Although we could say most hospital stays are not pleasant, for many of us it is a foreign experience where we let the medical professionals take control and we concede to process and hope for the best.
Some good planning can lead to a smoother experience, better care and a faster recovery. Being well informed and prepared is the best defence against common errors and adverse events, including drug errors, infection, mistakes in surgery and other errors.
Here are some hints on planning from check-in to discharge.
1. Plan your hospital stay itinerary
- If it is a planned hospital stay, it is important that you do your homework and understand as much as possible about your treatment, where you’re going and what will happen when you get there and during your hospital stay.
- Ask how long you are likely to remain in hospital post procedure. Know what day your surgery or treatment is scheduled and, if on a Friday or close to a public holiday, what will the availability be of your surgeon or other specialists – will they be on call? Will this potentially delay your date of discharge?
- If you are currently receiving in-home support services, you may need to notify community care service providers who are helping you at home regularly and/or family/friends who may need to assist you with transport and post hospital care.
- Make sure you pack your Medicare, pension and private insurance cards, photo ID, as well as contact details of family or advocates
2. Appoint a health care representative
- Even with a minor procedure it is ideal to have a support person with you who can serve as another set of eyes, ears and hands to look out for and help with any problems. You are able to have someone at your bedside 24/7 if you wish.
- To ensure that your companion can advocate for you, it is important that you nominate them in any hospital documentation. Additionally, if you have an enduring guardianship or power of attorney, it would be ideal to bring this documentation to hospital.
- If a family member or friend can’t accompany you, you may want to consider the services of a professional patient advocate.
- It is important that you or your support person ask questions: don’t be intimidated or feel silly. This is critical to ensure mistakes are not made.
3. Keep a journal
- One very successful way to control your hospital stay is to maintain a daily journal of which doctor your saw, their contact details, the medications you’re taking, the tests you have had, conversations and advice given, problems encountered and questions you need clarified.
- If you have a few people who are supporting you in hospital, each person can update the journal with the interactions and activities which have occurred whilst they were with you in hospital.
- It is ideal to start this journal from your first pre-admission visits with your doctor to any post hospital visits.
4. Help minimise mistakes
- Make sure your hospital team is aware of all current medications and any past drug reactions. Note any new medication and don’t be afraid to ask what each is for, how long the you will need to take it and of which side effects you should be aware.
- Carefully check that the information on your wristband is accurate.
- To avoid unlikely wrong-site surgery, insist that the correct site is marked clearly before you receive sedation or anesthesia.
5. Protect against infection
- Diligent hand washing using the antibacterial soap provided by the hospital is a must.
- It is critical that all visitors do the same. It is also important that people only visit when fully fit.
- It is also important to wipe down door handles, remote controls and other surfaces where germs can survive.
6. Don’t be afraid to speak up
- When it comes to preparing for a hospital stay it is important to know your rights as a patient, as they can serve you well in many situations.
- The Australian Charter of Healthcare Rights outlines the rights patients have when using Australian health systems. It clearly describes your rights to take an active role in your care, the ability to ask questions, refuse treatment and make decisions on what happens to you.
- If you don’t understand why a test was ordered, why a medication was changed, or you have any questions at all about your care, you have the right to refuse that care until you can find out more. This is a very important time for your support person or health representative to assist if you are confused or needing support.
- If you don’t feel you’re getting resolution from your medical team, contact your hospital’s patient representative or patient advocate, whose name should be included in your hospital information packet.
7. In case of emergency
- If your visit to the hospital is unplanned, your experience may depend on variables over which you have no control. The very nature of emergency care may mean you are suddenly immobilised or unconscious.
- Pre-plan by having a signed enduring guardian/ power of attorney and a health care directive (living will), so that others can intervene on your behalf and know your wishes.
- It is important that your health care representative has copies of these documents and knows details of any health insurance you have in place.
- It would be ideal to have in your wallet a list of medications which you take, the dosage and times you take them. A list of allergies and a list of your medical history (current and past medical conditions, surgeries, etc.) and an emergency contact name/number is also useful.
- It’s important to have a health representative or support person if you visit the emergency room. If you go there alone, ask your support person to meet you there.
- Keep a journal of your emergency room experience so you can follow up with your own doctor.
8. Staying out of hospital when you leave
Every year many people are re-admitted to the hospital within 30 days of discharge. This could be avoided with better planning when leaving hospital
- Make sure to ask your doctors and nurses if they have hospital discharge planners to assist in helping you prepare to leave the hospital. Find out the signs and symptoms which indicate you are getting better or worse and who to contact if you have a problem or questions.
- Ask your doctors or nurses what after hospital care is required, including medications and follow-up visits. When you’re ready to be discharged, get your instructions in writing. Your health partner should be with you to help clarify any possible confusion.
- Ask for a copy of your written discharge plan which includes important information about your hospital stay and post hospital care.
- It’s important to understand which medicines you should take after you leave the hospital and when you should take them. If you were taking medications when you were admitted, you should work with the doctor, nurse, or pharmacist in the hospital to understand which of these medications should be continued and which should be stopped. Make sure that you have a written medication list before you go home.
- Having a family member or loved one help you when leaving the hospital can make it easier for you to get well after leaving the hospital.
- Talk with hospital discharge planners or nurses about short term in-home support services, such as Compacks or Transitional care programs, which may assist with nursing care, personal care, transport, mobility and domestic assistance whilst you recover.