New system-wide policy on use of medical chaperones

A new system-wide policy on the use of medical chaperones aims to provide a safe, comfortable environment for patients while also ensuring a positive experience for providers.  

A medical chaperone is a person who acts as a witness for a patient and a health professional during a medical examination or procedure. With the policy’s rollout, medical chaperones will be required during any sensitive exam, treatment or procedure. Any physical exam of the genitalia or rectum or female breasts is considered “sensitive.” These include: 

• Pelvic examination
• Intravaginal physical therapy 
• Examination, treatments, or procedures of or involving the external genitalia (inclusive of urinary catheterization)
• Examination, treatments, or procedures of the female patient’s breast(s)
• Rectal examinations, treatments, or procedures (inclusive of rectal tube insertion)

Medical chaperones will also be available during any other exam, treatment, or procedure at the patient’s request. Providers should inform patients that they are entitled to have a chaperone present for any physical exam. 

“Medical chaperones promote an overall sense of safety and comfort for patients. In addition, their presence can help prevent misunderstandings of physician intentions while protecting the patient’s dignity during sensitive exams and procedures,” said Christian Pettker, MD, chief of obstetrics at Yale New Haven Hospital and associate chief quality officer, YNHHS.  “Using chaperones during these examinations will help foster a safe environment and build a foundation of trust and confidence with our patients.”

The medical chaperone will be a YNHHS or Yale University employee or member of the medical staff who will stand in a location where they can observe and assist as needed. While friends and family can be invited to stay at the patient’s request, they will not be considered chaperones for patients over the age of 13. For patients under 13, a guardian may remain in the room and act as the chaperone. However, the patient or provider performing the exam, treatment, or procedure may request a chaperone in addition to the guardian. 

YNHHS providers may also request the presence of a chaperone during any exam, treatment, or procedure. If the patient declines a chaperone in this situation, the YNHHS provider may decline to perform the examination, treatment, or procedure.

When using a medical chaperone, proper documentation should be completed, particularly following sensitive examinations and procedures. Providers should document all conversations and wishes of the patient, as well as any individuals who are present for each interaction. In emergency cases where a chaperone is required by the policy but is not immediately available, the provider should proceed with the exam, treatment or procedure and document the situation.

Information about implementation will be disseminated at each delivery network in the coming months. For additional details on the chaperone policy, contact Dr. Pettker or David Depukat, RN, director, Accreditation and Regulatory Affairs, YNHHS.