Patient Rights & Responsibilities

You, as a patient, are a key member of your health care team and have the right to:

Access:

Be informed of the hospital’s policies about your rights and health care.
Be informed of visitation rights, including any clinical restriction or limitation on such rights. You have the right to designate who may visit to include a spouse, domestic partner, another family member, or a friend with the right to withdraw or deny such consent at any time. Visitation will not be restricted, limited or denied by the hospital on the basis of race, color, national origin, religion, sex, gender, identity, sexual orientation or disability. The hospital will ensure that all visitors enjoy full and equal visitation privileges consistent with your preference.
Know the names and roles of staff caring for you.
Have a family member or representative of your choice and a physician of your choice to be notified promptly of your admission to the hospital.
Request a consult from the Ethics Committee to help you work through difficult decisions about your health care.
Requests regarding information on religious and spiritual services will be honored.
Allow a family member, friend or other individual to be present with you for emotional support during the course of your hospital stay.

Respect and Dignity:

Receive quality care in a safe setting, free from all forms of abuse, neglect, harassment, exploitation and personal within the range of services that St. Mary's Janesville Hospital provices. Your dignity and personal privacy is recognized and respected.
Receive medical care without being discriminated against because of race, creed, color, gender, gender identity, gender expression, sexual orientation, age, disability, language, cultural values, beliefs, preferences, ancestry, marital status, newborn status, handicap, religion, national origin, culture or source of payment.
Your personal culture, spiritual and ethical beliefs will be respected as long as this does not interfere with the wellbeing of others.

Privacy & Confidentiality:

· Have privacy and confidentiality of your care discussion, medical records and health information. Your information will only be shared with your caregivers and those who can legally see it.

Medical Information & Consent:

Have access to an interpreter and/or translation services to help you understand medical and financial information.
Give informed consent, or have your legally authorized representative give informed consent prior to your participation in any form of research, investigation and clinical trials.
Ask for a change of care provider or a second opinion.
To give or withhold informed consent to produce or use recordings, films or other images made for external use.
To access information contained in your medical record and receive answers to questions, request amendment to and obtain information on disclosures of his or her health information in accordance with law and regulation.
Obtain informed consent, except in emergencies, prior to surgery

Provisions of Information:

Be told of realistic alternatives in order for you to make informed decisions while taking into account any ethical considerations regarding your care. If you are unable, your representative as allowed by Wisconsin State Law will have the right to make these decisions.
Take part in decisions about restricting visitors, mail or phone calls

Medical Treatment Decisions:

Receive compassionate care at the end of life.
Receive, or have a legally authorized representative receive information about your illness, course of treatment and prognosis for recovery in terms that you can understand. Have information about the outcome of your care, including unanticipated outcomes.
Upon admission, the hospital will provide you with information on the extent to which the hospital is able, unable, or unwilling to honor advance directive.
Formulate advance directives that state your wishes and values for health care decisions when you cannot speak for yourself. Hospital staff and practitioners who provide care will comply with these directives to the extent allowed by hospital policy and Wisconsin State Law.
Have your pain assessed and managed.
Except in emergencies, consent will be obtained by you or your legally authorized representative before treatment is administered.
Donate, request or refuse organ and tissue donations.

Continuity of Care:

· You will not be transferred to another facility without being given a full explanation for the transfer, without a provision being made for continuing care and without acceptance by the receiving institution and physician. In an emergency you/your family/legal representative will be provided an explanation for transfer.

Refusal of Treatment:

Participate in the development, implementation and revision of your plan of care and treatment. You will be able to refuse treatment to the extent of the Wisconsin State Law and shall be informed of the medical consequences of the refusal.
Leave the hospital against your physician’s advice regardless of your condition, to the extent permitted by Wisconsin State Law, after signing a release form.

Financial Information:

You may obtain a copy of your medical record at a fair cost in a reasonable time frame.
Receive a detailed copy of your bill and receive an explanation of the bill, regardless of source of payment. Upon request, you shall receive information related to financial assistance available through the hospital.
Ask about and be informed of business relationships among payors, hospitals, educational institutions, and other health care providers that may affect your care.

Personal Safety:

Have a safe environment, including zero tolerance for violence, and the right to use your clothes and personal items in a reasonably protected environment.
Receive protective oversight while a patient in the hospital, and receive a list of patient advocacy services, such as protective services or guardianship.
Be free from restraints or seclusions, unless clinically necessary to improve your well-being and less restrictive interventions have been determined to be ineffective. Physical safety of you, staff and others is of the utmost importance. The use of restraint or seclusion will be discontinued at the earliest possible time.

Complaints or Concerns:

When a complaint has been shared with a care-giver or On-Call Administration, the goal is to address any patient complaint “on the spot” by staff present and make every attempt to resolve it within 7 days.
Patients may also express unresolved concerns to the:

The Joint Commission
Office of Quality Monitoring
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
800-994-6610
complaint@jointcommision.org

Wisconsin Department of Health Service
Division of Quality Assurance
P.O. Box 2969
Madison, WI 53701-2969
608-266-8481

MetaStar, Inc.
Quality Improvement Organization
2909 Landmark Place
Madison, WI 53713
1-800-362-8980

Patient Responsibilities

Provide correct and complete information about yourself and your health, including present complaints, past health problems and hospital visits, medications you have taken and are taking and any other information you think your caregivers need to know.
Discuss and share your views about your care/service needs and expectations, including your pain needs and any perceived risk or safety concern.
Provide correct and complete information about your Advance Directive, if you have one, and provide a copy.
Follow instructions, hospital policies, rules and regulations which include respecting property and helping control noise.
Follow the agreed-upon care plan and recommendations of your physician and health care team. Inform your physician or nurse if you cannot follow instructions or do not understand your care plan or course of care, treatment and services. Report any unexpected changes in your condition.
Accept consequences for outcomes if you do not follow the recommended care, service or treatment plan.
Leave your valuables and personal belongings at home, have your family members take them home or have them placed with Security until you are discharge.
Respect the property, privacy dignity and confidentiality of patients and others in the hospital. Be respectful in your interactions with other patient, employees, physicians and visitors without regard to age, race, color, national origin, language, religion, culture, disability, socio-economic status, sex, gender identity or expression or sexual orientation.
Comply with safety instructions and hospital rules and regulation. Possession of a weapon of any kind is prohibited on the hospital property.
Keep a safe environment free of drugs, tobacco and alcohol. St. Mary’s Janesville is a tobacco and smoke-free facility.
Provide correct and complete information about your financial situation as best you can and promptly meet any financial obligations agreed to with the hospital.