Bristol Regional

SPEAK UP!

Ask Questions and Voice Concerns

SUCCESSFUL DISCHARGE How to Plan Ahead

PATIENT GUIDE Key Information For Your Stay

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CO N T E N TS WELCOME. . . . . . . . . . . . . . . . . . . . . . . 2 PHONE DIRECTORY.. . . . . . . . . . . . . . 3 OUR COMMITMENT TO CARE.. . . . 4 CONDITION H.. . . . . . . . . . . . . . . . . . . 6 FAST FACTS ABOUT YOUR STAY.. . 7 SILENT HOSPITALS HELP HEALING. . . . . . . . . . . . . . . . . . . 12 SPECIAL SECTION . . . . . . . . . . . . . . . 13 BLOOD TRANSFUSION GUIDE. . . . . 20 YOUR PRIVACY MATTERS.. . . . . . . . 22 ADVANCE DIRECTIVES. . . . . . . . . . . 24 SUPPORT FOR CAREGIVERS. . . . . . . 25 LEAVING THE HOSPITAL. . . . . . . . . . 26 AFTER-HOSPITAL CARE. . . . . . . . . . . 28 UNDERSTANDING YOUR BILL. . . . . 29 HOSPITAL RESOURCES.. . . . . . . . . . . 31 GIVING BACK. . . . . . . . . . . . . . . . . . . . 34 STAFF DEFINITIONS. . . . . . . . . . . . . . 36

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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 5 Ways to Fight Infections n Prevent Falls n Prepare for Surgery n Manage Your Meds n

On Our Cover Speak Up! Ask Questions and Voice Concerns. . . . . . . . . . . . . . . 13 Successful Discharge How to Plan Ahead. . . . . . . . . . 26

MYWELLMONT. . . . . . . . . . . . . . . . . . 38 GAMES. . . . . . . . . . . . . . . . . . . . . . . . . . 39 MEDICINE TRACKER. . . . . . . . . . . . . . 40

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Welcome Thank You for Trusting Us Welcome to Bristol Regional Medical Center. On behalf of our nearly 2,000 dedicated employees, physicians, board members and volunteers, I thank you for entrusting your health care needs to your community hospital.

It is our goal to provide outstanding medical care and compassionate customer service to our patients and guests. We are constantly striving to enhance our quality and services to be among America’s safest hospitals.

MISSION STATEMENT We deliver superior health care with compassion.

Vision

We will deliver the best health care anywhere.

Values n

Integrity

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Respect

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Compassion

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Empowerment

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Innovation

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If there is anything I can do to assist you during your visit here at Bristol Regional, please let me know. You can call me at 423-844-3219 or email Greg.Neal@ wellmont.org. Thank you for making Bristol Regional the region’s premier hospital for more than eight decades.

Sincerely,

Greg Neal President, Bristol Regional Medical Center

Phone Directory Key Numbers Main: 423-844-1121 Wellmont Nurse Connection: 9 + 877-230-NURSE (6877)

Calling from INSIDE the hospital?

Dial the last four digits only.

OTHER HOSPITAL SERVICES Admissions Ext. 4551 Case Management/Social Services Ext. 3760 Chaplain/Pastoral Care 0 Complaints or Grievances Ext. 3219 Gift Shop Ext. 2841 MedAssist (for assistance with Ext. 4738 Medicaid/TennCare) Room Service (meals) Ext. 3171 Security Ext. 2800 Walgreens Pharmacy Ext. 2888

Using the Phone in Your Room To place a local call to: n

Bristol, Tennessee, dial 9 + number.

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Bristol, Virginia, dial 9 + area code 276 + number.

To place a long-distance call, dial 9 + 0 + 0. To place a long-distance call with a calling card, dial 9 for an outside line, then dial the toll-free number on your calling card and follow the prompts.

For more information on the resources available at Bristol Regional Medical Center, visit wellmont.org.

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Our Commitment to Care Patient Experience Matters to Us How’s your stay? Are you getting the care you need?

Are your doctors and nurses listening and responding to your questions or requests? Our goal is to always to provide the best quality care. To do so, we ask for feedback from patients like you.

During Your Stay

Please speak with your nurse or nursing supervisor if you have any questions or concerns about your care. If your issue still is not resolved, then contact the Risk Management department at ext. 3471 or the hospital president at ext. 3219. You also have the right to file your complaint with either: Tennessee Department of Health Division of Health Care Facilities Centralized Complaint Intake Unit 227 French Landing, Suite 501 Heritage Place Metrocenter Nashville, TN 37243 877-287-0010 www.tn.gov/health/article/ hcf-complaint

Office of Quality and Patient Safety The Joint Commission One Renaissance Blvd.

Oakbrook Terrace, IL 60181 800-994-6610 Email: patientsafetyreport@ jointcommission.org www.jointcommission.org

How are we doing?

We want you to be satisfied with your care. To help, speak up if we can ‌ Respond quicker to your needs Explain things more clearly Help keep your room clean or quiet Ease your pain

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Help you understand your medicine plan

After Your Stay

Once you leave our care, we will continue to seek your feedback through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The HCAHPS survey is a tool to measure and report patient satisfaction. It’s made up of simple questions on key care topics such as:

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doctor and nurse communication

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medicine and discharge information

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pain management and staff responsiveness

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overall quality of the hospital environment

If you’re selected to receive this brief survey, please take the time to complete it. The results will help us know what we’re doing right and where we can improve.

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 these accrediting organizations: n Healthcare Facilities Accreditation Program (HFAP): www.hfap.org n DNV GL Healthcare: www.dnvglhealthcare.com n The Joint Commission: www.qualitycheck.org

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Condition H Special Support to Prevent Emergencies During your stay, you have access to a special service called Condition H. You can call this service, and a critical-care team will check on you or your loved one and provide help before there is a life-threatening emergency.

WHEN to Call Condition H Call for help if you notice: n

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c hanges in heart rate or drop in blood pressure c hange in respiratory (breathing) rate or oxygen levels c hanges in urine output (much more or less urine) c hange in mental status or level of consciousness

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a ny time you are worried something might be wrong a ny change in the patient’s condition that needs immediate attention and the health care team is not responding, or if you continue to have serious concerns after speaking with the health care team

HOW to Call Condition H Step 1: Dial 0 on bedside phone.

Step 2: Tell the operator: your name, room number, patient’s name and your concern.

Step 3: The medical emergency team will be sent to your room.

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Fast Facts About Your Stay An A-Z Guide to the Most Frequently Asked Questions Armbands

All patients at Bristol regional receive color-coded armbands to ensure proper identification. To improve patient safety, different colored stickers are used to alert staff of patient allergies (red), do not resuscitate status (purple) and potential fall risks (yellow).

ATM

A branch of the United Southeast Federal Credit Union is located on the ground floor and offers complete banking services. ATMs are located on the first floor near the gift shop and on the ground floor across from the credit union.

Calling Your Nurse

A button to call your nurse is located at your bedside.

When you press the button, the nurses’ station is alerted that you need assistance and a light flashes above your door. A staff member will respond to your signal as soon as possible.

Cafeteria

Location: Ground floor Hours: Monday through Friday: 6:00 a.m. to 7:00 p.m.

Saturday and Sunday: 6:00 a.m. to 2:00 p.m.

VISITING THE HOSPITAL? Thanks for taking the time to support your loved one’s care and recovery.

See p. 10 for important visitor information.

The newly renovated Skylight Café offers a variety of freshly prepared food selections and healthy dining choices. Look for the Mindful logos to identify healthy options and the barcodes on menu signage to track your nutrition and fitness with MyFitnessPal.

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Facts About Your Stay continued Coffee Shop

Location: First floor, main entrance Hours: 6:00 a.m. to 10:00 p.m. daily Bristol Regional’s coffee shop, The Coffee Clinic, proudly brews Starbucks coffee. The Coffee Clinic offers flavored coffees, lattes, frappuccinos, freshly brewed teas and many other drink creations, as well as pastries, cookies, snacks, sandwiches, salads and a variety of other food choices.

Electrical Appliances

Electrical appliances including hairdryers, curling irons, razors, radios, heating pads, portable heaters, VCRs and other devices are not permitted in patient rooms.

You may use only battery-operated devices.

Fire Safety

For your protection, the hospital conducts fire and disaster drills regularly. If a drill occurs while you are here, please remain in your room and do not become alarmed.

The hospital is a fire-resistant building, and the staff is trained in fire protection.

Gift Shop

Saturday: 9:00 a.m. to 4:30 p.m.

Sunday: 1:30 p.m. to 4:00 p.m.

The proceeds from the gift shop are donated back to the hospital through the Volunteer Auxiliary to assist the needs of our patients.

Cash, check and credit cards are accepted.

Hearing Impaired

A telecommunications device is available to help hearing-impaired patients or patients who want to communicate with a hearingimpaired relative or friend.

Arrangements also can be made to have a sign language interpreter help a hearing-impaired or deaf patient. Your nurse can assist you in obtaining a telecommunications device.

Housekeeping Services

A member of the housekeeping staff cleans your room daily. If there is a housekeeping problem in your room, tell your nurse and it will be taken care of as soon as possible.

Internet

Bristol Regional offers free, easy-touse Wi-Fi for patients and guests.

To access the internet: n

Location: First floor, near the main hospital entrance

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Hours: Monday through Friday: 9:00 a.m. to 6:00 p.m.

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elect the “WHSGuest” network S in your device’s Wi-Fi settings. ellmont Health System’s Terms W of Agreement page will appear. lick “Accept” at the bottom of C the page.

No username or password is necessary. For questions or connection problems, please call the Wellmont Service Desk at 423230-8383.

Interpreters

The hospital has access to interpreters for a number of foreign languages if a patient needs one.

Mail and Flowers

Mail and packages will be delivered to you by a hospital volunteer.

Florists deliver flowers to the nurses’ station, and a nurse will bring them to your room. Fresh and artificial flowers can be bought in the hospital gift shop. Postage stamps also are available in the gift shop.

Medicines

All medicines you take while in the hospital are prescribed by your doctor, dispensed by the hospital pharmacy and administered by a nurse. Patients are not permitted to administer their own medicines or keep personal medicines at their bedsides.

Newspapers

Newspapers may be bought in the gift shop or cafeteria.

Notary

Free notary services are available for patients. For information, contact your case manager or dial 0 and ask for the nursing supervisor.

Parking

Parking at Bristol Regional is free and available 24 hours a day, seven days a week. Please do not park in reserved areas or certain designated areas, and be sure to lock your car.

Personal Items and Valuables

Patients are asked not to bring personal items to the hospital. If you do bring a personal item, it should be deposited in the safe in the security office. You will be given a written receipt for all items, which must be presented when you withdraw them. The hospital does not accept responsibility for personal items unless they are deposited in the safe.

Pharmacy

Patients and visitors can get prescriptions filled and find various health-related items at Walgreens, located on the first floor of the hospital, in the medical mall area. The pharmacy is open from 7:00 a.m. to 10:00 p.m. Monday through Friday and 9:00 a.m. to 5:30 p.m. Saturday. It may be reached by dialing 423-844-2888.

Public Restrooms

Please do not use the bathrooms in patient rooms. They are reserved only for patients to protect their health. Public restrooms are located throughout the hospital.

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Facts About Your Stay continued Shuttle Service

Free pickup and drop-off service is available for all Bristol Regional patients and visitors. Please call 423844-1121 if you would like a ride.

Smoking

Bristol Regional is a tobacco-free facility. Tobacco products are not allowed on our grounds except within your own vehicle.

Spiritual Needs

Bristol Regional has a hospital chaplain and spiritual volunteers to pray over your requests. They are available 24 hours a day. Please feel free to complete a prayer request card, located in your My Care Journey folder, and give it to any staff member. You also may call 423-844-4357 to voice your prayer request. If you would like a visit from one of our chaplains, please dial 0.

Vending Machines

Vending machines offering beverages and snacks are located in the cafeteria on the ground floor.

They are available 24 hours a day, seven days a week.

Veteran Recognition Program

We have a veteran recognition program that allows us to better recognize our active duty military personnel and veterans. Please inform your nurse if you meet these criteria and would like to be recognized. Thank you for your sacrifice to our country.

Visitor Guidelines n

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TV

TVs are provided in each room. Please be considerate of other patients by keeping the volume down and turning off your TV at bedtime.

Bristol Regional is happy to offer a dedicated Patient Education Channel on Channel 81.

For a list of available TV channels, please see the sheet inside your My Care Journey folder.

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isitors must dress appropriately V and wear shirts and shoes. eople with colds, sore throats or P any contagious diseases should not visit patients.

isitors should maintain a V quiet environment and avoid unnecessary noise.

Visitors may be asked to leave the room during tests or when the doctor or nurse needs to see the patient. hildren younger than 3 are C asked to visit only if they are immediate family members.

Waiting Areas

There are designated lounge areas for visitors on the main floor in the lobby. Specific waiting areas have been designated for families of patients in the critical care units, the emergency department and the surgery area. Please do not bring home appliances, cribs, playpens, air mattresses or linens into the waiting area.

Your Hospital Bed

Hospital beds are electrically operated and a staff member will show you how to work your bed properly. Your hospital bed is

probably higher and narrower than your bed at home. Bedside rails are for your protection. They may be raised at night or during the day if you’re resting, recovering from surgery or taking certain medications.

Your Room

Each patient room has a recliner for your comfort. If you need a foldaway bed for a visitor, please let a staff member know, and one will be brought to your room. Blankets and pillows also are available for guests upon request.

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Silent Our Commitment Hospitals Help to Care Healing Helping You Heal in a Quiet Environment The hospital is full of noises—pagers, phones, machines, overhead announcements and much more. We want to help you get the best sleep possible, regardless of the hustle and bustle around you.

Our goal is to help you heal in a quiet environment, so let our care team know if we can provide you with any of the following: n

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Silent hospitals help healing, so we will begin quiet time at 10:00 p.m.

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arm blanket—Get cozy with a blanket that feels like W it’s right out of the dryer.

Ear plugs—Soft foam ear buds to help reduce noise. ontinuous Ambient Relaxation Environment C (C.A.R.E.) Channel—Found on Channel 75, this channel provides you with soft music and beautiful scenery to help you relax. leep aid—Mediation to help you sleep also is S available (by physician order only).

Take Charge of Your Care You are the center of your health care 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 health care wishes? (see p. 15)

Ask Yourself Is there anything else the hospital should be aware of to improve my care experience?

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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 health care 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 health care 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 health care 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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a sk questions you might not think of and write down information ouble-check your d medicines and treatments atch for signs w 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: Ask 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 health care team.

Know what time you normally get medicine, and tell your nurse if you don’t get it.

Understand your treatment

equest drawings or R illustrations to help you learn about your condition.

Ask questions Speak up about pain

ead and understand all R medical forms before signing. Ask if you need information explained.

Know your medicines Plan early for a successful discharge

I f your treatment involves medical equipment, practice using it with your nurse before you leave the hospital. on’t be afraid to ask for a second opinion. The more information you D 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.

5 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 the staff 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.

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.

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TAKE CHARGE OF YOUR CARE continued

Prevent Falls While you are here, you may feel dizzy or weak. Illness, procedures, medicines or even just lying down for too long can 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. For more information on Bristol Regional’s Fall Prevention Program, please see the flyer in your My Care Journey folder.

Prepare for Surgery

Before your procedure, make sure you and your surgical staff confirm: n n

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your name t he type of surgery you are having t he body part to be operated on—In fact, hospital staff 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.

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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)?

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).

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. 40.

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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Blood Transfusion Guide Understand Why a Transfusion is Right for You Your health care provider may order a blood transfusion as part of your treatment. As the patient, we understand you will have many questions about transfusions.

We encourage you to read ahead to better understand how the procedure is handled and why a transfusion is the right fit for your medical needs.

What is a transfusion?

A transfusion is a medical procedure that is used to replace red blood cells or blood components, such as platelets,

20

plasma or cryoprecipitate, that have been lost due to injury, surgery or medical problems.

Where does blood for transfusions come from?

Blood is collected from healthy volunteer donors who must pass a detailed screening process prior to donating. Donated blood is tested for infectious diseases by trained laboratory staff using highly sensitive test equipment.

The entire donation process is regulated and monitored by the U.S. Food and Drug Administration.

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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

What happens during a transfusion?

Before the transfusion, you will have blood drawn to verify your blood type. When necessary, the Blood Bank will perform additional testing to make sure the blood you receive is a good match.

Once blood has been selected and your health care provider has instructed you about certain signs and symptoms to watch for during and after the transfusion, you’ll be ready to start the transfusion.

During your transfusion, the blood component will be connected by tubing to an IV catheter that has been placed in your vein so it can be administered directly into your bloodstream. Your blood pressure,

heart rate, body temperature and breathing will be closely monitored throughout the process. The transfusion can take up to four hours, depending on the blood component being given.

Are alternatives to transfusions available?

There are alternatives to blood transfusion, including some pharmaceutical agents and iron therapy, so you should discuss alternatives with your health care provider and see if they are appropriate in your case.

If you have any questions or concerns about blood transfusions, please ask one of your health care providers.

Are Transfusions Safe?

About 5 million Americans receive blood transfusions every year, making it the most frequently performed medical procedure during hospital stays.

Transfusions are generally considered to be very safe. However, as with any medical procedure, blood transfusions are not risk free, and you should discuss concerns with your health care provider.

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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 health care providers and their vendors

Health insurance companies, HMOs and most employer group health plans Certain government programs that pay for health care, 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 health care 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:

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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

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 health care, your information can be used and shared: For your treatment and care coordination

To pay doctors and hospitals for your health care and help run their businesses

Contact 423-844-3500 for copies of medical records.

With your family, relatives, friends or others you identify who are involved with your health care or your health care 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 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 your nurse.

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 health care: This is a legal document that names your health care proxy—someone who can make medical decisions for you if you’re unable to do so.

An official health care proxy can represent your wishes on emergency care Choose Your Care but also on other medical issues like potential treatment Fill out advance options, blood transfusions, directives so your wishes are met and kidney dialysis, etc. Choose your loved ones are someone you trust, discuss sure of what you your medical wishes and 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.

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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

n

n

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.

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

n

F amily Caregiver Alliance www.caregiver.org aregiver Action Network C www.caregiveraction.org

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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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 26

Checklist for Discharge Make sure you have the following information before you leave the hospital.

p Discharge 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. p Prescriptions. Check that your pharmacy has your new prescriptions and 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 Health care: 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.

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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 Health Care— Care

provided by professionals in your home to help maintain or restore health. Can include: home care services such as housekeeping and meal preparation; personal care services such as bathing, dressing or eating; and health care 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. Health care services like skilled nursing are not usually standard.

Assisted Living— Individual units or apartments, usually in a longterm 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 on-site 24 hours.

Nursing Home— Long-term care facility 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

Eldercare Locator www.eldercare.gov National Respite Network and Resource Center www.archrespite.org

You can also talk to your case manager or social worker for help finding the right after-hospital care.

Contact your health insurance, Medicare or Medicaid to find out what care and services are covered for you, and to obtain help with costs.

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Understanding Your Bill Take Charge of Your Payments The hospital billing process may seem complicated, but you can feel more in control by knowing exactly what your bill covers. For example, if you stay overnight, you can expect to see charges for your room, meals, 24-hour nursing care and medicines. The bill also will show charges for any special services, such as X-rays and lab tests. You’ll receive bills for doctors, surgeons and specialists separately from the hospital.

Medicare

If you have Medicare, you’ll have to fill out an MSP (Medicare Secondary Payer) form. This ensures that Medicare only pays for services not covered by other insurance you may have. If you have secondary insurance, this usually covers Medicare deductibles.

If you don’t have secondary insurance, you need to pay these amounts yourself.

Also be sure to read your quarterly MSNs (Medicare Summary Notices) to review: the amount your doctor(s) charged the amount Medicare approved and paid

n the amount you owe

n your current deductible status If you have questions, call the customer service number listed on your statement.

n

n

Commonly Confused Terms

KEEPING TRACK

One of the key ways to feel wellinformed and less overwhelmed about the hospital billing process is to stay organized.

Keep all of your statements and bills together and review each one as it arrives.

• Deductible: The amount you owe each year before your insurance begins making payments.

• Co-payment: A flat fee you pay for a specific service, usually due at the time of service.

• Coinsurance: The portion of your medical expenses that you’re personally responsible for paying. For example, your insurance may cover 80 percent of a bill, while you have to pay the remaining 20 percent.

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Understanding Your Bill continued Commercial Insurance Providers

If you use a commercial insurance provider, then the hospital forwards your claim based on the information you provide at registration. About a month after you leave the hospital, you’ll get an explanation of benefits (EOB) statement from your insurance provider. This isn’t a bill. EOBs show:

n

the amount billed by your doctor or hospital

n

how much of that cost is covered by your insurance

n

how much you owe

Review this and all other bill-related documents carefully. If you have questions, contact your doctor or the customer service number listed on the statement.

Self-Pay Patients and Payment Arrangements

If you’re planning to pay your bills without help from Medicare or a commercial insurance provider, then you’ll get bills directly from the hospital. When the first bill arrives, call the hospital’s financial services department to set up a payment plan.

Need Help?

If you don’t understand something on your bill, or if you’re having trouble paying your bills, let us know. A patient representative can work with you and guide you to services that can help.

Communicate with the financial services department as soon as possible.

If you don’t set up a payment plan, or if you stop making payments, then your account may be placed with a collection agency. The hospital wants to work with you, so reach out with any questions or concerns you have.

Understanding Coordination of Benefits (COB) COBs happen when you’re covered under two or more insurance companies. This may occur when spouses or partners are listed on each other’s insurance policies, or when both parents carry their children on their individual policies.

To prevent duplicate payments, COBs determine the primary payer. You choose who this is when you’re admitted. Insurance companies usually request completed COBs from you before paying a claim, so make sure you address these requests quickly.

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Hospital Resources Diabetes Treatment Center

Wellmont Health System’s Diabetes Treatment Center provides opportunities for education and diabetes information to help people improve self-management. A free outpatient program also is offered to patients who get a written physician order during their hospital stay and start the program within 30 days of discharge. For more information, please contact the Diabetes Treatment Center at 423-844-2950 or ext. 2950 from inside the hospital.

Home Health Care

After your stay in the hospital, your doctor may decide you will need additional help with your health care needs at home. Wellmont Health System has partnered with Advanced Home Care to provide you with highly trained

and professional nurses, therapists and other health care personnel to help with the healing process in the comfort of home. Medication assistance, IVs, wound care, nursing care, physical therapy and assistance with personal care are just a few of the services our home care staff can provide. For help at home, please speak with the doctor or case manager.

Hospitality House

Many patients and families at Bristol Regional Medical Center are a long way from home. Unexpected and extended hospital stays place a difficult burden on loved ones in addition to their concerns over the patient.

The McGlothlin-Street Hospitality House serves as a home away from home for hundreds of families

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Hospital Resources continued each year. Located on Bristol Regional’s campus, it provides a safe, clean place for our patients’ families while their loved ones are being treated. Each of the 12 guest rooms is equipped with two double beds, a sitting area with a table and chairs, and a private bathroom.

The hospitality house also offers a laundry room, living and dining areas, and a kitchen. For more information, please call 423-8445200.

Marsh Regional Blood Center

Marsh Regional distributes blood to 22 health care facilities in Northeast Tennessee and Southwest Virginia. All blood donated to Marsh Regional Blood Center stays local to help people in this region.

Anyone who is at least age 17, weighs at least 120 pounds and is generally healthy is encouraged to donate blood at Marsh Regional’s collection center, located on State Street in Bristol, Tennessee.

Individuals who have had a cold, sore throat, fever, flu or fever blister within the past three days should not donate.

For more information about donating blood and how each donation can save as many as three lives, please call 423-224-5888 or visit marshblood.com.

Wellmont Hospice House

The Wellmont Hospice House is the first freestanding facility in Tennessee to offer specialized service and support for those 32

whose illness no longer offers the possibility of cure. Located on the campus of Bristol Regional Medical Center, the facility provides care for terminally ill patients with specific short-term needs such as respite care, acute care and care for patients when they are in their final days of life. If a loved one requires hospice care, Wellmont’s hospice experts want to help ease that burden. Please contact them at 423-844-5252 for more information.

Wellmont Lifeline – Medical Alert Service

For patients who are returning home but still feel like they need the security of an on-call nurse, Wellmont Lifeline can provide help at the push of a button 24 hours a day. It is the nation’s No. 1 medical alert system. To order Wellmont Lifeline or for more information, please call 1-877-230-NURSE (6877).

Wellmont Urgent Care

Hours: Weekdays: 8:00 a.m. to 8:00 p.m.

Weekends: 10:00 a.m. to 6:00 p.m.

Wellmont Urgent Care is the best option for expert care of minor illnesses and injuries. Our emergency and urgent care teams include the best, most experienced physicians and highly trained nurses and technicians, and they’re ready to assist you when you need it most.

No appointment is necessary. We have eight Tri-Cities locations to

serve you: Abingdon, Bristol (TN and VA), Johnson City, Kingsport, Lebanon, Norton and Rogersville.

Hotlines & Helplines

Wellmont Nurse Connection Wellmont Nurse Connection is a free service provided by Wellmont Health System. The experienced nurses staffing this 24-hour hotline are available to assist residents with health care needs such as: n

n

F inding a doctor. We can assist with finding a physician to meet your needs, including location and office hours, insurance plans accepted, specialty and treatment philosophy, gender and other special requirements.

Locating community resources and health information. Obtain health information and find

resources and services in your community such as class and screening information and registration, support groups and urgent care. n Getting answers to health care questions. Our nurses are RNs with many years of health care experience. Contact them at Wellmont Nurse Connection or visit our website at wellmont.org for health information. n Assessing your symptoms. Not sure what to do next? We can help you decide whether to call 911, contact your physician or try a treatment at home.

Reach Wellmont Nurse Connection 24 hours a day, seven days a week, at 1-877-230-NURSE (6877).

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Giving Back Philanthropy and giving have the power to transform the lives of those who receive and the lives of those who give. Through the gifts of committed donors like you, Wellmont is able to fulfill its mission of delivering superior health care with compassion to the Tri-Cities region of Northeast Tennessee and Southwest Virginia.

Why Should I Give to the Wellmont Foundation?

Your gift, working hand-in-hand with others, will ensure we can continue bringing the best in medical technologies and health care innovations to our patients. Your charitable donation will: n

n

n

Provide assistance to patients in need, including those who may need help purchasing wigs or gas to get to appointments through the cancer patient assistance fund.

Help fund new technology, equipment and other valuable healing environment needs to make certain our patients continue to receive state-of-the-art care right here at home.

Fund health education for our staff members, so they may better serve our patients, and for the community, so our friends and neighbors may better manage their health and wellness.

Make Your Gift Today

There are many ways to give to the Wellmont Foundation. You can use the foundation’s secure and convenient online donation system to make a gift to the area of your choice at wellmont.org. You also can call the Wellmont Foundation at 423-230-8550 to make your gift by credit card or to speak with a Wellmont Foundation officer. Wellmont Foundation staff is available to assist you during regular business hours, and you may leave a message at any time.

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Donations in the form of a check may be mailed to Wellmont Foundation at the following address: Wellmont Foundation Gift Processing P.O. Box 1069 Kingsport, TN 37662 Thank you in advance for your gift.

Want to Volunteer?

Volunteers play a very important role in Wellmont’s day-to-day operations, and many volunteer opportunities are available throughout Wellmont. Through serving patient needs, assisting employees and directing visitors, volunteers of all ages have donated many hours, talents and gifts.

Wellmont’s volunteers help out in a variety of departments, including business offices, reception desks, gift shops, blood banks, critical care units and many others.

To learn more about volunteer service opportunities, please call 423-8442831 or visit wellmont.org/volunteering.

Helping Us Help Others Wellmont Foundation offers a range of giving options. Donors can choose to donate to special areas of giving, including Wellmont hospitals, Children’s Miracle Network hospitals, specific medical service lines or various other needs within the health system. Honorary and memorial gifts also are welcome and serve as a lasting tribute to a special person.

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Staff Definitions Attending Physician: The

physician who admits the patient.

This physician coordinates the medical care of the patient while he or she is in the hospital.

Case Manager: Also known as

a social worker, the case manager assists with discharge goals and plans, including home health, medical equipment needs, hospice care, skilled or rehabilitation care, or nursing home plans. The case manager is a support resource for patient and family needs including insurance issues, finances and advance directives.

Consulting Physician: The

attending physician consults this specialist for evaluation, recommendation and treatment of specific medical problems. Some examples of consulting physician specialists include: n Advanced Illness Consultants: also known as palliative care specialists, provide support in progressive disease, pain and symptom management, and goals of care n Anesthesiologist: anesthesia specialist n Algologist: pain specialist, often an anesthesiologist n Cardiologist: heart specialist n Critical Care/Pulmonologist: lung specialist, often manages the critically ill n Infectious Disease: infectious illness specialist n Nephrologist: kidney specialist

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n

n

n

n

n

n

n

n

ndocrinologist: gland specialist, E provides expertise with illnesses of the pancreas, thyroid and pituitary.

Gastroenterologist: stomach and bowel specialist Neurologist: nervous system specialists, provides expertise in brain and spinal cord disorders O bstetrician/Gynecologist: women’s health specialist Oncologist/Hematologist: cancer and blood disease specialist Pediatrician: children’s health specialist Psychiatrist: mental illness specialist Urologist: urinary tract specialist

Dietitian: Evaluates patient’s

current nutritional status and needs, and makes recommendations for diet, supplements or alternative methods of nourishment. If you have questions about your meals or diet, please call ext. 3171.

Fellow: A physician who has completed a residency program and is in advanced specialty training.

Residents and fellows work under supervising faculty physicians.

Hospitalist Physicians:

Hospitalists work in close consultation with the patient’s primary care physician and specialists. They manage a patient’s entire hospital experience, from admission to discharge.

Medical Students: Students in their third and fourth year of medical school may have some patient responsibilities. They work under supervising faculty physicians.

and works closely with nursing to support and manage the patient’s care. The RT also manages patients on external breathing machines and administers breathing treatments.

Nurse: A primary nurse works with physicians to provide care to patients. The nurse administers medications and evaluates the effectiveness of medicines and treatments, and is a liaison among the patient, family, therapists and the physician.

Student: Bristol Regional partners with area education institutions to provide opportunities for clinical learning for student nurses, therapists, pharmacists and PCTs. Students are identified on their name badge and work under the supervision of a clinical educator.

Nurse Practitioners and Physician Assistants: Masters-

Surgeon Specialist: There are several types of surgeon specialists.

Some examples include: n Cardiovascular: heart and blood vessel surgeon n ENT: ear, nose and throat surgeon n Gynecology: women’s surgeon n Neurosurgery: brain and spinal cord surgeon n Oral/maxillofacial: mouth, jaw, and teeth surgeon n Orthopedic: bone surgeon n Thoracic: lung and chest surgeon n Trauma: specialize in treatment of accidental injury n Urology: urinary tract surgeon

prepared clinical professionals working under the direct supervision of a physician.

Patient Care Technician:

Provides personal care such as bathing and toileting and assist in other care needs of patients. PCTs work under the supervision of the primary nurse and also can take vital signs and help with feeding, ambulation and linen changes.

Pharmacist: Provides expertise in recommending medications and determining dose of medications according to the patient’s condition and illnesses.

Resident Physician: A physician

who has completed medical school and is undergoing advanced general or specialist training.

Respiratory Therapist: A therapist who evaluates and treats a patient’s oxygen needs and manages the mechanical ventilator in the intensive care units. The RT is directed by a pulmonologist

Therapists: Speech, occupational

and physical therapists evaluate and treat patients requiring specific services. A speech therapist may evaluate a person’s ability to swallow safely and effectively. Occupational therapists help patients gain strength in their upper body and teach patients how to eat, bathe and care for themselves. Physical therapists help patients learn how to wash themselves and improve the function of their lower body.

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MyWellmont What is MyWellmont?

MyWellmont is a new, free tool offered by Wellmont Health System, and registering is one of the best things you can do to keep up with your health care.

Access your health story anytime, anywhere.

With a MyWellmont account, you can access up-to-date medical information and actively manage your health anytime, anywhere, using your computer or smartphone.

From MyWellmont, you have a simple and secure way to: n n

n

n

ccess your test results A Request an appointment with your Wellmont providers Check medical information for your children or other dependents Review medications and request refills

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n

n

end and receive message with S your primary care physician View and pay bills online

MyWellmont puts you in control of your health like never before— your entire health record is at your fingertips.

Signing up is easy.

Visit MyWellmont.org and fill out some information—it’ll ask for your name, date of birth, Social Security number and email address.

You’ll receive an activation code through your email. You can use that to create your username and password.

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

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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

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 safe to take together. Be sure to also include over-the-counter medicines, vitamins and supplements.

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MEDICINE 3

MEDICINE 4

24 HOURS A DAY, 7 DAYS A WEEK, WE ARE HERE.

The American Cancer Society is there for you to help answer your questions, connect you to the resources you need, and just listen.

24 /7

Information We can answer your questions about cancer, including prevention, diagnosis, treatment options, and clinical trials.

Day-to-day Help HOPE

We can help you with everyday needs like transportation and lodging during treatment.

Emotional Support We can connect you to local and online support groups for both patients and caregivers.

We’re here to help you through every step of your cancer experience. Visit www.cancer.org or call 1-800-227-2345 anytime, day or night.

What CCS Provides: • Substance Abuse/Co-Occurring Screening • Substance Abuse/Co-Occurring Assessment • Medical Assessment • Referral to the Appropriate Level of Care Using American Society of Addiction Medicine Standards (ASAM) • 24-Hour Clinical (Social) Detoxification Program • Pain Pill Addiction Treatment

• Outpatient Counseling • Intensive Outpatient Counseling • Residential Treatment • Motivational Counseling • Aftercare/Discharge Planning • Recovery Support Services • Safe Social Setting

Residential Treatment Center 6145 Temple Star Road Kingsport, TN 37660

Corporate Office 2514 1/2 Wesley Street, Suite 5 Johnson City, TN 37601

423.349.4070

423.928.6581

Outpatient Counseling 128 South Main Street, Suite 301 Greeneville, TN 37743

423.639.7777 Outpatient Treatment Hours: Monday-Friday, 8:30am-4:30pm

ccstreatment.com • ccskptadmissions@aol.com