National Hospitalized Patient Bill of Rights
- Medical Records: Hospitalized patients shall be offered their medical record daily and be shown how to make entries into their record and correct any misinformation. Medical records shall be electronic by 2012.
- Evidence-based care: Diagnosis and treatment shall be according to federal healthcare guidelines or according to peer-reviewed guidelines published by expert organizations for the medical condition of the patient. If the physician determines that a deviation from guidelines is needed, then the patient must be told that her care should deviate from guidelines and given an explanation for the deviation.
- Therapeutic Drugs: No patient shall be prescribed a medication for off-label purposes without being informed that the drug prescribed has not been approved by the FDA for the patient’s medical condition. The rationale for prescribing the off-label drug and the risk associated with this must be revealed to the patient and documented. The patient shall be told how to report adverse effects of any prescription drug to the FDA.
- Physician Competency: Patients have the right to be told the competency status of their physician before they are treated. This status shall include completion of state mandated CME, board-certification status, maintenance of board certification, rehabilitation from drug abuse, and any other factors that bear on the physician’s competency.
- Costs: Patients shall know the ordinary costs of the diagnosis and treatment that they are going to receive before they agree to a diagnostic plan or treatment plan. Treatment found to be against guidelines without the patient’s consent does not have to be paid for.
- Adverse Events: If an unanticipated adverse event occurs during diagnosis or treatment, the patient has a right to a full accounting of what happened and how the hospital intends to prevent similar adverse events in the future. If the adverse event was caused by a medical error, then the patient has a right to just compensation. Falsification of medical records after an adverse event constitutes tampering with evidence.
- Duty to Warn: Patients shall know the hospital’s infection rate and morbidity and mortality associated with planned invasive procedures. The patient shall be warned of any lifestyle activity that threatens their health. They shall be given guidance on management of that activity.
- Informed Consent: The patient shall give their informed consent for invasive procedures according to guidelines published by the American Medical Association in 1998. Fear shall never be used to elicit consent for invasive procedures. Invasion of another person’s body without genuine informed consent is battery.
- Feedback on Care: The patient has a right, even a duty, to provide feedback to an independent agency on the quality of care they received during hospitalization. This feedback shall be systematically captured and made available to the public.
- Right to an Advocate: Research (Gittell, High Performance Healthcare) has shown that while in the hospital the main one to integrate the care of a patient is the patient’s advocate. All hospital patients must have the right to an advocate.
Legislative Goals in Texas
- These are currently under development of the 2015 session.