Preparing for your Procedure This booklet contains information about your scheduled procedure.
P R E PA R I N G F O R Y O U R P R O C E D U R E Welcome Lexington Avenue Entrance We are pleased that you chose King s Daughters for your upcoming surgery/procedure. This brochure will provide you and your family with information to make your experience as comfortable as possible. We encourage you to ask questions whenever anything is unclear; please feel free to ask any of our team members. We wish you a speedy recovery. Preparing for Your Procedure Procedure date: Time: Surgeon: 22nd Street Entrance Procedure type/site: Surgery entrance: Keep this with you throughout your journey with us. Heart and Vascular Center Where Do I Go? ASHLAND, KENTUCKY Lexington Avenue Entrance 22nd Street Entrance (Center for Advanced Care) Heart and Vascular Center Entrance Pre-admission testing and lab work 23rd Street Entrance 23rd Street Entrance (Outpatient Surgery Center) PORTSMOUTH, OHIO King s Daughters Ohio Hospital Entrance King s Daughters Ohio Urgent Care Entrance Pre-admission testing and lab work King s Daughters Ohio 2
A GUIDE FOR PATIENTS ASHLAND, KENTUCKY - CAMPUS King s Daughters, 2201 Lexington Ave. 22nd Street Customer Parking Customer Parking 22nd Street Entrance Main Entrance Open Parking 3 Open Parking HVC 2 G-Lot Customer Parking Bath Avenue Lexington Avenue Administration Human Resources ALLEY Data Center Medical Plaza A Medical Plaza B Emergency Department 1 4 23rd Street Lexington Avenue Parking Garage H-Lot Customer Parking 23rd Street Parking Garage E-Lot Customer Parking Montgomery Avenue Tri-State Regional Cancer Center Medical Arts Building Medical Arts Customers Only 24th Street 1 2 3 4 Lexington Avenue Entrance Please report to surgery center registration desk here. Parking is available in the Lexington Avenue Parking Garage across the street from this entrance. Cardiovascular Surgery (CVOR) Please report to the 22nd Street registration area. Parking is available in the surface lot on Bath Avenue. Heart & Vascular Center Entrance Please report to the Heart & Vascular Center reception desk for pre-admission, testing and lab work. Outpatient Surgery Center - 23rd Street Entrance Please report to the reception desk on the third floor. Parking is available in the 23rd Street Parking Garage and surrounding parking lots. Valet Parking and Shuttle Service - (606) 408-0454 King s Daughters offers valet parking at the 23rd Street entrance. Last car parked will be 4:30 p.m. A valet attendant is available to return cars to customers until 5:30 p.m. Monday Friday. King s Daughters free shuttle provides service to those who prefer to park their own cars. Hours are 7 a.m. to 4:30 p.m. weekdays. Just park your car in the Shuttle parking lot at Bath Avenue and 24th Street and a member of our Shuttle/Valet service will take you to your destination. 3
PREPARING FOR YOUR PROCEDURE PORTSMOUTH, OHIO - CAMPUS King s Daughters Ohio, 2001 Scioto Trail 1 Open Parking King s Daughters Ohio All surgical patients should enter at the hospital entrance. Patient parking is conveniently located just outside the hospital entrance doors. Open Parking Hospital Entrance Urgent Care Entrance 1 Scioto Trail Entrance Customer Parking US 23 Customer Parking Customer Parking (first four rows) Open Parking Argonne Road Customer Parking US 23 24 7 365 hours a day days a week days a year Anytime. All the time. 4 2001 Scioto Trail, Portsmouth
A GUIDE FOR PATIENTS Answer these questions before your procedure and talk about them with our team. Health History Do you have a health condition, such as diabetes, heart disease or high blood pressure? Do you have a bleeding or clotting disorder? Are you taking any medications? Include all prescriptions, vitamins, supplements and over-thecounter medications. Do you use tobacco, alcohol or illicit substances? Do you have any allergies to medications? Could you be pregnant? Do you have a fever, cold or rash? Healthcare Needs Do you have a living will or medical power of attorney? If you need a living will or POA, please see/call your attorney and complete them prior to your surgery date and bring them with you on the day of your surgery. Do you have legal documentation of guardianship? If so, please bring your documents on the day of surgery. Do you have medical interpreter needs? If so, please let us know in advance. Family members are unable to translate for medical procedures. Do your loved ones need a place to stay overnight? Please let us know. Do you have transportation and after-care plans? You will need a driver and caregiver for 24 hours after anesthesia. Patients may not drive or walk home. If you plan to take public transportation home after surgery, you must be accompanied by a caregiver who is at least 18 years of age. 5
PREPARING FOR YOUR PROCEDURE Getting Ready for a Procedure Pre-Admission Testing (PAT) Ashland: (606) 408-2570 King s Daughters Ohio main: (740) 991-1570 Kinneys Lane, Portsmouth, Ohio: (740) 991-1600 Several days before your surgery, you will be interviewed by a registered nurse. This is a confidential health history interview to identify specific things about you that help us plan ahead for your care. Please be prepared to tell us about your current medications, health conditions, allergies and other important health information. Our registered nurse will answer your questions and review any special instructions with you. For example, you may be asked to have diagnostic testing done, such as an EKG, blood draw, or X-ray, before surgery. Be sure to ask about taking any of your current medications before surgery. Our PAT nurse will also pre-register you. They will update your address, phone numbers, email, insurance information, etc. Lower Risk of Infection You may be instructed to follow special skin preparation instructions. If so, you will receive these instructions at your surgical readiness visit or phone call. It is required that you follow these instructions precisely to minimize your risk of infection. Do not remove any body hair prior to your arrival at the hospital. Men with beards who are having open-heart surgery might completely remove their beards prior to surgery. Before your surgery or procedure, shower three times using an antibacterial soap like Dial or Safeguard. If you visited our PAT Department, you will have received chlorhexidine to use for showering. Please be sure to follow the special instructions the PAT nurses provided for the chlorhexidine. These showers should be taken within 48 hours of your scheduled surgery/procedure. Use clean towels and washcloths with each shower and be sure to have clean sheets on your bed. Skin bacteria are the most common cause of post-operative surgical wound infections. If you have diabetes, keep your blood sugar below 200 mg/dl. High blood sugar increases your risk for infection. Care24/7 Care24/7 connects you with King's Daughters, no matter the time of day. You can make or update an appointment for primary care, request a prescription refill or talk to a nurse about a current medical concern. Call toll-free 1-844-324-2200 or (606) 408-8999. 6
A GUIDE FOR PATIENTS Preparing at Home Checklist r Are you having a joint replacement? Have you been to joint school with our team? (It s required to attend at least one week before your procedure. Available every week.) r Notify your surgeon if you have had a cold, flu or fever recently - even if you feel you have recovered from it. r Do not drink or eat anything after midnight. This includes mints, gum, water, hard candies, etc. You may brush your teeth, but do not swallow. r Don t smoke or use tobacco products for at least 24 hours before your procedure. r Unless directed otherwise by your surgeon, do not take any medications after midnight. If you are diabetic, take heart or blood pressure medications, or blood thinners, ask your surgeon for specific instructions. r Shower or bathe the morning of your procedure. (Use special skin instructions if given.) Don t apply deodorant, lotions, oils, moisturizer, makeup, etc. r Don t use hairpins or other metal objects in your hair. r Wear loose, comfortable, and freshly laundered clothing that s easy to take off and put on. r If you wear nail polish, please remove it. If you have artificial nails, please remove at least one nail from each hand. r All jewelry and body piercings must be removed and left at home. r If a red bracelet has been placed on your wrist by the lab, DO NOT REMOVE. What to Bring Checklist r Insurance cards, photo ID and Power of Attorney documents r A copy of your prescription card (if you would like your prescriptions filled here) r A copy of your living will (if applicable) r A copy of guardianship papers (if applicable) and the legal guardian must be present for the procedure. r A list of medications (please include all prescription medications, vitamins, supplements, and over-the-counter medications) including name, dose and how often you take each one r Inhalers (if applicable) r Financial payment, if required by your insurance provider r If you are being admitted to the hospital following your surgery, bring personal hygiene items like a toothbrush and hairbrush. r A case to hold items, such as dentures or glasses r CPAP or BIPAP mask for sleep apnea, if used (mask only) r Portable oxygen for transport to and from hospital if used at home (if applicable) 7
PREPARING FOR YOUR PROCEDURE Patient Registration Most patients are pre-registered by our Pre-Admission Testing (PAT) Department over the phone. Depending on the type of procedure and location, you may be asked to visit the department. During registration, we will ask questions to help identify you, gather information for billing purposes, and have you sign consent for treatment and billing. King s Daughters Medical Center, Ashland: Patient registration is located on the first floor of the medical center, inside the Center for Advanced Care lobby. Registration is open: 6 a.m. to 7:30 p.m. Monday-Thursday 6 a.m. to 6 p.m. Friday King s Daughters Medical Center Ohio: Registration is located inside the lobby of the hospital entrance. 6 a.m. to 4:30 p.m. Monday-Friday Outpatient Pre-Registration Outpatients may register for services by phone. Hours are 8 a.m. to 8 p.m., Monday-Thursday; 8 a.m. to 5 p.m. Fridays. Pre-registered patients are asked to bring insurance cards and photo ID on the day of service. Contact patient registration at (606) 408-2736 or toll-free at 1-877-304-1084 To Register We will need the following to complete the registration process: A photo ID, driver s license, state-issued ID card or a U.S. Passport Your insurance card(s) The order for the test/procedure (unless electronically submitted) Parent/legal guardian, if under 18 We also recommend you bring a copy of your living will with you, if applicable. 8
A GUIDE FOR PATIENTS Day of Your Procedure Surgery Schedule Time Changes We do everything we can to ensure the day of your procedure is not changed, but time changes may occur. If we need to change the start time of your surgery/procedure, you will be notified of the most updated schedule as soon as we become aware of the change. Arrival Time A Surgical Services team member will call you prior to your procedure with your arrival time. If you have not received a call by the afternoon on the day before your procedure, if you have missed the call, or have been unavailable, you may call Care 24/7 for your arrival time at (606) 408-8999. For Your Safety If there is anything you don t understand, or if you have any questions, please ask us. Expect that we will ask your name and date of birth several times. Don t be alarmed. This is done for your safety. It ensures that everyone knows we have the correct patient for the correct surgery/procedure. Your surgeon may place a mark on your body where the surgery/procedure is to be done. Tell the anesthesiologist about any medical conditions you may have, including diabetes or high blood pressure. Let the anesthesiologist know about any experiences you may have had with anesthesia. A family member may be able to join you in the pre-op area while you are being prepared for surgery. Others are asked to wait in the surgery waiting area. During surgery, family and friends may relax in the surgery waiting area. MyChart from King s Daughters is a great way to stay connected to your medical care. This tool is available to access 24/7 over a secure internet connection. And, best of all, it s free. With MyChart you can: Ask your provider a question through a secure messaging system Access your health history Review lab and outpatient test results View your list of current medications and request refills Keep track of upcoming appointments Learn more about health conditions and screening recommendations How do I sign up? The process is simple and can be done by making the request during registration for a test, office visit, or during an inpatient admission. Another fast and easy way is by going to the MyChart section of kingsdaughtershealth. com, or by calling King s Daughters Care 24/7 (606) 408-8999. After verification of your information and providing an email address, you will receive a link to your own MyChart account. It s simple, sign up today! 9
PREPARING FOR YOUR PROCEDURE Anesthesia General Anesthesia. You will be completely unconscious (deeply asleep), have no sensation of pain and be unaware of surgery. Regional Anesthesia. An injection of medication will block the nerves to the part of your body where your surgery will be. This may be done for surgical anesthesia and/or to manage pain after surgery. Epidural or spinal blocks numb the abdomen and lower body. Other nerve blocks may be done to numb only certain nerves in the arms or legs. With regional anesthesia, IV medications are given to relax you and blur your memory. Sometimes regional anesthesia is combined with general anesthesia. Monitored Anesthesia Care (MAC). IV medication is given to you to keep you relaxed and sleepy. Your memory will be blurred by the IV sedation so you may not remember the procedure. Local Anesthesia. This is used for minor procedures. Numbing medicine is injected by the surgeon at the surgery site. An anesthesia doctor is usually not present for these procedures. Post-Anesthesia Care Unit (PACU) You will be transferred to a recovery area after your procedure. Your anesthesiologist will ensure your well-being and then hand over your care to a highly trained post-anesthesia care unit (PACU) nurse. Your anticipated stay in the PACU will be 60 minutes or less. We apologize but we are not able to allow visitors into the recovery area. We want you to be with your family and friends as soon as possible but we have two major concerns that prevent you from having visitors. The first concern is for your safety. Our recovery nurses need to intensely focus on you and your health monitoring systems. The second concern has to do with patient privacy. The recovery period can be a difficult transition. Most patients have expressed a strong belief that they are not comfortable with other patients visitors seeing them during this sensitive time. Your family and friends will be able to speak with the surgeon immediately after the procedure and they can get periodic updates on your PACU status through our care team. They will be able to join you in the dismissal area if you are heading home, or in your room if you will be staying overnight. 10
A GUIDE FOR PATIENTS Anesthesia affects your thinking, reflexes and hand-eye coordination. For this reason, we require you have someone stay with you for the first 24 hours after your surgery. In addition, avoid the following for 24 hours, or until cleared by your surgeon: Driving or operating heavy machinery or other potentially dangerous equipment Cooking, using sharp knives, etc. Making any significant decisions or signing any contracts Alcohol, tobacco and smoking For pediatric patients: Do not allow your child to ride a bike, scooter, ATV, or similar mode of transportation for 24 hours. Do not allow your child to participate in any running, playing (such as recess or climbing on playground structures) or sports for 24 hours. If you develop any signs or symptoms of a problem, or if symptoms worsen, call your surgeon s office immediately or go to the nearest emergency room. Signs that require immediate attention include: Fever Redness, tenderness, swelling of the affected area Oozing, seeping or foul odor from incision, bright red blood Surgery & Recovery If you are staying in the hospital after surgery: You will be brought to your hospital room You can expect your nurse to check on you hourly Depending on your procedure, you may not be able to drink or eat right away Pain Management Pain is a natural consequence of surgery. We will do everything we can to minimize your discomfort, but please understand that pain is a part of the healing process. Your pain should lessen, bit by bit, day by day. Within three to five days, your pain should be at a level that it can be managed using over-thecounter medications, such as Tylenol; changes in position; applications of cold/ice; and compression/elevation. Your nurse will discuss these pain-relief strategies with you. Here are some additional tips: Take your medications as prescribed. Don t take others medications and don t share your medication with anyone else. Don t take your medications with alcohol. If your pain does not improve after five days, or if it worsens, please contact your surgeon for follow-up. We recognize that everyone experiences pain differently and that people respond differently to pain control methods. Our team will work with you to provide the best possible, and safest, pain relief. 11
PREPARING FOR YOUR PROCEDURE Your Role in Recovery Do not try to get out of bed alone. Your nurse will help you when you first try to walk, as you might be at risk for falling. You may also have compression devices on your legs that help prevent blood clots. You may have monitoring equipment that you may continue to wear during your hospital stay. As soon as directed by your surgeon, your role is to do mild physical activity while still giving yourself time to heal. Rest when you feel tired. Cough and breathe deeply. This helps to clear and expand your lungs and can prevent pneumonia. You may be given a spirometer to practice deep breathing. Your nurse or respiratory therapist will show you how to use the spirometer. Patients who are well informed and involved in their care typically experience better outcomes and are more satisfied. Going Home Before you go home, you will be given discharge instructions. Ask a family member or friend who is at least 18 years of age to listen to these instructions with you and plan to have someone stay with you for at least 24 hours after your procedure. That way, he or she can help you during recovery. Avoid driving if continuing to take pain medications post-discharge. Things to Ask Before you leave, make sure all your questions are answered. Your discharge instructions may answer most of your questions. If you have additional questions after arriving home, call your physician s office. The telephone number will be listed on your discharge instructions. Some of the most common questions you might want to ask include: Bathing and showering Diet what to eat, what to avoid Driving Incision and dressing care Medications dosages and when to take Pain control what to expect, what to do Physical activity Physical and occupational therapy Resuming sexual relations Returning to work Signs of infection You will need to schedule a follow-up visit with your surgeon. Information on this will be listed on your discharge instructions. Bring a list of your questions and concerns to this visit. You will be receive a call from us 24 to 48 hours after you go home to check on you. 12
A GUIDE FOR PATIENTS Understanding Your Bill We encourage you to contact your insurance company and discuss coverage of your planned procedure. If your insurance(s) requires precertification/pre-authorization, please be sure to let us know when you register. Your physician s office will obtain this information. Many insurance companies will not pay, or will greatly reduce payment for, procedures that are not pre-certified/authorized. Payment for costs not covered by your insurance plan will be billed to you after the insurance company has paid its share. Please be aware that in addition to your bill for hospital services, you may receive bills for professional services from physicians involved in your care. This may include bills from radiologists, pathologists, emergency room physicians, anesthesiologists, etc. Deductibles & Co-Pays We are required by most insurance companies to collect deductibles and co-payments up front when services are provided. If you have any questions about what your plan requires or your financial obligation under your insurance plan, please check with your employer or insurance company. Patient Billing Office Our patient billing office assists patients, insurance companies, physicians offices and hospital departments by managing patient accounts for King s Daughters and its subsidiaries, including: King s Daughters Medical Center Ashland King s Daughters Medical Center Ohio 13 King s Daughters Home Health King s Daughters Family Care Centers King s Daughters Integrated Practices King s Daughters Occupational Medicine Insurance Claims One of the most important things our Patient Billing Team does for patients is submit claims to your insurance company. To do this as efficiently as possible, our team asks that you provide us with the necessary information that will assist in filing your claim: Your current address Your current telephone number Copies of your insurance card(s) A photo ID, such as a driver s license Your Social Security number Your date of birth Financial Assistance Our Health System provides financial assistance for qualifying patients. A financial counselor can visit with you to help determine your needs and explain available financial resources. To get started, please complete our financial assistance determination form, which is available at kingsdaughtershealth.com. The form can be mailed to you; please call (606) 408-6454.
PREPARING FOR YOUR PROCEDURE Phone Numbers Ashland, Kentucky Campus Hospital Operator...(606) 408-4000 Business Office...(606) 408-4446 Toll free... 1-877-420-3555 Care 24/7...(606) 408-8999 Toll Free... 1-844-324-2200 Cardiothoracic OR...(606) 408-9102 Endoscopy...(606) 408-1490 Financial Assistance...(606) 408-6454 Family Pharmacy...(606) 324-0092 Lobbies/Waiting Rooms Center for Adv Care (22nd St)...(606) 408-0965 Heart & Vascular Center...(606) 408-0967 Lexington Avenue Lobby...(606) 408-0966 Open Heart Waiting...(606) 408-6689 Outpatient Surgery Center...(606) 408-1900 Pastoral Care...(606) 408-1745 Daily devotional...(606) 408-1746 Patient Registration...(606) 408-2736 Toll Free... 1-877-304-1084 Pre-Admission Testing...(606) 408-2570 Security...(606) 408-4000 Shuttle / Valet Service...(606) 408-0454 Portsmouth, Ohio Campus Hospital Operator...(740) 991-4000 Care 24/7... 1-844-324-2200 Centralized Scheduling...(740) 991-9021 Financial Assistance...(606) 408-6454 Medical Records...(740) 991-1592 Patient Information...(740) 991-0962 Patient Registration... 1-877-304-1084 Pre-Admission Testing King s Daughters Ohio...(740) 991-1570 Kinneys Lane Satellite...(740) 991-1600 Security...(740) 991-4487 Surgical Services...(740) 991-2001 If a situation arises that makes it necessary for you to reschedule or cancel your procedure, please call your surgeon s office immediately. After hours, you will be transferred to the answering service where you can leave a message or speak with someone in Care 24/7 by calling 1-844-324-2200 or (606) 408-8999. Your voice matters Following your visit with us, you may receive a survey asking about your experience with King s Daughters. We value your feedback and look forward to receiving your response. Thank you Thank you for choosing King s Daughters for your health care needs. We wish you well and hope you have a speedy recovery. 4/2018 14
A GUIDE FOR PATIENTS Notes 15
2201 Lexington Avenue Ashland, KY 41101 2001 Scioto Trail Portsmouth, OH 45662 kingsdaughtershealth.com