1.6 Visit to the Idrija psychiatric hospital Special attention when dealing with the patients’ documentation and careful insertion of the individual files in the patient’s medical record are recommended. The hospital’s response report stated that they have all necessary regulations and protocols which regulate the management of medical records in the hospital. Despite the strict requirements set by the Rules on medical records and other internal regulations, mistakes in keeping records are always possible due to inconsistencies or inattentiveness of the personnel. As a part of the activities of the Office for hospital information system and archives, the hospital established a uniform and effective system of medical records management in order to monitor the patient from the admission to the discharge from the hospital. In 2013, the hospital introduced a system of keeping the medical records for each patient separately in the individual hospital unit (the so-called patient’s file system) to avoid the possibility of mistakes. By doing that the hospital ensured that the medical and other accompanying documentation for every patient is safely kept in one place in a structured and pre-set form. After the medical treatment or discharge of the patient, it is put into the clinical history which is kept in the hospital’s central archives according to the rules of archiving. The hospital’s medical archives are a model of regularity and an example of excellency which was pointed out by a five-member international accreditation commission which has, as a part of the assessment of the NIAHO standard, verified the adequacy of the system for medical documentation management. As a part of the preparations to obtain the ISO 9001 Standard in the beginning of 2014, the hospital adopted a special protocol to regulate the procedure of documentation management on the hospital level which will decrease the possibilities of mistakes in documentation keeping. It is welcomed that the hospital will reinforce the regular control of the correct keeping of medical documentation. It is recommended that the hospital respects the legislative provisions on notifying the relatives and keeps a record of the notifications. It is also recommended that the hospital prepares a notification for the relative to see the reasons why a certain measure was taken, the time or the duration of the measure and the reasons why the goal could not be achieved with a less strict measure. In its second response, the hospital stated that the deadline for notifications as set by the law is respected whenever a special prevention measure is taken. Respecting the deadline is also subject to annual inspection of the Health Inspectorate which has not yet found any imperfections and irregularities. In addition to notifications on applying special protection measures, the hospital also keeps a written record of notices on submitting registered mail (date and time of sending). In relation to the Ombudsman’s recommendation on updating this notice, the hospital pointed out that ZDZdr does not specify the content of the notice and only specifies that application and implementation of special protection measures are communicated to the relatives. The hospital believes that the content of the notice for the relatives on applying special protection measures is fully compliant with legislative provisions and is the most appropriate from the medical and ethical point of view. The reason to apply special prevention measures is usually the acute worsening of the patient’s condition which poses a threat to their or somebody else’s life or health or when the patients cause severe material damage to themselves or others and this behaviour cannot be prevented with other less severe measures and a special prevention measure was necessary in order to prevent or control their dangerous behaviour. Data on medical reasons for applying a particular special prevention measure and the data on causes, circumstances and consequences of this condition are among the most sensitive personal data which the hospital has to treat as confidential data of this person, which are regulated by Personal Data Protection Act, Health Services Act and recommendations of the Information Commissioner. The right to protect personal data, reasons and circumstances of this condition is one of the fundamental rights of the health care services users, therefore the hospital believes that, in relation to the NPM’s recommendation, they should study the legal and ethical aspects of the regularity of notifying the relatives about concrete data on reasons for application of special prevention measures and other circumstances, especially in cases when patients have not given consent to give data to third persons or they were not able to give consent due to their mental illness, and put this recommendation into practice at a system level of all psychiatric hospitals. The hospital expects the same approach will be required in the hospitals where special protection measures are taken in the same way, but their obligation of notifying is not in place. With the current notice, the hospital specially notifies the relatives that they can obtain additional information from the attending doctor who can give them all necessary information on application of the special protection measures. The hospital believes that this approach is the most appropriate and the most effective compared to the previous practice and much better than impersonal administrative correspondence. IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2013 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 129