vague statuses are often used for media purposes. It prevents health care professionals from disclosing specific information about patients that might violent HIPAA. According to the AHA, any detailed statement beyond the one-word description requires the patient’s (or next-of-kin’s) permission.
If you’re still confused about what one-word conditions reveal about a patient, apparently, so are doctors.
“The law [HIPAA] is pretty difficult to understand. I think hospitals assert a lot of stuff that [HIPAA] doesn’t mean,” Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, told TheDC. “I don’t think there’s anything in [HIPAA] defining what these conditions mean.”
Orient said there is “a lot of confusion about what the law does and does not mean [and] certain inconsistency in policies that are based on it.”
“I don’t know that these things ‘critical’ or ‘serious’ ever had a standard definition,” said Orient. “If you really want to tell how the person is doing, they’re not very revealing anyway”
For Orient, serious condition means “well, they’re looking better [than critical].”
So apart from press conferences with Giffords’ doctors and her husband Kelly’s affectionate revelations, the congresswoman’s upgrade to “serious condition” indicates that “vital signs may be unstable and not within normal limits,” according to UMC and AHA’s standard. “Despite all the good news regarding Giffords’ recovery, those in serious condition do face ‘questionable’ indicators.”
According to AHA’s guide, “good condition” would indicate that “vital signs are stable and with normal limits, [the] patient is conscious and comfortable, [and] indicators are excellent.”
Let’s hope Giffords soon qualifies for that condition, whatever it may mean.
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TheDC would like to thank Michele Winkler, nurse practitioner and professional “Momma.”