Operation Guide

We at Herzliya Medical Center make every effort to provide you with a secure feeling and peace of mind before, during and after the surgical procedure, and to help you to fully return to your daily routine as rapidly as possible.

This guide provides you with the information you need to be prepared for the operation or procedure at hospital, and to know in advance what to expect at each stage of the process.

We, the Medical staff, are personally committed to your health, and are working together to help, assist, support and provide the highest standard of medicine together with personal, dedicated and professional nursing care.

We wish you lots of success and good health.

General guidelines in the absence of other guidelines from the physician:

*Arrival: You must arrive about two hours before the time of the operation for the purpose of administrative and nursing registration and admission.

*Fast: You must fast, absolutely abstaining from food for 8 hours before the operation.
In the first 3 hours – it is permitted to drink plain water only.
Note: do not chew gum, suck candies or smoke during the fast.
The fast is necessary in order to maintain your safety during the procedure, which may be cancelled if you break the fast.

*Medicines: Take them on the morning of the operation as instructed by the surgeon or by the physician in the pre-operative clinic if you visited there prior to coming to hospital.
If you used anticoagulant medicines (blood thinners), it is important to check with the physician whether it is necessary to stop treatment with these medicines, or whether alternative treatment needs to be taken.

*Bathing: The night before the operation, wash your entire body except for you head and face with an antibacterial agent – Septal Scrub – and again on the morning of the operation.

*General: Avoid bringing valuables to hospital, and remove makeup before arriving at hospital.
The hospital is not responsible for the loss of valuables.

Before coming to hospital, it is important to make sure that you have the following documents and to bring them to hospital:

• Identification card / driving license / passport / guardianship approval
• If the patient is a minor under the age of 18, bring the parent’s identity card in which the minor is listed.
• X-ray, ultrasound, MRI and CT imaging that you have performed before the operation.
• All medicines that you take regularly, in their original packaging.
• Financial commitment from the insurer and means to pay the required copayment.
• All the medical material that you have been asked to bring, including imaging and test results.

We recommend that you bring your personal toiletries for your convenience during your hospitalization.

Registration and Admission

When you arrive at the hospital, you should go to the Admissions Office at the front of the hospital, in the building marked with the letter C.

The admission process includes initial confirmation of details, opening your file, filing the documents you brought from home, and paying your copayment.

If you wish, you may leave the cellphone number of a family member or an accompanying person, to whom text messages will be sent with updates regarding the progress of the admission, operation, recovery and hospitalization stages.

Nursing Admission

On completion of registration, we will accompany you to Nursing Admission for a meeting with a nurse and preparation for the operation. In this framework, a meeting will be held with the anesthesiologist, the surgeon and the operating room nurse.

Your family members and the persons accompanying you will wait in the hospital’s waiting area until you are transferred to the hospitalization Department after recovery from the operation.

The duration of the operation depends on a number of factors, and varies depending on the type of operation, the technique and the equipment used by the surgeon, and your unique characteristics.

The surgical staff, including your surgeon and the nursing staff, will care for all your needs and will utilize various systems for monitoring your bodily systems during the operation for your safety.

On completion of the operation, the surgeon will come out to your family to update them about the course of the operation.

Recovery

The end of the operation is the moment at which the medical procedure is completed and the stage of recovery from the anesthesia and operation begins.
Depending on the physician’s directions and the type of operation, the nursing staff will have you transferred to the Recovery Department or Intensive Care Department for observation and initial treatment.
The process of recovery and your stay in the department varies from one person to the next and depends on your personal speed of recovery.

It is important to note:
In order to maintain all patients’ privacy, comfort and health, and of course your own, we cannot allow the entry of accompanying persons or family members, with the exception of the parents of a minor.

In the event that you opted for updates to be received by one of your family members or an accompanying person, we will make sure to update him immediately when you are transferred to the Recovery Room and when you leave for the hospitalization department in which where they will be able to visit you.

At the hospital, there are 5 hospitalization departments, designated by the letters A-E.

The hospitalization department and room will be determined by the nursing staff on completion of the operation, taking into account the physician’s directions, the type of operation and the treatment required.

The hospitalization room is the place where recuperation begins. As such, we have made every effort to give you the feeling that you have arrived home: a personal closet, set of bathing accessories, a face towel, a personal dressing gown, slippers, disposable earphones, free Wi-Fi, television with a host of channels to choose from, and more.

In order to enable you and the other patients in the department to have all the quiet and rest that they should have after the medical procedures, the hospital’s policy is to not allow family members or accompanying persons to remain at your side during the night. Only the parents of children up to the age of 18 may stay overnight, in coordination with the department’s responsible person.

Visiting Hours in the Hospitalization Departments

07:00-20:00 And subject to the department instructions

Visiting Hours in Intensive Care

Morning:

10:00-10:15

12:00-12:15

Evening:

16:30-16:45

19:30-19:45

The Medical and Nursing Staff are at Your Service

The surgeon will follow you throughout the hospitalization period, and will instruct the nursing staff regarding the individual treatment needed during your hospitalization.
The nursing staff, who have rich experience in all fields of nursing, and the hospital’s team of house physicians, are available for you 24 hours a day, and are at your service for any problem or need that arises during your hospitalization.

Depending on the type of operation, a physiotherapist in the hospitalization department will be at your service and will guide you in safely performing such tasks as: getting out of bed, going to and using the toilets, walking, and physiotherapy exercises that you will be able to perform at home.

Meals:

Meals at the hospital are served in accordance with the surgeon’s instructions, and if possible, we will offer you a choice from the hospital chef’s menu.
In case of special dietary requirements, including vegan food, it is important to update the nursing staff about this in advance.
The hospital kitchen and the food served is kosher and is under the strict supervision of a kashrut supervisor. It is therefore forbidden to bring in food from outside the hospital.

Meal Times:

Breakfast: 08:00-09:00

Lunch: 12:00-13:00

Dinner: 18:00-19:00

In case you are still hungry or if you arrived at the department after meal times, the nursing staff will be happy to help.

The discharge process will be performed in the hospitalization department, with the exception of cases in which payment arrangements are required in the Admissions Office.

The timing of your discharge will depend on the surgeon’s decision, the type of operation and the progress of your recuperation.

Returning Home

Our treatment does not end at the moment that you are discharged from hospitalization and you go home.

24-48 hours after your discharge from hospitalization, you will be contacted by the recuperation center, staffed by an expert team of task-specific nurses, in order to make sure that the recuperation process is proceeding normally.
You may ask the team any question and bring up any worry or problem that arises.

It is important to note situations that need to be immediately address by a physician:

• Fever above 38 degrees
• Worsening or appearance of acute pain in the operated area
• Bleeding from the surgical wound
• Redness and discharge from the area of the surgical scar
• Such symptoms as: nausea, vomiting or abnormal pain

To make report and receive assistance, contact the surgeon, the hospitalization department or the recuperation center at telephone: 03-7166190.

We wish you lots of success, good health and a rapid return to your normal routine.

Herzliya Medical Center – Committed to Your Health

There are cases in which a framework for further treatment will be needed after the operation. The decision as to the framework that suits you is in the hands of your physician, with your and your family’s participation, depending on your condition and your personal needs.

Rehabilitation Options:

Home Rehabilitation:

• Patients requiring minimal assistance in their daily function after the operation and have help from a supportive environment may be discharged to their home. If home physiotherapy is required, physiotherapy services at your home can be obtained from your health fund at no cost.
  You may also inquire at the relevant health fund regarding additional services provided in the framework of home rehabilitation from the health fund.

• Patients in need of a higher level of assistance in their daily function or in situations where there is not supportive environment may receive temporarily, at no charge, a service called “provisional caregiving” from a caregiving agency in the area of your home. In order to receive the service, ask any caregiving agency in the area of your home; the agency will assist in submitting the application for caregiver assistance to the National Insurance Institute.
  Until a reply is received from the National Insurance Institute, 6 hours weekly of caregiver services will be provided.

• Patients who are recognized as holocaust survivors will be able to submit an application for 50 hours of caregiver assistance in their home, at no charge, from the Foundation for the Benefit of Holocaust Victims. The Foundation approves applications for assistance in case of monthly income that does not exceed: 9,514 NIS per month. This amount includes all types of income: income from the National Insurance Institute, pension, rental income and other additional income, with the exception of income received due to the applicant being recognized as a holocaust survivor (reparations, pension and compensation), which are not included in the calculation of monthly income.

• Patients in need of maximal assistance or who have no family and desire home rehabilitation should ask private caregiver agencies that provide home rehabilitation services, or consult with the surgeon about the option of going to institutional rehabilitation, as they desire.

Institutional Rehabilitation from the Health Funds:

Rehabilitation in a rehabilitation institute requires approval of the health fund, and is fully funded by the health fund.
The application is submitted by the secretary of the hospitalization department after the operation, and includes a physician’s recommendation, a social worker’s recommendation, a physiotherapist’s recommendation and a nursing report.

If you desire institutional rehabilitation, you have to consult with the surgeon about this option before the operation.
If there is a physician’s recommendation, an application may be submitted after the operation; the hospitalization secretary will bring in a social worker for you for the purpose of writing an additional recommendation, and she will submit the application to the district office of the relevant health fund. The health fund will reply within two days, and the hospitalization staff will ensure that you are updated.

Recuperation Center:

Rehabilitation in private recuperation centers that can be contacted directed, with no need for the process of submitting an application or receiving approval. Recuperation centers provide personal services and treatment provided by a multidisciplinary team (physicians, nurses, physiotherapists). These centers operate as a type of medical hotel and provide rehabilitation services on a private basis, funded by the patient. If private health insurance is held, it is possible to find out whether it is possible for the insurance to participate in the cost of staying at a recuperation center. Additionally, it is possible to contact the health fund in order to check whether the health fund offers participation in funding the cost of the institution.
It is important to note that the period of hospitalization will not be prolonged due to an application for continued treatment in the framework of a recuperation institution, unless there is a medical reason.

We wish you lots of success, and that you be bestowed with good health.

Since the hospital environment is unfamiliar to you, this in combination with the medical condition necessitating your operation could increase the risk of falling.

Please read this guide carefully, and make sure to let the medical staff know of any past falling incidents.

Mobility:

• Before you get out of bed independently after surgery, find out from the nurse whether there are any special instructions.
• It is important to avail yourself of assistance from the clinical staff when transitioning from the bed to the armchair, when washing and/or in any instance in which you feel weak or unconfident.
• If you are connected to any tubing following the operation, request the assistance of a staff member when getting out of bed and for tasks that you need to carry out.
• Formal guidance about conducing yourself with infusion tubes will take place in the Department.
• We recommend reducing fluid intake after 18.00, and emptying the bladder before going to sleep.
• Wear steady (flat heeled) closed-back shoes.
• If you walk unsteadily, use a rail, walker or cane.

Maintaining a Safe Environment

• The bell for calling a nurse is within reach.
• It is important to make sure that the area near the bed is in an orderly state, and that the closet is within arm’s reach.
• The bed rails are raised as necessary, for your safety.
• Make sure to walk in dry areas to prevent slipping.
• Avoid walking while the floor is being cleaned.

Bathing

Before you go to the shower/toilet, it is important to make sure that the floor is dry.

• The nurse should be informed before you go into the shower.
• Before you enter the shower, please make sure that you have all necessary items (towel, toiletries, change of clothes).
• It is preferable to bathe while seated and to make sure that you have found the location of the call button in the shower so you can call for help if necessary.
• Do not lock the door when you go into the shower/toilet.

We are here for you and to help you.

Infection in hospital is a critical issue that can harm patient health.
The hospital staff invest great effort in preventing hospital infections, punctiliously following the strict guidelines of the Ministry of Health and world health organizations.
For this purpose, we have set up a special team that carries out inspections, staff and patient training, in additional to many additional actions taken to care for your health.
In order to reduce the risk of infection we ask you to act in accordance with any guidelines you were given at the pre-operative clinic and during your hospitalization.

Hand Hygiene

One of the important procedures in preventing infection is washing hands before and after contact with the patient and with his surroundings.
Hand washing that prevents infection is hand washing with soap and water or disinfection of the hands with an alcohol-based product located throughout the hospital, in every department and next to every bed and sink.

Your help is essential – your health is in your hands

We would like you to participate in our efforts to reduce infections, and to be careful with your hand hygiene during your treatment at the hospital, as well as that of your family members and visitors.
It is your right to ask the physician and staff members to wash their hands before all contact with you or with your surroundings.
We would be happy to receive feedback from you and to take note of situations in which the staff is not careful with hand hygiene, so that we can make improvements and improve.

Instructions on Pain Prevention and Treatment

What is pain?

Pain is a subjective, unpleasant sensory experience.

Effective treatment of pain increases the feeling of comfort, prevents post-surgical complications and alleviates anxiety and suffering.

During your stay in the hospital, the staff will speak to you at regular intervals to determine the level of your pain based on the pain scale:

0 – defined as no pain

1-3 – reflects mild pain

4-6 – reflects moderate pain

7-9 – reflects severe pain

10 – a state of intolerable pain (the most extremely you can imagine)

According to your report on the intensity of pain, the staff will adapt the drug treatment to be administered to you in order to optimally treat pain.

What is quality pain treatment?

Quality pain treatment is defined as application of several principles at the same time that will allow you to experience a minimum amount of pain, if any.

1. Administration of drugs “round the clock”

Administration of a drug to alleviate pain within the allotted period of time for one day.  The purpose of administering drugs in this manner is to prevent pain,

i.e. treatment of pain before it occurs. As such, it is important to take the drugs that are being administered to you even when there is no pain (you are not in pain because you are receiving treatment).

2. Combination of drugs

In order to alleviate pain, we largely combine drugs (you will receive 2-3 types of drugs from different families that work on different sites of pain) in order to facilitate optimal pain relief and reduce side effects.

3. Administration of treatment for breakthrough pain

If despite round the clock treatment, you have pain (breakthrough pain), you will receive additional drugs to alleviate the pain.  It is important that you report any breakthrough pain (sudden onset of pain under treatment). It is important to know that it is easier to control ‘weak’ pain than severe pain. It is therefore important that you immediately report any onset of pain.

Principles of Pain Prevention and Treatment

• Make sure to take the drugs that are administered to you even when you are not experiencing any pain. You are not experiencing pain because you are receiving treatment.
• You should report pain immediately upon its onset, in order to improve the efficacy of the treatment. It is easier to treat pain before it increases.
• Inform the nurse of any pain while resting or during exertion based on the pain scale.
• If pain occurs while under treatment, you must request additional pain killer that quickly acts to alleviate pain.
• It is important to know whether the treatment you received reduced the severity of the pain.

Pain treatment is for your well-being,

Your cooperation with the staff is necessary for the success of the treatment!

The right to receive proper medical treatment:

• Every patient has the right to receive professional, quality medical treatment and to be treated in a humane manner without any discrimination on the basis of religion, race, gender, nationality, country of origin, sexual orientation, etc.
• If a patient presents to a Department of Emergency Medicine, it is his right to be examined by a physician.

Identity of the Clinician:

• The clinician must wear a clear identification badge and identify himself to the patient and his family.

Providing Consent for Medical Treatment:

• The provision of medical treatment is contingent on the provision of the consent of the patient or his legal representative (guardian/holder of a power-of-attorney).
• It is the patient’s right to receive an understandable explanation of his medical condition, his treatment options and their alternatives, risks, benefits and possible side effects.
• The explanation of the treatment shall be given, so far as is possible, in the patient’s language, in accordance with his ability to understand.
• The patient must provide the clinical staff with information about his medical history, so that the diagnosis and treatment offered will be the most appropriate and the best.
• The patient has a right to refuse to receive medical treatment (with the exception of exceptional cases set down in the law).
• The patient has the right to give a power-of-attorney to a person who will be authorized to consent to medical treatment on the patient’s behalf in the event that the patient will be unable to make the decision.

Maintaining Dignity and Privacy:

• Employees of the medical center are obliged to maintain the patient’s privacy and dignity.
• The patient has the right to request the presence of an additional person in the treatment room.

Maintaining Medical Confidentiality:

• Employees of the medical center are obliged to maintain the confidentiality of information that they are exposed to during their work and due to their position.

Conveying Medical Information to Others:

• It is the patient’s right that medical information about him be conveyed only after the patient consents or if under the provisions of the law this is permitted or is obligatory.

Additional Opinion:

• It is the patient’s right to take the initiative for an additional medical opinion within or outside of the medical institution.
• It is the obligation of the medical staff to assist the patient with this.

Continuity of Treatment:

• When switching between clinicians or between various medical institutions, the patient has the right to request that the clinicians work in cooperation in order to ensure proper continuity of treatment.

Receiving Visitors:

• The patient is entitled to receive visitors during the hours intended for this in accordance with the medical center’s administration’s procedures.

Receiving Medical Information:

• The patient has the right to receive all information in his medical file from the medical center.
• Upon his discharge, the patient will receive a summary of the course of his hospitalization in writing.
• Receiving an additional copy of the medical record will incur a fee.

Public Inquiries:

• It is the right of patients, of their families and/or of any other person to contact the Public Enquiries Officer or the Patient Rights Officer with any comment, complaint, query or suggestion.

Ethics Committee:

• In the Medical Center, there is an Ethics Committee, which is careful to assist in making decisions in complex cases.
• It is the right of the patient, his family members and relevant parties to request that the Ethics Committee convene.
• Additional information is available on the Medical Center’s website.

Base on the “Patient Rights Act 5756-1996”