Medical State
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Medical states or medical conditions are used to describe a patient's condition in a hospital. These terms are most commonly used by the news media and are rarely used by physicians, who in their daily business prefer to deal with medical problems in greater detail.
Either or both of two aspects of the patient's state may be reported. First, the patient's current state may be reported, e.g., as being good or serious. Second, the patient's short-term prognosis may be reported, e.g., that the patient is improving, is getting worse, or that no immediate change is expected (stable).
US practice
A wide range of terms are often used to describe a patient's condition. The American Hospital Association advises doctors to use the following one-word conditions in describing a patient's condition to those inquiring, including the media. [1]
Undetermined
Patient is awaiting physician and/or assessment.
Good
Vital signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.
Fair
Vital signs are stable and within normal limits. Patient is conscious, but may be uncomfortable. Indicators are favorable.
Serious
Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.
Critical
Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.
Other terms
Other terms used include: grave, extremely critical, critical but stable, serious but stable, guarded,[2] satisfactory, and others.
A frequently cited condition is "stable". Typically, stable is not a condition on its own; it is usually qualified with a true condition. It is commonly used to denote conditions where a patient has a favorable prognosis or stable vital signs. The American Hospital Association has advised doctors not to use the word "stable" either as a condition or in conjunction with another condition, especially one that is critical, because a critical condition inherently implies unpredictability and the instability of vital signs.[1] Despite this, "critical but stable" conditions are frequently reported, likely because the word "critical" in mainstream usage is often used to denote a condition that is severe but not necessarily immediately life-threatening (provided that the patient is under professional care).
The use of such conditions in the U.S. media has increased since the passing of the HIPAA in 1996. Patient privacy has become more of a concern to doctors and hospitals, and they are less likely to release specific medical conditions, fearing litigious patients.
Definitions vary among hospitals, and it is even possible for a patient to be upgraded or downgraded simply by being moved from one place to another, with no change in actual physical state. Furthermore, medical science is a highly complex discipline dealing with complicated and often overlapping threats to life and well-being. In the case of possibly life-threatening illness, a patient may be treated by a dozen or more specialists, each with their area of medical expertise. It is to be expected that there will be a range of opinion concerning that patient's immediate condition.[3]
UK practice
The release of patient information to the press is strictly controlled in the National Health Service (NHS). The Department of Health (DH) publishes a Code of Practice for guidance to NHS Trusts.[4] In general, no information can be released at all without patient consent, unless there are exceptional circumstances. If consent is withheld, it would not be possible for the hospital to state even that fact to the press, since it would confirm that the patient is receiving treatment.
Each NHS Trust has its own guidance for statements to the press. The DH Code of Practice has no official definitions of the standard phrases in use. However, most NHS Trusts will specify some[5] or all[6] of the following phrases in their guidance;
- Deceased
- Critical
- Critical but stable
- Stable
- Satisfactory
- Comfortable
- Progressing well
- Discharged
References
- ↑ 1.0 1.1 American Hospital Association; (2003-02-01). AHA : Advisory : HIPAA Updated Guidelines for Releasing Information on the Condition of Patients. American Hospital Association. Retrieved and archived on 2008-01-28.
- ↑ Former President Bush remains in ICU with lingering fever. CBS News (27 December 2012). Retrieved on 30 December 2012.
- ↑ "What does it mean when a patient is in 'critical' or 'serious' condition?", The Straight Dope, 18 October 1999. Accessed on 10 January 2011.
- ↑ Confidentiality: NHS Code of Practice, November 2003
- ↑ Royal Free Hampstead NHS Trust: condition checks webcite archived 16 December 2007
- ↑ Ashford & St. Peter's Hospitals NHS Trust Policy for Handling Press Enquiries webcite archived 16 December 2007