patient guides

At Cook Children's Medical Center, our goal is to make your stay as comfortable as possible.

We offer medical technology and treatment, attract some of the best medical personnel from around the country and house them all in a friendly environment designed especially for children. Although we use the term "parents" throughout this guide, we do realize that caregivers come with many names-grandmother, grandfather, aunt, uncle, sister, brother, cousin and friend. No matter what your child calls you, we understand how important each and every one of you is in the life of your child.

Parents as Team Members
As parents or caregivers, you are important members of the team that cares for your child. Our family-centered care can help relieve your child's fears and often helps speed recovery. It may also help ease the stress felt by parents and siblings. You should continue regular routines such as brushing your child's teeth and hair while your child is in the medical center. When it is appropriate, you also are encouraged to participate in the treatment of your child. This is particularly important for parents who will provide treatment for chronically ill children at home. Ask your nurse or physician how you can help.

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For Safety's Sake
Here are safety hints:

• Make it official. Never entrust your child to anyone not wearing an official Cook Children's name badge. Badges include a photo as well as the person's name, title and department.
• Keep in touch. Please inform the nurse in charge before taking your child away from the unit. Units provide sign-out sheets for this information. Any parent who takes his/her child away from the floor for any reason or who spends the night at the medical center must have a wristband (similar to your child's wristband).
• Keep it safe. When your child is in bed, side rails should be up at all times. Make sure he/she wears shoes or slippers when walking in the halls. Never leave your child unattended in strollers or wagons.
• Check it out. To prevent accidents, our Biomedical Department before use must inspect patient-owned or rented equipment. Call ext. 4023 (682-885-4023).
• Protect valuables. Valuables should be left at home or in the vault located in the Patient Registration Office.
• Wait for instructions. Fire drills are conducted occasionally for medical center personnel. If you hear an alarm, wait for instructions. Report anything unusual. Any unusual event or breach of security should be reported to an employee, who will contact security. Call ext. 1047 (682-885-1047).

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Your Child's Room
Beds. Because hospital beds are higher than beds at home, remember to keep side rails up for the safety of your child.
Televisions. Patient rooms are equipped with TVs and VCRs. Keep volume at a level that won't disturb others. Ask the Child Life Specialist on your floor about available videos. Channel 24 broadcasts information in English and Spanish on such topics as seizure disorders, childhood asthma and child care. Channel 12 provides information on infant and child CPR, car seat safety and patient safety.
Telephones. Free local calls may be made from patient rooms by first dialing 9. Calls within the medical center may be made by dialing the four-digit extension number. Friends and relatives may reach you by calling the seven-digit number on the telephone in your child's room. Calls to the room may be blocked and you may ask that no information about your child be given to anyone. Ask the charge nurse for assistance.

• Long distance calls may not be charged to your child's room. Be prepared to give the operator a calling card number.
• Payphones are located near Sir Eatsalot Restaurant, the Emergency Room, and PICU and NICU waiting areas.
• If you need a phone for the hearing-impaired, please ask your nurse.

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Visiting Your Child
You are welcome to stay as long as you wish in general care units. Intensive care units have special visiting policies, and patients in certain isolation areas may not have visitors younger than age 12. For more information, please ask a nurse. All visitors younger than 18 must be accompanied by an adult. Siblings and other visitors may only visit if they are free of contagious diseases. Siblings and other visitors may be asked to leave during procedures or checkups.

Please note these visitor guidelines:

• Cover up. Shoes and shirts are required for all medical center visitors, including adults and children.
• No smoking, please. Smoking is not allowed anywhere inside the medical center. Smoking is allowed only in designated smoking areas outside the building. Ask a nurse about medications. Never give your child prescription or non-prescription medications without first speaking to his/her nurse. Remember that NPO means "nothing by mouth" and is usually ordered before tests or surgery. If your child has NPO orders, do not give him/her food (including candy or ice), drinks or medicine without first checking with a nurse.
• Balloon rules. Latex balloons are not allowed. If your child receives latex balloons, they may be stored at the information desk until you can take them home. Latex balloons will be discarded after 24 hours. You may exchange latex balloons for one Mylar balloon at the Gift Shop.
• Sorry, no plants in ICU. If your child is in an intensive care unit or other isolated area, please give him/her books or toys instead of live plants or flowers.
• Your child needs sleep. Remember that visiting hours for persons other than parents are 8 am to 9 pm.
• Wash up. Parents and visitors should wash their hands before and after visits. To further reduce the spread of germs and infections, we ask that parents and visitors remain on their child's unit unless visiting other patients.
• Mind the crowd. Try to make sure your child has no more than two visitors at a time.
• Leave germs at home. People with contagious diseases, even as minor as a cold or flu, should not come to the medical center.

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Staying Overnight
Most patient rooms are equipped with sofa beds for parents to spend the night. A nurse can help you find linens and towels. Only two adults at a time and no siblings are allowed to stay overnight.

Because medical center personnel must have access to patients at all times, parents cannot sleep in the same bed with their child and must remain appropriately dressed. Since most doctors see patients early in the morning, we ask that parents be awake and dressed by 8 am.

Immediate family members may be able to stay at the Ronald McDonald House. Ask a social worker for more information about this home-away-from-home for families of patients. To help find other accomodations, go to the Fort Worth Visitors & Convention Bureau's online hotel listings.

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When You're Away
When it is necessary for you to leave your child because of other responsibilities, please notify the nursing staff and leave a telephone number where you may be reached. It's important for your child to know that the separation is temporary, so we ask that you be as accurate as possible about your return time. If you are delayed or are unable to return that day, please call and leave a message for your child. You may also call the nursing station at any time to ask about your child.

The medical center's main entrance is locked at 9:30 pm. Other entrances are also locked. Parents may use the Emergency Room to enter when entrances are locked.

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Medical Center Staff
Nursing and clinical staff. A charge nurse and team leader oversees the activities on your child's floor. Your physicians work primarily with nurses. Other medical professionals include therapists, technologists, lab personnel, nutritionists and specially trained clinicians.

Physical rehabilitation services. Physical rehabilitation provides care for children recovering from orthopedic injuries and procedures, head and spinal cord injuries, neurological disorders and musculoskeletal diseases and injuries. Therapists assist patients with regaining skills and adapting to physical changes.
Child Life Services. The Child Life Department helps children and families cope with the medical center experience by providing support and information a child can understand.
Pastoral Care. Chaplains provide spiritual and emotional support and counseling for families of any religious preference. A chaplain is available 24 hours. Chaplains may be reached by calling ext. 4030 (682-885-4030), 8:30 am to 5 pm weekdays. After hours, weekends and holidays, a chaplain may be reached through the medical center operator or a nurse. Non-denominational services are at 9:30 am Sundays and holidays and a special children's service is every Thursday at 11 am. Teen chapel is every Thursday at 3 pm, and Catholic mass is at noon every Friday.
Social Services. Social workers are available to support families with emotional needs, to discuss your child's illness, to help arrange accommodations and to help find community resources. Social workers are available 24 hours. During business hours, call ext. 7932 (682-885-7932). Evenings and weekends, social workers may be contacted through the medical center's operator or your nurse.

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Special Services
Financial counselors. Admission counselors assist families with financial assistance and payments. An admission counselor can explain insurance benefits, as well as assist families who may qualify for government programs.
Patient representatives. A patient representative is available to answer questions, provide information, assist in advance directives and investigate complaints or special problems. Call ext. 3926 (682-885-3926) weekdays from 8am to 5 pm.
Schooling. Teachers affiliated with the Fort Worth Independent School District provide instruction for children during extended hospitalizations. Classes are available for kindergarten through grade 12, using curriculum from the Fort Worth ISD or the child's home school district. Hospitalized children who are unable to go to the schoolroom in the medical center receive bedside tutoring.
Special companion program. Special companions are volunteers trained to assist families by playing with your child or sitting with your child when you need a few minutes away. If possible, notify the Child Life Specialist on your floor in advance of needing a volunteer to sit with your child.
Special events. Parents' Night Out, a program organized by volunteers, is an opportunity for you to take a break from the intensity of caring for an ill or injured child. This two-hour program for parents includes meals and entertainment. Trained volunteer sitters stay with your child and his/her siblings for the duration of the program. Ask your nurse or the Child Life Specialist on your floor for scheduled nights. Other special events are often held in the medical center Atrium. Call Community Relations at ext. 4337 (682-885-4337).
Translation services. Translation services are available to patients and families who need language assistance. Call Case Management at ext. 4119 (682-885-4119).
Banking facilities. An automatic teller machine (ATM) is located near the emergency room adjacent to Sir Eatsalot restaurant. Banking services are also available in the Harris Professional Building, 1325 Pennsylvania Ave.
Newspapers. Fort Worth, Dallas and other newspaper vending machines are located near the Vision Clinic near Sir Eatsalot. Local papers are also available in the Gift Shop.
Mail. Mail is delivered to patient rooms Please ask friends and relatives to address mail sent to you or your child at this address:

Cook Children's Medical Center
Child or parent's name and room number
801 Seventh Avenue
Fort Worth, Texas 76104

If your child receives mail after he or she has been discharged, every effort will be made to forward that mail. An outgoing mailbox is located in the Atrium in the corridor by the Gift Shop. Mail is picked up between 1 pm and 2 pm, Monday through Friday.

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Going Home
If your child requires home care or has special care needs, your physician or nurse may schedule a case manager to meet with you prior to discharge. Case managers are registered nurses who help ease the transition from medical center to home. Referrals may be made to Cook Children's Home Health for assistance with recovery or chronic illness.

Texas law requires that all children younger than age 2 ride in a car safety seat that meets federal safety standards, and children between ages 2 and 14 ride in a car seat or wear a seat belt. The law applies to both the front and rear seat of the vehicle. If you need assistance locating a car seat, please tell your nurse.

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Patient Billing Information
You will receive a bill from Cook Children's for all medical center, emergency and clinic services. You will also be billed by one or more physicians who care for your child. This might include radiologists, pathologists, anesthesiologists or surgeons. Call ext. 4432 (682-885-4432).

Methods of payment
Self-pay patients: Self-pay means that you are responsible for paying 100 percent of the bill. You will receive a statement every 30 days until the balance is paid in full. You may also receive letters more frequently. A deposit will be required at the time of service or you can arrange a payment plan.

HMO/CHIP patients: Co-payments are due at the time of registration. We will bill your HMO (health maintenance organization) for approved services, so please be sure that all information about your policy is accurate and up-to-date and present your current insurance card at registration. You will not receive a bill from the surgery center unless your co-payment is not paid in full. Contact your insurance company regarding payment. If you have CHIP (also known as TexCare Partnership), you may owe a co-payment to Cook Children's.

Commercial insurance: We will bill your insurance company, so please be sure that all information about your insurance is accurate and up-to-date and present your current insurance card at registration. When your insurance company pays the surgery center, you will receive an explanation of payment from the company. The portion you owe the surgery center will be billed to you after payment is received from the insurance company. This may take up to three months.

Medicaid/CSHCN: Please present your Medicaid/CSHCN card at the time of registration so that we may bill on your behalf for approved services. If accurate Medicaid/CSHCN information is provided, you will not receive any bills from the surgery center.

Medicare: We will bill Medicare on your behalf and you will receive a bill for any remaining charges.

Financial assistance
We try to help all families in working with their financial needs. Insurance verification is not a guarantee for payment. If your insurance provider denies payment, please work with us to find other possible programs to assist you.

Charity medical treatment is also available to qualified families. Qualification is determined by family size and income, as determined in the Federal Poverty Guidelines posted in various areas of the surgery center. For more information, ask a surgery center representative.

As required by state law, Cook Children's files an annual report of its community benefits plan with the Bureau of State Health Data and Policy Analysis of the Texas Department of Health. The report is public information and is available upon request from the Texas Department of Health, 100 West 49th Street, Austin, TX 78756.

Charity medical treatment is available to qualified families. Qualification is determined by family size and income, as determined in the Federal Poverty Guidelines posted in Patient Registration and other areas of the medical center. Call Patient Accounting at ext. 4432 (817-885-4432) or 1-888-852-6635.

Cook Children's Medical Center files an annual report of its community benefits plan with the Bureau of State Health Data and Policy Analysis of the Texas Department of Health, 100 West 49th St., Austin, TX 78756.

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Medical Center Resources
Bomar Library. A variety of books, videos and cassettes for children and adult reference materials may be borrowed from the Bomar Library. The library is located opposite the elevators on the second floor and is usually open from 9:30 am to 3 pm, Monday through Friday. A return box is available after hours and on weekends. Volunteers also staff traveling book carts for children who are unable to leave their room. Call ext. 6214 (682-885-6214) or page 817-669-6119.
Matustik Family Resource Center. Up-to-date, understandable information about children's health is available in the Matustik Family Resource Center, located in the basement below Sir Eatsalot. Resources include pamphlets, videos, books, magazines, electronic databases and Internet access. The center is open Monday through Friday, 8 am to 5 pm, with professional librarians available to assist families. Call the center at ext. 3976 (682-885-3976).
Volunteers. Volunteers serve in a variety of locations throughout the medical center, including the information desk, Gift Shop, Library, Surgical Recovery and Child Life. If you are interested volunteering, call Volunteer Services at ext. 6208 (682-885-6208). Gift Shop. Toys, games, magazines, and personal articles are available in the gift shop on the First Floor near the entrance. Hours are posted on the shop door. All proceeds from the Gift Shop benefit the medical center.
Gardens. Ask your nurse if it is okay to take your child outside to playground and gardens.
Parking. Parents and visitors may park in the parking garage for $1 per hour.

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Meals and Dining Facilities
Mealtime is very important. Please learn about your child's dietary restrictions and try not to tempt him/her with restricted foods or beverages. If your child wants a snack, ask the nursing staff . You may order meals for you to be sent to your child's room. Ask your nurse for assistance.

Sir Eatsalot, the medical center's restaurant, serves breakfast, lunch and dinner. Items such as pasta, salads, pizza, fruit, ice cream, soup, hot and cold sandwiches, and hot and cold take-out meals are available. The restaurant is located on the first floor adjacent to the Emergency Room. Vending machines are also there.

Restaurant Hours
Grab-and-Go items (soft drinks, juice, fruit, ice cream, pre-packaged sandwiches, etc.) are available Monday through Friday, 6:30 am until 11 pm, and on weekends from 7 am until 11 pm. Other hours are as follows:

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Patient Rights
You and your child have the right

• to be treated respectfully, regardless of your race, gender, cultural, economic, educational or religious background
• to know the names of your child's physicians
• to be told by physicians, in words you can understand, about your child's illness, treatment and prospects for recovery
• to participate in decisions about your child's medical care
• to receive as much information as you need to give or refuse consent for treatment
• to privacy and to the confidentiality of your child's records
• to expect a reasonable response to any reasonable request
• to know your child's healthcare requirements upon discharge from the medical center
• to examine your medical bills and receive an explanation of the charges, regardless of the source of payment
• to refuse to participate in any research project affecting your child's care and treatment
• to know about any connections between Cook Children's Medical Center and other institutions, as far as your child's care is concerned and,
• to remove your child from the medical center, even when advised otherwise; you will be asked to sign a form that relieves the medical center of responsibility

You and your child have the responsibility

• to provide accurate and complete information about matters relating to your child's health;
• to be considerate of other patients and to follow Cook Children's Medical Center rules and regulations;
• to provide insurance information necessary to process your child's bill; and,
• to follow the treatment plan recommended by healthcare personnel.

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Ethical Concerns
Our ethics committee's resources and services are available to all patients, families of patients, and healthcare professionals. The committee provides a forum for everyone involved in a patient's care to express concerns, raise questions, give input and receive guidance on decisions related to technology and treatment.

You may contact the ethics committee through your child's attending physician or through the Patient Representative Department at ext. 3926 (682-885-3926).

To our patients:
We are the doctors, nurses and staff of Cook Children's Medical Center. Everyone who works here thinks you are special.

These are our promises to you.

• We will tell you and your parents the truth.
• We will listen to you and your parents.
• You may talk freely with the medical team. You and your parents are a part of our medical team. We want you to help us decide the best ways to care for you.
• What you say will not be told to others unless it is important to your care and safety.
• It is okay to tell us what you want or do not want, if you are afraid, angry, lonely, or sad.
• It is okay to laugh and it is okay to cry.
• We will tell you
  • Who we are
  • Why you are here
  • What we do in the medical center
  • What the medical team thinks will help you
  • Why we have entered your room and,
  • How things may feel to you.
• We will explain all these things in ways you can understand.
• We care about you no matter
  • Your race or religion;
  • If you are a boy or girl;
  • Where you were born;
  • What you can and cannot do;
  • What you look like; or,
  • How much money your family has.

• We will be as gentle as possible when we have to touch you.
• We will keep your body covered as much as we can.
• If you hurt, we will do what we can to help you feel better in a safe way.
• Your religious, cultural, and personal traditions are important to us.
• Your family and friends can be with you when the medical center rules say it is okay. If you wish, we will help you limit their visits.
• Your parents can take you home when it does not hurt your health or safety.
• We will help you and your parents learn how to take care of you after you leave the medical center.
• If you and your parents wish, you can go to another medical center, and we will help you figure out how to do this safely.
• You and a nurse or medical professional may read your chart together.
• We will help you do what you need to grow and learn. You are not here to be punished.
• If we ask you to be part of an experiment or research, you and your parents can say yes or no.
• If you think we have not kept our promises, tell your doctors or nurse so we can work together to solve the problem. If you tell us you are sad or angry about a broken promise, we will still give you good care.

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