Patient Responsibilities

Speak up if you have questions or concerns. All patients have the following responsibilities:

• To know and follow hospital rules and regulations.
• To give cooperation and to follow the care or treatment prescribed or recommended for you by your physician, nurse or other health care professionals. You must realize that you are responsible for the results of your actions if you refuse such care or treatment.
• To notify your physician or nurse if you do not understand your diagnosis, treatment, or prognosis. Ask questions about any instructions if you do not understand.
• Tell your doctor and nurse about the medicines that you take, including over-the-counter medicines such as aspirin, ibuprofen and dietary supplements like vitamins, diet pills, and herbals.
• To report to your physician or nurse any unexpected changes in your condition.
• To let the nurse and your family know if you feel you are receiving too many outside visitors.
• To respect the privacy of other hospitalized patients.
• To accept financial obligations associated with your care.
• To advise your nurse or physician of any dissatisfaction you may have in regard to your care at the hospital.
• To be considerate of the rights of other patients and hospital personnel, to assist in the control of noise, and to follow the hospital's no smoking, visitor and other policies.

Speak Up

Everyone has a role in making health care safe - physicians, health care executives, nurses and technicians. Health care organizations across the country are working to make health care safety a priority. You, as the patient, can also play a vital role in making your care safe by becoming an active, involved and informed member of your health care team.

An Institute of Medicine (IOM) report has identified the occurrence of medical errors as a serious problem in the health care system. The IOM recommends, among other things, that a concerted effort be made to improve the public's awareness of the problem.

The "Speak Up" program, sponsored by The Joint Commission, urges patients to get involved in their care. Such efforts to increase consumer awareness and involvement are supported by the Centers for Medicare and Medicaid Services. This initiative provides simple advice on how you, as the patient, can make your care a positive experience. After all, research shows that patients who take part in decisions about their health care are more likely to have better outcomes.

To help prevent health care errors, patients are urged to "Speak Up."

Speak up if you have questions or concerns, and if you don't understand, ask again. It's your body and you have a right to know.

• Your health is too important to worry about being embarrassed if you don't understand something that your doctor, nurse or other health care professional tells you.
• Don't be afraid to ask about safety. If you're having surgery, for example, ask the doctor to mark the area that is to be operated upon, so that there's no confusion in the operating room.
• Don't be afraid to tell the nurse or the doctor if you think you are about to receive the wrong medication.
• Don't hesitate to tell the health care professional if you think he or she has confused you with another patient.

Pay attention to the care you are receiving. Make sure you're getting the right treatments and medications by the right health care professionals. Don't assume anything.

• Tell your nurse or doctor if something doesn't seem quite right.
• Expect health care workers to introduce themselves when they enter your room and look for their identification badges.
• Notice whether your caregivers have washed their hands. Hand washing is the most important way to prevent the spread of infections. Don't be afraid to gently remind a doctor or nurse to do this.
• Know what time of day you normally receive a medication. If it doesn't happen, bring this to the attention of your nurse or doctor.
• Make sure your nurse or doctor confirms your identity, that is, checks your wristband or asks your name, before he or she administers any medication or treatment.

Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.

• Ask your doctor about the specialized training and experience that qualifies him or her to treat your illness (and be sure to ask the same questions of those physicians to whom he or she refers you).
• Gather information about your condition. Good sources include your doctor, your library, respected websites and support groups.
• Write down important facts your doctor tells you, so that you can look for additional information later. And ask your doctor if he or she has any written information you can keep.
• Thoroughly read all medical forms and make sure you understand them before you sign anything. If you don't understand, ask your doctor or nurse to explain them.
• Make sure you are familiar with the operation of any equipment that is being used in your care. If you will be using oxygen at home, do not smoke or allow anyone to smoke near you while oxygen is in use.

Ask a trusted family member or friend to be your advocate.

• Your advocate can ask questions that you may not think of while you are under stress.
• Ask this person to stay with you, even overnight, when you are hospitalized. You will be able to rest more comfortably and your advocate can help to make sure you get the right medications and treatments.
• Your advocate can also help remember answers to questions you have asked, and speak up for you if you cannot.
• Make sure this person understands your preferences for care and your wishes concerning resuscitation and life support.
• Review consents for treatment with your advocate before you sign them and make sure you both understand exactly what you are agreeing to.
• Make sure your advocate understands the type of care you will need when you get home. Your advocate should know what to look for if your condition is getting worse and whom to call for help.

Know what medications you take and why you take them. Medication errors are the most common health care mistakes.

• Ask about the purpose of the medication and ask for written information about it, including its brand and generic names. Also inquire about the side effects of the medication.
• If you do not recognize a medication, verify that it is for you. Ask about oral medications before swallowing, and read the contents of bags of intravenous (IV) fluids. If you're not well enough to do this, ask your advocate to do this.
• If you are given an IV, ask the nurse how long it should take for the liquid to "run out." Tell the nurse if it doesn't seem to be dripping properly (that it is too fast or too slow).
• Whenever you are going to receive a new medication, tell your doctors and nurses about allergies you have, or negative reactions you have had to medications in the past.
• If you are taking multiple medications, ask your doctor or pharmacist if it is safe to take those medications together. This holds true for vitamins, herbal supplements and over-the- counter drugs, too.
• Make sure you can read the handwriting on any prescriptions written by your doctor. If you can't read it, the pharmacist may not be able to either.

Use a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established, state-of-the-art quality and safety standards, such as that provided by The Joint Commission.

• Ask about the health care organization's experience in treating your type of illness. How frequently do they perform the procedure you need and what specialized care do they provide in helping patients get well?
• If you have more than one hospital or other facility to choose from, ask your doctor which one offers the best care for your condition.
• Before you leave the hospital or other facility, ask about follow-up care and make sure that you understand all of the instructions.
• Go to Quality Check to find out whether your hospital or other health care organization is accredited.

Participate in all decisions about your treatment. You are the center of the health care team.

• You and your doctor should agree on exactly what will be done during each step of your care.
• Know who will be taking care of you, how long the treatment will last, and how you should feel.
• Understand that more tests or medications may not always be better. Ask your doctor what a new test or medication is likely to achieve.
• Keep copies of your medical records from previous hospitalizations and share them with your health care team. This will give them a more complete picture of your health history.
• Don't be afraid to seek a second opinion. If you are unsure about the nature of your illness and the best treatment, consult with one or two additional specialists. The more information you have about the options available to you, the more confident you will be in the decisions made.

Ask to speak with others who have undergone the procedure you are considering. These individuals can help you prepare for the days and weeks ahead. They also can tell you what to expect and what worked best for them as they recovered.