Medical state
Encyclopedia
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 doctors
, 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).
advises doctors to use the following one-word conditions in describing a patient's condition to those inquiring, including the media.
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 used include: grave condition, extremely critical condition, critical but stable condition, serious but stable condition, satisfactory condition, 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 to not 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. 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.
(NHS). The Department of Health (DH) publishes a Code of Practice for guidance to NHS Trusts. 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 or all of the following phrases in their guidance;
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
's condition in a hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
. These terms are most commonly used by the news media
News media
The news media are those elements of the mass media that focus on delivering news to the general public or a target public.These include print media , broadcast news , and more recently the Internet .-Etymology:A medium is a carrier of something...
and are rarely used by doctors
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
, 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 AssociationAmerican Hospital Association
The American Hospital Association is an organization that promotes the quality provision of health care by hospitals and health care networks through such efforts as promoting effective public policy and providing information related to health care and health administration to health care...
advises doctors to use the following one-word conditions in describing a patient's condition to those inquiring, including the media.
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 used include: grave condition, extremely critical condition, critical but stable condition, serious but stable condition, satisfactory condition, 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
American Hospital Association
The American Hospital Association is an organization that promotes the quality provision of health care by hospitals and health care networks through such efforts as promoting effective public policy and providing information related to health care and health administration to health care...
has advised doctors to not 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. 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
Medical privacy
The main subject of medical privacy or health privacy is the 'medical record' which historically has been a paper file of the entire medical history of the patient. Various electronic forms of medical records have existed in western countries, but mostly in an unintegrated fashion. This lack of...
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.
UK practice
The release of patient information to the press is strictly controlled in the National Health ServiceNational Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
(NHS). The Department of Health (DH) publishes a Code of Practice for guidance to NHS Trusts. 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 or all of the following phrases in their guidance;
- Deceased
- Critical
- Critical but stable
- Stable
- Satisfactory
- Comfortable
- Progressing well
- Discharged