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A Guide to Your Care


Important information about medical and ethical issues

If you are reading this guide, you are probably in the hospital or preparing to be in the hospital. Our goal while you are a patient in our hospital is to help you experience the best possible outcome from your stay here. For this to happen, everyone — you, your family and your health care team — must all work together and communicate clearly. This guide is provided to help you understand how you and your family can work with your health care team toward the goal of achieving the best possible outcome, as well as to help you understand what our rights and responsibilities are while you are a patient here.

We know that a hospital can be a confusing place. You may have many different doctors who visit when your family isn?t nearby. Physicians and nurses may use words you don't understand. You may have questions about hospital rules or your rights as a patient. You may be very sick and hard choices may need to be made about your treatment. Making those decisions can be difficult and emotions may be strong. We hope the information you find in this guide will ease your mind, make you feel comfortable communicating with your health care team about your treatment or any other issues, and enhance the experience of both you and your family.

Your rights and responsibilities as a patient

As a patient, you have certain rights and responsibilities. As a hospital, it is our responsibility under federal law and hospital accreditation standards to make sure you are informed about those rights and responsibilities.

For example, you have the right to:

  • information about your condition, treatment options and test results
  • information about outcomes that may be different from what you and your family expected
  • treatment for pain and suffering
  • information about hospital ethics policies
  • participate in your treatment decisions, including ethical decisions about treatment
  • refuse or accept treatment or research that is offered to you. This includes the right to refuse treatments that can potentially help prolong your life, such as mechanical breathing machines, dialysis, artificial nutrition/hydration or attempted cardiopulmonary resuscitation (CPR)
  • complete advance directives such as a living will or medical power of attorney. These forms can be obtained from your nurse, chaplain, social worker, or physician
  • privacy, confidentiality, security and culturally respectful communication
  • have a language interpreter to assist you with conversations about your health throughout your visit free of charge
  • have access to items and/or devices to assist you with conversations about your health throughout your visit free of charge
  • decide who may visit you during your hospital stay
  • choose a primary support person to stay with you during your hospital stay
  • be informed if family or guest visitation must be restricted
  • freedom from mental, physical, sexual or verbal abuse or neglect

With your rights come certain responsibilities.
Your responsibilities, among others, include:

  • the responsibility to give your health care team honest and accurate information about your medical history
  • the responsibility to follow treatment directions and cooperate with your health care team
  • the responsibility to treat other patients, visitors, your health care team and hospital property with respect

Who is on my health care team?

Throughout this guide we refer often to your health care team. Depending on many factors, your health care team may be made up of any number of individuals who will provide your care. Every team member brings special expertise to your plan of care. .ese individuals will identify themselves, their professional status if applicable, their relationship to others on the team, and their role in your treatment and care.

Goals and types of treatment

The most basic goal of medicine is to fix or cure your health problem. If a complete cure is not possible, the goal of the health care team is to try to slow down the problem or make it go away for a while (remission). Perhaps the most important goal is to provide you with comfort and relief of suffering at all times. You will receive medically appropriate treatment to meet these goals and we hope that you will do well.

Communicating with your health care team

Good communication is essential to every part of medical treatment. It is important when things are going well. It may be even more important when things are not going well and the outcome you and your family expected is not being achieved. Either way, it is vital that you, your family and your health care team communicate clearly. You should feel free to discuss any topic associated with your care and treatment with members of your health care team. For example, you may want to discuss:

  • your diagnosis
  • goals of your treatment
  • the types of treatment appropriate to
  • meet those goals
  • the benefits, burdens, and risks of treatment
  • as well as the probability of success

It is important that you discuss your goals and the types of treatment with your physicians, nurses and your family while you are able to speak for yourself. How do you want to be treated if you have an accident or an illness and become so sick you can't speak for yourself? Who should speak for you and what should they say?

The importance of advance care planning

Many people see a visit to the hospital as a reminder to do important thing like: make sure arrangements are made if you have to stay a little longer than you thought; make sure family and friends know that you'll be out for a little time; prepare yourself mentally by looking forward to a positive outcome (your Plan A); make sure you?ve made legal preparations in the event that you need to go to a Plan B. These are Advance Directives.

Advance Directives guide your care when you can't. For instance, surgery on patients, they are taking medicine preventing them from making choices. During times like this, everyone needs forms to speak for them: The forms should say who makes choices for you and what kinds of choices you would want.

People often say, Someday, I'll fill one of those out. Sadly, too often they never get around to it. Like most things that come about when we haven't planned, if we don't get advance directives ahead of time, it often hurts our survivors. The guilt of having to make decisions can be overwhelming. Here?s the good news: in one large study, written guidelines significantly reduced emotional distress for family members who had to make hard decisions.

Are Advance Directives hard to do? No, not really. Currently, at Baylor Jack and Jane Hamilton Heart and Vascular Hospital, we recommend doing them online. There are several resources you can use. Baylor Scott & White Health helped participate in the development of one tool: www.MyDirectives.com. It combines all the directives you need into one handy tool.

Reasons to complete directives online:

  • You can update it anytime: 365 days a year, 24/7.
  • Change your mind about one of your alternate decision-makers? No problem. Just update it online.
  • You get one document. You don't have to keep up with two or more different documents.
  • You can access them from anywhere at any time. People you designate can access them anywhere at any time.
  • Health care providers can access them if needed.
  • It's digitally signed. You set up an account and then you sign it via email link: no witnesses needed (though you can name someone to witness it online, if you desire). One of the big problems of doing them on paper at home is trying to get folks together to witness it when you sign it.
  • Some online services like www.MyDirectives.com allow you to leave a video that visually states your wishes. This may have legal value as well as being a great help to family.
  • Finally, with some services you can leave information that can help your family to know who to contact, account numbers, and other resources.

In spite of the advantages of completing directives online, some people prefer written style forms. If you?re one of these folks, you can get the forms at the address below. Witnesses must be present and the first witness should be someone who is not related to you.

Whichever way you choose to do your documents, please bring a copy with you when you come to the hospital. You will be asked upon registration if you have Advance Directives. We'll attach this document to your chart so your doctors know about it. Also, if you complete paper forms, make sure to give a copy to anyone who has a vested interest or provide directions and permission for any on-line access to your documents. For additional Baylor Scott & White resources or more information about Advance Directives, you may request the following information from your nurse, social worker, chaplain or physician. Or you may access Advance Directives from www.MyDirectives.com. Additional documents are available online at www.BaylorHealth.com/PatientInformation.

  • Advance Care Planning
  • A Guide to Your Care
  • Common Questions and Answers About Artificial Nutrition and Hydration
  • Common Questions and Answers About Autopsies
  • Common Questions and Answers About Cardiopulmonary Resuscitation (CPR)
  • Common Questions and Answers About Hospice
  • Common Questions and Answers About Pain in the Setting of Serious Illness
  • Common Questions and Answers About Palliative Care
  • Common Questions and Answers About Severe Brain Injury
  • Information About Serious Illness
  • Official State of Texas forms for a: Living Will (Directive to Physicians and Family or Surrogates), Medical Power of Attorney, Notice of Declaration and Declaration for Mental Health
  • Out-of-Hospital Do-Not-Resuscitate Order
  • Simplified Advance Care Plan and Living Will (Optional)

If I complete an advance directive, can I change my mind?

Yes, you may cancel any advance directive simply by destroying the document, signing and dating a written statement that states your desire to cancel the directive, or telling your doctor or nurse. You may also review and revise your advance directive. If you choose to change an advance directive, you must execute a new one.

Where else can I get help?

In addition to your personal physician, all Baylor Scott & White Health hospitals have specially trained social workers, nurses, and chaplains who can help you with advance care planning concerns. You may also have ethical concerns as you consider potentially serious issues. All Baylor Scott & White Health hospitals have access to ethics committees and ethics consultants who may offer counsel and assist in resolving ethical issues that might arise. These services are provided free of charge. You, your family or health care decision maker, your physician or any member of your health care team may request guidance from a Baylor Scott & White Health hospital ethics committee. For further information, your physician, nurse, social worker or chaplain can help you reach the ethics committee at your facility or you may call one of the phone numbers at the end of this handout. You may also wish to consult your personal or family lawyer if you have questions about advance care planning.

What if there is disagreement about ethical issues?

On rare occasions there may be ethical disagreements between you, your family and/or health care providers. We believe good communication can prevent most ethical disagreements. It is also worth remembering the following:

  • We will make every reasonable attempt to honor your treatment preferences within the mission, philosophy and capabilities of Baylor Scott & White Health hospitals and the accepted standards of medical practice. This includes those expressed by an advance directive or by others on your behalf if you lack an advance directive and are unable to make decisions.
  • We respect your right to reject treatments offered.
  • We do not recognize an unlimited right to receive treatments that are medically inappropriate.
  • Texas law, specifically Chapter 166 of the Texas Health & Safety Code, provides a process for resolving ethical disagreements between you, your family, and/or health care providers in those rare cases where further communication does not resolve the disagreement. This process relies on ethics consultants and ethics committees available at each Baylor Scott & White Health hospital to help as needed.

At some point, you may be asked to make hard choices about treatment when cure of your illness is no longer possible and emotions may be strong. We have provided this information in hopes of helping you better understand your rights, responsibilities and ethical issues associated with being in the hospital. We hope a better understanding will improve communication, treatment and lessen stress for all.

Complaints

We welcome your feedback at all times, both positive and negative. If you have any complaints, we hope you will:

  • First report your complaint to the clinical manager for the unit or facility involved. The bedside nurse will help you identify the clinical manager.
  • You may also contact hospital administration at the number listed in the Contact Information contained in this document.

We will investigate your complaint through our formal complaint process and we will give you a response.

Although we encourage you to bring your concerns directly to us, you always have the right to take any complaint to the Texas Department of State Health Services and/or the Joint Commission by e-mail, fax, letter or phone at the contact numbers and addresses listed below.

Grievance Process Information

THE JOINT COMMISSION:

  • E-mail: complaint@jointcommission.org
  • Telephone: (800) 994-6610
    weekdays 8:30 a.m. to 5 p.m., Central Time
  • Fax: (630) 792-5636 Office of Quality Monitoring
  • U.S. Mail:
    Office of Quality Monitoring
    The Joint Commission
    One Renaissance Boulevard
    Oakbrook Terrace, IL 60181

TEXAS DEPARTMENT OF STATE HEALTH SERVICES:
If you have any complaints concerning the information that we have provided in this document, you may contact the Texas Department of State Health Services
at (888) 973-0022 (toll free number).
1100 W. 49th Street
Austin, TX 78756-3199

Baylor Scott & White Health:

PATIENT PRIVACY OR CONFIDENTIALITY COMPLAINTS:
If you have concerns about patient privacy or confidentiality, you may call (866) 245-0815 (toll-free number).

BILLING CONCERNS:
(214) 820-3151 or (800) 725-0024

Baylor Scott & White Health Facility Contact Information:

BAYLOR ALL SAINTS MEDICAL CENTER
Administration: (817) 926-2544
Pastoral Care/Chaplain Office: (817) 927-6150
Guest Representative: (817) 922-2777
Public Safety: (817) 922-1911

BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Administration: (214) 820-0695
Pastoral Care/Chaplain: (214) 820-2542
Guest Representative: (214) 820-0629
Public Safety: (214) 820-4444

BAYLOR SPECIALTY HOSPITAL
Administration: (214) 820-9756
Pastoral Care/Chaplain: (214) 820-2542
Guest Representative: (214) 820-9756
Public Safety: (214) 820-4444

BAYLOR UNIVERSITY MEDICAL CENTER AT DALLAS
Nursing Administration: (214) 820-7727
Pastoral Care/Chaplain: (214) 820-2542
Guest Representative: 3-SERV or (214) 818-7378
Public Safety: (214) 820-4444
Dial-a-Prayer Line: (214) 820-2333


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