A Patient's Guide to a Hospital Stay

The Florida Agency for Health Care Administration is the chief health policy and planning group for the state and licenses and regulates health care facilities and health maintenance organizations (HMOs) in Florida.  The Agency also manages the Medicaid program that provides health care to Florida’s low-income and disabled citizens.  The mission of the Agency is better health care for all Floridians.  As part of this mission, we publish the Consumer Awareness Series, a variety of brochures to help the public make informed health care decisions.

TThis brochure provides information to help you prepare for a stay in the hospital.  Other resources can include your doctor, insurance company, and contacts listed in this brochure.

Note:  This brochure is not designed to offer medical or legal advice.  Please talk with your doctor for medical advice and an attorney for legal advice.

Information in this brochure is current as of June 2009

Introduction

If your doctor decides you need medical treatment that will require a stay in ahospital, this brochure provides information and questions to help you prepare.

Before going into the hospital ask your doctor to explain your condition and the treatment you will receive.  Ask if there are other choices of treatment available.  You can also request a second opinion from another doctor, or you may be referred to a specialist. 

Ask the doctor for written material about your condition and treatment that can help you know what to expect and how best to help in your healing.  You might also find information on the Internet (see the websites listed in this brochure). 

Before You Go Into The Hospital

• When you meet with the doctor, if possible take a friend or loved one with you.  They can help you ask questions and take notes, if necessary.
• If there is more than one hospital you can choose from, talk with your doctor about this choice. 
• Ask your insurance company if they will pay for the treatment, if they cover this doctor, and if you need approval from them before going into the hospital.  Ask which hospitals are covered by your insurance.  If they do not approve coverage, ask how you can appeal the decision.
• Ask your insurance company about coverage limits and if there is a deductible and/or co-payment.
• Be sure to give the doctor a complete medical history, including medical conditions, past surgeries, and allergies.  Provide a full list of the medications you take (prescription, over-the-counter, vitamins, and herbal supplements), including the names and dosages.  You can either make a list or bring the medicine containers with you.
• An anesthesiologist is the person who will give you medication in order to block pain and/or put you to sleep during the procedure or surgery.  Be sure this person has your medical history, including any allergies, your medications, and if you have had reactions to medicines.
• If you have a health care advance directive, make sure your doctor and the hospital have a copy.  An advance directive states how you want medical decisions made should you not be able to make them yourself. 
  
  Hospitals are required to ask if you have an advance directive or to provide you with an advance directive form, should you wish to complete one.  More information can be found in the pamphlet “Health Care Advance Directives – The Patient’s Right to Decide.”  You can print this at www.FloridaHealthFinder.gov (click “Brochures and Guides”).
• Plan for your hospital stay and recovery before you go into the hospital by arranging for childcare, pets, plants, transportation home, and, if needed, home health care or rehabilitation.  (Your doctor or the hospital staff may help you arrange home health care or rehabilitation.)
• Following are personal items you may want to bring with you to the hospital:  toiletries (hairbrush, toothbrush and toothpaste, deodorant, etc.); a robe, nightgown and slippers; reading material; TV listings; and other things to occupy your time.  Some of these items may be provided by the hospital, but are often costly and may not be paid for by your health insurance.
• Do not take jewelry, cash, or other valuables.

Questions You May Want to Ask the Doctor

About the Procedure/Surgery

• Why do I need the procedure/surgery and what are the risks?
• Are there alternative treatments?
• Will you or someone else perform the procedure/surgery?  If it’s someone else, ask to meet with that person.
• What is your experience with this procedure/surgery?
• When will I meet with the anesthesiologist?

About the Hospital Stay

• Is there preparation I need to do before coming to the hospital?
• Do I need to stop or change any of my medications before this procedure/surgery?
• What can I expect once I arrive at the hospital?
• How long will the procedure/surgery take?
• How long do you think I will be in the hospital?

About Recovery

• Will I have any restrictions on walking, eating, drinking, bathing, lifting, etc., while in the hospital or once I return home?
• What signs or symptoms should I watch for that might show I am not healing well, am having a poor reaction, or developing an infection?
• Will I need home health care, special medical equipment or rehabilitation when I leave the hospital?  Will you or hospital staff help me arrange for this care?
• Will there be any changes in my medications after this procedure/surgery?
• How do I take care of my incision?
• How soon can I drive, exercise, resume sexual activity, return to work, etc?

Consumer Tips

• If you need more time to think about your choices, talk with your doctor about your concerns.  You can also ask for a second opinion from another doctor.  Ask if your health insurance will cover a second opinion.
• If you do not understand something when talking with your doctor or the hospital staff, ask that it be more clearly explained to you. 
• You may be able to save money or a hospital day by having routine tests before going into the hospital.  Discuss this with your doctor.
• If you prefer privacy, you might want to compare the cost of private and semi-private rooms and ask your insurance company how much they would pay for the room.  If you want a private room you can pay the additional charge above what your insurance company will pay.
• If possible have a friend or loved one at the hospital and ask the doctor to speak with them after your procedure/surgery.  If someone is unable to be with you at the hospital, provide the names and telephone numbers of people to contact in case of a medical emergency or a change in your condition.  Due to federal law, hospitals and medical staff are not allowed to share medical information unless you give them permission to do so.
• Make sure your hospital wristband has your correct information.
• Before you are given medication or other treatments, ask that the order be checked to make sure it is the correct medication or treatment.
• Be aware of the medicines you are given, what they are for, and what side effects they may cause.  If you think they are late giving you medicine or you think they have missed a dose, speak with the nurse.
• Find out when your doctor plans to visit so you will not be asleep or if you want to have a loved one with you during the visit. 
• Have paper and pen to write down questions for your doctor or nurse.  You or a loved one can also take notes on information given to you.
• If you are in pain, speak with your doctor or nurse to see if your pain medication can be adjusted.
• If your condition changes and you begin to feel worse or have symptoms that concern you, speak with your doctor or nurse.

A Child's Hospital Stay

Being in a hospital can be frightening for children since they may not know what to expect and may not be able to easily express their concerns.  The more a child and the parents can learn will help the child be better prepared. 

Much of the information presented earlier in the brochure can be helpful as you prepare for your child’s hospital stay.  In addition, the following information is useful for children’s special needs.

Before the Hospital Stay

• Have the doctor describe the procedure or surgery to your child, in an age appropriate way, describing what your child can expect during the hospital stay.  You may want to meet separately with the doctor to get more details.
• Ask your child if he or she has any questions or concerns.  Give a truthful and clear response to each concern, providing information appropriate for the child’s age.  Reassure your child you will be there to give help and comfort.
• If possible, take your child for a visit to the hospital before they are admitted, as this can make them feel more familiar and comfortable.
• Have your child choose a favorite book, game, stuffed animal, blanket, and similar items which will give comfort and entertain them.  Ask them to help pack a suitcase for their stay, so they are a part of the preparation.
• Inform your child’s school of his or her upcoming absence and, if appropriate, ask how your child can keep up with school work, arranging for assignments and books.

Questions You May Want to Ask the Doctor

Along with the questions presented earlier in the brochure, you may want to discuss the following with your child’s doctor.

• Is this procedure/surgery commonly performed on children?
• How have other children reacted to this procedure/surgery?
• Will I be allowed to be with my child during the procedure/surgery?
• If my child is going to be taking medicine, is it commonly given to children?
• Is there a Child Specialist on staff to help prepare my child for the visit?
• Can I stay overnight in my child’s room?
• Is there a children’s area or a program to provide arts and crafts, children’s videos, or other types of activities?
• When can my child return to school and to normal activities?

Helpful Tips for Kids & Parents

• Have a family member or friend with your child as much as possible.  If you need to leave, show your child how to operate the nurse call button and let the staff know the child will be alone.
  
  Explain to your child where you are going, what time you will return, and reassure them the hospital staff is ready to help them.  If possible, write down your cell phone number and the phone numbers of other loved ones.  Place the phone where it’s easy to reach, along with a game, book, and/or television remote.
• Introduce hospital staff to your child when they enter the room and ask the staff to explain what they are doing. 
• Encourage your child to talk about their experiences and feelings.  Let them know it is okay to be afraid, to cry, and to ask questions. 
• Assure your child that the visit to the hospital does not mean he or she has done something wrong.  Remind them why they are there and what is going to happen.
• Remind your child to tell you, the nurse or doctor if something hurts or if they start to feel worse.  Watch your child for changes in mood, behavior, temperature, upset stomach or throwing up, and other things that might show they are not healing well, are having a poor reaction, or are developing an infection.
• Allow your child to make decisions (about food, TV programs, what to play or read).  This will help them feel some control in an unfamiliar situation.
• Your child may begin acting younger than his or her age, by clinging or whining, wetting the bed, sucking their thumb, wanting to sleep with the light on.  These can be normal reactions to the stress and change of being in a hospital.  Such behaviors will likely begin to disappear when your child returns home to a more normal routine.  However, if such behavior continues for a long period of time, you may want to talk with your child’s doctor.

Consumer Resources

• To find a list of Florida hospitals, go to www.FloridaHealthFinder.gov (click “Find Facilities”).
• To compare Florida hospitals by looking at certain medical conditions and treatments for average cost, length of stay, health outcomes, and other information, go to www.FloridaHealthFinder.gov (click “Compare Hospitals and Ambulatory Surgery Centers”). 
  
  On the same website you can find educational information about medical conditions and treatment by using the links or search box under the section “Look up a Medical Condition.”
• To compare how well Florida hospitals care for their adult patients with certain medical conditions, view the Medicare website www.HospitalCompare.hhs.gov. 
• To file a complaint against a hospital or other type of health care facility, call the toll-free number (888) 419-3456.
• To file a complaint against a doctor or other health care professional, call the toll-free number (877) 425-8852 or view the website www.FLHealthSource.com (click “Citizen/Consumer”). 
• To prepare for a stay in the hospital, you might want to read the brochure “Patient Safety.”  (See the end of this brochure for order instructions.)

Patient’s Bill of Rights and Responsibilities

Section 381.026, Florida Statutes

A patient has the right to:

• Be treated with courtesy and respect, with appreciation of his or her dignity, and with protection of privacy.
• A prompt and reasonable response to questions and requests.
• Know who is providing medical services and is responsible for his or her care.
• Know what patient support services are available, including if an interpreter is available if the patient does not speak English.
• Know what rules and regulations apply to his or her conduct.
• Be given by the health care provider information such as diagnosis, planned course of treatment, alternatives, risks, and prognosis.
• Refuse any treatment, except as otherwise provided by law.
• Be given full information and necessary counseling on the availability of known financial resources for care.
• Know whether the health care provider or facility accepts the Medicare assignment rate, if the patient is covered by Medicare.
• Receive prior to treatment, a reasonable estimate of charges for medical care.
• Receive a copy of an understandable itemized bill and, if requested, to have the charges explained.
• Medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
• Treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
• Know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such research.
• Express complaints regarding any violation of his or her rights.

A patient is responsible for:

• Giving the health care provider accurate information about present complaints, past illnesses, hospitalizations, medications, and any other information about his or her health.
• Reporting unexpected changes in his or her condition to the health care provider.
• Reporting to the health care provider whether he or she understands a planned course of action and what is expected of him or her.
• Following the treatment plan recommended by the health care provider.
• Keeping appointments and, when unable to do so, notifying the health care provider or facility.
• His or her actions if treatment is refused or if the patient does not follow the health care provider’s instructions.
• Making sure financial responsibilities are carried out.
• Following health care facility conduct rules and regulations.

Resource Directory

Florida Agency for Health Care Administration
http://ahca.MyFlorida.com and www.FloridaHealthFinder.gov
(888) 419-3456

Florida Department of Health
www.FloridasHealth.com or www.FLHealthSource.com
(850) 488-0595

Florida Hospital Association
www.fha.org

Medicare
www.HospitalCompare.hhs.gov
www.Medicare.gov
(800) 633-4227; (877) 486-2048 (TTY)

MedlinePlus
www.MedlinePlus.gov

National Institutes of Healt
www.nih.gov
(301) 496-4000 or TTY (301) 402-9612
NIH Toll Free Information Lines:
www.nih.gov/health/infoline.htm

The Joint Commission
www.JointCommission.org
(800) 994-6610 (Complaint Hotline)

Additional consumer brochures include:

• A Consumer’s Guide to Health and Human Services Programs
• Assisted Living in Florida
• Emergency Medical Care
• End-of-Life Issues – A Practical Planning Guide
• Florida Medicaid – A Reference Guide
• Health Care Advance Directives (available only online)
• Home Health Care in Florida
• Long-Term Care
• Patient Safety
• Understanding Prescription Drug Costs

For additional copies of this brochure, or others in the series, contact our Agency’s toll-free number (888) 419-3456.  To view or print any brochure in the Consumer Awareness Series, visit www.FloridaHealthFinder.gov.

This brochure may be copied for public use.  Please credit the Agency for Health Care Administration for its creation.

If you have comments or suggestions, call (850) 922-5771.

The Agency for Health Care Administration created the following websites to help Florida residents be well informed health care consumers.

www.FloridaHealthFinder.gov
This website provides tools to compare hospitals, ambulatory surgery centers, emergency rooms, health plans, and nursing homes.  The site includes the A.D.A.M. Health Encyclopedia with thousands of articles and illustrations.  The site also provides a list of health care facilities; information on insurance, medications, seniors, medical conditions, and resources for the uninsured; consumer publications; information for health care professionals; and much more.

www.MyFloridaRx.com
This website compares prices for the most commonly used prescription drugs in Florida.

www.fhin.net/e-prescribe
Some doctors can send a drug prescription electronically to the pharmacy. To learn more visit the website or ask your doctor about e-Prescribing.

http://ahca.MyFlorida.com
This website includes information on health care facility regulation and licensing, the Florida Medicaid program, managed care (HMOs), and other topics related to the Agency for Health Care Administration.