Leaving hospital can be stressful for patients and their families. Many patients are still recovering and they and their families are often anxious about how to manage at home. This stress can make it difficult to remember instructions from hospital staff upon discharge about when to take medications, what symptoms to look out for and when to schedule follow-up appointments. A new tool being introduced by Temiskaming Hospital will help you better manage your own care after leaving hospital. The Patient Oriented Discharge Summary (PODS) has the potential to improve care for many patients and families. Patients and health care providers co-developed PODS to make important discharge information and instructions clear and easy to follow by patients and families after the transition home. 

PODS highlights five important issues for you when leaving hospital:

• Medications they need to take

• How they might feel and what to do

• Changes to their routine

• Appointments they have to go to

• Where to go for more information

PODS uses plain language, large type, pictures and images to make the information as easy-to-understand as possible. Patients, families and their care providers complete the summary together, and the patient is asked to recall the instructions in their own words to ensure they have been understood. In addition, a traditional discharge summary is still sent to the patient’s family doctor.

Temiskaming Hospital PODS

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In addition to Temiskaming Hospital, PODS is being adopted by 26 other hospitals across the province and could benefit approximately 50,000 patients in the first year alone. This expansion is taking place with support from ARTIC (Adopting Research to Improve Care), a joint program of the Council of Academic Hospitals of Ontario and Health Quality Ontario. ARTIC is dedicated to accelerating the spread of proven health care throughout the province.

https://youtu.be/YMaY3VHZJXQ

The definition of family is made by the patient/patient representative, recognizing that family may include anyone who normally provides physical, psychological, or emotional support to the patient.  Patients may identify individual(s) as their care partners and how they will be involved in care, care planning, and decision making. Visitor:  guest or friend of the patient. 

• Visiting hours are between 10 a.m. to 8 p.m. Try to coordinate your visit times with other family members and friends to ensure your loved one has a healthy care environment.

• Patients admitted to Hospital should have no more than two visitors/family members at a time.

• Visits of more than two people may be accommodated through collaboration with the patient and the inter-professional care team.

• Children under 12 years must be directly supervised by an adult, who is not the patient.

• Visitors are asked to use the available spaces in the waiting area, chapel and/or common areas to avoid overcrowding the patient care areas.

• Visitors who feel unwell, have an active infection, have symptoms of respiratory illness, symptoms of flu-like illnesses, or have symptoms of other communicable diseases should not visit. Appropriate Personal Protective Equipment (PPE) must be worn as instructed to support existing safety procedure requirements.

• To ensure confidentiality all health care information is shared directly with the patient, or if the patient’s condition warrants, the Substitute Decision Maker (SDM). To help facilitate effective communication among family members and hospital staff, the patient is encouraged to name one or two spokespersons that can provide information to extended family members.

• Visits may be restricted to protect the health care needs and privacy rights of other patients or to maintain safety and security decisions. Any or all visitors may be asked to leave at the discretion of the Nursing Team Leader or designate.

• Some patient care units have locked doors and a phone located outside the unit entrance (i.e. Obstetrics, Emergency Department, and Operating Room). Please use the phone to call in to the unit and check in before visiting.

• To ensure patient privacy and in respect to other families in the Special Care Unit (SCU), the number of visitors is limited so that no more than two people are visiting at one time.

• Disruptive behavior and unsafe practices are not acceptable by any visitor or family member; these situations, while usually rare, will be addressed directly and promptly.

• In the event of a public health event affecting the hospital, visitors may be temporarily limited or restricted.

• In exceptional circumstances these visiting hours may be waived at the discretion of the Nursing Team Leader or designate.

• For family visiting, please see policy: ADM-G-71 Family Presence

 Effective January 24, 2020

Reference: ADM-G-23

Essential Care Partner: is defined as family member(s), guardian, or other person(s) who provides critical and often ongoing physical, psychological, or emotional support to the patient.

Essential care partners work with the patient or substitute decision makers and health care team, and are involved in care, care planning, and decision making. Essential care partners are designated by the patient or substitute decision maker (SDM).

Designated Care Partner: is defined as another guest or friend of the patient.

Expanded Care Partner: encompasses both essential and designated care partners

Guidelines:

1. To support in the recovery and well-being of patients, care partner presence will be based on the patient’s condition; care needs and expressed wishes at the time of their current hospital experience.

2. Care partner presence hours are flexible to accommodate the patient circumstance; there are no prescribed hours. The time and number of care partners may be based on the clinical care needs of the patient. This is planned in collaboration with the patient, family and inter-professional care team. Care Partners are not restricted from leaving the Hospital and returning.

3. Care partner presence may be interrupted for the provision of patient care and may be restricted to protect the health care needs and privacy rights of other patients or to maintain safety and security decisions.

4. Quiet hours are between 8 p.m. and 7 a.m. Patients can choose one care partner to stay with them at the bedside. The care partner will be requested to create a quiet atmosphere and refrain from moving throughout the hospital. Between 8 p.m. and 7 a.m. the care partner must enter through the Main Entrance.

5. Appropriate personal protective equipment (PPE) must be worn as instructed to support existing safety procedure requirements.

6. To ensure confidentiality, all health care information is shared directly with the patient, or if the patient’s condition warrants, the Substitute Decision Maker (SDM). To help facilitate effective communication among family members and hospital staff, the patient is encouraged to name one or two spokespersons that can provide information to extended family members. Care Partners will also be designated by the patient or SDM.

7. We ask that care partners be 16 years of age or older; however special circumstance will be considered on a case-by-case basis.

8. Care Partners must comply with hospital policy. Disruptive behaviour and unsafe practices (including explicitly ignoring or disregarding public health requirements during their time at the Hospital) are not acceptable. These situations, while usually rare, will be addressed directly and promptly, up to asking the care partner to leave the Hospital.

9. For visitors, please see policy ADM-G-23 Visiting Guidelines

10. All care partners must be free of communicable diseases and must respect the hospital’s infection control policies. Care Partners who are feeling unwell, have an infection, have symptoms of respiratory illness, symptoms of flu-like illnesses or symptoms of other communicable diseases should not come to the hospital.

11. In the event of a public health alert affecting the hospital (i.e. outbreak, pandemic), to minimize the risk of harm to health care workers and patients and ensure preservation of personal protective equipment, care partner presence may be temporarily limited or restricted. Where care partners are limited to only essential or designated care partners, the following phases will be determined based on a continued risk assessment on the degree of active transmission in the community, nosocomial spread, availability of PPE and critical supplies, and other infection prevention and control components. Patients with confirmed or suspected infectious organisms will be granted essential care partners, with the requirement of additional protection considerations.

Due to transmission risk for all patients in isolation, additional considerations include:

a. The essential care partner must comply with hospital policy relating to outbreak management and care partner regulations e.g. hand hygiene and masking

b. The essential care partner has been trained on safe PPE donning and doffing protocols

c. Are aware of hospital policy pertaining to the compliance of PPE utilization.

d. The essential care partner will be instructed to exclusively visit one (1) patient within the facility at a time.

e. Essential Care Partners must only proceed to their designated area (i.e. room of patient they are visiting), will not be allowed to wait in the waiting rooms, cafeteria or other common areas and are required to limit movement within the Hospital.

Reference: ADM-G-71

Policy Statement

The Hospital is committed to maintaining a healthy and safe environment, and to comply with the Smoke-Free Ontario Act, 2017 (“the Act”). Temiskaming Hospital is a smoke-free environment. The Hospital notes that smoking poses a significant medically documented risk to the health of non-smokers as well as smokers. Smoking is not permitted on Hospital property, either inside or outside, including parked cars, parking lots, bus shelters and courtyards (Ontario Regulation 268/18). Smoking includes cigarettes, e-cigarettes, cigars or pipes containing burning tobacco, or any other substance (such as medical or recreational cannabis) that can be smoked in any other manner. At the request of an Indigenous resident, the hospital shall set aside an indoor area, separate from any area where smoking is otherwise permitted, for the use of tobacco for traditional Aboriginal cultural or spiritual purposes. In keeping with its commitment to health and wellness and as required by law, the sale and use of tobacco products is not permitted on Hospital property.

Implementation of the Policy

The smoke-free rules apply to all staff, patients, volunteers, students, Board/Foundation members, physicians, contractors and to members of the public. All managers and supervisors are responsible for implementing this policy in their areas of responsibility. Anyone associated with the Hospital is also encouraged to report non-compliance and is protected by the Act in doing so. Staff concerned about non-compliance with this policy should approach their supervisor or delegate. An individual found to be smoking in the smoke-free area (indoor or outdoor) of the hospital may be charged with an offence by the Timiskaming Health Unit’s Tobacco Enforcement Officer, and if convicted, could face a maximum fine of $1,000 - $5,000.

Smoking Cessation Programs

Staff are encouraged to contact the Health and Safety/Occupational Health Coordinator to obtain information regarding Smoking Cessation Programs.

Information Dissemination and Signage

Information about this smoking policy is published on the Hospital internal (Intranet) and external websites.  Signs designating the Hospital as a smoke-free environment are posted prominently at entrances and exits and throughout the hospital property.

Reference: ADM-G-24

Exposure to scented products triggers adverse reactions in many people, including sore throat, dizziness, sinusitis, asthma attacks, migraine and tension headaches, severe allergic reactions, etc. Perfume, Body Lotions, Laundry Products, Etc. The employees, students, volunteers, auxiliary members and physicians of Temiskaming Hospital do not wear perfume or cologne, aftershave, scented hand creams, scented toiletries and hair products, scented laundry products, etc., while in the workplace. Flowers, Room Deodorizers, Potpourri, Candles, Personal Clothing, Etc. Scented flowers, imitation or real, room deodorizers, whether battery operated, electric, block or spray, potpourri, scented candles, etc., are not brought to the hospital, as well as pajamas or your own clothing if strong scented laundry products have been used. Candles are not lit in the hospital, in accordance with fire regulations.

Reference: ADM-G-32

Temiskaming Hospital promotes an attitude of mutual respect amongst and between employees, professional staff, patients and visitors to the Hospital. Any act of violence or harassment committed by or against any member of our workplace or member of the public, is unacceptable conduct that will not be tolerated.