When is it OK to share information about a patient's healthcare with his family or friends? What topics are permitted and what's off limits?

The U.S. Department of Health and Human Services has issued a fresh set of guidelines to help healthcare providers navigate the sometimes murky waters of the HIPAA Privacy Rule in terms of disclosing patient information to friends, family members and others involved in the patient's care. The new guidance is presented in a Q-and-A format and "is intended to clarify these HIPAA requirements so that healthcare providers do not unnecessarily withhold a patient's health information from these persons," explains the department's Office of Civil Rights.

According to the guide, healthcare providers may discuss patient information with others in the following situations:

Thanks to a four-year-old conservation effort, the ORs at Oregon Health and Sciences University in Portland now recycle 300 pounds of uncontaminated paper and plastic every day and save about $40,000 in electricity each year.

Without compromising the facility's infection control practices, wrappers and packaging material for surgical instruments, suture material and gauze pads go directly into a recycling bin.

"They are no-brainers for recycling because they are never contaminated," says Juliana E. Hansen, MD, FACS, the university's chief of plastic surgery, in a press release. "They are never handled by the surgeons. They are opened sterilely and removed from surgical products before being used in an operation."

Dr. Hansen and her colleagues presented the results of the university's "green OR" program at the American College of Surgeons' annual meeting in San Francisco last week. The program is part of the university's environmental sustainability program, which recycled nearly 1,100 tons of solid waste and saved more than $85,000 in waste management fees in 2007.

Twenty-one ORs were refitted with energy-efficient LED lights and low-mercury lamps to reduce electricity usage. The university also purchases electricity generated from sustainable sources and uses cleaning supplies that meet the standards of Green Seal, a non-profit organization that certifies products with minimal environmental impact.

Dr. Hansen began the green OR program in 2004 after noticing how much waste even the simplest procedures generated. "Just because we are dealing with life-and-death issues doesn't mean that we have to stop thinking about the environment," she says.

Kent Steinriede

A Providence, R.I., hospital will overhaul its wrong-site surgery prevention protocol in the wake of a state health department investigation that found several deficiencies that led surgical staff to operate on a patient's incorrect knee during elective surgery last month.

Miriam Hospital has signed a consent agreement with the state department of health, vowing to: