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Healthcare Directive

Altru Health System is dedicated to providing quality services for its patients. We want you to have the best possible care as prescribed or recommended by those who are treating you. We want you to know your rights as a patient as well as what your obligations are to yourself, your physician, and the hospital. We encourage you to talk openly with those involved with your care.

Expanded Care Options with Altru Health System’s Palliative Care Program

An important part of dealing with any serious illness is to ensure that patients are made as comfortable as possible so they can focus on their recovery and overall well-being. Palliative care, also known as comfort or supportive care, is an area of healthcare that provides vigorous treatment for pain and other symptoms, as well as the emotional distress patients may feel when they are seriously ill. Patients can receive palliative care before, during and after treatments for your disease(s) or illness. The goal of palliative care is to give the patient the best possible quality of life by aggressively fighting symptoms while other care is fighting the disease or illness. When diseases cannot be cured, palliative care efforts are enhanced to increase the patient's physical, emotional, psychological, social, and emotional comfort.

Palliative care treats a broad range of conditions, including pain, nausea, fatigue, breathlessness, constipation, depression, and anxiety. The palliative care program works with physicians to help build a treatment plan with the patient and family wishes in mind. The palliative care program can help coordinate the multiple sources of treatment and care that patients with advanced illness need. This coordination includes communicating with different physicians, explaining treatment choices and options, and finding resources for counseling, spiritual support and daily living needs inside and outside the hospital. Comfort care always includes adequate pain control.

Altru Health System has a palliative care program to provide this care to our patients and families. Physicians can provide a referral to the service so that patients can benefit from this care. Ask your physician or healthcare provider about palliative care.

Click here to learn more about the Meaning of Code Status/POLST.

Altru Health System’s Ethics Advisory Committee

There are times when making a decision for yourself or a family member about whether or not to undergo treatment presents some difficulties or conflicts. A source of assistance that is available to you or your family is the Altru Health System Ethics Advisory Committee. The purpose of the Ethics Advisory Committee is to provide a mechanism to ensure that communication about ethical issues and decisions occurs among health care providers, patients, and families. The Ethics Advisory Committee does not make decisions itself; rather, it serves in an advisory capacity to the decision maker, whether that be the physician, patient, family, or legal decision maker.

Any patient, family member, physician, or staff member may request a review by the Ethics Advisory Committee of situations which involve ethical issues.

To refer an issue to the Altru Health System Ethics Advisory Committee, you may call the Pastoral Services office 701.780.5300 or social Work/Case management office 701.780.5345 during the day between 8:00 am and 4:30 pm.

In the evening or on weekends, you may request a referral to the Ethics Advisory Committee by contacting the hospital supervisor. Call the hospital operator (dial 0 if you are in the hospital; dial 701.780.5000 if you are out of the hospital) and ask for the hospital supervisor.

Code of Ethics

Altru Health System recognizes its responsibility to its patients, staff, physicians and the community it serves to conduct patient care and all other operations in an ethical manner based on its values, mission, vision, and strategic plan. Values serve as the guiding principles for ethical behavior in all activities and are supported by policies, procedures, practices, and quality service. A Code of Ethics is the mechanism by which values are brought to life. The six value statements of Altru Health System serve as the focal points for the organization’s Code of Ethics.

Respect and Caring for Individuals

  • All patients, families, significant others, employees, and medical staff will be treated with dignity, respect and courtesy.
  • Patients and families will receive appropriate information about therapeutic alternatives and risks associated with their care and will be active participants in their care.
  • Patients, families, and employees will have their ethnic, cultural, religious, and lifestyle diversity honored.
  • The confidentiality and privacy of patients, families and employees will be respected and protected.
  • Employees will be provided with fair and equitable compensation and support.
  • Professional and ethical codes of employees and medical staff will be respected and supported.

Honesty and Dependability

  • Potential conflicts of interest in patient care, business practices and contractual relationships will be brought to the attention and addressed by leadership and/or the governing board.
  • Patients and/or third party payors will be billed only for services actually provided and will be assisted in understanding the cost related to their care.
  • All public advertising and information disseminated will be truthful and accurate.
  • The commitments made with patients, families and one another will be met.

Commitment to Serve

  • Patients will be admitted to, transferred and discharged from the hospital on the basis of their medical needs and the ability of the hospital to meet those needs.
  • Patients/families will be informed of the need for admission, transfer, or discharge and given appropriate options so that they can be part of the decision making process.
  • Conflicts and complaints will be addressed in a timely manner and all efforts to reach a mutually satisfactory resolution will be made. Resources available to assist patient/families are: employees, Area and Executive Leaders, Risk Manager, and the Ethics Committee.

Continuous Quality Improvement

  • Care provided will be of the same level regardless of the location within Altru Health System or the patient’s ability to pay.
  • Care will be based upon quality standards with consideration of the patient/family needs.
  • Care will be provided in the most cost effective manner that continues to meet the requirements of patients, families, physicians, and staff.
  • Resolution of problems, issues, and concerns of patients and their families will be addressed.

Teamwork Based on a Common Purpose, Performance Goals, and Mutual Accountability

  • Employees and medical staff will be encouraged and supported in efforts to collaborate, problem-solve, and innovate.
  • Employees and medical staff will be kept informed of changes in the health care environment and will be encouraged and supported in responding to the changes.

Stewardship of the Community's Healthcare Resources

  • Patient care and organizational processes will be designed using quality improvement methods so that patient’s needs and requirements will be met in a manner that preserves resources of the community and the organization.
  • Competitive costs and prices to ensure access to services needed by the community will be maintained.

Healthcare Directive (Advance Directive): North Dakota & Minnesota

A Healthcare Directive is a written document that includes one or more health care instructions, a health care power of attorney, or both.

The Healthcare Directive permits you to make your healthcare wishes known and gives your health care agent the power and guidance to make healthcare decisions according to your wishes when you are unable to make or communicate your decisions. The document may include the type of treatment you want or do not want and under what circumstances you want these decisions to be made. You may state where you want or do not want to receive treatment.

In this document, you may name an agent who would make healthcare decisions for you if you are unable to make them for yourself. The agent has a duty to act consistently with your known wishes. If the agent does not know your wishes, the agent has the duty to act in your best interests. If you do not name an agent, your healthcare providers have a duty to act consistently with your instructions or tell you that they are unwilling to do so.

A Healthcare Directive becomes effective when it meets the requirements of the law and when you are unable to decide or make known healthcare decisions. You cannot be required to sign a Healthcare Directive. Your decision to complete a Healthcare Directive is personal and should be based upon your individual values and beliefs.

To Complete a Healthcare Directive:

  1. Use the appropriate form. The law includes a recommended form. Forms are available at Altru Health System from Pastoral Services staff (Chaplain) at 701.780.5300 or write Altru Health System Pastoral Services, 1200 South Columbia Road, Grand Forks, ND 58201, the Hospital Supervisor 701.780.5250, or from Altru Home Services staff 701.780.5880. If you have questions regarding filling out forms contact Social Workers or Case Managers at 701.780.5345 or Pastoral Services at 701.780.5300.
  2. Carefully select the person you want to act as your agent and/or alternate agent. Discuss the role of your agent and/or alternate agent with the persons you select.
  3. Tell your agent what kinds of health care decisions you want your agent to make on your behalf.
  4. When you are completing a Healthcare Directive, if you have questions or special circumstances to consider, it might be advisable to consult an attorney who is knowledgeable about advance directives.
  5. Make certain you sign your Healthcare Directive and have it properly witnessed or notarized. There are specific limitations under the law on who is qualified to be a witness.
  6. Give a copy of your Healthcare Directive to your physician and any other health care providers such as your nursing facility, hospice or home health agency. Altru Hospital accepts an ORIGINAL form or a copy and will keep it on file in the Medical Records Department. A copy will be kept on your chart while you are a patient. Ask your other healthcare providers if they need an original or if a copy will be sufficient.

In addition, you may want to give originals or copies of your Healthcare Directive to other persons such as close family members and your attorney, if you have one.

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