Frequently asked questions about traumatic injuries

Delirium is a state of mental confusion that develops quickly and the level of confusion may change throughout the day. It is a potentially serious and common condition for patients who are in the hospital, especially those in the ICU. It is usually temporary but may last for many weeks.

Patients with delirium may have the following signs:

• Trouble focusing and paying attention
• Can’t think clearly or remember recent things that have happened
• Disoriented, forgetful, and can’t express themselves clearly
• May be very sleepy or very restless
• May see or hear things that do not exist (visual or auditory hallucinations)
• May not recognize their family members or may be convinced that the hospital staff wants to harm them.

Usually many things can cause or contribute to delirium. Some examples of these include the patient’s medical condition, certain medications and the hospital environment, where noise and light may make it difficult for patients to sleep.

The health-care team is regularly looking for signs of delirium among patients. However, family members are encouraged to tell a member of the health-care team if they notice that their loved one is not behaving as usual.

You can find more information about delirium in the Navigating the ICU section of Sunnybrook’s website: sunnybrook.ca/icu-delirium

• It is difficult to predict your recovery and sometimes things take longer than expected, but at other times things can happen faster than you think.
• Everyone’s experience is different and depends on a lot of factors inside and outside of the hospital.
• You may find this frustrating, but the team members will do their best to prepare you.

Some patients might have made their long-term health-care wishes known before they were injured. The wishes may be written in a document such as a living will, an advance-care plan or an advanced directive.

Some patients have also completed a Power of Attorney for Personal Care document, in which they name the person they wish to have as their Substitute Decision Maker if they are unable to speak or make decisions for themselves.

• If your loved one has expressed his or her wishes, please talk to members of the health-care team.
• You can find more information on Sunnybrook’s website at: sunnybrook.ca/advancecareplanning

• Ask your nurse who is the most responsible staff physician (MRP) for your loved one. This is often written on the white board in the patient’s room or in the nursing station.
• Once you know the name, you can ask at the nursing station for the doctor’s business card, which will have her/his contact information.
• You can call the doctor’s office and arrange an appointment to discuss the patient’s care.
• You may wish to arrange the meeting early in your stay to keep the communication going after discharge from hospital.
• You should also think of bringing any forms that need to be filled out.

• It is not completely necessary to have this meeting before discharge.
• The residents involved in your care will be able to provide you with up-to-date information about medical issues and plan of care.

• The hospital will send your family doctor – or primary health-care provider – a summary of what happened to you while in hospital.
• You may be told to follow up with your family doctor when you leave.
• Your doctor may offer extra resources and emotional support throughout your recovery.

• Blood for transfusion needs to be carefully tested before it can be given to a patient, even if it is a family member.
• For this reason, blood donated by a family member cannot be used for a patient.
• However, if your loved one will need blood, we make sure that we have specially matched blood available.

A patient has a right to see his or her medical records and get copies of them. The person who is your Substitute Decision Maker or has Power of Attorney can also see your medical records under certain situations.

Your medical records are available in two ways:

MyChart

This is a secure online website where patients can read a lot of their health records from their Sunnybrook chart. This could include results of tests and x-rays, blood work, doctor and other team member notes, and appointments. MyChart can be viewed from any computer that has an Internet connection. You can also let other people see this website, including your family doctor, family members, and other health-care providers.

In order to see your MyChart you first need to register. Please go to: mychart.ca and choose “Sign up for MyChart” and follow the instructions.

There is no cost to get MyChart.

Paper record or medical images

You may want to see a part of your record that is not in MyChart. You also may want a paper copy of part of your record or a CD of your medical images, including x-rays, CT scans, MRI, and ultrasound results. For these things, you may need to go to the Health Data Records office of Sunnybrook.

• The Health Data Records office is located in E-Wing 1st Floor, Room 23 (E1 23). The phone number is 416-480-6100 extension 4433. The office is open Monday to Friday, from 8:30 a.m. to 4:30 p.m.
• You may not be able to get your records right away, as it can sometimes take many days. There may also be a cost to get some of these records.

• There may be times when you or your family members need help finding information or letting staff know about a concern.
• If the staff on the unit or the department have not been able to help deal with your concerns or complaints, you may wish to contact Sunnybrook’s Office of the Patient Experience.
• A staff member will listen to you, and help find some solutions to your concerns in a confidential setting.
• The Office of the Patient Experience is located in C-Wing, 1st Floor, Room 61 (C1 61). It is open Monday to Friday; 9:00 a.m. to 4:30 p.m.
• The phone number is 416-480-4940.
• If you are calling outside of business hours, please leave a message with your name and contact information. Your call will be returned on the next business day.
• You can also send an email: patient.experience@sunnybrook.ca

• The Ontario government has rules and regulations about your personal health information. The act is called the Personal Health Information Protection Act (PHIPA).
• During your hospital stay, we collect personal information from you directly or from the person acting on your behalf. The information may include your name, date of birth, address, health history, records of your visits and the care that you received.
• We may also ask for your permission to collect information about you from other places, such as your family doctor. There are many different reasons why we use and share your health information, including:
  • To treat and care for you.
  • To get payment for your treatment, such as from the Ontario Health Insurance Plan (OHIP).
  • To do research, and for teaching reasons.

For more information about Sunnybrook’s privacy protection practices, you can contact the Privacy Office at 416-480-6100 extension 1236.

• Some patients are able to make claims through insurance companies, depending on how their injuries happened.
• For example, if you were injured at work, you may be able to get benefits through the Workplace Safety and Insurance Board (WSIB). Or, if you were injured in a motor vehicle collision, you may be able to get benefits from motor vehicle insurance. Other types of insurance may also apply to you.
• If you are not sure about how to make a claim or if you are even able to make a claim, please speak to one of your care team members such as a social worker.

• If you have a medical form from your workplace or insurance that needs to be filled out or a letter that you need written, please ask one of your care-team members about who is the right doctor to complete the form or do the letter.
• Once you know the most appropriate doctor to do this, please take the form to his or her office yourself and drop it off. A member of your heath-care team can help you to find the office.
• The form or letter is not always done the same day or even same week.
• You will need to tell the office how to be contacted when your request is completed.
• There may be a fee to get the form or letter done.

• Start by asking the staff members what can be done. They may suggest you bring in some personal toiletries (toothbrush, toothpaste, shampoo), clothing, shoes or slippers, or familiar photographs.
• You may also be asked to assist with other support, including feeding, personal care and getting the patient out of bed - if it is safe to do so.
• Take the patient out of the room, or off the unit (if allowed) to have a change in setting and a different type of stimulation.
• Family members can provide emotional support during the patient’s time in the hospital and help communicate needs and preferences to the staff.
• There are practical things to do that can help the patient in the long term, such as starting an insurance claim early, or consulting a personal-injury lawyer. Please ask the social worker if you need information or help in these matters.