In an ambulatory care setting where we expect to provide less invasive care to patients who are not acutely ill, admission to the Surgery Center indicates the patient will tolerate the procedure in this setting without difficulty. If a patient should suffer cardiac or respiratory arrest or any life-threatening condition, the patient will be transferred to a more acute level of care, that is, the hospital emergency room.
If a patient who is to receive a procedure at the Surgery Center presents the staff with an Advance Directives/Living Will, the patient will be advised that the Surgery Center will not honor any Advance Directives/Living Wills that do not allow resuscitation. It is the policy of Nicklaus Children’s Ambulatory Surgery Center to transfer any patient requiring resuscitation to the hospital. The hospital can determine when to implement the Advance Directives/Living Will once the patient or others notify them of the Advance Directives/Living Will.
Regulations require the Surgery Center to notify patients that we will not honor Advance Directives. Patients who disagree with this policy must address the issue with the attending physician prior to signing the form acknowledging an understanding of the policy regarding Advance Directives/Living Wills.
Patients are informed about this policy prior to the date of admission so the patient will have the opportunity to discuss any concerns with the attending physician and/or make arrangements for a change in admission. The patient can receive information about where he/she can learn information about a Living Will if the patient desires to consider preparing or revising one. The Surgery Center will provide information about a Living Will if the patient requests this information. Information may include a state-provided resource directory for a Living Will, such as a state agency, library or state website.
It is not required that a patient have a Living Will or Advance Directives. It is required that the Surgery Center inform the patient of the right to have a Living Will, the right to have the Living Will placed in the patient’s medical record, the policy of the Surgery Center to resuscitate and transfer when indicated, and the right to discuss these policies with the provider of services.
