Setting

This audit is relevant to all specialties in psychiatry and in all settings.

Background

Doctors have a duty to keep confidential information about their patients safe and to destroy confidential information in a safe and secure manner. Clinical notes and typed letters are often put into general waste bins instead of being shredded. This can result in sensitive information being viewed by third parties, which may have legal or disciplinary ramifications.

Standards

The Data Protection Act 1998 applies to all organisations that hold personal data on individuals. The seventh principle of the Act concerns unlawful processing and accidental loss of personal data, phrased in the Act as follows: ‘Appropriate technical and organisational measures shall be taken against unauthorised or unlawful processing of personal data and against accidental loss or destruction of, or damage to, personal data.’ The Act advocates shredding of confidential waste to reduce the risk of confidential information being made public. Compliance with the Act is mandatory: failure to comply can result in legal action and fines. The target in this audit was that no patient-identifiable information should be disposed of as general waste.

Method

Data collection

The waste bins in all rooms in a psychiatry department were checked at the end of each day for a set time period without the knowledge of the staff in that department. If confidential waste was identified, it was categorised as:

ᐅ ‘patient identifiable’ waste (i.e. that linked an individual to the department)

ᐅ ‘sensitive’ waste (i.e. that linked the individual to the department and included sensitive information, such as history, diagnosis and treatment).

Data analysis

The number of ‘patient identifiable’ and ‘sensitive’ waste items was counted. A brief description of what form they took and where they were found was recorded.

Resources required

People

This audit can be completed by a single person.

Time

This audit may involve staying behind after work for approximately 30 minutes so that waste bins can be examined at the end of the day. This would be necessary for the duration of the audit timeframe.

Results

Several items of confidential waste were identified during the data-collection period, with a few rooms being responsible for the majority. After implementation of the first suggestion below, the amount of confidential waste reduced significantly.