8/12/2019 GLA Patient Rights

http://slidepdf.com/reader/full/gla-patient-rights 1/5

VA CREATER LOS ANGELES

HEAL]HCARE SYSTEM

pffitr^sA Aitisi6n ol VA Desef, Pacifit

HEalthcarc NEt*ark POLICY

JULY 2004 00-EI-12

PATIENT RIGHTS, RESPONSIBILITIES, AND DENIAL OF RIGHTS

1. PURPOSE: To describe the rights and responsibilities of patients and under what

circumstances those rights may be denied.

2. POLICY:

A. The Healthcare System recognizes that each patient is an individual with unique

spiritual, cultural, ethnic, age-specific characteristics, and health care needs. We are committedto providing considerate, compassionate, and competent care that focuses on the patient's

individual needs. We foster patient participation in treatment planning; create a therapeutic

environment in which to maximize treatment benefits; use the least restrictive means to attainpatient therapeutic goals; and support the patient's increased self reliance, judgment for care

decisions, and fundamental respect for self and others.

B. Patient rights and responsibilities are posted on every nursing unit of the Healthcare

System; and provided as part of a patient handbook to patients who receive acute and/or

extended care at this Healthcare System. These were developed by Veterans Health

Administration as a common set for every VA facility. They are meant to convey the basic

rights and responsibilities in lay terminology; and are not inclusive of all rights, which patientshave. The staff is responsible for documenting as appropriate.

3, DEFINITIONS:

GLA

A. Rights: privileges or liberties to which a person is entitled by law; and by policy.

B. Responsibilities: those actions for which an individual is accountable and liable; and

expected to do for self.

4. RESPONSIBILITIES:

A. PATIENT RIGHTS INCLUDE:

(l) Reasonable response to requests and need fbr service within capacity, mission,

laws and regulations.

(2) Considerate and respectful care.

8/12/2019 GLA Patient Rights

http://slidepdf.com/reader/full/gla-patient-rights 2/5

,rl'i?ili

(3) Collaboration with practitioner in matters regarding personal health care.

(4) Formulation of advance directives (living will, durable power of attorney forhealth care) and appointment of surrogate to make health care decisions.

(5) Access to information necessary to make care decisions that reflect his/her

wishes for informed consent.

(6) Access to information about patient rights and handling of patient complaints.

(7) Participation of patient or representative in consideration of ethical, cultural,ethnic, and spiritual decisions regarding care.

(8) Access to information regarding any human experimentation orresearch,/education proj ects affecting his/her care.

(9) Personal privacy and confidentiality of information.

(10) Action by legally authorized person to exercise patient's rights if patient isjudged incompetent in accordance with law, or is found by physician to be medically incapableof understanding treatment or is unable to communicate his/her wishes.

(11) Forgoing or withdrawing life-sustaining treatment including resuscitation.

(12) The opportunity to address ethical conflicts by referral to the BioethicsCommittee.

(13) Refusing treatment after being afforded sufficient information to make an

informed Decision without disqualifying patient for current or future care.

(14) Freedom from physical restraint or seclusion except in those situations wherethere is substantial risk of imminent harm by the patient to himself/herself and/or to others.

(15) Knowledge of who is the caregiver, by name, and who is responsible forcoordinating the patient's care.

B. ADDITIONAL PATIENT RIGHTS FOR HOSPITALIZED PATIENTS:

(l) To communicate freely and privately with persons outside the HealthcareSystem; and to have or refuse to have

visitors.There

will be reasonable access to publictelephones for making and receiving calls.

(2) To receive unopened mail. If there is reason to believe the mail may containcontraband, then the patient will open the mail in the presence of an appropriate medical staffmember.

(3) To be allowed to wear one's own clothing and to keep personal possessions.

8/12/2019 GLA Patient Rights

http://slidepdf.com/reader/full/gla-patient-rights 3/5

00-EI- I 2

.IIJI,Y 2OO4

(a) To keep and spend one's own money.

(5) To social interaction, as well as to regular exercise; and an opporlunity forreligious worship.

(6) To not be denied legal rights (e.g. to vote), except where State law providesotherwise.

(7) Appropriate pain management.

(8) Palliative carelreferral, as appropriate to prognosis.

(9) Be provided reasonable assistance for communicative/cognitive disorders and

physical disabilities.

C. PATIENT RESPONSIBILITIES INCLUDE:

(l) Following Healthcare System safety rules, especially those regarding smokinglimitations, and other posted safety signs.

(2) Being considerate and respectful of all other patients and Healthcare System

personnel.

(3) Cooperating with one's treatment staff. If questions or disagreements arise, todiscuss these first with the treatment staff (there are other provisions for referral to BioethicsCommittee and to Patient Representatives).

(4) Preventing injury to one's self, other patients, visitors, and staff members byone's own actions and being responsible for safekeeping of one's clothing, money, and personal

possessions, which are kept at the Healthcare System during the course of care delivery.

(5) Keeping scheduled diagnostic and treatment appointments and being on timefor these.

(6) Avoiding interference with the treatment of other patients, particularly inemergency situations

(7) Alerting staff when another patient is having difficulty.

(8) Advising one's visitors to be considerate of other patients and staff, and toobserve visiting hours.

(9) Being understanding and patient if one encounters reasonable delays.

10) Refraining from verbal or physical behavior which is offensive to otherpatients or staff.

8/12/2019 GLA Patient Rights

http://slidepdf.com/reader/full/gla-patient-rights 4/5

00-l:l- I 2

JULY 2OO4

(l l) Understanding what medications one must take following discharge (as wellas other discharge instructions such as diet, physical activity limitations, etc.) and when the next

scheduled outpatient follow up appointment will be.

D. Staff is responsible for honoring patient rights and creating the appropriate

therapeutic environment in which patients experience their rights and responsibilities. In manycases, documentation in the medical record is required to assure that these rights were respected

as well as to communicate appropriate assessment, treatment, and continuity of care to otherhealth care providers who are also treating the patient.

5. PROCEDURES:

A. Upon admission, each patient will receive a Patient Handbook. Psychiatric patients

will additionally receive the Mental Health Patient Rights Handbook; and a Mental HealthPatient Rights document, which the patient will be asked to read and sign for placement into themedical record.

B. The Patient Advocates (Customer Service Office) for the Healthcare System serve as

liaison between the patient and the Healthcare System as a whole by enabling patients and theirfamilies to obtain solutions to problems/concerns by acting on their behalf with other staffmembers, coordinating between departments/services, as appropriate; and makingrecommendations to improve services to patients. For psychiatric patients, their Handbook willinclude the phone number and address of the Los Angeles County Patients' Rights Advocate as

an additional source of lodging complaints.

C. Any denial of patient rights will be via physician's order, e.g. restraint usage

(described in GLA Policy, Restraints and Seclusion 00- l0B- I 1 8-36). The most prominent

reasons for denying a patient his/her rights are:

(l) Exercise of the specific right would be injurious to the patient.

(2) There is evidence that the specific right, if exercised, would seriously infringeon the rights of others.

(3) The Healthcare System would suffer serious damage if the right were notdenied.

(4) There is no less restrictive way of protecting the interests noted.

D. For psychiatric patients there are very specific requirements for the process ofdenying a right defined by Mental Health Law. This includes specific physician orders, timelimits on those orders, clinical rationale and documentation requirements.

E. In addition, for psychiatric patients, an on-going record of rights denied is mairrtainedby the professional nursing staff on each nursing unit. The Denial of Rights log is completed and

8/12/2019 GLA Patient Rights

http://slidepdf.com/reader/full/gla-patient-rights 5/5

,,,?1'1l;li

returned at the beginning of each month to the Mental Health Executive Leadership Office,

where an aggregation of these records is made by the patient relations assistant and submitted to

the Los Angeles County Mental Health Department as required by State Law.

6. REFERENCES:

A. M-1, Part l, Chapter l.

B. Medical Staff Bylaws and Rules

C. JCAHO Accreditation Manuals

D. VA Greater Los Angeles Healthcare System's Patient Handbook

E. GLA Policy, Organizational Ethics 00-EI-01, dated March 2004

F. GLA Policy, Restraints and Seclusion 00-10B-118-36, dated March2004.

G. 38 CFR, Section77.34

H. State Law, California Welfare and Institution Code, Section 5000

7. RESCISSIONS:

A. Healthcare System Policy ll-66 Patient Rights and Responsibilities and Denial ofRights. dated June 6, 1998.

B. Corporate Policy 00-EI-12, dated July 2001; Corporate Policy 00-EI-12, dated July

2001.

8. REVIEW DATE: Review as needed and reissue every three years.

Charles M. Dorman. FACHE

Director

Date