Patient Guide

Patient Guide

In This Guide Welcome from the CEO .................................................................................................................... 1 Mission, Vision, and Values ............................................................................................................... 2 Hospital Directory ............................................................................................................................... 3 Upon Admission .................................................................................................................................. 4 During Your Stay ................................................................................................................................. 5 Advance Directives .......................................................................................................................... . 8 How to Help with Pain ...................................................................................................................... .. 9 Patient Well Being ............................................................................................................................. 1 1 Speak Up! .......................................................................................................................................... 1 4 Rapid Response Team ..................................................................................................................... 15 Keeping you Informed .................................................................................................................... 16 Early Mobility ..................................................................................................................................... 17 Palliative Care Consultation Service .............................................................................................. 19 Visitor Guidelines ............................................................................................................................... 2 1 If You Have a Concern .................................................................................................................... 2 2 Discharge Information ..................................................................................................................... 2 3 Recovering at Home ....................................................................................................................... 2 6 Outpatient Physician Services and Locations .............................................................................. 29 Shout Out ......................................................................................................................................... 3 1 Kern Medical Foundation ................................................................................................................ 3 2

Thank you for choosing Kern Medical Welcome from the CEO

Scott Thygerson, Kern Medical

At Kern Medical, we pride ourselves on improving the health of our patients and the community. Since our commitment to our patients is to provide quality care, we want to ensure to treat you as we would our own loved ones. Our staff, physicians, and nurses use their knowledge and expertise to do amazing things everyday here at Kern Medical. We understand that being in the hospital is a challenging time for both patients and their families. Our hope is that this patient guide will offer some answers to common questions and a sense of comfort that may provide some ease during your stay.

We thank you for choosing Kern Medical for your healthcare needs.

Sincerely, Scott Thygerson Chief Executive Officer

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Defining Statement, Mission, Vision & Values Who We Are

Kern Medical is proud to be a Highly Specialized Tertiary Referral Center, Academic Teaching Institution, and Safety Net Hospital. Mission Guided by the needs of our patients and their families, Kern Medical delivers safe, compassionate, high quality care, and improves the health and well-being of our community. Vision

Kern Medical will: • Place the patient at the center of the healthcare experience • Lead academic and professional excellence in the community • Advance healthcare delivery through a fully integrated system across the spectrum of care • Realize the triple aim of providing the best patient experience, highest quality of care, and most appropriate use of healthcare resources • Hire and develop the best team that is both inspired and committed to healing • Commit to financial stability through efficient management of resources Values Kern Medical is guided by the principles of: • Compassionate Healing : We ensure a culture of caring that nurtures the well-being of the whole person • Respect : We are kind, listen to and understand, while embracing the skills and knowledge of others • Integrity : We earn your trust by delivering the best in healthcare • Innovation : We are committed to new ideas, creativity, and academic achievements • Collaboration : We value our partnerships to advance the health of our community • Fiscal responsibility : We are committed to effectively utilizing and maximizing our resources

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Hospital Directory

TV Televisions are provided in each patient room. Please be considerate of others by keeping the TV volume down and turning off your TV at bedtime. The TV networks are listed below

Main Number

661-326-2000

Admitting

661-326-2331

Clinic Appointments

661-326-2800

Outpatient Pharmacy

661-326-2506

Prescription

661-326-2860

KBAK TV – 29 (CBS) KERO TV – 23 (ABC) KGET TV – 17 (NBC) KUVI TV – 45 KABE TV – 39 (Spanish) KWFB (WB) KBFX TV – 58 (FOX)

Administration

661-326-2102

Billing Office

661-326-2378

Business Office

661-326-2378

Case Management

661-326-2432

Collections

661-326-2392

Food Service Office

661-326-2355

Discharge

661-326-2332

Emergency Department

661-326-2667

Gift Shop

661-326-2542

Housekeeping

661-308-6211

Medical Records/Legal

661-326-2591

Palliative Care

661-369-6016

Pastoral Care

661-326-2685

Secu r ity

661-326-2056

Social Services

661-326-2630

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Upon Admission

We want the admissions process to run smoothly for you and your family. Your preparation and cooperation will help us achieve that goal. Please review these admission guidelines so you are prepared for your hospital stay.

Please bring the following: • Insurance card and/or policy • Medicare, or Medicaid card • Social Security numbers of the patient and the insured • Driver’s licenses and/or photo ID cards of the patient and the insured • Emergency contact information When You Arrive (If Your Stay is Planned)

• A list of your current medications, over the-counter and prescription drugs, vitamins and herbals • Physician’s orders, if you have any • Your Advance Directives (living will, power of attorney, POLST, etc.)

Leave Your Valuables At Home The safety of your valuables is important to us. Please keep your belongings to a minimum at the hospital and notify your nurse when valuable items are brought into your room so we can assist you in keeping your items properly secured. Please contact your nurse should you have concerns about your belongings. If you have valuables, such as jewelry, credit cards and cash, please give them to a relative or friend to take home during your stay. Store your contact lenses, eyeglasses, hearing aids and dentures in your bedside stand when not in use. Please don’t put them on your bed or food tray—they may become damaged or lost. Kern Medical cannot be responsible for replacement of personal belongings. Your ID Bracelet As a patient, you will receive a special identification (ID) bracelet that states your name and hospital number, your physician’s name and other important information. Our care team members will ask your name and date of birth before providing care. Please wear it at all times. If your ID bracelet is damaged or lost, please let your nurse know immediately.

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During Your Stay

Interpreters It is very important to us that you understand your healthcare providers and are informed about the care you receive. Interpreter services are available 24 hours a day. Please inform your care provider of the language you prefer to speak and if you would like interpreter services. Hearing Impaired We have telecommunication devices and sign language services available. Please inform your care provider if you are in need of assistive services. Public Restrooms To protect the health and privacy of our patients, bathrooms located in patient rooms are reserved exclusively for patients. Public restroom are located near each main entrance into the hospital and in many of our patient care areas. Feel free to ask any staff member for directions to the the nearest public restroom. Hospital Equipment Our care team is concerned about your safety. Please ask for assistance before removing or adjusting equipment used in your care. Please do not leave your nursing care area without first checking with your nurse who can assist in meeting your needs. Security Security is committed to providing a safe and secure environment for all guests and patients. Security can assist with a safe escort to and from your car 24 hours a day, free of charge. Room Temperature Your comfort is very important to us. The room temperature is controlled and monitored centrally. Please notify your nurse if your room is too warm or cold and we will make every effort to improve your room temperature. If you would like extra blankets for your comfort, just ask your nurse. Calling Your Nurse Your nursewill be checking on you every hour to ensure your safety. We call this “Hourly Rounds”. Your nurse will be making sure you are comfortable, assisting you with position changes and bathroom needs, and taking care of your immediate needs every hour while you are awake. A “Nurse Call Button” will be placed within your reach at all times. You will receive assistance from your nurse or nursing assistant when you press on your Nurse Call Button.

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Telephone Telephones are provided in all patient rooms by Kern Medical. If you choose to keep your cell phone with you, Kern Medical is not responsible for loss or damage to your cell phone. Local Calls : Dial 9, listen for the dial tone, and then enter the number you wish to call. Other Calls : Dial “0” for operator assistance with collect, calling card and long distance calls. Wireless Network Kern Medical is pleased to offer our patients free Wi-Fi access to the Internet. Connecting is quick and easy. Activate wireless networking on your laptop or mobile device and select “Wifi Guest” (password not required). Launch any web browser and click “accept” on the Terms & Conditions page. That’s all there is to it. Lost and Found Pleasecontactyournurseshouldyouneedassistanceinlocatingabelonging.Ourstaffwilldoasearchforyour belongingandnotifyourHospitalComplianceOfficerifyourbelongingisnotimmediatelylocated.Patients mayalsocontactthePatientsRelationsDepartmentat661.345.6976regardinglostitems.Weencourageyou to leave your valuables at home. Medications from Home Please do not bring medication (prescription, over-the-counter, or illegal drugs) to the hospital. All medications you take while a patient at Kern Medical have been prescribed by your physician, are dispensed by the hospital pharmacy and administered by a trained professional. Patients are not permitted to administer their ownmedications or to keep personal medications, unless approved by their physician. Pastoral Care We strive to support patient and family spiritual well being. Please ask your nurse to assist you with locating a spiritual resource to fit your needs.

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Smoking & Tobacco use Kern Medical is a tonacco free campus. Smoking and/or the use of any tobacco products is not permitted anywhere in or on hospital grounds. Gift Shop The Auxiliary Gift Shop is staffed by volunteers and is located off the “D-Wing” (East) Lobby on the first floor of the hospital. A wide variety of gift items, snacks and other necessities are available. Cash and credit cards are accepted. Vending Machines Vending machines offering beverages and snacks are located near the Emergency Department waiting area and are available 24 hours a day, 7 days a week. Patient Meals Our Dietary staff will assist you daily in meal planning and preferences. Please notify your nurse if you have special dietary needs, concerns, or questions about your meal delivery. The diet office will be notified and work with you in meeting your dietary needs.

Breakfast is served between: 7:00am–9:00am Lunch is served between: 11:15am–1:00pm Dinner is served between: 4:45pm– 6:15pm Cafeteria

Our cafeteria is located on the first floor “C” wing. Because some patients are on a restricted diet and may not be feeling well, patient meals will be provided to the room. We encourage all family members and guests to sit in the Café while eating. Meals are served in the Café during the following times: Cafe Hours

Grill Hours 6:00 am– 9:00am 11:00 am– 1:30pm 4:00 pm– 6:00pm

Weekend/Holiday Grill Hours 6:00 am– 1:30pm 6:00am– 9:00am 11:00 am– 1:30pm

M– TH 6:00am– 7:00am Friday 6:00am– 6:00pm

Sat/Sun/Holidays 6:00am– 1:30pm ATM An ATM is located in the cafe. Photos/Video

For the protection patient and staff privacy laws limit the use of cameras (including video and cell phone camera) to a patient’s room and only with permission of the patient and staff member. Taking pictures and/or video of procedures, medical records or charts is not allowed. In the maternity areas staff will discuss with you the photography/video guidelines.

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Advance Directives Medical decisions are often difficult. As a patient, you have the right to make decisions about your own medical treatment. Decision making can become more difficult, when you are ill or experience a changes. You may become unable to tell your doctor and loved ones what kind of health care treatments you do and do not want. It is important for you to make your decisions known in advance. Note: Because circumstances change and each medical stay is different, you will be asked to either bring a copy of your existing advance directive with you during each hospital stay or to fill out a new advance directive during each stay. A Living Will, Advance Directive Form, POLST (Physician Order for Life Sustaining Treatment), Healthcare Proxy and Durable Power of Attorney (for healthcare and for finances) are all legal documents which allow you to give direction to medical personnel, loved ones and friends concerning your medical wishes. Your directive (wishes) will be followed when you are not able to speak for yourself. You do not need an attorney to complete the documents. For more information, please ask your nurse or hospital social worker. California Advance Directive Form This advance directive form is available at Kern Medical. Please ask your nurse for a copy.

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How to Help with Pain

You are the expert about how you are feeling. Be sure to tell your doctor or nurse when you have any kind of pain. To help describe your pain, be sure to report:

• When the pain began • Where you feel pain • How the pain feels—sharp, dull, throbbing, burning, tingling

• If the pain is constant, or if it comes and goes • What, if anything, makes the pain feel better • What, if anything, makes the pain feel worse • How much, if any, pain your medicine is taking away If your medicine helps with the pain, how many hours of relief do you get? What You Can Do If your current pain treatment is not working, talk with your caregiver about finding other methods that will help reduce or relieve your pain. Some things you can do to help relieve your pain: • Hold the incision or painful area with a blanket or pillow when coughing or moving • Walk if your doctor allows • Take your mind off the pain by watching a movie, reading, and change position often in bed. Because your comfort is important to us we will frequently ask you to rate your pain from 1-10.

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PAAST Pharmacy - Move to Discharge Our Meds to Beds program can fill and deliver your discharge medications to you before you leave the hospital at no extra cost. This also ensures you get the education you need from one of our expert pharmacists. This is an optional service, offered for your convenience. Please note, you have the right to choose any pharmacy you wish to provide your medications. Hospital Discharge Services Our pharmacy is located on the grounds of Kern Medical, making it convenient for you to get your medications quickly upon being discharged from the hospital. We can have the prescriptions faxed over to the pharmacy and have them ready for pickup before you are discharged! Our #1 goal is to make sure you leave our facility with the medications you need! Authorizations? No Problem We understand how frustrating it can be to be told “NO” from your insurance provider. Our staff is well-trained in the art of getting your insurance to say “YES,” and we will work our hardest to get the issue resolved as soon as possible. We have direct access to your medical record, allowing us to expedite the coverage of your medication(s)!

Medication Is Our Game Campus Pharmacycarriesa largeselectionof medications. If we do not have a medication in stock, we will notify you right away and can have it for you the following business day. If a medication is not covered by your insurance, we offer discounted and competitive pricing to those that are seen buy our providers at Kern Medical and Sagebursh clinic. Our pharmacy system is up-to-date, has an easy to use refill system, and we can even text you when your medication is ready!

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Patient Well Being

Infection Control Safety is everyone’s responsibility. Your participation is the best way to ensure your own safety. The following are five ways you can partner with us to help prevent infections. Clean your hands (ask your family members and guest to wash theirs too).

Use soap and warm water. Rub your hands together for at least 15 seconds. Rub your palms, fingernails, between your fingers, and the backs of your hands. If your hands do not look dirty, clean them with alcohol-based hand sanitizer. Rub the sanitizer all over your hands, especially under your nails and between your fingers, until your hands are dry. Ageneralruleforgoodhandhygieneistocleanyourhandsbefore touchingoreatingfood,afterusingthebathroom,takingoutthetrash, changingadiaper,visitingsomeonewhoisill,and/orplayingwitha pet.Eachtimeyourfamilymembers,guests,andstaffentersorexits your room they should clean their hands.

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Vaccinations Make sure that your vaccinations are current—even for adults. Check with your doctor about shots you may need. Vaccinations are available to prevent these diseases: • Chicken pox • Diphtheria Many diseases are spread through sneezes and coughs. When you sneeze or cough, the germs can travel three feet or more! Cover your mouth and nose to prevent the spread of infection to others. Use a tissue! Keep tissues handy at home, at work and in your pocket. Be sure to throw away used tissues and clean your hands after coughing or sneezing. If you do not have a tissue, cover your mouth and nose with a bend of your elbow or hands. If you use your hands, clean them right away. Make sure health care providers clean their hands or wear gloves. Health care providers come into contact with lots of bacteria and viruses. So before they treat you, it is okay to ask them if they have cleaned their hands . Health care providers should wear clean gloves when they perform tasks such as taking throat cultures, taking blood, touching wounds or body fluids, and examining your mouth or private parts. Do not be afraid to ask them if they should wear gloves or to put gloves on. Cover your mouth and nose.

• Human Papilloma Virus (HPV) • Whooping cough (Pertussis)

• Mumps • Tetanus • Pneumonia (Streptococcus pneumonia) • Flu (influenza)

• Measles • Hepatitis • German Measles (Rubella) • Meningitis • Shingles

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Family members, friends, and guests can help too. • If you are sick, considering visiting when you feel better • Please do not shake hands, touch others or touch equipment • Cover your mouth and nose when you sneeze or cough • Cleanyourhandsbeforeenteringandwhen exiting the patient’s room

Fall Prevention Hospitalized patients often fall because of muscle weakness, illness, or medical procedures, medications, or because they have been sitting or lying down for too long. Kern Medical cares about your safety. We need your help to keep you as safe as possible by following these guidelines during your hospital stay: • Do not get out of bed by yourself. Call your nurse for help. Your hospital bed is probably higher and narrower than your bed at home. You can easily fall while trying to get in or out of bed. Please “Call don’t fall” by using your nurse call button and asking for assistance. • Keep often used items within easy reach: call button, tissues, water, eyeglasses, telephone, TV remote. • Do not walk with bare feet. Wear non-skid socks or slippers. Kern Medical provides non-skid socks. • Make sure your robe or pajamas don’t drag on the floor; they can cause you to trip. • Use the handrails in your bathroom and throughout the hospital at all times. • Ask your nurse to show you how to properly walk with your IV pole, drainage bags, or any other equipment. • Be sure your wheelchair is locked when getting in or out of it. Never step on the footrest. • If you see a spill on the floor, report it immediately.

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Speak Up! During your stay, the doctors, nurses and staff at Kern Medical will treat you and your family as partners in your health care. One important way that you can be involved is to “speak up”. Ask questions, voice your concerns, and don’t be afraid to raise any issues relating not only to your care and treatment but your hospital stay overall. SPEAK UP : Ask questions and voice concerns. It’s your health and you have a right to know. PAY ATTENTION : Make sure you’re getting the right treatments and medicines. EDUCATE YOURSELF : Learn about the medical tests you get and your treatment plan. FIND AN ADVOCATE : Pick a trusted family member or friend to be your advocate. Tell your care team who your advocate is. Make sure your advocate knows your wishes. WHAT MEDS &WHY : Know what medications you take and why you take them. PARTICIPATE IN YOUR CARE : You are the center of the healthcare team and hold information that no one else knows unless you “speak up.” Remember: Write down any questions you have. Choose a family member or trusted friend to communicate with the doctors and staff. Keep a list of doctors you see and the medications they prescribe.

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Rapid Response Team The Rapid Response Team is a group of specially trained staff who bring critical-care expertise to the patient. The purpose of the team is to quickly check the condition of the patient and provide help before there is a medical emergency. When to Call Friends and family of the patient can call the Rapid Response Team:

Friends and family know the patient best. So if friends and family notice a change in condition please talk with the patient’s care team (doctor, nurses and staff) about your concerns. If still worried, call the rapid response team to assess the patient’s condition. How to Call CALL 5# FROM THE BEDSIDE PHONE . The operator will notify the Rapid Response team and help will arrive at the patient’s bedside within minutes. A team of medical professionals will arrive in the room to assess the situation. After the immediate need is addressed, the Unit’s Clinical Director or Supervisor will visit to assure that everyone is satisfied with the care provided by the patient. Signs that the Rapid Response team may need to be notified: • Changes in heart rate (slower or faster) • Difficulty breathing on their own • Chest pain, discomfort • Sudden sweating • Difficulty walking or speaking • A drop in blood pressure • Using the bathroom less or more frequently • Confusion, agitation or other mental status changes (less awake than normal) • Sudden loss of consciousness or a collapse • Any noticeable change in the way you look or feel • Any time you are worried about the patient looks or feels

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Keeping you Informed

KernMedicaliscommittedtoprovidingyouwithexceptionalqualitycare.OurHospitalLeaders careaboutyouandstrivetovisiteachpatientduringtheirstaytodiscussyourexperience. Shouldyouhaveanyconcernspleaseasktospeakwithyourunit’sleadershipteam.Weare here to assist you.

There are 3 ways your Nursing Staff will help to keep you informed: 1. Bedside Report 2. Hourly Rounding 3. Leadership Rounding

What is discussed?

Why 7am & 7pm?

Who participates?

Nurses change shifts at 7am and 7pm

Patients have the right to ask anyone to step out of the room during bedside report. Patients can notify their nurse if they don’t want to participate in bedside report.

• Medical History • Treatment Plan • Test Results • Diagnosis • Pain Management • Special Needs

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Early Mobility Spending time in bed can prevent your body systems from working correctly. For every day spent in bed it can take 3.8 days to get your strength back. Early mobility (movement) is one of the most important things you can do to help prevent problems that can occur from lack of movement. Some of these problems includeweakness, constipation, pneumonia, blood clots and skin breakdown. Why Is Mobility Good? • Helps maintain muscle tone and strength • Helps move blood/oxygen throughout your body • Speeds wound and incision healing • Improves bowel and bladder function • Decreases risk of complications from not moving • Helps you get home sooner! Up Sooner, Safer: Kern Medical’s Mobility Program

Kern Medical’s team members are specially trained to help you get up and moving as soon as it is safe to do so. Each day your nurse will complete a few tasks with you to determine the type of activity it is safe for you to complete. This is called your mobility level. Based on your mobility level, care teammembers will work with you to complete daily exercises. Team members may use special equipment designed to keep you safe during movement.

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Exercise Activities Exercise activities will be different for each patient and will be determined by your mobility level. Your activity will be tracked each day and may include: • Raising the head of the bed to different angles • Repositioning every two hours • Moving the joints of the arms/legs toward and away from body

• Sitting up to the edge of the bed • Getting up to a chair/restroom • Walking in the room or hall Equipment

Equipment will be different for each patient and will be determined by your mobility level.

Equipment is designed to move people safely. Staff will explain each step of the process. Some may use fabric seats to help you move. These should not be uncomfortable. Please speak with your care team if you have concerns about the equipment. Safety Our goal is to keep you safe while you are in our care. For your safety please do not attempt to get out of bed without a member of your care team, unless your nurse or therapist has specifically told you that you are able to get up by yourself. Falls during hospitalization can often result in injuries that require a longer stay. Let’s get Up Sooner, Safer! If you have any questions about our program, please speak with your nurse or charge nurse.

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Palliative Care Consultation Service

We want to help you understand...

What is Palliative Care? A medical specialty focused on the care of patients diagnosed with chronic, life limiting illness, with equal attention to their social, emotional, and spiritual well being. The goal is to ease pain and suffering and to help patients and their families achieve the highest quality of life. Palliative Care can be complimentary to other therapies that are available and appropriate to the care of the patient. How does a patient gain access to Palliative Care? You can ask your physician for a consultation on behalf of your loved one or yourself. A referral can also be recommended by physicians, nurses, social workers, case managers, or other staff members. A member of the Palliative Care team will work closely with both the patient and their family to address specific needs and goals of care. Forfurtherinformation,pleasefeelfreetocontact the Palliative Care Liaison at 661.369.6016.

Is Palliative Care right for me? Palliative care may be right for you or a loved one that is suffering from pain or symptoms due to an advanced or chronic illness such as: • Cancer • Advanced Heart Disease • Lung and Respiratory Disease • End stage liver disease • Dementia or Alzheimer’s Disease • Kidney Failure • AIDS/HIV • ALS (Amyotrophic lateral sclerosis) • MS (Multiple Sclerosis) • Stroke with loss of over 50% of functional ability

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“Nobody can go back and start a new beginning, but anyone can start today and make a new ending.” – Maria Robinson

Who Provides Palliative Care? Your physician will continue to care for you with the assistance of a teamof professionally trained health care professionals which includes a physician, advanced practice nurse, nurse liaison, medical social worker, pharmacist, and spiritual care provider. How does Palliative Care help patients and their families? Palliative Care offers medical, emotional, spiritual, andpsychosocial support. It provides the patient with pain relief and management of symptoms such as shortness of breath, fatigue, constipation, nausea, vomiting, diarrhea, loss of appetite, depression and difficulty sleeping. Palliative Care also provides the patient and family with an understanding of the illness, options for care, and guidance for difficult medical decisions. It offers spiritual care and social support for patients and family members who have unresolved psychosocial and spiritual issues. The Palliative Care team will work with your physician and other people involved in your care to ease the transition between health care settings and ensure that you or your loved one has the opportunity for quality living.

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Visitor Guidelines Family and guests are an important part of the healing process and we will do as much as possible to support you and your family. Visiting guidelines are designed to promote safety

and comfort for all of our patients, family members and guests. How to help all of our patients have a pleasant stay

We encourage family and guests be at their loved one’s side for emotional support and recovery. To provide a restful and safe environment, we ask that all visitors comply with the following guidelines: • Refrainfromvisitingifyouhaveacold,flu,fever,sorethroat,orany other known or suspected contagious illness.

• Children under 18 years must be supervised by an adult • Children may visit on our Psychiatric Unit during family time meetingswhen theyhavebeenpre-arrangedwithUnit staff • Beconsiderateofotherpatientsbykeepingnoisetoaminimum • “NoVisiting”or“Isolation”signsremindourvisitorstoaskforhelpor additionalinformationbeforevisiting.Visitorsmustbe13yearsof age or older. • Donotsmokeanywhereinsidethehospitaloronhospitalgrounds. • Please leave the room during tests or treatments if asked

• Please do not eat in the patient’s room Requests for Overnight Stay by Visitors

Weunderstandthat,asapatienthavingaccesstoyoursupportperson atalltimesisveryimportantandcomforting.Althoughrare,theremay betimeswhenvisitationmayneedtobelimited.Ourstaffwilldoalltheycanmeetyourvisitationneeds.We thank you in advance for your understanding. Visitor Rules KernMedical’sgeneralhoursforaccessis6:00amto5:00pmMondaythroughFriday.Afterhourentrance is5:00pmto9:00pmthroughtheMainD-Winglobby.Pleasecheck-inatSecuritywithValidIDtoreceivea visitorpass.D-Winglobbyisclosedfrom9:00pmto6:00am.EveryoneisredirectedtotheEmergencywaiting room. Holidays and weekends enter through the Main D-Wing lobby.

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If You Have a Concern Our goal is to provide the best patient care and hospital experience. If at any time you have questions or concerns about the quality of care you or a family member are receiving or have received at our hospital, we encourage you to let us know.

• Ask to speak to the department manager • Contact the hospital by phone or in writing

Risk Management Kern Medical 1700 Mount Vernon Avenue Bakersfield, CA 93306 661.326.2000

You can also contact one or all of the following agencies to file a complaint:

California Department of Public Health Licensing and Certification Program Bakersfield District Office 4540 California Avenue, Suite 200 Bakersfield, CA 93309

Local Call: 661.336.0543 Toll Free: 1.866.222.1903

The Joint Commission One Renaissance Boulevard Oak Brook Terrace, IL 60181 Customer Service: 1.800.994.6640 PatientSafetyReport@jointcommission.org Livanta Medicare Quality Improvement Organization BFCC-QIO Program, Area 5 9090 Junction Drive, Suite 10 Annapolis Junction, MD, 20701 Livanta BFCC - Q10 Help Line - 1.877.588.1123

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Discharge Information We want your discharge to be a pleasant experience. The following Information will help you better understand the discharge process and assist in your transistion home. Whodetermineswhen I amdischarged from the hospital?

Your physician will assess your health status and determine when it is appropriate for you to go home (or to another facility suitable for your recovery). During your stay, your care team will be planning for your needs after you leave the hospital. They will work with you and your physician to arrange any special requests for care at home. This will involve meeting with a case manager on the first or second day of your stay. Will someone discuss withme how to take care of myself once I leave the hospital? You will be given complete instructions from your care team on how to take care of yourself outside the hospital. Your nurse will review the information with you as well as provide written instructions for you to take home. Please include your family or support person as part of this process to also hear about your home care instructions and to ask questions. Be sure you and/ or your support person have spoken with a case manager and that you understand what services you may need after leaving the hospital. Can I just walk out when I’m told that I’m ready for discharge? No. To ensure your health and safety we have a discharge process. This process will involve a discharge assessment with your nurse and a review of your home care instructions. A hospital representative will also escort you to the pick-up location and help you safely to the car. When should I arrange for transportation home? Early planning is the best way to ensure you will be ready to go as soon as your doctor has approved your discharge. Please make sure that you tell your nurse how you will be getting home. We will make every effort to assist anyone with special circumstances.

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If I am leaving the hospital by ambulance, or medi van, what time should I expect to leave?

Ambulance and medi-van availability varies and therefore an exact time is not always possible to determine. Your care team will give you an approximate time for departure. We recommend that you send any personal items in advance as space is limited and items could be lost. How will I know when to see my physician for follow-up? You will receive written instructions before you leave the hospital that will tell you when your doctor would like to see you next. What if I need special equipment or supplies at my home? Your nurse or case manager can help with arrangements for special equipment or supplies. What medications should I take after leaving the hospital? Medication is an important part of your healthcare and well-being. Before you leave the hospital you will be given complete instructions from your team including specifics regarding your medications. Should your physician give you a prescription at the time of discharge, you may fill it at the Kern Medical outpatient pharmacy on campus, or any pharmacy near your home. If you have any questions regarding your medication, you may ask to speak to one of our pharmacists. What if I have questions regarding my bill? You may speak with a financial counselor about your questions or concerns regarding your bill before you go home. You will receive a separate bill from physicians.

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Discharge Checklist It is important you are involved in decisions about your discharge and understand priorities in your health care. Please make sure we have helped to answer the following: □ I understand where I am going after I leave the hospital and what will happen once I arrive. □ I have the name and phone number of a person I should contact if a problem should arise during my transfer. □ I understand what my medications are, how to obtain them and how to take them (especially if my medications have changed). □ I understand the potential side effects of my medication and whom I should call if I experience them. □ I understand what symptoms I need to watch out for and whom to call should I notice them. □ I understand how to keep my health from becoming worse. □ My doctor or nurse has answered my most important questions prior to leaving the hospital. □ My family or someone close to me knows that I am coming home and what I will need once I leave the hospital, including new dietary needs/plans and home care needs. □ If I am going directly home, I have scheduled a follow-up appointment with my doctor. I can help prevent coming back to the hospital by: • Knowing what I need to do before and after I leave the hospital. • Being sure to communicate with my primary care provider and tell them I was hospitalized. • Avoiding people who are sick. • Washing my hands often (asking those around me to wash their hands often too). • Taking care of my wounds or surgical site as I was instructed and checking for increasing redness, swelling, or increased drainage every day. Staff Recognition If there are members of your health care team that you would like to recognize for the care they provided, there are Shout-Out cards located at the elevators (and at the end of this guide). Our employees and physicians like to hear from you.

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Recovering at Home

Urgent Concerns after Discharge Your continued recovery is important to us. You will receive specific information on whom to contact for continued treatment and follow-up. Following discharge, should you have any urgent concerns about your health and recovery relating to your procedure or treatment please contact your primary physician at Kern Medical Clinics or our emergency department. It is important to contact us if you are experiencing any of the following: • Acute uncontrolled pain (including severe headache) • Calf pain; tenderness and swelling of the leg; skin discoloration that is pale, blue, or a reddish-purple color • Prolonged vomiting and/or diarrhea • Acute urinary symptoms including inability to pass urine • Surgical site bleeding • Difficulty swallowing • Confusion or disorientation; repeated episodes of dizziness • Repeated falls • Patients receiving chemotherapy treatment with an elevated temperature

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Contact emergency services immediately by dialing 911 if you are experiencing: • Unconsciousness or altered consciousness • Sudden onset chest pain • Facial weakness, arm weakness, slurred speech • Sudden onset shortness of breath; difficulty breathing • Acute and severe trauma, including head injury • Heavy uncontrolled bleeding • Sudden loss of vision following ophthalmic surgery When you call us please inform the nurse in charge of any emergency treatment you have received. Please review the information supplied within this information pack. Rest and Activity It is a normal part of the recovery process to feel tired and lethargic after a hospital stay, especially if you had surgery. It is important you rest more than usual when you get home and you should ask your physician when you will be safe to return to work. Plan to gradually increase your activity over the next few days, but remember to pay attention to how you feel and rest when your body tells you to. Some medications can also cause you to feel unwell or tired. If the side effects of themedications are causing you a problem, alternatives may be available. Please speak to your local pharmacist or primary care physician for advice. Eating You may find your appetite is reduced and your digestive system is temporarily altered; for example, you may experience bloating or indigestion. These symptoms usually clear by themselves as you become more active. Small meals including fruit and fiber, taken regularly, can reduce the likelihood of this happening. Nausea and Sickness Nausea and sickness may be due to your treatment and should only last a short time. Sipping clear, cold fluids, like water and soft drinks should help. If these symptoms persist call your primary care physician. Passing urine Most patients will have no difficulties passing urine after discharge. It is important to remain well hydrated, particularly in hot weather. If you are finding it difficult to pass urine and have any associated pain or discomfort please contact your primary care physician.

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Bowels Changes in diet, less activity and some drugs may lead to changes in bowel habit. An anesthetic can alter your bowel function which may worsen if you are immobile for a time. It is quite normal for the bowels to not function normally for a day or so after an operation. Most patients find their bowel habit resumes normally once they get their appetite back and become fully mobile. If your bowels have not returned to normal function after two days and you feel uncomfortable, youmaywish to consider takingamildover-the-counter laxative such as bisacodyl (Dulcolax®). However, please consult your physician before taking any medication or home remedies not specifically recommended upon discharge from the hospital. Toavoidconstipation, it is advisable toeat ahealthy diet includingplenty of fruit and vegetables and to drink plenty of fluids. Try to have at least eight to ten glasses of fluid each day. Include water, juice, herbal tea, tea, and coffee. Diarrhea can be another common side effect of some drugs, such as antibiotics, certain anti inflammatories and iron supplements. If diarrhea is particularly problematic, you should discuss it with your Physician. Medications Please take your medications as directed. If you are discharged on an antibiotic prescription it is important to finish the prescription. Should you have questions about your medications, contact your pharmacist or refer to your medication discharge instructions.

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GIVE SOMEONE AT KERN MEDICAL A SHOUT OUT

Recognize a physician, employee or volunteer. Tell us about your quality customer service and exceptional care.

Date: _______________ Floor/Department (if known): ___________________________

□ Day Shift □ Clinic Describe your experience: ___________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ I am a: □ Patient/Family □ Manager/Supervisor □ Co-Worker Please deposit completed form in a designated SHOUT OUT box. □ Night Shift

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Give A Little, Help A Lot The Kern Medical Foundation was established to help carry on the tradition of quality, compassionate care close to home by raising philanthropic support for Kern Medical. Grateful Patients, Physicians, Staff, Volunteers and our Community are the primary ways we secure funds and resources necessary to support Kern Medical’s life-changing and life saving programs. These generous donations are used for patient care, academics, medical research and cutting-edge technology both within and beyond the walls of Kern Medical. The Kern Medical Foundation has highlighted several ways to give that are aligned with the strategic priorities of Kern Medical:

Valley Fever Institute Latest medical treatments available Cutting edge research Community & physician education Women & Children’s Services Neonatal Intensive Care Unit (NICU) High-Risk Pregnancy Program Pediatrics

Academics Medical Student, Resident & Fellow Education Simulation Lab & Equipment Medical Research & Clinical Trials Behavioral Health Child & Adolescent Programs Addiction Medicine Patient care amenities

Cancer Institute Infusion Therapy Clinic at Columbus State of the art Surgical Services Patient care amenities Community Health & Wellness Programs Chronic Disease Management Safe Home, Safe Baby Stay in the Game and more!

If you or someone you know is interested in supporting the Kern Medical Foundation, please contact us at: Kern Medical Foundation www.KernMedicalFoundation.com (661) 489-5252 Erica.Easton@KernMedical.com Kern Medical Foundation is a non-profit corporation as provided under section 501(c) (3) of the Internal Revenue Code. Contributions are tax deductible in accordance with state and federal regulations.

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