Patient Rights and Responsibilities

Patient rights set forth herein include adults, newborns, children, adolescents and parents and/or guardians of minors.

This statement does not presume to be all- inclusive. It is intended, however, to convey the relationship between hospitals and PATIENTS and to emphasize the need for the observance of the rights and responsibilities of PATIENTS.

PATIENT RIGHTS

Patients are involved in all aspects of their care. The family also participates in care decisions.

Access to Care - Individuals shall be accorded impartial access to treatment or accommodations that are available or medically indicated, regardless of race, creed, sex, national origin, or sources of payment for care. The patient has the right to access protective services, if needed.

Respect and Dignity - The patient, as an individual with personal value and belief systems, has the right to considerate, respectful care at all times and under all circumstances, with recognition of his personal dignity, including the exercise of cultural and spiritual beliefs that do not interfere with the well-being of others or the planned course of medical therapy. If the patient has a terminal condition, the patient has the right to the identification and appropriate treatment of primary and secondary symptoms that can respond to treatment, if treatment is desired; establishment of a pain assessment process that results in aggressive management of pain; and appropriate support in the grief process. The patient, family member or significant other may request the services of the Institutional Ethics Committee by contacting the patient's nurse.

The patient has the right to request to see a copy of the hospital's Code of Ethical Behavior Policy.

• Has the right to access pastoral care and other available spiritual services. 
• Has the right to access the Ethics Committee on ethical dilemmas related to care, treatment or service.

Privacy and Confidentiality - The patient has the right, within the law, to personal and informational privacy, as manifested by the following rights:

• To refuse to talk with or see anyone not officially connected with the hospital but not directly involved in his care. 
• To wear appropriate personal clothing and religious or other symbolic items, as long as they do not interfere with diagnostic procedures or treatment. 
• To be interviewed and examined in surroundings designed to assure reasonable visual and auditory privacy. This includes the right to have a person of one's own sex present during certain parts of a physical examination, treatment, or procedure performed by a health professional of the opposite sex and the right not to remain disrobed any longer than is required for accomplishing the medical purpose for which the patient was asked to disrobe.
• To expect that any discussion or consultation involving his case will be conducted discreetly and that individuals not directly involved in his care will not be present without his permission.
• To have his medical record read only by individuals directly involved in his treatment or in the monitoring of its quality and by other individuals only on his written authorization or that of his legally authorized representative.
• To expect all communications and other records pertaining to his care, including the source of payment for treatment, to be treated as confidential.
• To request a transfer to another room if another patient is unreasonably disturbing him.

Personal Safety - The patient has the right to expect reasonable safety in so far as hospital practices and environment are concerned.

Complaints - The patient has the right to voice complaints regarding care received and to have those complaints reviewed and when possible resolved.

Identity - The patient has the right to know the identity and professional status of individuals providing services to him and to be cared for by staff educated about patient rights and their role in supporting those rights, and to know which physician or other practitioner is primarily responsible for his care. This includes the patient's right to know of the existence of any professional relationship among individuals who are treating him, as well as the relationship to any other health care or educational institution involved in his care. Participation by patients in clinical training programs or in the gathering of data for research purposes should be voluntary.

Information - The patient has the right to obtain, from the practitioner responsible for coordinating his care, complete and current information concerning his diagnosis (to the degree known), treatment, and any known prognosis. This in- formation should be communicated in terms the patient can reasonably be expected to understand. When it is not medically advisable to give such information to the patient, the information should be made available to a legally authorized individual. The patient, and when appropriate, their family or legally authorized individual, have the right to be informed about outcomes of care, including unanticipated outcomes.

Communication - The patient has the right of access to people outside the hospital by means of visitors and by verbal and written communication.

When the patient does not speak or understand the predominant language of the community, he should have access to an interpreter. This is particularly true where language barriers are a continuing problem.

Informed Consent - The patient has the right to reasonable informed participation in decisions involving his health care. To the degree possible, this should be based on a clear, concise explanation of his condition and of all proposed technical procedures, including the possibilities of any risk of mortality or serious side effects, problems related to recuperation, and probability of success. The patient should not be subjected to any procedure without his voluntary, competent, and understanding consent or that of his legally authorized representative. Where medically significant alternatives for care or treatment exist, the patient shall be so informed.

The patient has the right to know who is responsible for authorizing and performing the procedures or treatment.

The patient shall be informed if the hospital proposes to engage in or perform human experimentation or other research/educational projects affecting his care or treatment, and the patient has the right to refuse to participate in any such activity.

Pain Management - All patients have a right to pain relief.  A patient can expect:

• Information about pain and pain relief measures. 
• A concerned staff committed to pain prevention.
• Staff to ask throughout a hospital stay about any pain a patient may be having.
• Staff to believe reports of pain, and to have staff effectively address the pain.
• Health professionals who respond quickly to reports of pain.
• Effective pain management.

Consultation - The patient, at his own request and expense, has the right to consult with a specialist. 

Refusal of Treatment - The patient may refuse treatment to the extent permitted by law. The patient has the right to formulate advance directives and appoint a surrogate to make healthcare decisions on his behalf to the extent permitted by law, although provision of care is not conditioned on the existence of an advanced directive. When refusal of treatment by the patient or his legally authorized representative prevents the provision of appropriate care in accordance with professional standards, the relationship with the patient may be terminated upon reasonable notice.

Transfer and Continuity of Care - A patient may not be transferred to another facility unless he has received a complete explanation of the need for the transfer and of the alternatives to such a transfer and unless the transfer is acceptable to the other facility. The patient has the right to be informed by the practitioner responsible for his care, or his delegate, of any continuing health care requirements following discharge from the hospital.

Hospital Charges - Regardless of the source of payment for his care, the patient has the right to request and receive an itemized and detailed explanation of his total bill for services rendered in the hospital. The patient has the right to timely notice prior to termination of his eligibility for reimbursement by any third-party payer for the cost of his care.

Hospital Rules and Regulations - The patient should be informed of the hospital rules and regulations applicable to his conduct as a patient. Patients are entitled to information about the hospital's mechanism for the initiation, review, and resolution of patient complaints.

Access Protective and Advocacy Services

• The hospital provides resources through the Social Services department.
• The hospital maintains a list of names, addresses, and telephone numbers of pertinent state client advocacy groups such as the state authority and the protection and advocacy network.
• The list is given to patient when requested.

PATIENT RESPONSIBILITIES

Provision of Information - A patient has the responsibility to provide, to the best of his knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his health. He has the responsibility to report unexpected changes in his condition to the responsible practitioner. A patient is responsible for making it known whether he clearly comprehends a contemplated course of action and what is expected of him.

Patient Safety -  A patient has the responsibility to identify issues that affect his or her personal safety.  Safety concerns should be discussed with the physician and nurse caring for the patient.  Please refer to our brochure which is called "For Your Safety", and is given to patients at registration.

Pain Management - A patient has the responsibility to:

• Ask a doctor or nurse what to expect regarding pain and pain management.
• Discuss pain relief option with his/her doctor or nurse.
• Work with the doctor or nurse to develop a pain management plan.
• Ask for pain relief when pain first begins.
• Help the doctor and nurse measure the pain.
• Tell the doctor or nurse if pain is not relieved.

Compliance with Instructions - A patient is responsible for following treatment plans recommended by the practitioner primarily responsible for his care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the responsible practitioner's orders, and as they enforce the applicable hospital rules and regulations. The patient is responsible for keeping appointments and, when he is unable to do so for any reason, for notifying the responsible practitioner or the hospital.

Refusal of Treatment - The patient is responsible for his actions if he refuses treatment or does not follow the practitioner's instructions.

Hospital Charges - The patient is responsible for assuring that the financial obligations of his health care are fulfilled as possible.

Hospital Rules and Regulations - The patient is responsible for following hospital rules and regulations affecting patient care and conduct.

Respect and Consideration - The patient is responsible for being considerate of the rights of other patients and hospital personnel and for assisting in the control of noise, smoking, and the number of visitors. The patient is responsible for being respectful of the property of other persons and of the hospital.  The patient has the responsibility to maintain the smoke free environment and respect the no smoking/smoke free campus of Presbyterian Hospital of Denton.  Patients should not leave the unit for any reason without notifying the nurse providing the patient’s care.

Conflicts Concerning Care of the Patient - Occasionally, a conflict will develop between the patient (and/or parent or guardian, in the case of minors) and hospital staff or physician concerning the care of the patient.  When this occurs, it is the responsibility of the patient (or guardian if appropriate) to inform the Unit Director of the conflict. The Unit Director will attempt to resolve the matter. If she cannot, she will refer the matter to the Chief Nursing Officer, who will review the matter with the patient (or guardian) and Administration and the physician as appropriate to resolve the matter. The final outcome will be communicated to the patient (or guardian). Presentation of a complaint does not in itself serve to compromise a patient's future access to care.

Research Projects

• All patients asked to participate are given a description of the expected benefits; a description of the potential discomforts and risks; a description of alternative services that might prove advantageous to them; a full explanation of the procedures to be    followed, especially those that are experimental in nature. 
• The hospital protects patients and respects their rights during research, investigation, and clinical trials involving human subjects.
• Patients may refuse to participate and the refusal will not compromise their access to services.