Advocacy Tips to Prepare for Hospitalization

Posted on October 31, 2012

Hospitalization is among the most stressful of life events. As a nurse advocate, I have witnessed the distress that hospitalization can bring to my clients and their families. To reduce some of the helplessness and uncertainty of hospitalization, here are some advocacy tips for you and your caregivers to consider.

1)    Understand reason, purpose and goals of hospitalization? Who is your attending physician (physician responsible for coordinating your care while in the hospital)? Know how best to communicate with him/her, e.g., phone, email, text, during rounds.

2)    Decide in advance who will be the main caregiver/spokesperson if necessary for the patient. Provide primary caregiver name and contact information to the medical team.

3)    Provide your doctor and hospital team with a written summary of your health history, allergies, current medications, dietary restrictions, emergency contacts and copies of advance directives, Health Care POA information.

4)    Discharge planning begins the day of admission. Ask to speak with the designated discharge planner, case manager, social worker (titles vary among hospitals) and meet with this individual regularly to discuss discharge process, goals, transition issues and to anticipate discharge timing and level of care needs.

5)    Know when medical rounds are scheduled for your unit.  When possible, your primary caregiver should be present for rounds and have written questions ready.  Ask for clarification if you do not understand medical terminology.

6)    Inquire as to your admitting diagnosis. What medical conditions are being “ruled out” (evaluated to see if they are correct)? What is your prognosis? How will your medical condition potentially impact your activities of daily living and quality of life?

7)    Question any recommended tests, procedures and/or surgeries.  Ask about the purpose, the benefits and risks? Why is the procedure necessary? What information will it yield? How will that information be used to make treatment decisions and to achieve overall goals of care? Are there alternatives to gaining similar information?

8)    Understand the nursing staffing on your unit.  What nursing model is used, e.g., primary vs. team nursing? Who is the nurse responsible for your daily care? Ask that that all hospital caregivers identify themselves and explain their role in your care. Who is responsible for overall management of your unit in the event you have care questions/concerns?

9)    Infections acquired in hospitals are often the result of health caregivers’ failure to thoroughly wash their hands. Although it may be uncomfortable for you, ask all who administer medication or treatments to please wash their hands.

10) Check your hospital band for accuracy and correct name spelling and room number. Be sure that health care providers confirm your identity by examining your hospital band and asking your name before they give you any medications or treatments.

11) Know what time of day your medications and treatments are usually given. If you think something has been missed be sure to tell your nurse or doctor.

12) If you encounter problems with hospital care, follow the chain of command. Speak first to the individual involved. State the issue respectfully, clearly, providing detail and impact on you. Ask how to ensure that this problem does not occur again. If this approach is not successful, speak to the nursing supervisor/ manager if the care problem is a nursing issue. If the problem remains unresolved, contact the hospital advocate/ombudsman.

13) Before being discharged from the hospital be certain that you are clear about the type of care that will be needed at home and that all necessary home care services are in place. Know when to return to see your provider and the signs/symptoms you should look for that may indicate you are experiencing a complication.

14)  Understand how best to contact your provider should problems arise. Obtain a copy of your discharge summary and list of medications. Review and reconcile any difference in current medications from pre-hospitalization medications with your health care provider before hospital discharge. Ask your provider about any activity restrictions, when you can return to work, resume exercise and driving.

15)  Above all, trust your instincts. If you sense that something is not correct, say so.

Be certain that you have strong support and advocacy systems in place before hospitalization.  Consult with a professional health advocate, if needed.

 

For more information see the Agency for Health Care Research and Quality site:

http://www.ahrq.gov/