SPEAK UP!
Ask Questions and Voice Concerns
ALL ABOUT ADVANCE DIRECTIVES
PATIENT GUIDE Key Information For Your Stay
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www.anaheimregionalmc.com | 714-999-1450
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1111 West La Palma Avenue • Anaheim, CA 92801 • (714) 999-6075 ANAHEIM TERRACE CARE CENTER
Orthopedic Rehabilitation • Wound Care • Physical Therapy Medical Director On-Site • Speech Therapy • Occupational Therapy 24-Hour Emergency Alert and Response System • Case Management Beautiful Gardens • Private Bathroom • Activity and Fitness Center
Call for Your Complimentary Tour
(714) 821-7310 141 S. Knott Ave., Anaheim, CA 92804
CO N T E N TS WELCOME. . . . . . . . . . . . . . . . . . . . . . . 2 PHONE DIRECTORY.. . . . . . . . . . . . . . 3 OUR COMMITMENT TO CARE.. . . . 4 THE BIRTH PLACE. . . . . . . . . . . . . . . . 6 SPECIAL SECTION . . . . . . . . . . . . . . . 7 YOUR PRIVACY MATTERS.. . . . . . . . 15 ADVANCE DIRECTIVES. . . . . . . . . . . 17 SUPPORT FOR CAREGIVERS. . . . . . . 18 LEAVING THE HOSPITAL. . . . . . . . . . 19 HOSPITAL INFECTIONS. . . . . . . . . . . 22 AFTER-HOSPITAL CARE. . . . . . . . . . . 24 MEET OUR HEALTHCARE TEAM. . . 25 SPOTLIGHT ON HEALTH. . . . . . . . . . 27 Heart Attack & Stroke Warning Signs Stop Smoking FOOD & MEDICINES SAFETY. . . . . . 30 GAMES. . . . . . . . . . . . . . . . . . . . . . . . . . 33
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Take Charge of Your Care Speak Up, Plus 7 Key Ways to Take Charge of Your Care n Choose a Support Person n Check IDs n Pay Attention to Your Care n 6 Ways to Fight Infections n Don’t Ignore Pain n Prevent Falls n Prepare for Surgery n Manage Your Meds n
On Our Cover Speak Up! Ask Questions and Voice Concerns.. . . . . . . . . . . . . . . 7 All About Advance Directives. . . . . . . . . 17
POWER FOOD RECIPES. . . . . . . . . . . 34 MEDICINE TRACKER. . . . . . . . . . . . . . 35 NOTES. . . . . . . . . . . . . . . . . . . . . . . . . . . 36
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Welcome Thank You for Trusting Us On behalf of our team of employees and physicians, I want to thank you for choosing Anaheim Regional Medical Center for your healthcare needs. Anaheim Regional Medical Center has been servicing the community since 1958, and we are proud of our reputation as a large community hospital able to provide complex services.
Our Mission
To provide compassionate, high-quality healthcare to a culturally diverse community.
At ARMC, our 600 physicians and 1,500 employees are committed to providing excellent health services and medical care to each and every one of our patients. We strive to ensure that all aspects of our patients’ care are addressed in a responsive, considerate and compassionate environment, resulting in a positive healthcare experience. Thank you for choosing Anaheim Regional Medical Center. Sincerely, Patrick Petre Chief Executive Officer
Our Vision
To be recognized by patients, physicians and staff as the BEST place to receive healthcare, the BEST place for physicians to practice, and the BEST place to work.
Our Commitment
Anaheim Regional Medical Center is committed to providing excellent health services and medical care to our patients and our community. We believe that partnering with our patients and physicians is far more effective than working independently, which assists our patients in achieving a positive outcome and a quick return to their optimal health.
Our Values
Advocacy Responsiveness n Mutual Respect n Caring n n
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CONTACT US 11111 W. La Palma Ave. • Anaheim, CA 92801 PH: 714-999-1450 • www.anaheimregionalmc.com
Phone Directory Key Number Main: 714-999-1450
Calling from INSIDE the hospital? Dial the last four digits only.
OTHER HOSPITAL SERVICES Admitting 714-999-2038
Nutrition Service 714-999-6012
Case Management/ 714-999-3806 Social Services
Parent Education 714-999-5153 Programs
Directions to 0 Hospital Education 714-999-3124 Emergency 714-999-6111 Department
Pastoral Care 714-999-3185 Patient Affairs 714-999-3917 Patient TV Services 714-999-3831
Employee Health 714-999-5285
Physical Therapy 714-999-5780
Environmental 714-999-6123 Services
Pre-Admission 714-999-3847 Testing
Gift Shop 714-999-5128
Preregistration 714-999-5179
Human Resources 714-999-6113
Security 714-999-5150
For more information on the resources available at Anaheim Regional Medical Center, visit www.anaheimregionalmc.com.
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Our Commitment to Care Welcome to Anaheim Regional Medical Center! It is a privilege for us to provide care and service for you and your family. Our healthcare team is committed to providing you and your family with excellent care and service. Our goal is to deliver compassionate care and exceptional service to our patients while considering their clinical needs and care preferences. Family participation is essential to support the healing process, and family presence is encouraged.
During your stay, our staff will: n
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MAKING A DIFFICULT HEALTHCARE DECISION?
Sometimes a healthcare choice can involve an ethical concern— such as a wish to refuse life-saving treatment or a disagreement over advance directives (see p. 17). Our Bioethics Committee can help your team of support people make difficult decisions. For help, contact 714-999-5278.
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rovide a quiet, restful environment that promotes P healing. heck on you every hour between 6:00 a.m. and C 10:00 p.m. and check on you every two hours between 10:00 p.m. and 6:00 a.m. as part of our commitment to meeting your needs. Keep you informed. o over your plan of care with you, and help you set G daily goals. artner with you to manage your pain, which includes P repositioning you frequently, providing other comfort measures such as heat or cold therapy, providing music and/or television to distract you from your pain and administering medications as ordered by your physician. xplain the reason for a medication, review any E associated side effects and answer your questions. Clean your room and bathroom daily.
We are committed to our patients, and we want to know if we are not meeting your expectations. Please call and let us know how we can better assist you. The clinical manager on your unit, or the department director, are available from your call light, or by dialing 0 and asking the operator to have them paged. Our house supervisor is available 24 hours a day to assist you, as well, and can be reached at (714) 999-5268. If your complaint is not resolved, you have the right to file a complaint with either the California Department of Public Health, (800) 228-5234, or the Joint Commission for the Accreditation of Hospitals, (800) 994-6610.
After discharge from the hospital, you will receive a follow-up phone call from a 205 area code from a company called JL Morgan. The purpose of the call is to follow up on the care provided in the hospital, to make sure you were able to schedule a follow–up appointment with your doctor, to ensure you have started your discharge medications, and to answer any questions. We also want to recognize staff that does an excellent job, so please share their names with us!
After Your Stay
Lastly, after the follow-up phone call, you may receive another call for the official government survey to determine how we are doing. WE ASK YOU TO PLEASE PARTICIPATE in the survey as it is the only way that we know if we are meeting your expectations. The survey will ask you about the following topics:
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Communication with doctors and nurses
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Medication effects and side effects
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Pain management and responsiveness of staff
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Cleanliness and quietness
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Your overall rating of the hospital
We thank you in advance for your input and helping us to better serve our patients!
If you are selected for the survey, you will receive a call from Area Code 205
Want to Know How We Score? You can review and compare the quality, care and safety ratings for different hospitals at: n Medicare Hospital Compare, uses HCAHPS results and other data: www.medicare.gov/hospitalcompare You also can find information on hospitals through this accrediting organization: n The Joint Commission: www.qualitycheck.org
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The Birth Place The Birth Place clinicians and staff strive to ensure that your birthing experience is a memory to cherish for many years to come. To secure the safety of the newborn and maintain the comfort of the mother, father or significant other, we ask that you follow these policies:
Visiting Hours n n
11:00 a.m. to 8:00 p.m. daily nlimited visiting hours are provided to fathers/ U significant others.
General Guidelines
VISITING THE HOSPITAL? Thanks for taking the time to support your loved one’s care and recovery.
All visitors must wait outside the Labor and Delivery Room (LDR) for the first hour and a half after delivery. n This private time is used specifically to acquaint the newborn with the parents. After the skin to skin bonding, you may have up to two people visit at a time in the LDR. All other visitors can either rotate in to visit, or they can wait in the LDR waiting room. n
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ue to fire department regulations, we cannot have D people waiting in the hallways. ur two-person visitation policy O also is for the baby’s protection and infection control. We ask that visitors use the waiting room and rotate visitation. nly siblings of the O baby are allowed to visit if they are under the age of 12 years. iblings may be further S restricted during peak flu season in order to protect the mother and newborn.
Take Charge of Your Care You are the center of your healthcare team. Let this special guide help you get the best results from your hospital stay.
Speak Up! If you have questions or concerns, you have the
right to ask and get a response from your doctor or nurse that makes sense to you. To help, share your answers to these questions with hospital staff.
What language would you prefer to speak?
Do you need glasses, hearing aids or other devices to help with talking to hospital staff?
Do you prefer to hear, see or read health information?
Do you have any cultural, ethnic or religious-based special needs?
Who will be your support person who talks with hospital staff about your healthcare wishes? (see p. 17)
Ask Yourself Is there anything else the hospital should be aware of to improve my care experience? 7
TAKE CHARGE OF YOUR CARE continued
7 Key Ways
TO TAKE CHARGE OF YOUR CARE SPEAK UP. Ask questions and voice concerns. It’s your body, and you have the right to know. PAY ATTENTION. Always double-check that you are getting the right treatments and medicines from the right hospital staff. EDUCATE YOURSELF. Learn about your medical condition, tests and treatment options, so you know why following your care plan is so important. FIND A SUPPORT PERSON. Pick someone to help speak up for your care and needs during your stay. KNOW YOUR MEDS. Understand what your medicines treat, why you need them and how to take them for the best results. CHECK BEFORE YOU GO. Make an informed decision when selecting additional healthcare services. Choose only accredited providers who meet patient safety and quality standards. Go to www.qualitycheck.org to learn more. PARTICIPATE IN YOUR CARE. You are the center of your healthcare team. Make sure you know what’s happening every step of the way—from admission through discharge. Source: The content within the “Take Charge of Your Care” section reinforces the safety and quality care goals and standards issued by The Joint Commission and other hospital accreditation organizations.
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Choose a Support Person A trusted friend or family member can be a big help during your hospital stay. Select one key person to be your healthcare advocate. If you become stressed or your ability to communicate changes, this person can stand in for you—and stand up for your care.
A support person can: n
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ask questions you might not think of and write down information double-check your medicines and treatments watch for signs your condition is getting worse and ask for help
Don’t forget to tell the staff who you’ve picked to be your support person.
Check IDs
While you are here, many people will care for you (doctors, nurses, aides) and these same people will care for many patients. To prevent errors in your care: A sk to see the ID of everyone who comes into your room, so you know the name and job of the person caring for you. If you do not see an ID badge, contact your nurse immediately. peak up if hospital staff does not S check your ID. Any time staff enters your room to give you medicine, transport you, or perform procedures or treatments, state your name and birth date.
Always double-check your name with staff to avoid errors.
This may seem repetitive at times, but it helps ensure you receive the correct care.
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TAKE CHARGE OF YOUR CARE continued
Pay Attention To Your Care n
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Tell your nurse if something doesn’t seem right.
You Are Key You are the most important member of your healthcare team.
Know what time you normally get medicine, and tell your nurse if you don’t get it.
Understand your treatment
Request drawings or illustrations to help you learn about your condition.
Ask questions Speak up about pain
Read and understand all medical forms before signing. Ask if you need information explained.
Know your medicines Plan early for a successful discharge
If your treatment involves medical equipment, practice using it with your nurse before you leave the hospital. Don’t be afraid to ask for a second opinion. The more information you have, the better you will feel about making decisions. Talk to your doctor and family about whether you want life-saving actions taken.
And Remember, Take Charge of Your Communication Ask About Jargon: I f you hear a medical term you don’t understand, ask what it means.
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“Teach Back”: After you get instructions or an explanation, repeat back what you thought you heard so you can double-check that you understood.
Take Notes: W rite down any key facts your doctor tells you so you won’t forget.
6 Ways to Fight Infections The hospital is a place you come to get well, but you also can come in contact with germs that can make you feel worse. Reduce your chances of infection by taking these safety precautions. 1 Clean your hands. n after touching hospital objects or surfaces n before eating n after using the restroom 2 Ask hospital staff members to clean their hands. This should be standard practice, but don’t be afraid to remind them if they forget or to ask them to wear gloves when touching you. Ask visitors to clean their hands, too!
CLEANING TIP: Use soap and water or hand sanitizer under your nails, in between your fingers, and on the palms and backs of your hands. Rub for 15 seconds (the time it takes to sing Happy Birthday).
3 Cover if you are sick. If you get an infection, limit the spread of germs by sneezing and coughing into tissues you promptly throw away, and avoid touching other people. Ask staff members if there is anything else you should do—like wear a surgical mask—to prevent the spread of germs. 4 Keep an eye on bandages or dressings. If a dressing on a wound or IV becomes loose or wet, let your nurse know. Also if you have a catheter or drainage tube, tell your nurse if it becomes loose or dislodged. 5 Keep your vaccinations up-to-date. Make sure you are as protected as possible from the spread of infection. Check with hospital staff about whether it’s safe for you to receive any vaccines you might need. 6 Eat healthy and maintain good oral hygiene.
Tell friends and family not to visit if they are sick. And make sure all your guests wash their hands when they enter your room. 11
TAKE CHARGE OF YOUR CARE continued
Don’t Ignore Pain No one knows how much pain you are in but you. Tell your doctor or nurse when pain strikes or if it comes back again after it goes away. Talk about your pain level throughout the course of your stay.
Ask yourself, then share with your nurse. n
Where does it hurt?
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When does it hurt?
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Does it keep you from doing things—like sleeping, dressing, eating?
Which words describe your pain? q aching
q cramping
q pressure
q shooting
q bloating
q cutting
q pulling
q soreness
q burning
q dull
q radiating
q stabbing
q comes and goes
q numbing
q searing
q throbbing
q constant
q pressing
q sharp
q tightness
How bad is it on this pain scale? Wong-Baker FACES® Pain Rating Scale
0 No Hurt
2 Hurts Little Bit
4 Hurts Little More
6 Hurts Even More
8 Hurts Whole Lot
*Copyright 1983, Wong-Baker FACES® Foundation, www.WongBakerFACES.org. Used with permission.
You’re the Expert on Your Pain Starting to get uncomfortable? Pain medicine not working? Speak up. You may need to get more of the current pain medicine you are on or switch to a different kind of medicine to get relief. Don’t try to ignore painful symptoms. Managing your pain will help with your healing process. Talk to your doctor or nurse when pain strikes.
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10 Hurts Worst
Prevent Falls While you are here, you may feel dizzy or weak. Illness, procedures, medicines or even just lying down for too long can all make you less steady on your feet. To keep yourself safe: n n
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Use the nurse call button for help getting out of bed. sk for help going to the bathroom or walking around. A (And use hospital handrails when they’re available.) Wear nonslip socks or footwear. eep often-used items within easy reach K (glasses, remote, tissues, etc.). ake sure your wheelchair is locked when you get in M or out of it. Never step on the footrest.
Patients of all ages are at risk for falls. It’s better to be extra careful than risk another medical problem.
Prepare for Surgery Before your procedure, make sure you and your surgical staff confirm: n n
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your name the type of surgery you are having the body part to be operated on—In fact, your surgeon will mark the correct spot on your body. Make sure you or your support person checks that it’s correct.
Take simple steps like these to help prevent medical mistakes.
Ask your surgeon to take a “time out” to check: you’re the right person, getting the right surgery, on the right body part. 13
TAKE CHARGE OF YOUR CARE continued
Manage Your Meds Whether you take one medicine or five, it’s important to know what you are taking and why. Ask your doctor these questions about any new (and current) medicines you take: n
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hat is the name of my W medicine? Generic name? hy am I taking it? How will W it help? When will it start working? hat dose? How often? W How long? hat is the best time (morning, W night, etc.) or way to take it (with food, with water)? hat are possible side effects? W What do I do if they happen? re there any foods, drinks or A activities to avoid? What do I do if I miss a dose?
For a medicine tracker, see p. 35.
Remember, Take Charge of Your Medicines Think you’re due for your next dose? Wondering if this new medicine can replace one you already take? Want to make sure all your medicines and supplements are safe to take together? Don’t be afraid to ask.
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Prevent Medicine Errors Be sure your doctors and nurses know: n All the prescription drugs, over-the-counter medicines and herbal or vitamin supplements you take. n Any allergies you have to medicines, anesthesia, foods, latex, etc. n That your name matches the name on the medicine (use your ID bracelet to double-check).
Your Privacy Matters Privacy and Health Information You have privacy rights under a federal law that protect your health information. This law sets rules and limits on who can look at and receive your health information. These rights are important for you to know.
Who must follow this law? Most doctors, nurses, pharmacies, hospitals, clinics, nursing homes and many other healthcare providers and their vendors
Health insurance companies, HMOs and most employer group health plans
Certain government programs that pay for healthcare, such as Medicare and Medicaid
Right to Complain If you believe your rights are being denied or your health information isn’t being protected, you can file a complaint with your provider, health insurer or the U.S. government at www.hhs.gov/ocr/privacy.
What information is protected? Information your doctors, nurses and other healthcare providers put in your medical records
onversations your doctor has with nurses and others regarding C your care or treatment
Information about you in your health insurer’s computer system
Billing information about you at your clinic ost other health information about you held by those who must M follow this law
What rights do you have over your health information? Providers and health insurers must comply with your right to:
sk to see and get a copy of your A health records ave corrections added to your H health information Receive a notice that tells you how your health information may be used and shared
ecide if you want to give D your permission before
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Your Privacy Matters continued
y our health information can be used or shared for certain purposes, such as for marketing et a report on when and why your health information was shared G for certain purposes File a complaint
What are the rules and limits on who can see and receive your health information? To make sure that your health information is protected in a way that doesn’t interfere with your healthcare, your information can be used and shared:
For your treatment and care coordination To pay doctors and hospitals for your healthcare and help run their businesses
Contact 714-9996126 for copies of medical records.
With your family, relatives, friends or others you identify who are involved with your healthcare or your healthcare bills, unless you object To make sure doctors give good care and nursing homes are clean and safe To protect the public’s health, such as by reporting when the flu is in your area To make required reports to the police, such as reporting gunshot wounds
Without your written permission, your provider cannot:
Give your health information to your employer Use or share your health information for marketing or advertising purposes Share private notes about your mental health counseling sessions
Another law provides additional privacy protections to patients of alcohol and drug treatment programs. For more information, visit: www.samhsa.gov.
Source: U.S. Department of Health & Human Services Office for Civil Rights
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Advance Directives A Simple and Smart Way to Take Charge of Your Care One of the most important decisions you can make about your care is to fill out advance directives in case you can no longer speak for yourself. Advance directives are documents that let others know your wishes about the type of care you want. And they will only be used if you become unconscious or too ill to communicate yourself. Different states have different laws about advance directives. Check with your Admissions Department or nurse if you have any questions. Directives can include:
Living Will
This set of instructions explains the type of lifeprolonging medical care you wish to accept or refuse. It can include your wishes about the use of resuscitation (CPR) if your heart stops, a ventilator if you stop breathing, or feeding tubes or IVs if you cannot eat or drink.
Durable Power of Attorney
For healthcare: This is a legal document that names your healthcare proxy—someone who can make medical decisions for you if you’re unable to do so. An official healthcare proxy can represent your wishes on emergency care but also on other medical issues Choose Your Care like potential treatment Fill out advance options, blood transfusions, directives so your kidney dialysis, etc. Choose wishes are met someone you trust, discuss and your loved ones are sure of your medical wishes, and what you want. make sure the person agrees to represent you in this role. For finances: You also have the right to appoint someone or the same person to help manage your finances if you cannot.
FILL OUT YOUR FORMS
Make sure you submit advance directives each time you go to the hospital, so your most current information and wishes are on file. You do not need a lawyer to fill these out. For more information and to obtain the forms you need, contact visit Aging with Dignity’s website at www. agingwithdignity. org.
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Support for Caregivers How to Play a Role in Your Loved One’s Recovery
We encourage patients to pick a key person to support them during their hospital stay. Whether you are that primary support person, or just one of many people caring and supporting your loved one, you can play an important role in making sure your loved one gets the safest and best care both here—and beyond the hospital.
What to Know Before You Leave
Caregivers can help ensure the best outcome for their loved one after a hospital stay by getting the answers to these three questions: n
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hat is the next step for medical W care (home or facility, follow up with primary care physician or physical therapy, etc.)? Help your loved one arrange the details to make this happen—financial plan, transportation, scheduling, etc. hat new and former medicines W does my loved one need to take? Help your loved one understand the details—timing, dosing instructions, side effects, prescription refills, etc. hat health warning signs do I W need to watch for and what do I do if they happen? Help your loved one by writing these symptoms down, as well as the name and contact number to call.
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Caregivers Need Care Too If you feel like you need a break or help, reach out to friends and family. And consult the resources listed here. RESOURCES n National Alliance for Caregiving www.caregiving.org n
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Family Caregiver Alliance www.caregiver.org Caregiver Action Network www.caregiveraction.org
6:00am GET BATH READY FOR DAD 6:30am PACK LUNCH FOR THE
KIDS 10:00am GIVE DAD HIS MEDICINE 1:00pm FOLD EVERYONE’S LAUNDRY 2:00pm SORT DAD’S BILLS 3:30pm PICK UP THE KIDS 4:20pm TAKE DAD OUT FOR FRESH AIR 5:30pm REMEMBER THE DAYS WHEN DAD TOOK CARE OF ME 6:00pm MAKE DINNER 8:00pm HELP DAD TO BED 11:00pm FINALLY GO TO SLEEP
Only those who care for others know what it’s really like to care for others. That’s why AARP created a community with experts and other caregivers to help us better care for ourselves and for the ones we love.
aarp.org/caregiving or call 1-877-333-5885
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Your Health. Your Life. Trust Your Healthcare to One of Our Many Great Doctors. Serving the Anaheim Community for 40 years. HealthCare Partners is a Top-Performing Medical Group Multi-Specialty Medical Group to Meet Your Needs On-Site Primary Care, Specialty, Lab, Radiology, Mammography, Pharmacy Walk-In Clinic Open Evenings, Weekends, and Most Holidays Electronic Medical Records Disease Management Programs Fast Appointments and Referrals 24-Hour Telephone Support We Welcome Most Insurance Plans, Cash, and Credit Cards To find a great doctor or to schedule a VIP Tour of our medical office, call
714.995.1000 91
N. Magnolia Ave.
N
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Anaheim Office W. Woodland Dr.
11620 11-13
La Palma Ave.
Anaheim Medical Office 1236 N. Magnolia Avenue Anaheim, CA 92801 healthcarepartners.com
Medical Group and Affiliated Physicians
661 Center Street Costa Mesa, CA 92627 Phone: 949-548-5584 Admissions E-Fax: 1-866-740-2643
At Mesa Verde Post Acute Care Center, our mission is to provide skilled nursing and rehabilitation services with respect and concern for each individual. We work with local physicians and other medical professionals to establish programs and address patient needs, including cardiac and orthopedic rehab, neuro trauma, stroke recovery, and wound care. Our friendly and compassionate staff makes the difference, paying attention to the smallest details for every resident. We would love the opportunity for you to come see what sets us apart. Call us today at (949) 548-5584 to schedule a tour of our facility.
• 24/7 nursing care • Individualized resident care plan treatments • Cardiovascular • Catheter care • Colostomy care • Enteral tube feeding • Diagnostic imaging/ laboratory services • Intravenous therapy (IV) • Palliative care • Post-surgical care • Total parenteral nutrition (TPN) • Skin and advanced wound care • Tracheostomy care • Respiratory therapy • Isolation (C-Diff/MRSA/VRE)
145-Bed Skilled Nursing Facility Specializing in Short-Term Nursing and Rehab Santa Ana Healthcare and Wellness Centre provides a caring and comfortable environment for all residents • 24-Hour RN Services • Innovative Rehab Services Team including Physical, Occupational and Speech Therapists • Respiratory Therapy • Trach Care • Intravenous Therapy
• Advanced Wound Care • Post-Surgical Care • Nutritional Counseling with a Registered Dietician • Social Services and Discharge Planning • Private and Semi-Private Rooms with Cable TV
1209 Hemlock Way • Santa Ana, CA 92707 Phone: 714-546-1966 • Admissions E-Fax: 714-546-2820
• Short-Term Care • Long-Term Care • Skilled Nursing/Rehabilitation Services including Physical, Occupational and Speech Therapy • Advanced Skin and Wound Care Services
• IV Therapy • Respiratory Therapy and Trach Care • Private and Semi-Private Rooms with Cable TV • Admissions 24 hours a day, 7 days a week
920 W. La Veta Street • Orange, CA 92868 Phone: 714-633-3568 • Admissions E-Fax: 714-633-1524
Before You Leave the Hospital
A successful recovery after your stay starts with a solid plan before you go.
Plan Early to reduce your chances of being readmitted and
increase your chances for a healthy recovery. Take steps as soon as possible during your stay to plan for a successful transition from the hospital.
To begin, ask to speak with your discharge planner, and review the following: n your discharge summary and discharge plan n your complete medicine list and instructions n your upcoming appointments n what to do if you don’t feel well
A Reason To Plan Early If you need a rehabilitation facility, nursing home, skilled care, or other service after your stay, you’ll need time to find and weigh your options. For help comparing services in your local area, go to: n www.medicare.gov/nursinghomecompare n www.medicare.gov/homehealthcompare n www.qualitycheck.org
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Before You Leave continued
Checklist for Discharge Make sure you have the following information before you leave the hospital.
pD ischarge summary. This includes why you were in the hospital, who cared for you, your procedures and medicines.
Not Ready To Leave? You have the right to appeal your discharge if you don’t agree with the decision that you are ready to leave the hospital. Speak with your discharge planner or physician and share your concerns. You also may need to reach out to Medicare, Medicaid or your insurance company.
pM edicine list. This includes all your new and former prescriptions, overthe-counter medicines, vitamins and supplements. Ask if there are any medicines you can stop taking or that are not good to take together. Also make sure you know why, how and when to take each one. pP rescriptions. Check that your pharmacy has your new prescriptions and that you have a plan to get them filled. p Follow-up care instructions. Beyond medicine, this can include: n warning signs to watch for n foods or activities to avoid n daily living adjustments n tests or appointments (like how to get into bed) n how to care for incisions or n who to call with questions use equipment pA fter-hospital services. Know how much support you’ll need in these areas: n Personal care: bathing, eating, dressing, toileting n Home care: cooking, cleaning, laundry, shopping n Healthcare: taking your medicines, doctor’s appointments, physical therapy, wound care, injections, medical equipment p Local Resources. Ask your discharge planner for help finding local after-care services or other support groups. Try the teach back method. Repeat back what you hear the discharge planner say to make sure you understand the details correctly. 20
Top 10 Questions to Ask Before Discharge 1. What number can I call 24 hours a day if I have questions or concerns? Who is my contact? 2. Has my follow-up appointment been scheduled? With whom? Do I have a ride there? 3. What are key warning signs I need to watch out for? Whom do I call if they happen? 4. What special equipment do I need? What special instructions do I need (wound care, injections, etc.)? 5. What kinds of activities and foods are limited? For how long? 6. Do the doctors caring for me after my stay have access to my test results and medicines? Do I need follow-up tests? 7. Are my new medicines safe to take with my other medicines, vitamins or supplements? 8. D o I know how and when to take my medicines and how I will get prescriptions filled? 9. Who will provide the extra personal, home or healthcare services I may need? 10. Who can help me if I have concerns about medical costs?
Need Medical Equipment or Supplies? If you need durable medical equipment (walker, wheelchair, hospital bed, oxygen, etc.), Medicare will only cover the cost if you use an approved supplier. To find one in your area, visit www.medicare.gov and select “Find suppliers of medical equipment and supplies� or call 1-800-MEDICARE (800-633-4227).
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Prevent Hospital Infections Take Steps to Reduce Your Risk During Your Stay According to the U.S. Department of Health and Human Services, 1 in 25 patients gets a healthcare-associated infection while staying at the hospital. Often, these happen because hospital procedures and equipment can expose internal parts of your body to germs. The chart below lists common infections and steps you can take to prevent them.
TYPE
22
HOW IT STARTS
Catheter-Associated Urinary Tract Infections (UTI)
Germs enter your urinary tract while using a tube to drain urine
Surgical Site Infections
Germs affect the site of your surgery—either on your skin or internally
Central Line-Associated Bloodstream Infections
Germs enter your bloodstream through a large tube that’s inserted in a vein near your neck, chest or groin
Ventilator-Associated Pneumonia
Germs enter your lungs through a tube in your mouth, nose or neck used to help you breathe
Superbugs
A superbug is a germ that causes a bacterial, viral or fungal infection, but does not respond to the usual treatments. This means these bugs make you sicker longer and increase your risk of more serious complications. Common strains include MRSA, E. coli, and VRE. Superbugs spread from person to person through touching germy hands or objects. Protect yourself by taking the steps below. And remember, wash your hands and ask everyone you see during your stay to wash his or her hands, too.
SYMPTOMS n n n n
n n n
n
n
n n
fever burning pain bloody or frequent urination redness pain drainage of cloudy fluid fever r ed skin and soreness at site fever chills
PREVENTION n n
n n
n
n n n
n n
n
n
n
n n n n n
cough mucus fever chills shortness of breath
n n n
n
clean hands before touching area keep urine bag below level of bladder to prevent backflow don’t tug, pull, twist or bend the tube secure catheter to your leg and ask every day if it’s still needed o not shave surgery site (irritation increases d risk of infection) clean hands before touching area don’t let visitors touch or dress your wound ask your nurse to show you how to care for your wound c lean hands before touching area make sure staff wears gloves, gown, cap, mask and sterile drape when handling tube speak up if your bandage comes off, looks wet or dirty, or if your skin looks sore avoid touching tube or letting visitors touch tube ask that tube be removed as soon as possible c lean hands before touching area ask if it’s safe to raise the head of your bed know how often the inside of your mouth needs to be cleaned and speak up when it hasn’t happened ask that the tube be removed as soon as possible
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After-Hospital Care Quick Guide to Recovery Options for After Your Stay
After-hospital care that fits your needs is important. Make sure you understand what your hospital staff recommends for you.
Home Healthcare— Care provided by professionals in your home to help maintain or restore health. Includes: home care services such as housekeeping and meal preparation; personal care services such as bathing, dressing or eating; and healthcare services such as physical therapy or skilled nursing. Independent Living—
Communities with individual, private apartments or homes. Includes: meals, housekeeping, maintenance, social activities and possibly transportation. Healthcare services like skilled nursing are not usually standard.
Assisted Living— Individual
units or apartments, usually in a long-term care facility. Includes: home and personal care services, as well as help managing health conditions and medicine routines—plus social activities and transportation. Medical staff is onsite 24 hours.
Nursing Home— Long-term care facility with individual rooms for those who don’t need a hospital, but can’t be cared for at home. Includes: all daily living and personal care services, 24-hour skilled nursing care, plus social activities and events. Special units often available for people with Alzheimer’s disease or memory loss.
Hospice— Care program that
provides support for terminally ill patients and families in hospitals, facilities or homes. Includes: 24-hour help with pain control, symptom management and emotional or spiritual support. To get started evaluating or finding after-hospital care resources in your area, visit:
n
n
ldercare Locator E www.eldercare.gov ational Respite Network and N Resource Center www.archrespite.org
Contact your health insurance, Medicare or Medicaid to find out what care and services are covered for you, and to obtain help with costs. 24
Meet Our Healthcare Team Case Managers and Social Workers
Case managers will review your medical record and discuss your discharge planning. They also are available to help you with arrangement for home care, admission to a long-term care facility or rehabilitation care. Social workers offer emotional support, counseling and guidance to help patients and their families deal with financial, social and emotional problems related to illness or hospitalization.
Chaplain
The hospital chaplain and a group of volunteer ministers are available to all patients and their families. A Prayer Ministry is available for the sharing of prayer with staff members. Please contact your nurse to request these services.
Dietitians
A registered dietitian will review your medical record and work with your healthcare team to develop a nutrition care plan for you. Registered dietitians also are available to educate you about any diets you may need to follow after you are discharged.
Hospitalists
A hospitalist’s only focus is to take care of patients when they are in the hospital. Hospitalists work in close consultation with the patient’s primary care physician and specialists. They manage a patient’s entire hospital experience, from admission until discharge.
Nurses
In each nursing unit, a registered nurse is responsible for supervising patient care and directing the nursing and support staff of the unit. Registered nurses are assisted by nursing assistants and nurse technicians. The nursing staff is available around the clock.
We Are Here to Serve You. If at any time during your stay, you have a question about who is caring for you, or you need help for any reason, please ask. Our staff member will find the right person to provide you with the care you need.
25
Staff Definitions continued Pharmacists
While you are in the hospital, hospital pharmacists will dispense all of your medicines. They can answer any questions you have regarding your medicines.
Physicians
Your primary care physician, a resident physician on duty or a hospitalist will supervise your care while you are in the hospital.
Rehabilitation Therapists
Physical therapists, occupational therapists, speech pathologists and audiologists will work with you, your family and your medical team to help meet goals of recovery. Therapy may range from brief consultation to long-term intervention, based on the extent of your injuries or illness.
26
Technicians and Technologists
Skilled health professionals perform and assist with laboratory and other procedures, including X-rays, mammograms, ultrasound, CT scans, MRIs, cardiac catheterization, radiation therapy and other procedures that helping diagnosing and treating your illness or injury.
Volunteers
Volunteers give thousands of hours each year to our hospital to enhance the care of our patients and their families. They provide support throughout the hospital, including staffing the information desk, delivering mail and flowers, operating the gift shop and escorting patients.
SPOTLIGHT ON HEALTH
Heart Attack & Stroke Warning Signs Recognize the Signs and Get Help Quickly A heart attack or stroke is a medical emergency and every second counts. The faster you or a loved one recognizes the symptoms and gets help, the better your chances of surviving, with the least amount of damage to your heart or brain. Once you’ve had an event, you’re at greater risk of having another in the future. But keep in mind that the symptoms of a second event can be different from what you experienced the first time.
Heart Attack Warning Signs
The main symptom of a heart attack is chest pain or discomfort. It also can feel like pressure, fullness or squeezing in your chest. These feelings may start gradually and get worse, or they may come and go. The symptoms of a heart attack can be different for women. Women also may have unusual heartburn, shortness of breath, lightheadedness, nausea, or they may feel tired or anxious weeks before a heart attack.
Stroke Warning Signs
Think F.A.S.T. when it comes to recognizing a stroke:
F ACE DROOPING: Does one side of your face droop or is it numb? Try to smile.
A RM WEAKNESS: Is one arm weak or numb? Raise both arms. Does one arm drift downward?
PEECH DIFFICULTY: Is your speech slurred? Are you unable to speak? S Try to say a simple sentence like “The sky is blue.”
T IME TO CALL 911: If you notice any of these symptoms, even if they go away, call 911 right away.
Other sudden symptoms can include:
n
numbness or weakness in your leg
n
confusion or trouble understanding
n
trouble seeing in one or both eyes
n
trouble walking, dizziness, loss of balance and coordination
n
severe headache with no known cause
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SPOTLIGHT ON HEALTH
Stop Smoking Reduce Your Chances of Returning to the Hospital No matter how long you’ve been a smoker, it’s never too late to set aside this unhealthy habit. The benefits start right away and last a lifetime: n
n
n
n
n
n
0 MINUTES after quitting, 2 your heart rate and blood pressure drop. WEEKS TO 3 MONTHS after 2 quitting, your circulation improves and your lungs work better. 1 YEAR after quitting, your risk of heart disease is half that of a smoker’s. YEARS after quitting, your risk 5 of mouth, throat, esophagus and bladder cancers is cut in half. 10 YEARS after quitting, your risk of lung cancer is half that of a smoker’s. 1 5 YEARS after quitting, your risk of heart disease is the same as a nonsmoker’s.
More Benefits
When you quit smoking, you:
n
save money
n
breathe better and cough less
n
n
n
ave whiter teeth and h fresher breath s et a good example for your loved ones r educe your chances of being hospitalized again
Cigarette smoking is the No. 1 preventable cause of death in the U.S. Quitting is hard, but you can do it. There are now more former smokers than current smokers nationwide. Quitting smoking even 12 hours before surgery will help with healing. Smoking after surgery stresses your heart, raises your blood pressure, and reduces the oxygen your blood and tissues need in order to recover.
What’s in a Cigarette? More than 7,000 chemicals are in cigarette smoke. Some of them also are in wood varnish, DDT, arsenic, nail polish remover and rat poison. The tar, gases and other poisons in cigarettes damage your heart and lungs and make it harder for you to fight infections.
28
Ready, Set, Quit!
Now that you’ve decided to quit, take it one day at a time. Remind yourself that you are in control— you can choose to smoke or not. Make a commitment to yourself. Write down why you want to quit and read it every day. Be prepared to have nicotine cravings. They usually pass soon, so wait it out. The good news is that they become weaker and less frequent the longer you go without smoking. When a craving hits, take a walk, call a friend, or do something else you enjoy.
Here’s How You Can
S.T.A.R.T. S ET a quit date. T ELL your family, friends and coworkers that you plan to quit, and ask for their support. A NTICIPATE the challenges you’ll face. R EMOVE cigarettes and other tobacco products from your house, car and workplace. T ALK to your doctor about getting help to quit—including medicines or products that can help, and other tools and resources like those found at the sites below: n American Cancer Society: www.cancer.org n National Cancer Institute: www.smokefree.gov
Free Smoking Cessation Services at Anaheim Regional (ARMC) ARMC offers free quit smoking seminars every month. Call 714-999-3991 for more information. If you or anyone you know is interested in quitting smoking, you can call 1-866-NEW-LUNG (1-866-639-5864) to make a reservation for an upcoming seminar. Participants that are age 18 years and older receive a free supply of nicotine patches. Services are offered in English, Spanish and Vietnamese.
29
Foods & Medicines Safety This chart will help you steer clear of side effects that can be caused by pairing certain foods and medicines. Did you know foods you eat could affect the medicine you take? Eating or drinking certain foods can cause your body to absorb medicine slower or faster. This can make medicine less effective or cause troubling side effects. The chart below lists some common drug-food interactions, but it does not include every medicine or food interaction. Be sure to ask your doctor or pharmacist about possible interactions between food, vitamins, supplements, herbals or other drugs before taking any prescription or over-the-counter medicines. Class DRUGDrug CLASS
Prescription Medication RX MEDICINE
TIPS
Analgesics (pain relievers)
Endocet, Magnacet, Percocet, Primlev, Roxicet
Avoid alcohol. May need to take with food.
Comments
(acetaminophen + oxycodone) Tylenol #3, #4
(acetaminophen + codeine) Antibiotics
Ampicillin Penicillin Tetracycline
Take 1 hour before or 2 hours after a meal.
Cipro Proquin
Don’t take with dairy products, antacids, or calcium-fortified juices.
(ciprofloxacin) Doryx, Monodox, Oracea, Vibramycin
Take with food or milk if it causes upset stomach.
(doxycycline) Flagyl (metronidazole) MetroCream, MetroGel, MetroGel Vaginal, MetroLotion, Noritate Cream (topical)
Avoid alcohol.
(metronidazole) Anti-coagulants (blood thinners)
30
Coumadin, Jantoven
(warfarin)
Avoid sudden change of diet with foods rich in vitamin K (like green leafy vegetables), as well as vitamins and supplements with vitamin K.
DRUG CLASS
RX MEDICINE
TIPS
Antidepressants
Buspirone, Abilify
Avoid grapefruit, grapefruit juice, and alcohol.
Paxil, Pexeva (paroxetine) Prozac, Rapiflux, Sarafem (fluoxetine) Zoloft (sertraline)
Avoid alcohol.
Aplenzin, Budeprion (SR, XL) Buproban, Forfivo, Wellbutrin (SR, XL) Zyban (bupropion)
Take with food or milk if it causes upset stomach.
Dilantin, Phenytek (phenytoin) Depakene, Depakote (ER, Sprinkle), Stavzor (divalproex/ valproate sodium; valproic acid) Lamictal (CD, ODT, XR) (lamotrigine) Zartontin (ethosuximide)
Talk to doctor first before drinking alcohol or using other drugs and natural products that slow your actions.
Lyrica (pregabalin)
Avoid alcohol.
Gabtril (tiagabine)
Tell your doctor if you are taking any herbal products, especially St. John’s wort. Avoid alcohol. Take with food.
Topamax (topiramate)
Don’t follow a high-fat or low-carbohydrate diet. Avoid alcohol.
Carbatrol, Epitol, Equetro, Tegretox (XR), Teril (carbamazepine)
Talk to your doctor first before drinking alcohol or using other drugs and natural products that slow your actions. Avoid grapefruit and grapefruit juice.
Aldactone (spironolactone) Amiloride + Hydrochlorothiazide Dyrenium (triamterene) Monopril (fosinopril) Prinivil, Zestril (lisinopril) Vasotec (enalapril)
Avoid high potassium foods (e.g., almonds, bananas, potatoes with skin, and salt substitutes). Follow a low-salt, low-sodium diet.
Calan, Verelan (verapamil/iproveratril hydrochloride) Cardizem (CD, LA, SR), Cartia XT, Dilacor XR, Dilt-CD, Diltzac, Taztia XT Tiazac (diltiazem)
Tell your doctor if you are taking any herbal products, especially St. John’s wort. Avoid grapefruit, Grapefruit juice and alcohol.
Anti-seizure
High Blood Pressure
Continued on next page.
31
Foods & Medicines Safety continued DRUG CLASS
RX MEDICINE
TIPS
High Blood Pressure continued
Felodipine Adalat (CC), Afeditab CR, Nifedical XL, Nifeditab CR, Procardia (XL) (nifedipine) Sular (nisoldipine)
Avoid grapefruit, salt and sodium, high potassium foods and herbal supplements.
Cholesterol
Lipitor (atorvastatin) Altoprev (lovastatin) Zocor (simvastatin)
Avoid grapefruit, grapefruit juice and alcohol.
Anti-arrhythmics
Cordarone, Pacerone
Avoid grapefruit, grapefruit juice and herbal products, especially St. John’s wort.
Diabetic Medicines
DiaBeta, Glynase PresTab (glyburide) Glucotrol (XL)
Avoid alcohol.
Metozolv ODT, Reglan (metoclopramide)
Talk with your doctor before you drink or use other drugs and natural products that slow your actions.
Nexium (esomeprazole) Prilosec (omeprazole)
Take at least 1 hour before meals.
Colcrys (colchicine)
Avoid grapefruit and grapefruit juice.
Aloprim, Lopurin, Zyloprim (allopurinol)
Take after meals with plenty of fluids.
Gengraf, Neoral; Sandimmune (cyclosporine)
Avoid grapefruit and grapefruit juice.
Prograf (tacrolimus) Rapamune (sirolimus)
Take always with food or always without food.
Maplan (isocarboxazid) Nardil (phenelzine) Parnate
Avoid foods high in tyramine like aged cheeses, meats, sour cream and bananas. Avoid drinks containing tyramine like draft beer and hearty red wine, and drinks with caffeine.
(amiodarone)
(glipizide)
Gastrointestinal Drugs
Gout Medicines
Immunosuppressants
MAO Inhibitors (an antidepressant)
(tranylcypromine/ transamine sulphate)
Respiratory Medicines Elixophyllin, Theo-24, Avoid foods and drinks high in caffeine. Theochron, Uniphyl (theophylline)
32
Games Crossword Puzzle Complete the crossword by filling in a word that fits each clue. ACROSS
1 “Lorna Doone” character 5 Sinbad’s bird 8 Demolish: Brit. 12 Idea (Fr.) 13 Alas 14 Cheese 15 Leg ends 16 Burmese knife 17 Taro 18 Small S.A. rabbit 20 Pilgrim 22 Skin vesicle 23 Veneration 24 Beginning 28 Blaubok 32 Public vehicle 33 54 (Rom. numeral) 35 Israelite tribe 36 Ringed boa 39 Reading desk 42 Abdominal (abbr.) 44 Have (Scot.) 45 Female falcon 48 Butterfly 52 State (Fr.) 53 Television channel 55 Endearment 56 Mine (Fr. 2 words) 57 Rom. first day of the month 58 Per. poet 59 Maid 60 Compass direction 61 Foreign (pref.)
DOWN
1 Breach 2 Design 3 Profound 4 Hate 5 Fanatical 6 Wood sorrel 7 Rudderfish
8 Flat molding 9 “Cantique de Noel” composer 10 Kemo ______ 11 Turk. title 19 Jap. fish 21 Intimidate 24 Amazon tributary 25 Grab 26 Kwa language 27 “_____ Abner” 29 “Fables in Slang” author 30 Rhine tributary 31 Television channel 34 Car 37 Insect 38 Presidential nickname 40 Helper 41 Caddy (2 words) 43 Male duck 45 Loyal 46 Hindu soul
47 Cella 49 Crippled 50 Dayak people 51 Aeronautical (abbr.) 54 Low (Fr.)
Answer Key
Source: www.satorimediaworks.com
33
Power Food Recipes Give Your Recovery a Boost with These Simple, Nutrient-Rich Dishes
2. Add ½ cup diced red onion and 3 cloves of minced garlic. 3. Season with salt and pepper and sauté for about 4 minutes. 4. Add 2 medium sweet potatoes, peeled and cut into ¼-inch pieces; fresh rosemary leaves from 1 stem, chopped; and 4 cups of low sodium chicken broth.
ER FOO OW
D
1. Melt 2 tablespoons unsalted butter in a pot over medium-high heat.
P
Creamy Sweet Potato Soup (serves 4)
SWEET POTATO Vitamin A for a healthy immune system
5. Bring to a boil and then simmer for 30 minutes. 6. Turn off heat and blend the mixture (either in a food processor or using an immersion blender) until smooth. 7. Whisk in ½ cup mascarpone cheese at room temperature. 8. Serve warm. Bonus Tip! For baked sweet potatoes, mix in applesauce or pineapples for extra moisture and sweetness. ER FOO OW
D
1. Preheat oven to 450° F.
P
Wrapped Asparagus (serving = 1 to 2 bundles) 2. Spread 1 to 2 slices of prosciutto or ham with reduced-fat cream cheese. 3. Wrap meat around 2 to 3 asparagus spears, so the tips and ends aren’t covered. Repeat to reach desired number of servings. 4. Lay asparagus bundles on a baking sheet and cook for 15 minutes, or until the asparagus is tender. Bonus Tip! Cook asparagus so it’s tender enough to be poked by a fork but still bright green.
34
ASPARAGUS More folic acid than any other vegetable to help your body make new cells
Medicine Tracker Keep track of all the new medicines you are prescribed while in the hospital—plus any other medicines you already take.
MEDICINE 1
MEDICINE 2
MEDICINE 3
MEDICINE 4
Drug Name What Does it Treat?
Dose How to Take it
(With food, on an empty stomach, etc.)
When to Take it
(Time of day, morning, night, etc.)
Notes
(Prescribing doctor, pharmacy, side effects)
Share With Staff Fill out this list with hospital staff to double-check you’re taking your medicines correctly and that they’re all safe to take together. Be sure to also include over-thecounter medicines, vitamins and supplements. 35
Notes
? 36
Have a question or concern on your mind? Share it with hospital staff. We want to help but can’t unless you tell us what you need.
Recovery Isn’t Simply a Goal, It’s Our Mission. At Kindred Healthcare, we understand that when people are discharged from a traditional hospital, they often need continued acute care in order to recover completely. Kindred Hospitals are transitional care hospitals providing aggressive, specialized interdisciplinary care to medically complex patients who require extended recovery time. We offer: • ventilator weaning and management • advanced wound care • infectious disease care • renal dialysis • neuro/post-trauma care • telemetry
• critical care unit • 24-hour, on-site physician • 24-hour, on-site pharmacy • 24-hour nursing care • procedure/endoscoscopy suites • rehabilitation therapies (PT, OT, ST)
To learn more about our hospitals or to schedule a tour, please call a facility below.
Kindred Hospital Brea 875 N. Brea Boulevard Brea, CA 92821 714.529.6842 kindredhospitalbrea.com
Kindred Hospital Westminster 200 Hospital Circle Westminster, CA 92683 khwestminster.com
Kindred Hospital Santa Ana 1901 N. College Avenue Santa Ana, CA 92706 CA TDD/TTY 800.735.2922 kindredsantaana.com
© 2013 Kindred Healthcare Operating, Inc. CSR 172082-01, EOE
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with quality care
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AppleCare Medical Group is a network of over 900 physicians
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patients have access to quality healthcare services. AppleCare Medical Group contracts with several insurance companies, including Medicare Advantage plans and commercial plans.
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To become a member of AppleCare Medical Group or to learn more, please call 1(800) 460-5051 or visit AppleCareMedical.com.