Patient's Rights
The hospital is committed to ensuring that the individual rights
of all patients are respected during their hospital stay. Most
importantly, all patients have the right to expect to be treated with
dignity and respect. It is important for all health care providers to
be familiar with patients' rights under state law and hospital policy
and observe them at all times. Patients afforded these basic
considerations are usually more satisfied with their hospital
experience, and from a risk management perspective, it makes them
less likely to make a complaint, which could ultimately result in a
claim or lawsuit.
The hospital is obligated to provide appropriate assistance,
including the use of an interpreter, to ensure that patients
understand their rights. All individuals are entitled to receive
emergency care and/or treatment without discrimination due to race,
color, religion, sex, national origin, disability, sexual
orientation, or source of payment. Patients are entitled to be
informed of the identity and role of all physicians and support staff
involved in their care, and have the right to refuse treatment or
examination by them. Patients have the right to privacy while in the
hospital and to expect all information and records regarding their
care will be kept confidential.
Patients must be given all the information they need to give informed
consent regarding treatment and refusal of treatment. Under most
circumstances patients are entitled to review, and should they so
desire, obtain a copy of their medical records (after discharge if
the record is a hospital record). A patient may refuse to take part
in research and should be able, without fear of reprisals, to
complain about the care and services they have received.
Patients, or appropriate family members, should be informed about
unexpected and/or negative outcomes promptly. This should include the
nature and cause of the event, if known, as well as the manner in
which the event will affect the patient's prognosis and treatment
plan. Failing to disclose, or disclosing only partial information
regarding such occurrences, is perhaps the most common cause of
patient dissatisfaction. Often, this dissatisfaction results in
malpractice claims and lawsuits. Regardless of how difficult it may
be for patients, it is legally unwise to speculate on the cause of an
untoward event.
Patients should also be made aware that in order for the health care
team to render good care, patients have certain responsibilities. The
most important of these is to provide, to the best of their
knowledge, accurate and complete information about their present
complaints, past illnesses, hospitalizations, medications and other
matters relating to their health. Patients are responsible both for
following the treatment plan recommended by the members of the health
care team, and for the consequences should they refuse treatment or
not follow recommended instructions.
While trying to treat all patients with dignity and respect,
occasionally, the use of physical restraints must be employed to
protect and avoid harm to the patient or those surrounding the
patient. In almost all circumstances, prior to the use of restraints,
the written order of a physician who has examined the patient must be
obtained. In emergency situations, a registered nurse may order
restraints but the physician must be contacted immediately. It is
imperative that the patient's medical record be documented regarding
the need for, use of, and termination of restraints. Hospital
policies are in compliance with the JCAHO policies on restraints and
will generally provide a sound procedural approach.
Competent adult patients have the right to refuse treatment. Since
this refusal may be subsequently disputed or denied by the patient,
it is important that all health care providers document these
occurrences in the patient's medical record. When a patient refuses
treatment, it is important that his or her physician disclose the
risks and consequences associated with the decision. The treatment
being proposed and refused by the patient should be documented in the
medical record, as well as the fact that the potential adverse
consequences have been discussed with the patient (and when
appropriate, family members).
Similarly, adult patients may not be detained in the hospital should
they wish to leave against medical advice, except under extreme
circumstances prescribed by law. Again, the patient's medical record
should be documented regarding his or her voluntary decision to be
prematurely discharged, noting the potential adverse consequences
that have been discussed and that the patient understands them. The
record should also note that further care has been recommended, as
well as where and when the patient intends to obtain this care. In
addition, most hospitals require that the patient be asked to sign a
form indicating he or she is being discharged against medical advice.
The patient's refusal to sign this form, which often occurs, should
be documented in the record.
The Patient Representative
The hospital has a patient representative to serve as a liaison
between the patient and his or her family, and the medical and
administrative staff of the hospital. The patient representative acts
as advocate, ombudsman and agent for the patient and enhances patient
care by assuring the identification, investigation and amicable
resolution of patient complaints and problems. In addition to
resolving patient complaints, the patient representative can explain
hospital policy and procedures for the patient and/or family and
handle lost property claims.
From a risk management perspective, the patient representative plays
a critical role in preventing patient complaints which, without their
early intervention, could evolve into malpractice claims and lawsuits
against the hospital and/or health care providers. All health care
providers are encouraged to contact the patient representative for
assistance.
Footnotes:
A medical device is an instrument, apparatus, contrivance, implant,
in vitro reagent, or other similar or related article, including any
component, part or accessory (e.g., catheters, infusion pumps, suture
materials, syringes, defibrillators, pacemakers, hospital beds,
patient restraints, wheelchairs, tampons, in vitro diagnostics,
etc.).
Permanent impairment of a body function or permanent damage to a body
structure.
Necessitates immediate medical or surgical intervention to preclude
permanent impairment of a body function or permanent damage to a body
structure.
Note, however, that the physician-patient relationship generally
cannot be terminated during a medical emergency, labor or any other
acute event.