Historically, each health care facility in the United States has subscribed to a written Patient Bill of Rights that was created by the American Hospital Association in 1995. That document was replaced a few years ago by The Patient Care Partnership which uses plain language to inform patients about what they should expect during their hospital stay with regard to their rights and responsibilities.(https://www.aha.org/aha/issues/Communicating-With-Patients/pt-care-partnership.html).
What you should expect during your hospital stay:
- High quality & respectful care
- Clean & safe environment
- Involvement in your own care
- Protection of your privacy
- Help when you leave the hospital
- Help with your billing claims
Who Are Your Caregivers?:
You have the right, upon request, to be given the name of your attending physician, the names of all other physicians directly participating in your care, and the names and functions of other health care persons having direct contact with you.
When Do Your Rights Begin?:
Either you, or when appropriate, your designated representative, have the right to be informed of your patient rights at the earliest possible time in the course of your hospitalization.
You have the right to have a family member or representative of your choice and your own personal physician notified promptly of your admission to the hospital.
Standards of Care:
You have the right to good quality care and high professional standards that are continually maintained and reviewed. You have the right to such care without discrimination based upon race, color, religion, sex, sexual preference, national origin or source of payment.
You have the right to be free from all forms of abuse, neglect or harassment from staff, other patients, and visitors.
You have the right not to be awakened by hospital staff unless it is medically necessary.
You have the right to be free from needless duplication of medical and nursing procedures.
You have the right to medical and nursing treatment that avoids unnecessary physical and mental discomfort whenever possible.
You have the right to be free from restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff.
Full Understanding:
You have the right to have a full understanding of your condition, including the diagnosis, prognosis, treatment options and potential side effects of such treatments. Have a notebook and pen with you at all times while you are a patient. Write down every question you have so you can get all of your questions answered. Write down the pertinent information that you are given so you can recall it, reflect on it and share it with your significant others. If you don’t understand the terms, ask for clarification. If you can’t spell the words, ask how to spell them.
You also have a right to see the written results of all of your diagnostic test results as well as any other information written about you in your chart.
If you do not speak English, or you are hearing impaired, you shall have access, when possible, to a qualified medical interpreter (for foreign language or hearing impairment) at no cost, when necessary or possible.
As a patient, you have the right to know what facility rules and regulations apply to your conduct as a patient.
You have the right to expect emergency procedures to be implemented without unnecessary delay.
Visitation:
You have the right to designate visitors who shall receive the same visitation privileges as your immediate family members, regardless of whether the visitors are legally related to your by blood or marriage.
Participating in Your Own Care:
You have the right to participate in the development and implementation of your own plan of care, including inpatient treatment/care plan, outpatient treatment/care plan, discharge care plan, and pain management plan.
Informed Decisions:
You have the right to make informed decisions regarding your own care. Your rights include being informed of your health status, being involved in care planning and treatment, and being able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate. Making informed decisions includes the development of your plan of care, medical and surgical interventions (e.g., deciding whether to sign a surgical consent), pain management, patient care issues and discharge planning.
Except for emergencies, the physician must obtain the necessary informed consent prior to the start of any procedure or treatment, or both.
Advance Directives:
You have the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives. Advance Directives allow you to orchestrate your own care when you are unable to do so.
Research Studies/Experimental Drugs:
You have the right to be advised when a physician is considering entering you as part of a medical care research program or donor program. Informed consent must be obtained prior to actual participation in such program and you or your legally responsible party, may, at any time, refuse to continue in any such program to which you have previously given informed consent.
Right to a 2nd Opinion:
You have the right to assistance in obtaining consultation with another physician at the your request and expense.
Payment of Medical Costs:
You have the right to examine and receive a detailed explanation of your bill. You may have to ask for it as usually the facility only sends you a bill indicating the total cost of the care. You should look at it carefully as in many cases, you may be responsible for 20% of your bill and you may be able to pick up some mistakes which you should share with the hospital’s business office or customer service department. You also have the right to full information and counseling on the availability of known financial resources for your health .
Right to Privacy:
You have the right to every consideration of your privacy concerning your own medical care program. Case discussion, consultation, examination, and treatment are considered confidential and shall be conducted discreetly. You have the right to have all records pertaining to your medical care treated as confidential except as otherwise provided by law or third party contractual arrangements.
You have the right to personal privacy. Privacy includes a right to respect, dignity, and comfort as well as privacy during personal hygiene activities (e.g. toileting, bathing, dressing), during medical/nursing treatments, and when requested as appropriate. It also includes limiting release or disclosure of your information such as your presence in facility, location in hospital, or personal information.
Access to Your Medical Records:
The facility shall provide you or your patient designee, upon request, access to all information contained in your medical records. This access may be restricted by your attending physician for sound medical reason only. If the physician restricts your access, he or she must record the reasons for such restriction on your medical record. In many cases, your designee may have access to the information in the your medical records even if your attending physician restricts your access to those records.
Right To Refuse:
You have the right to refuse any drugs, treatment or procedure offered by the facility, to the extent permitted by law, and a physician shall inform you of your right to refuse any drugs, treatment or procedures and of the medical consequences of the your refusal of any drugs, treatment or procedure. It is your privilege to refuse, but you should discuss the reasons for your refusal with your doctor so you do not get labeled as a difficult patient. Keep in mind that refusal of treatment on a regular basis could result in your insurance company NOT paying for that hospitalization… or at least the days in which it is documented that you refused care.
Right To Leave:
You are also not a prisoner in the hospital. You have the right to leave at any time if you are of sound mind. Be assured that the staff will explain to you the potential repercussions of your departure and will try and talk you out of leaving. If you insist on leaving against medical advice and you are of sound mind, that is your choice. You have a voice… and you have used it! The staff will ask you to sign a form called Against Medical Advice (AMA). This form documents your departure and negates any liability that the facility has in the event of a catastrophic occurrence as a result of your departure. If you refuse to sign the form, it will still be legally valid with the signature of two staff members who witnessed your refusal to sign it.
In the event that you are not of sound mind and may not understand the potential repercussions of your decision to leave, you will not be allowed to depart from the hospital against medical advice. In such instances, security will be called, and if necessary, protective devices applied until such time that a psychiatrist examines you and deems you mentally capable of making such a decision.
Being Transferred:
There may be times when medically permissible, that you may be transferred to another facility. This can happen only after you or your next of kin or other legally responsible representative has received complete information and an explanation concerning the needs for such transfer and alternatives to such transfer. The facility to which you are being transferred must first have accepted you for such transfer.
Discharge:
You have the right to expect that the facility will provide a mechanism whereby you are informed upon discharge of your continuing health care requirements following discharge and the means for meeting them.
When Your Rights are Violated:
The bottom line is that you should expect to have your physical, emotional, social and spiritual needs met with kindness, sensitivity and dignity by the entire staff of the hospital. You should always feel safe and secure. Your patient rights should never be violated. If you find that not to be the case, you or your representative has the right to have any concerns, complaints and grievances addressed. Sharing concerns, complaints and grievances will not compromise your care, treatment or services. Sharing may not necessarily get you better care, but if nothing else, it may serve to help the patients that come after you.
Share your negative experiences with your charge nurse or nursing supervisor. Hospital employed patient advocates will be more than happy to document any issues that might arise, but they have limited power to make anything happen especially when it involves doctor-patient issues. When all else fails, call for the hospital chaplain. Regardless of your religious affiliation, he/she will be compassionate, caring, willing and able to get things done. Some larger hospitals have a Customer Care hotline for such purpose. Once you are discharged, you have the right to contact your state’s department of health and human services or the Joint Commission on Accreditation of Healthcare.
Sharing Positive Experiences:
Be sure to let the hospital know when you have received excellence in care and caring. You will usually receive a written evaluation to complete upon discharge. Take the time to fill it out! Your experiences are very significant to the powers that be and your entire health care team.
ANECDOTE:
My 31 year old brother-in-law, Marty, was admitted to the hospital with severe right lower abdominal pain and right lower back pain which was a classical symptom of a kidney stone. An Intravenous Pyelogram (IVP) was ordered to see if Marty was passing a stone. In this test, dye is injected through a vein and a series of Xrays are taken to watch the dye go through the urinary system. When the admitting doctor spoke with the radiologist (medical doctor who performs & evaluates radiological tests) who performed the IVP, the preliminary verbal report came back negative for kidney stones. Marty responded to Intravenous antibiotics and was sent home after 2 days. Upon discharge, his medical chart was sent to the medical records department where it was filed. While the radiologist’s verbal report did not show a kidney stone, the official written report did show a suspicious looking mass in the colon ( large intestine) which was pressing on the ureter ( tube that delivers urine from kidney to bladder). That is why he was having both gastrointestinal symptoms ( pain in right lower abdomen) and pain in the right lower back. The admitting doctor never read the report as it was sent to Marty’s file already tucked away in the medical records department because he had been discharged. As a result, Marty walked around undiagnosed and untreated for 18 months until he was finally diagnosed with Stage 4 Colon Cancer. He died one month after his diagnosis, at the age of 33. Had Marty demanded to see the written results of his IVP, he might still be alive today.
” Patient Rights in The Hospital “- 1:30 minutes
” Home Care- Patient Safety, Rights and Protections ” – 5:20 minutes
Lead Me To The Cross – The Dying Patient’s Bill of Rights – 4:21 minutes