Patient Guide OUR COMMITMENT TO CARE YOUR SATISFACTION WHAT ARE YOUR RIGHTS AS A PATIENT? EASE THE TRANSITION FROM HOSPITAL TO HOME

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1 27200 Calaroga Avenue Hayward, CA OUR COMMITMENT TO CARE YOUR SATISFACTION WHAT ARE YOUR RIGHTS AS A PATIENT? EASE THE TRANSITION FROM HOSPITAL TO HOME Patient Guide

2 In This Guide Thank You 2 Welcome to St. Rose Hospital 2 Our Commitment to Care 3 Your Satisfaction 4 Telephone Directory 5 Rapid Response Team 6 Be Prepared 7-8 During Your Stay 9-11 Telephone 9 Interpreters 9 Visiting Hours 9 Waiting Rooms 9 Leave Your Valuables at Home 10 Medications from Home 10 Smoking 10 Electrical Devices 11 TV 11 Gift Shop 11 Cafeteria 11 Speak Up 12 Stay Safe Take Notes 18 Rights & Responsibilities St. Rose Hospital Calaroga Avenue Hayward, CA What Are Your Advance Directives? 22 Your Privacy & Health Information Don t Leave Until Preparing to Leave the Hospital 27 Patient Portal 28 After-Hospital Care Managing Your Medications 31 Giving Back 32 The editorial content displayed here is the responsibility of PatientPoint. This material is for your educational use only. It does not contain, nor should it be construed as containing, medical advice. Talk to your doctor before making any lifestyle or treatment changes. Sponsors are responsible for the material provided, and your healthcare provider s participation in the program does not represent an explicit or implied endorsement of any material presented. The people shown are models and are not known to have any health condition. Images are for illustrative purposes only. Image credits: Getty Images, istockphoto PatientPoint : 1

3 Thank You Mission St. Rose Hospital provides quality healthcare to our community with respect, compassion and professionalism. We work in partnership with our highly valued physicians and employees to heal and comfort all those we serve. Vision St. Rose Hospital will be the healthcare provider of choice in central and southern Alameda County. We actively seek partnerships with all groups and individuals dedicated to improving the overall health of the diverse community we serve. The medical staff, employees and volunteers of St. Rose Hospital wish to thank you for choosing St. Rose to provide your medical care. We realize you have many choices as you look at healthcare options. It is our hope that we exceed your expectations and provide quality healthcare with respect, compassion and professionalism. Often the experience of hospitalization can be quite overwhelming. We hope this handbook will inform you of the many hospital services and resources available to you. We are fortunate to work with physicians, nurses and other members of our healthcare team who are committed to bringing excellence in the care they provide to our patients. With the guidance of our Board of Directors, St. Rose Hospital remains your community hospital. Together, it is our goal to provide the best service and care during your hospital stay. Once again, thank you for making St. Rose Hospital your healthcare choice. Sincerely, Medical Staff, Employees and Volunteers of St. Rose Hospital Welcome to St. Rose Hospital We hope you find the following information about St. Rose Hospital helpful to you, your family and visitors. If you have any questions, please do not hesitate to request assistance from our hospital staff. Through innovation and strategic partnerships, St. Rose Hospital has helped create a healthier community, with a tradition of service, compassion and healing. The hospital looks forward to expansion and remains committed to bring excellence in healthcare to central and southern Alameda County. 2 :

4 Our Commitment to Care Our goal is to provide the best patient care. If at any time you have questions or concerns about the quality of care that you or a family member is receiving or has received at our hospital, do not hesitate to speak with your nurse or the nursing supervisor. If you feel that your issue wasn t resolved, please contact the hospital s patient experience coordinator at with your complaints or concerns. You may call at any time during or after your stay. In addition, you have the right to file a complaint or concern with either of the following: California Department of Public Health Services Center for Health Care Quality Licensing and Certification Division East Bay District Office 850 Marina Bay Pkwy Bldg P, 1 st Floor Richmond, CA Office of Quality and Patient Safety The Joint Commission One Renaissance Blvd. Oakbrook Terrace, IL patientsafetyreport@jointcommission.org Ethics Committee Some decisions are more difficult to make than others. There are times when you may need consultation regarding what is best for yourself or a loved one. We have a Bioethics Committee that convenes for the purpose of reviewing and discussing ethical issues surrounding the care you or your loved one is receiving. If you feel the need to access the Bioethics Committee, please discuss with your nurse or physician. To find out more, or to request a consultation, call the Case Management Department at Your Opinion Counts Soon after your discharge, you may receive a telephone call on behalf of this hospital. Please take the time to speak with the representative to share your opinions about your hospital stay. Your feedback is an important part of our goal of improving the care and services we provide : 3

5 Your Satisfaction We encourage your feedback to improve care. Your healthcare is our priority. To determine where improvements are needed, this hospital takes part in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The HCAHPS survey measures your satisfaction with the quality of your care. It is designed to be a standardized tool for measuring and reporting satisfaction across all hospitals in the U.S. After you are discharged from the hospital, you may be selected to participate in a telephonic HCAHPS survey. The surveyor will ask questions about your hospital stay. Please take the time to answer the HCAHPS survey; your feedback is valuable! What is HCAHPS? The HCAHPS survey is backed by the U.S. Department of Health and Human Services. The survey is used to improve the quality of healthcare. HCAHPS makes survey results public so hospitals are aware of where changes are needed. The results also enable healthcare consumers to review and compare hospitals before choosing a healthcare provider. You are part of the team COMMUNICATE It s your health; don t be afraid to ask your doctors and nurses questions. PARTICIPATE You are the center of your healthcare team so ask questions, understand your treatment plan and medications and communicate with your doctors and nurses. APPRECIATE There are hundreds of people in the hospital who need help; please be patient as doctors and nurses attend to everyone. Hospital Compare is a government website that allows users to compare the quality of care provided by hospitals. The information provided on this website is based on HCAHPS survey results. hospitalcompare The Joint Commission has created quality and safety standards for healthcare organizations. The Joint Commission reviews, accredits and certifies healthcare organizations that meet its high standards. Quality reports for all accredited organizations are available on its website. 4 :

6 Telephone Directory Administration Admitting Auxiliary Volunteer Services Gift Shop Business Office Customer Service Line Critical Care Education and Training Emergency Room Family Birthing Center Financial Counseling Food and Nutrition Services Foundation Health Information Services (Medical Records) Medical/Surgical/Telemetry Patient Experience Coordinator Rehabilitation Services Security Social Services MAIN NUMBER (Operator) Billing Cafeteria Gift Shop Please visit us at Calling a Department WITHIN the Hospital? Dial the last four digits of the number : 5

7 Rapid Response Team What is the Rapid Response Team? The Rapid Response Team is a group of specially trained individuals who bring critical-care expertise to the patient. The purpose of the team is to quickly check the condition of the patient and provide help before there is a medical emergency. HELP LINE for Families DIAL 0 You will be asked: n Caller Identification n Room Number n Patient s Name n Patient Concern (what issues are they having) A Rapid Response Team will be activated. St. Rose Hospital, like many hospitals nationally, is focusing on eliminating problems that affect optimal patient care. As a result, we ve created a Rapid Response Team line for patients, family or visitors to call for assistance. When to Call n If there is a noticeable change in the patient s condition that needs immediate attention and the healthcare team is not recognizing or addressing the concern. n If after speaking with a member of the healthcare team (i.e. nurses, physicians), you continue to have serious concerns on how care is being given, managed or planned. Warning signs that a patient is getting worse: n Changes in the heart or respiratory (breathing) rate n Change in blood pressure n Changes in urinary output (much more or much less urine) n Change in level of consciousness n Any time you are worried about the patient Where to Call Call the nurses station or use the patient s call button. The nurse will dial the operator. The hospital operator will ask for caller identification, room number, patient name and patient concern. In most cases, a Rapid Response Team will be activated. A team of medical professionals will arrive in your room to assess the situation. The Rapid Response Team consists of a critical care nurse and respiratory therapist. Additional staff will be called in as needed. 6 :

8 Be Prepared Rx X marks the spot be sure any mistaken markings on your body are completely cleaned off. How you can make your surgical procedure and follow-up care as safe as possible. Mistakes can happen during surgery. As an active member of your healthcare team, you can make your surgical procedure and follow-up care as safe as possible. Here s what you need to know: Before Your Surgery n Bring a list of any questions you have about your surgery to your pre-surgical doctor s visit. Also bring a list of all the prescription, over-the-counter and herbal medications that you are currently taking or that you took until very recently. Review the list with your surgeon and ask if there are any you should stop taking prior to your procedure. n Be sure your surgeon knows about any allergies you have to medications and foods. n Ask your surgeon whether you can eat or drink before your procedure. If so, ask what kinds of food or drink, and within how many hours of your surgery. n Ask your surgeon whether you should remove nail polish or temporary dental appliances (such as a bridge), if you can wear deodorant or body lotion and if there are other preparations you need to make prior to surgery. n Find out if you will need therapy after your surgery, who will arrange for it and whether you can have therapy at home. n Arrange for transportation to and from the hospital or surgical center. n Ask a relative or friend to go to the hospital or surgical center with you to stay during your procedure and accompany you home afterward. It s hard to remember everything yourself. When you meet with your doctor, bring your questions and a friend. Your friend can help listen, take notes and ask questions, too! : 7

9 A Team Effort Here s how to work with your surgical team to get the best outcome: n Know the preparations you must make before your surgery. n Arrive at the hospital or surgical center early on the day of your surgery. n Review all paperwork carefully before signing. n Make sure the proper part of your body is marked for surgery. n Get your post-surgical care instructions in writing before you leave. On the Day of Your Surgery n Shower or bathe and wash your hair. Don t wear makeup or perfume. Be sure to follow any other pre-surgery instructions you were given. n Leave your jewelry, money, credit cards and other valuables at home. n Allow yourself plenty of travel time to the hospital. n Once you arrive at the hospital or surgical center, you will be given an Informed Consent form to sign. Read it carefully. Make sure everything on the form is correct. If you don t understand something, ask questions before you sign the form. Before Your Procedure Begins n Staff at the hospital or surgical center should ask you the following questions more than once before your surgery: Your name What kind of surgery you re having The part of your body that is being operated on n A healthcare professional will mark the spot on your body that is going to be operated on. Make sure he or she marks only the correct part. If he or she makes a mistake and has to make a new mark, be sure the old mark is completely cleaned off. n If you won t be awake for the marking, be sure your relative or friend watches the marking. n Ask your surgeon if the team will take a time out just before your procedure. This is done to make sure the team is doing the right surgery on the right body part of the right person. After Your Surgery n Speak up about any pain you are having and ask for relief. Be specific about the intensity and location. n If you are given medications right after surgery, ask what they are and what they are for. Ask about side effects. If you are given a prescription for medications you must take while recovering, be sure you understand the instructions for the dosage, how frequently you need to take the medications and for how long. n If you are given IV (intravenous) fluids right after surgery, ask what they are and what they are for. Be sure someone monitors the fluid level. n Ask your surgeon if your activities need to be limited, and if so, for how long. Ask when you will be able to resume work, exercise and travel. n Be sure to get instructions for post-surgical care in writing before you leave. 8 :

10 During Your Stay We have policies and procedures in place to help you and your family work with our doctors, nurses and staff to get the most from your hospital stay. Please take a few minutes to review these guidelines with your loved ones. Visitor Passes A visitor pass will be issued to all visitors. Please sign in at the security booth next to the elevators in the main lobby to receive your pass. The pass must be worn at all times in all areas of the hospital. Visitor Guidelines We encourage visitors for emotional support and recovery. To provide a restful and safe environment, we ask that all visitors comply with the following guidelines: n Be considerate of other patients by keeping noise to a minimum. n Refrain from visiting if you have a cold, sore throat or any contagious disease. n Observe no visiting and precaution signs before entering the room. n St. Rose is a smoke-free hospital. n Leave the room during tests or treatments if asked. n Please remember to clean your hands when entering and exiting patient rooms. Telephone A telephone is located next to your bed. n Press 9 followed by the telephone number for free local calls. n Press 0 and a hospital operator will assist you with longdistance lines. You may call collect, use your telephone card or bill your home telephone number. Interpreters Cyracom interpreter services are available throughout the hospital. Please ask your nurse for assistance if English is not your primary language. If you are hearing impaired, video interpretation and TTY phones are available. VISITING HOURS General 10:00 a.m. 9:00 p.m. Maternity 10:00 a.m. 8:00 p.m. No children under age 16 permitted, except siblings of newborns Critical Care Units 8:00 a.m. 9:00 p.m. Waiting Rooms The hospital lobby and Outpatient Care Center waiting areas are available for those who are waiting. Registration When you are admitted to the hospital, an admissions representative is available to assist you or a family member in completing necessary registration information. You will be asked to sign a general consent, provide a copy of your insurance card, and inventory any valuables you may have in your possession. You will be given a wristband to identify you while you are a patient here at St. Rose. Please do not remove it until you are discharged : 9

11 During Your Stay Discharge Planning and Social Services We recognize that illness and hospitalization can be a time of anxiety and stress for you and your family. We will work with your physician to best meet your needs as you transition from the hospital. Counseling, discharge planning, home-health support and referral services are all available through Social Services. Leave Your Valuables At Home If you have valuables, such as jewelry, credit cards and cash, please give them to a relative or friend to take care of during your stay. Store your contact lenses, eyeglasses, hearing aids and dentures in containers labeled with your name and place them in a drawer in your bedside table when not in use. Please don t put them on your bed or food tray they may be damaged or lost. St. Rose Hospital cannot be responsible for replacement of personal belongings. Fire Safety We periodically conduct fire drills. If you hear an alarm, stay where you are. In the event of an actual emergency, hospital staff will notify you. Confidentiality St. Rose adheres to patient privacy and confidentiality standards as directed by federal law called the Health Insurance Portability and Accountability Act (HIPAA). Patients receive a copy of privacy practices at the time of registration that explains how medical information may be used and disclosed, and also explains your rights related to your medical information. Hospital Safe If you cannot send your valuables home, please speak with your nurse about storing them in the hospital safe. St. Rose Hospital is not responsible for any valuables left in your room. Medications from Home Please do not bring any medications (prescription, over-the-counter or illegal drugs) to the hospital; however, please provide a list of all the medications you take at home with dosage requirements. All medications you take while a patient at St. Rose Hospital have been prescribed by your physician, are dispensed by the hospital pharmacy and administered by a trained professional. Patients are not permitted to administer their own medications or to keep personal medications at the bedside. Smoking Smoking is only permitted in the designated smoking area located outside near the Emergency Room. 10 :

12 Electrical Devices Electrical devices including hairdryers, curling irons, razors, radios, heating pads, portable heaters, computers, and other devices are not permitted in patient rooms. You may use only battery-operated devices. TV Televisions are provided in each patient room with the Wellness Network. Please be considerate of others by keeping the TV volume down and turning off your TV at bedtime. ATM For your convenience, an ATM is located outside of the Emergency Room entrance and is available 24 hours per day. Gift Shop The St. Rose Hospital Gift Shop is located in the main lobby. The proceeds from the gift shop are donated back to the St. Rose Hospital Foundation through the Volunteer Auxiliary to assist the needs of our patients. Cash, check and credit cards accepted. Hours: Monday Friday: 9:00 a.m. 4:00 p.m. Open Saturdays Closed all holidays WHERE S THE CAFETERIA? Visitors are welcome to dine in the cafeteria which is located on the first floor. HOURS: Monday Friday Breakfast: 7:00 a.m. 10:00 a.m. Lunch: 11:00 a.m. 2:00 p.m. Dinner: 4:00 p.m. 6:00 p.m. Weekends 11:00 a.m. 3:00 p.m. Patient Meals Our goal is to provide nutritious and enjoyable food during your stay at St. Rose Hospital. Your physician will inform us of your dietary needs, and we will plan your meals accordingly. Vending Machines Vending machines offering beverages and snacks are located on the first floor of the hospital. They are available 24 hours a day, seven days a week : 11

13 Speak Up! Take charge of your care. During your stay, the doctors, nurses and staff of your hospital will treat you and your family as partners in your own care. One important way that you can be involved is to speak up. Ask questions, voice your concerns and don t be afraid to raise any issues relating not only to your care and treatment, but also to overall hospital services. In the pages that follow, you ll find a step-by-step guide to making the most of your hospital stay how to stay safe, get the information you need, ask the right questions and interact effectively with your doctors, nurses and hospital staff. STEP UP & SPEAK UP SPEAK UP: Ask questions and voice concerns. It s your body, and you have a right to know. PAY ATTENTION: Make sure you re getting the right treatments and medicines. EDUCATE YOURSELF: Learn about the medical tests you get and your treatment plan. FIND AN ADVOCATE: Pick a trusted family member or friend to be your advocate or support person. WHAT MEDS & WHY: Know what medicines you take and why you take them. Remember: n Write down any questions you have n Choose a support person to communicate with the doctors and staff n Keep a list of doctors you see and the meds they prescribe Don t Get Overwhelmed, Write It Down! CHECK BEFORE YOU GO: Use a hospital, clinic, surgery center or other type of healthcare organization that meets The Joint Commission s quality standards. PARTICIPATE IN YOUR CARE: You are the center of the healthcare team. Courtesy of The Joint Commission. 12 :

14 Stay Safe You can contribute to healthcare safety. While you are in the hospital, many people will enter your room, from doctors and nurses to aides and orderlies. The following information will help make your hospital stay safe and comfortable. Employee ID All hospital employees wear identification badges. Feel free to ask any staff member for his or her name and job classification. If you do not see an ID badge on an employee, please call your nurse immediately. Don t Be Afraid to Ask A number of people may enter your hospital room. Be sure to: n Ask for the ID of everyone who comes into your room. n Speak up if hospital staff doesn t ask to check your ID. n Ask if the person has washed his or her hands before he or she touches you. n If you are told you need certain tests or procedures, ask why you need them, when they will happen and how long it will be before you get the results. PATIENT IDENTIFICATION Any time staff members enter your room to administer medications, transport you or perform procedures and treatments, they must check your name and account number before they proceed. At times, you may be asked the same questions repeatedly. We are aware that this may be annoying. Please understand, however, that this verification process is a critical component in our patient safety program in order to guarantee that all of our patients receive the correct medications and treatments. Check ID : 13

15 STAY SAFE Preventing Infections While you re in the hospital to get well, there is the possibility of developing an infection. The single most important thing you can do to help prevent infections is to wash your hands and make sure that everyone who touches you including your doctors and nurses washes his or her hands, too. You, your family and friends should wash hands: 1. after touching objects or surfaces in the hospital room 2. before and after eating 3. after using the restroom It also is important that your healthcare providers wash their hands with either soap and water or an alcohol-based hand cleaner every time, before and after they touch you. Healthcare providers know to practice hand hygiene, but sometimes they forget. You and your family should not be afraid or embarrassed to speak up and ask them to wash their hands. Happy Birthday to You! Wash your hands with soap and warm water for 15 to 20 seconds. That s about the same amount of time that it takes to sing the Happy Birthday song twice. Doctors, nurses and other healthcare providers come into contact with a lot of bacteria and viruses. So before they treat you, ask them if they ve cleaned their hands. No Soap? No Problem. Alcohol-based hand cleaners are as effective as soap and water in killing germs. To use, apply the cleaner to the palm of your hand and rub your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry. 14 :

16 STAY SAFE Preventing Falls Hospital patients often fall because they are weak or unsteady due to illness or medical procedures, their medications make them dizzy, or they ve been sitting or lying down for too long. St. Rose Hospital cares about our patients safety. Please help us keep you safe by following these guidelines during your hospital stay: n Do not get out of bed by yourself. Your hospital bed is probably higher and narrower than your bed at home, and you can easily fall while trying to get in or out of it. Please use your nurse call button and ask for assistance. n Keep often-used items call button, tissues, water, eyeglasses, telephone, TV remote within easy reach. n Do not walk in bare feet. Wear socks or slippers. n Make sure your robe or pajamas don t drag on the floor; they can cause you to trip. n Use the handrails in your bathroom and throughout the hospital at all times. n Ask your nurse to show you how to properly walk with your IV pole, drainage bags or any other equipment. n Be sure your wheelchair is locked when getting in or out of it. Never step on the footrest. n If you see a spill on the floor, report it at once. DVT: Lower Your Risk Deep-vein thrombosis (DVT) occurs when blood clots form in the legs and block circulation. The clots can lodge in your brain, heart or lungs, causing damage or even death. When you re hospitalized and in bed with limited physical activity, your risk of DVT increases. Ask your doctor about using compression boots or stockings and/or blood thinners to prevent DVT during your stay. And be sure to tell your doctor or nurse if you have any of the following warning signs: A leg cramp or charley horse that gets worse Swelling and discoloration in your leg, upper arm or neck Unexplained shortness of breath Chest discomfort that gets worse when you breathe deeply or cough Lightheadedness or blacking out PATIENTS OF ALL AGES ARE AT RISK OF FALLS BECAUSE OF MEDICATIONS THAT MAY MAKE THEM DIZZY, WEAK OR UNSTEADY : 15

17 STAY SAFE Know Your Meds While you are hospitalized, your doctor may prescribe medications for you. Be sure that you understand exactly what they are and why they are being prescribed. Use this checklist to help you get the information you need from your doctor: What is the name of the medicine? What is its generic name? Why am I taking this medicine? What dose will I be taking? How often, and for how long? When will the medicine begin to work? What are the possible side effects? Can I take this medicine while taking my other medications or dietary supplements? Are there any foods, drinks or activities that I should avoid while taking this medicine? Should I take my medicine at meals or between meals? Do I need to take the medicine on an empty stomach or with food or a whole glass of water? What should I do if I forget to take the medicine and miss a dose? KEEP A WALLET-SIZED NOTEBOOK OF ALL MEDICATIONS YOU ARE TAKING. Preventing Medication Errors By taking part in your own care, you can help the members of your healthcare team avoid medication errors. Here s how: Be sure that all of your doctors know what medications you have been taking, including prescription drugs, over-thecounter medications, herbal and vitamin supplements, natural remedies and recreational drugs. Be sure that all of your doctors know of any allergies you may have to medications, anesthesia, foods, latex products, etc. When you are brought medications or IV fluids, ask the person to check to be sure you are the patient who is supposed to receive the medications. Show that person your ID bracelet to double-check. Remember you play an important role in helping to reduce medication errors. 16 :

18 STAY SAFE Questions for My Doctor Be Informed You and your caregiver need to stay informed about your medical condition and treatments while you are hospitalized. Once you are released from the hospital, it is important to have this information available so you can share it with your primary care physician during your next visit. These checklists will help you ask questions while in the hospital and keep track of vital health and medication information. About My Medicines See Know Your Meds on page 16. Once you are discharged from the hospital, your pharmacist can help answer your questions about medications, including what the label on the medicine bottle means. Ask your pharmacist to put your medicines in easy-to-open containers, and ask for large-print labels. About My Medical Tests 4 Why do I need this test? 4 What will this test show about my health? 4 What will the test cost? Will my health insurance cover the costs? 4 What do I need to do to get ready for the test? 4 How is the test done? What steps does the test involve? 4 Are there any dangers or side effects? 4 How will I find out the results of my test? How long will it take to get the results? 4 What will we know after the test? 4 Will I get a written copy of the test results? About My Condition 4 What effect did my hospitalization have on my condition? Is it cured or just under control for now? 4 How can my condition be treated, managed or made better? 4 How will this condition affect me? Will I need to change some of my activities? 4 Are there long-term effects of my condition? 4 How can I learn more about my condition? : 17

19 Rx Request a Meeting with Your Anesthesiologist Before Surgery to Ask Questions. Take Notes REFERENCE Q s Before surgery or procedure n What will happen before the surgery/procedure? n How long will it take? n Where can my family wait for me? n What effects (temporary or permanent) will the surgery have on me? n What is the doctor s experience in performing this procedure? n What medicines will be prescribed (short term/ long term)? n For how long will I have to rest at home after surgery? After surgery or procedure n When should I call my doctor? n How long should I stay in bed? n How much activity can I do? n What type of diet should I eat? n How soon can I drive? n When can I go back to work? n Can I have sex? n When should I schedule a visit to the doctor? n What changes should I make in my lifestyle? 18 :

20 Rights & Responsibilities Patients Have the Right to: 1. Considerate and respectful care, and to be made comfortable (including the right to respect for your cultural, psychosocial, spiritual, and personal values, beliefs and preferences). 2. Have a family member (or other representative of your choosing) and your own physician notified promptly of your admission to the hospital. 3. Know the name of the physician who has primary responsibility for coordinating your care and the names and professional relationships of other physicians and non-physicians who will see you. 4. Receive information about your health status, diagnosis, prognosis, course of treatment, prospects for recovery and outcomes of care (including unanticipated outcomes) in terms you can understand. You have the right to effectively communicate and participate in the development and implementation of your plan of care. You have the right to participate in ethical questions that arise in the course of your care, including issues of conflict resolution, withholding resuscitative services, and forgoing or withdrawing life-sustaining treatment. 5. Make decisions regarding medical care, and receive as much information about any proposed treatment or procedure as you may need in order to give informed consent or refuse a course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or non-treatment and the risks involved in each, and the name of the person who will carry out the procedure or treatment. 6. Request or refuse treatment, to the extent permitted by law. However, you do not have the right to demand inappropriate or medically unnecessary treatment or services. You have the right to leave the hospital against the advice of physicians, to the extent permitted by law. 7. Be advised if the hospital and/or personal physician proposes to engage in or perform human experimentation affecting your care or treatment. You have the right to refuse to participate in such research projects. 8. Reasonable responses to any reasonable requests made for service. 9. Appropriate assessment and management of your pain, information about pain, pain relief measures and to participate in pain management decisions. You may request or reject the use of any or all modalities to relieve the pain, including opiate medication, if you suffer from severe chronic intractable pain. The doctor may refuse to prescribe opiate medication, but if so, must inform you that there are physicians who specialize in the treatment of severe chronic pain with methods that include the use of opiates. 10. Formulate advance directives. This includes designating a decisionmaker if you become incapable of understanding a proposed treatment or unable to communicate your wishes regarding care. Hospital staff and practitioners who provide care in the hospital shall comply with these directives. All patients rights apply to the person who has legal responsibility to make decisions regarding medical care on your behalf : 19

21 Rights & Responsibilities 11. Have personal privacy respected. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. You have the right to be told the reason for the presence of any individual. You have the right to have visitors leave prior to an examination and when treatment issues are being discussed. Privacy curtains will be used in semiprivate rooms. 12. Confidential treatment of all communications and records pertaining to your care and stay in the hospital. You will receive a separate Notice of Privacy Practices that explains your privacy rights in detail and how we may use and disclose your protected health information. 13. Receive care in a safe setting, free from mental, physical, sexual or verbal abuse and neglect, exploitation or harassment. You have the right to access protective and advocacy services including notifying government agencies of neglect or abuse. 14. Be free from restraints and seclusion of any form used as a means of coercion, discipline, convenience or retaliation by staff. 15. Reasonable continuity of care and to know in advance the time and location of appointments, as well as the identity of the people providing the care. 16. Be informed by the physician, or a delegate of the physician, of continuing healthcare requirements and options following discharge from the hospital. You have the right to be involved in the development and implementation of your discharge plan. Upon your request, a friend or family member may be provided with this information. 17. Know which hospital rules and policies apply to your conduct while a patient. 18. Designate visitors of your choosing, if you have decision-making capacity, whether or not the visitor is related by blood or marriage, unless: n No visitors are allowed. n The facility reasonably determines that the presence of a particular visitor would endanger the health or safety of a patient, a member of the health facility staff or other visitor to the health facility, or would significantly disrupt the operations of the facility. n You have told the health facility staff that you no longer want a particular person to visit. However, a health facility may establish reasonable restrictions upon visitation, including restrictions upon the hours of visitation and number of visitors. 19. Have your wishes considered, if you lack decision-making capacity, for the purposes of determining who may visit. The method of that consideration will be disclosed in the hospital policy on visitation. At a minimum, the hospital shall include any people living in your household. 20. Examine and receive an explanation of the hospital s bill regardless of the source of payment. 21. Exercise these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, age, 20 :

22 disability, medical condition, sexual orientation, marital status or the source of payment for care. 22. File a grievance. If you want to file a grievance with this hospital, you may do so by writing or calling: Administration St. Rose Hospital Calaroga Ave. Hayward, CA A grievance committee will review each grievance and provide you with a written response within seven days. The written response will contain the name of a person to contact at the hospital, the steps taken to investigate the grievance, the results of the grievance process and the date of completion of the grievance process. Concerns regarding quality of care of premature discharge also will be referred to the appropriate Utilization and Quality Improvement Peer Review Organization (PRO). 23. You also may file a complaint with the State Department of Health Services regardless of whether you use the hospital s grievance process. The State Department of Health Services phone number and address is: Department of Public Health Alameda County District Office 850 Marina Bay Pkwy. Bldg. P, Floor 1 Richmond, CA / or you can report your concerns to: The Joint Commission Complaint Hotline at or: Office of Quality and Patient Safety The Joint Commission One Renaissance Blvd. Oakbrook Terrace, IL Patient Responsibilities Patients assume the following responsibilities: 1. Provides, to the best of his/her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to health status. 2. Reports unexpected changes in his/ her condition to the responsible practitioner. 3. Makes known whether he/she comprehends the contemplated course of treatment with risks and benefits, and what is expected of him/her. 4. Follows the treatment plan recommended by the attending physician and cooperates with members of the healthcare team as they implement the plan of care. 5. Is responsible for the resulting consequences of refusing the recommended treatment or not following instructions. 6. Provides the hospital with a copy of an advance directive if one has been executed. 7. Is considerate of the rights and privacy of other patients and respectful of the employees and property at St. Rose Hospital. 8. Ensure that the financial obligations of his/her healthcare are fulfilled as promptly as possible : 21

23 What Are Your Advance Directives? What Are Advance Directives? A living will, healthcare proxy and durable power of attorney are the legal documents that allow you to give direction to medical personnel, family and friends concerning your future care when you cannot speak for yourself. You do not need a lawyer in order to complete advance directives. Your advance directive is kept with your medical record. This way, you ensure that the hospital has a copy of your advance directive. For more information about advance directives or to obtain forms, please speak with a social worker. You have the right to make decisions about your own medical treatment. These decisions become more difficult if, due to illness or a change in mental condition, you are unable to tell your doctor and loved ones what kind of healthcare treatments you want. That is why it is important for you to make your wishes known in advance. Here is a brief description of each kind of directive: Living Will A set of instructions documenting your wishes about life-sustaining medical care. It is used if you become terminally ill, incapacitated or unable to communicate or make decisions. A living will protects your rights to accept or refuse medical care and removes the burden for making decisions from your family, friends and medical professionals. Surrogate Decision Maker A person (agent) you appoint to make your medical decisions if you are unable to do so. Choose someone you know well and trust to represent your preferences. Be sure to discuss this with the person before naming him or her as your agent. Remember that an agent may have to use his or her judgment in the event of a medical decision for which your wishes aren t known. Durable Power of Attorney For healthcare: A legal document that names your healthcare proxy. Once written, it should be signed, dated, witnessed, notarized, copied and put into your medical record. For finances: You also may want to appoint someone to manage your financial affairs when you cannot. A durable power of attorney for finances is a separate legal document from the durable power of attorney for healthcare. You may choose the same person for both, or choose different people to represent you. 22 :

24 Your Privacy & Health Information You have privacy rights under a federal law that protect your health information. These rights are important for you to know. Federal law sets rules and limits on who can look at and receive your health information. You have rights over your health information. Who must follow this law? n Most doctors, nurses, pharmacies, hospitals, clinics, nursing homes and many other healthcare providers n Health insurance companies, HMOs and most employer-group health plans n Certain government programs that pay for healthcare, such as Medicare and Medicaid What information is protected? n Information your doctors, nurses and other healthcare providers put in your medical records n Conversations your doctor has with nurses and others regarding your care or treatment n Information about you in your health insurer s computer system n Billing information about you at your clinic n Most other health information about you held by those who must follow this law You have rights over your health information. Providers and health insurers who are required to follow this law must comply with your right to: n Ask to see and get a copy of your health records n Have corrections added to your health information n Receive a notice that tells you how your health information may be used and shared n Decide if you want to give your permission before your health information can be used or shared for certain purposes, such as for marketing n Get a report on when and why your health information was shared for certain purposes n File a complaint To make sure that your health information is protected in a way that doesn t interfere with your healthcare, your information can be used and shared: : 23

25 Your Privacy & Health Information POA/Executor of Will Individuals requesting another person s records must provide a healthcare power of attorney, or if the person is deceased, a court order or proof he or she is the executor of the will. Follow steps 2-8 located below. n For your treatment and care coordination n To pay doctors and hospitals for your healthcare and help run their businesses n With your family, relatives, friends or others you identify who are involved with your healthcare or your healthcare bills, unless you object n To make sure doctors give good care and nursing homes are clean and safe n To protect the public s health, such as by reporting when the flu is in your area n To make required reports to the police, such as reporting gunshot wounds Without your written permission, your provider cannot: n Give your health information to your employer n Use or share your health information for marketing or advertising purposes n Share private notes about your mental health counseling sessions How do I get copies of my medical records? 1. This office is not open to the public due to HIPAA. 2. Anyone requesting records in person must report to the information desk in the Health Information Management (HIM) Department lobby. 3. The staff will supply the individual with a Release of Information (ROI) form to complete. 4. HIM staff will verify the individual was a patient here before any decision is made to release information. 5. To greet the individual in the lobby, introduce yourself, retrieve the ROI form and ask for valid state identification and make a copy for the record. 6. Print requested records and review printed copies carefully. 7. Have a coworker verify all the information and re-check the records for accuracy. 8. Two signatures of staff of HIM Department are required on the ROI form before any release of document is made. 24 :

26 Don t Leave Until 7 things to know before you walk out that hospital door. Be sure to meet with the hospital s discharge planner early in your stay to ensure a smooth discharge process later on. When it s time to be released from the hospital, your physician will authorize a hospital discharge. This doesn t necessarily mean that you are completely well it only means that you no longer need hospital services. If you disagree, you or your caregiver can appeal the decision (see If You Disagree, at right). On the other hand, you may be pleased to learn that your doctor has approved your discharge. But before you can leave the hospital, there are several things that you or your caregiver must attend to. The first step is to know who will be involved in your discharge process. This starts with the hospital s discharge planner, who may be a nurse, social worker or administrator, or may have some other title. You and your caregiver should meet this person relatively early in your hospital stay; if not, find out who this person is and be sure to meet with him or her well before your expected discharge date. If You Disagree You or your support person can appeal your doctor s discharge decision. If you are a Medicare patient, be sure you are given An Important Message from Medicare from the hospital s discharge planner or caseworker. This details your rights to remain in the hospital for care and provides information on who to contact to appeal a discharge decision : 25

27 Don t Leave Until... continued Make sure you have the following information before you leave the hospital: 1. Discharge summary. This is an overview of why you were in the hospital, which healthcare professionals saw you, what procedures were done and what medications were prescribed. 2. Medications list. This is a listing of what medications you are taking, why, in what dosage and who prescribed them. Having a list prepared by the hospital is a good way to double-check the information you should already have been keeping track of. 3. Rx. A prescription for any medications you need. Be sure to fill your prescriptions promptly so you don t run out of needed medications. Be sure to ask what foods to stay away from while on your medications. 4. Follow-up care instructions. Make sure you have paperwork that tells you: n what, if any, dietary restrictions you need to follow and for how long n what kinds of activities you can and can t do, and for how long n how to properly care for any injury or incisions you may have n what follow-up tests you may need and when you need to schedule them n what medicines you must take, why, and for how long n when you need to see your physician n any other home-care instructions for your caregiver, such as how to get you in and out of bed, how to use and monitor any equipment, and what signs and symptoms to watch out for n telephone numbers to call if you or your caregiver has any questions pertaining to your after-hospital care 5. Other services. When you leave the hospital, you may need to spend time in a rehabilitation facility, nursing home or other institution. Or you may need to schedule tests at an imaging center, have treatments at a cancer center or have in-home therapy. Be sure to speak with your nurse or physician to get all the details you need before you leave. 6. Community resources. You and your caregiver may feel unprepared for what will happen after your discharge. Make sure your discharge planner provides you with information about local resources, such as agencies that can provide services like transportation, equipment, home care and respite care. 7. St. Rose Care Call. You will receive a St. Rose Care Call a few days after you are discharged from the hospital. You will be asked a few questions about your health and progress. Based on your answers, a clinician may call you back to offer help and instructions. We care about your health in the hospital and at home. 26 :

28 Preparing to Leave the Hospital When your doctor feels that you are ready to leave the hospital, he or she will authorize a hospital discharge. Please speak with your nurse about our discharge procedures. Here are few tips to make the discharge process run smoothly: n Be sure you and/or your caregiver has spoken with a discharge planner and that you understand what services you may need after leaving the hospital. (See Don t Leave Until on page 25 for more discharge advice.) n Verify your discharge date and time with your nurse or doctor. n Have someone available to pick you up. n Check your room, bathroom, closet and bedside table carefully for any personal items. n Retrieve any valuables you have stored in the hospital safe. n Make sure you or your caregiver has all necessary paperwork for billing, referrals, prescriptions, etc. What a Hospital Bill Covers The hospital bill covers the cost of your room, meals, 24-hour nursing care, laboratory work, tests, medication, therapy and the services of hospital employees. You will receive a separate bill from your physicians for their professional services. If you have questions about these separate bills, please call the number printed on each statement. The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company, and you have the final responsibility for payment of your hospital bill. Commercial Insurance As a service to our customers, we will forward a claim to your commercial insurance carrier based on the information you provide at the time of registration. It is very important for you to provide all related information such as policy number, group number and the correct mailing address for your insurance company. When You are Discharged Your physician determines when you are ready to be discharged. Your physician and nurse will give you discharge instructions and answer any questions you have about managing your treatment and medications once you are home. If you are confused or unsure about what you need to do, what medications you must take or if you have to restrict your diet or activities, don t be afraid to ask and take notes. Be sure you understand any instructions you have been given before you leave the hospital. Uninsured? If you are in need of assistance with your hospital bill, call Hospital Financial Counseling at or : 27

29 Patient Portal Access Your Medical Record Online Today! We at St. Rose Hospital believe that every patient should have easy, instant access to his or her health information at any time. We are pleased to present this opportunity through the use of a secure internet portal. Using this portal, you will be able to access your health information online three (3) days post-discharge. All you need to activate this service is a valid address. You then will be able to access information from your visit, allergies, procedures, lab and radiology results, vitals, and more all in one place! Please see the Patient Access Department with any questions about enabling the portal for your medical records. Should you have any difficulty registering for this service, please contact RelayHealth Customer Support by phone at RELAY- ME ( ) or by at support@ RelayHealth.com. Using the System n Step 1: During Registration, provide the hospital registrar with a valid address. n Step 2: Upon discharge, you will receive an with a link to the Patient Portal. n Step 3: Check your and use the link to launch the online Patient Portal. n Step 4: You will be prompted to enter your date of birth to confirm your identity. n Step 5: You will be prompted to verify your demographic information. n Step 6: Create a User ID (using your address is recommended) and password. n Step 7: Create three security questions to verify your identity in case of password loss. n Step 8: Check the box to agree to the Terms of Use. n Step 9: Congratulations! Your account has now been activated. 28 :

30 After-Hospital Care Know what your healthcare options are after you leave the hospital. When you leave the hospital, you may need to spend some time in a rehabilitation facility, nursing home or other institution. Or you may be able to stay home and receive healthcare services there. Be sure that you and your caregiver understand the plan for your care before you are discharged from the hospital. Here s a brief explanation of the various services that you may use during your recovery. Home Healthcare Part-time healthcare provided by medical professionals in a patient s home to maintain or restore health. It includes a range of skilled and non-skilled services, including part-time nursing care, therapy and assistance with daily activities and homemaker services, such as cleaning Be sure that you and your caregiver understand your care plan before you are discharged from the hospital. and meal preparation. Medicare defines home healthcare as intermittent, physician-ordered medical services or treatment. Medicare-Covered Equipment and Supplies If you need durable medical equipment (such as a walker, wheelchair, crutches or a hospital bed), Medicare will only cover the cost if you get it from a supplier enrolled in the Medicare program. This means the supplier has been approved and has a Medicare supplier number. If your supplier does not have a Medicare supplier number, Medicare will not pay your claim. To find a supplier enrolled in the Medicare program, visit gov and select Find Suppliers of Medical Equipment & Supplies in Your Area or call 800-MEDICARE ( ). TTY users should call : 29

31 After-hospital care that is tailored to your needs can speed your recovery and help you get back to your normal routine. Independent Living Communities for seniors who are very independent and have few medical problems. Residents live in private apartments. Meals, housekeeping, maintenance, social outings and events are provided. Assisted Living An apartment in a long-term care facility for elderly or disabled people who can no longer live on their own but who don t need a high level of care. Assisted living facilities provide assistance with medications, meals in a cafeteria or restaurant-like setting, and housekeeping services. Nursing staff is on-site. Most facilities have social activities and provide transportation to doctor s appointments, shopping, etc. Nursing Home A residential facility for people with chronic illness or disability, particularly elderly people who need assistance for most or all of their daily living activities, such as bathing, dressing and toileting. Nursing homes provide 24-hour skilled care and also are called long-term care facilities. Many nursing homes also provide short-term rehabilitative stays for patients recovering from an injury or illness. Some facilities also have a separate unit for residents with Alzheimer s disease or memory loss. Hospice A licensed or certified program that provides care for people who are terminally ill and their families. Hospice care can be provided at home, in a hospice or other freestanding facility, or within a hospital. Hospice care emphasizes the management of pain and discomfort and addresses the physical, spiritual, emotional, psychological, financial and legal needs of the patient and his or her family. 30 :

32 Managing Your Medications Help avoid medication errors by asking questions and tracking your meds. The best way to avoid medication errors is by keeping up-to-date records of all the medications, supplements and herbs that you take and sharing that information with any doctors you visit. If you are hospitalized, you will be asked to list all the medications you are taking including prescription medications, over-the-counter drugs and vitamin/herbal supplements. Double-Check! Be sure that all of your doctors know what medications you have been taking. They also need to be aware of any allergies you may have. And whenever any of your doctors prescribes new medications, be sure to ask: n Which of my original medications/supplements should I still be taking? n Which of my original medications/supplements should I no longer take? n Will any new medications I am being prescribed interfere with my original medications/supplements? n What side effects do I need to be aware of? n Who should I call if I have questions or problems with my medications? Rx for Less The Partnership for Prescription Assistance helps qualifying patients who don t have prescription medication coverage get the medicines they need. Many medicines are available for free or are nearly free. To find out more, go to or call CHECK IT OUT! Use this checklist to be sure you understand what your medicines are and why they are being prescribed: 4 What are the brand and generic names of the medicine? 4 Why do I need to take this medicine? 4 What dose will I be taking? How often, and for how long? 4 What are the possible side effects? 4 Can I take this medicine while taking my other medications and/or dietary supplements? 4 Are there any foods, drinks or activities that I should avoid while taking this medicine? : 31

33 Giving Back The St. Rose Hospital Foundation is a tax-exempt, not-for-profit organization formed in 1977 to support the mission of St. Rose Hospital to provide quality healthcare regardless of the patient s ability to pay. To that end, the Foundation is devoted to the development of financial resources which enable us to provide that support. Your donation can help the Foundation acquire those resources so that we may continue to support St. Rose Hospitals services, programs and facilities in an effort to better care for our community. The ways that you can donate to St. Rose Hospital Foundation are varied. Your gift may be large or small, outright or deferred. It can be made by donations of cash, checks, credit cards, securities or property and can be done now or after your lifetime through your will or trust. You can mark a milestone or commemorate a particular date or event, pay tribute to a caregiver or someone who has inspired you, and to whom you have always wanted to say, Thank you! You may restrict your gift to benefit a particular program, service or fund. To explore the many ways you can help St. Rose Hospital Foundation or get assistance with planning your gift giving, please contact the St. Rose Hospital Foundation at or foundation@srhca.org. You also may visit our website at and go to the Foundation page for more information about gift giving and our events and programs. 32 :