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Planning a hospital stay helps the patient understand what to expect before
admission to the hospital and ensures the patient is physically and
psychologically ready. If the hospital stay was planned, some of the steps
involved in preparing for the hospital stay will take place one to two weeks
before the patient is admitted to the hospital. Many of these steps will not
apply if the hospital stay was unexpected or was the result of an
emergency.
Planning a hospital stay includes determining what hospitals
or facilities are covered by the patients insurance plan, evaluating the
credentials of the health care providers and hospital, gathering information
about the hospital, including services offered, scheduling the hospital stay,
completing pre-admission testing, receiving and following all of the appropriate
pre-admission instructions, registering at the hospital upon arrival, as well as
completing an informed consent form. Patients are admitted to the hospital for a
variety of reasons, including scheduled tests, procedures, or surgery; emergency
medical treatment; administration of medication; or to stabilize or monitor an
existing medical condition.
Determining insurance coverage
Although
there are many types of hospitals available to meet the needs of different
patients, the patients choice of hospital may be limited by his or her
insurance plan. The patient should find out if the selected hospital is approved
by his or her insurance plan. If the patient receives care from a facility that
is not approved by the health care plan, the patient may be responsible for
paying for most or all of the medical expenses related to the hospital stay.
Managed care insurance plans often require pre-certification before any
hospital stay, except for emergency hospital admissions. Usually, the patients
doctor has to authorize the hospital stay, and some types of care provided in
the hospital may require insurance clearance. If the patient has Medicare
insurance (for patients over age 65), a semiprivate room, meals, general nursing
care, and other hospital services and supplies are covered services. Those
services not covered by Medicare include private duty nursing, a private room
(unless medically necessary), and television and telephone fees.
The
patient may desire to seek a second opinion to confirm the doctors treatment
recommendations. The patient should check with his or her insurance provider to
determine if the second opinion consultation is covered.
FOR PATIENTS
WITHOUT INSURANCE COVERAGE
For patients who do not have insurance coverage,
other payment options and sources of financial aid can be discussed. The patient
should ask to speak with the hospitals financial counselor for more
information.
Evaluating credentials
The patient should find out if
the physicians who will provide care in the hospital are board certified. Even
though board certification is not required for an individual physician to
practice medicine, most hospitals require that a certain percentage of their
staff be board certified.
There are 24 certifying boards recognized by
the American Board of Member Specialties (ABMS) and the American Medical
Association (AMA). Most of the ABMS boards issue time-limited certificates,
valid for six to 10 years. This requires physicians to become recertified to
maintain their board certification - a process that includes a credential review,
continuing education in the specialty, and additional examinations. A
physicians membership in professional societies is also an important
consideration. Professional societies provide an independent forum for medical
specialists to discuss issues of national interest and mutual concern.
Examples of professional societies include the Society of Thoracic
Surgeons (STS) and the American College of Physicians - American Society of
Internal Medicine (ACP-ASIM).
To find information about a physicians
qualifications, the patient can call a state or county medical association for
assistance. A reference book is also available, The Official ABMS Directory of
Board-Certified Medical Specialists, that lists all physicians who are certified
by approved boards. This publication also contains brief information about each
physicians medical education and training, and it can be found in many
libraries.
Evaluating the health care team
Selecting a hospital that
has a multi-disciplinary team of specialists is important. The medical team
should include surgeons (as applicable), physicians who specialize in the
patients medical condition (such as cardiologists for heart disease and
pulmonologists for lung disease), infectious disease specialists,
pharmacologists, and advanced care registered nurses. Other medical team members
may include fellows, residents, interns, clinical coordinators, physical
therapists, occupational therapists, respiratory therapists, registered
dietitians, social workers, and financial counselors.
Evaluating the
hospital
The patient should find out if the hospital has been accredited by
the Joint Commission on Accreditation of Healthcare Organizations, a
professionally sponsored program that stimulates a high quality of patient care
in health care facilities. Joint Commission accreditation means the hospital
voluntarily sought accreditation and met national health and safety standards.
Here are some questions to consider when evaluating a hospital:
•
Does the hospital offer treatment for the patients specific condition? How
experienced is the hospital staff in treating that condition?
• What is the
hospitals success record in providing the specific medical treatment or
procedure the patient needs?
• Does the hospital have experience treating
other patients the same age as the potential patient?
• Does the hospital
explain the patients rights and responsibilities?
• Does the hospital have
a written description of its services and fees?
• How much does the
patients type of treatment cost at the hospital?
• Is financial help
available?
• Who will be responsible for the patients specific care plan
while he or she is in the hospital?
• If the hospital is far from the
patients home; will accommodations be provided for caregivers?
• What type
of services are available during the patients hospital stay?
• Will a
discharge plan be developed before the patient goes home from the hospital?
• Does the hospital provide training to help the patient care for his or her
condition at home?
Hospital services
Usually, the patient receives
information about the hospital from the admitting office when the hospital stay
is scheduled. This information should include directions to the hospital,
parking information, lodging information if the patient is from out of town,
types of rooms, and services offered.
Hospital services offered may
include:
• Ethics consultation: Bioethics professionals are available at
most hospitals to provide advice or help the patient identify, analyze, and
resolve ethical issues that may arise during the patients care at the hospital.
• Barber or beautician: These services may incur a fee, in addition to the
fees of the patients hospital stay.
• Complementary techniques such as
guided imagery and relaxation tapes, massage therapy, or aromatherapy (to reduce
a patients level of stress and anxiety).
• Home care: If home health
services will be needed after the patient is discharged, they can be arranged by
the social worker or nursing staff.
• Interpreter: An interpreter or other
special services may be available to assist patients and family members who do
not speak the language or are from out of the country.
• Nutrition therapy:
Registered dietitians are available to provide comprehensive nutrition
assessment, counseling, and education.
• Ombudsman: Health care personnel
available to address concerns and problems about medical services that cannot be
resolved by reporting these concerns to the nursing staff.
• Pastoral care:
Clergy members are available at most hospitals to provide religious support and
services to meet patients spiritual needs. Many hospitals also have a small
chapel that provides a quiet retreat for patients and family members of all
religious backgrounds and faiths.
• Patient education: A variety of services
are available to teach patients about their medical condition or to help them
prepare for their scheduled tests or procedures. Patient education may include
one-on-one instruction from a health care provider, educational sessions in a
group setting, or self-guided learning videos or modules. Informative and
instructional handouts are usually provided to explain specific medications,
tests, or procedures.
• Pediatric services: Many hospitals have dedicated
services and programs available to help children, teenagers, and their parents
feel better prepared to cope more effectively with hospital stays, surgery,
procedures, and other health-related events.
• Social work: Social workers
are available to help patients manage the changes that may occur as a result of
the patients hospitalization. Socials workers provide referrals to community
resources and can help the family make arrangements for care in the home as
necessary after the patient is discharged from the hospital.
Patient
rights and responsibilities
All hospitals have a list of patient rights and
responsibilities, established by the American Hospital Association. These rights
and responsibilities are usually published and posted throughout the hospital.
By law, all patients have certain rights.
Some patient rights include
the right to:
• considerate and respectful care
• complete information
about diagnosis, treatment, and expected recovery in terms the patient can
understand
• knowledge of the name and function of any health care
professional providing care
• informed consent
• the right to refuse
treatment to the extent permitted by law and be informed of the medical
consequences of refusing treatment
Each patient should obtain a list of
his or her rights and responsibilities prior to a hospital admission.
Hospital environment
Most hospital rooms have a bed, bedside table,
chair telephone, television, and bathroom. Some hospitals charge a fee for use
of the telephone or television; patients should be notified of these charges
prior to their hospital admission. Each patient area has a call signal button so
the patient can notify the nursing staff if help is needed. Most hospital rooms
are doubles that are shared by two patients, unless a private room was
previously requested. Some hospitals also have wards in which four or more
patients stay in one room. Three nutritionally balanced meals are provided to
the patient daily during a hospital stay; daily menus are usually provided for
patients to select their food choices, as applicable. (Some patients have
dietary restrictions so their food choices may be limited.)
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