Reducing family members' anxiety while waiting on the day of surgery: systematic review of studies and implications of HIPAA health information privacy rules.
OBJECTIVE
To investigate changes that most surgical suites will need to make in the process of giving reports to family members on the day of surgery by the compliance date (April 14, 2003) of the privacy regulations of the Health Insurance Portability and Accountability Act (HIPPA) of 1996.


METHODS
Systematic review of the medical literature on ways in which providing information to family members changes their anxiety.


METHODS
The endpoints of the controlled studies included Spielberger State Anxiety. The observational studies reported percentages of family members with a specific concern.


RESULTS
An in-person progress report can reduce family members' anxiety, but this is not always. A personal approach is superior to providing pagers or a phone call. Observational studies suggest that family members want information specific to their relative, particularly if the case is running later than expected. Statistical methods exist to provide such an estimate of the time remaining in surgical cases.


CONCLUSIONS
Surgical facilities should strive to provide in-person progress reports to family members while their relatives are undergoing surgery. To satisfy HIPAA regulations, the staff and physicians who talk to family members in the waiting room will need to determine first if the patient has agreed to the release of information. As hospital information systems are updated to assure that this process is HIPAA-compliant, facilities can also incorporate the relevant statistical methods.
Dexter
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Department of Anesthesia, University of Iowa, Iowa City, IA 52242, USA. Franklin-Dexter@UIowa.edu
Epstein
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RH
D001007:Anxiety / Q000517:prevention & control*; D003219:Confidentiality; D005190:Family; D006801:Humans; D013514:Surgical Procedures, Operative / Q000523:psychology*; D013997:Time Factors