Code of Patient Concern

(VA Form 10-7991)


The Veterans Administration is committed to providing high quality medical care for its patients. It is also committed to providing this care in a climate in which the human needs and concerns of the patient are met, and in which individual interests are protected. This climate must be based on respect for the dignity of the patient as an individual, and on care which is provided in a courteous, concerned and compassionate manner. In order to achieve these goals, the dedication of each employee to the principles outlined in this document is essential. It is only through the willing assumption of this responsibility on the part of the staff that this healthcare facility will be able to provide the kind of patient care to which it is committed. To this end, this Code of Patient Concern reaffirms the commitment of the Veterans Administration.

        1. Each patient must be accorded dignity as an individual and treated with
           compassion and respect.

       2. Each patient seeking advice or assistance will be helped in a prompt,
           courteous responsive manner.

       3. Every effort should be made to make the patient feel that all
           employees care about him / her as an individual.

       4. In all cases, the needs and feelings of the patient and family will be primary
          consideration.

       5. Each employee in contact with patients and their family, is responsible for
           creating and fostering an atmosphere of mutual acceptance and trust.

       6. The physician responsible for the care of the patient, or a designated
           employee will provide the patient with information concerning diagnosis,
           treatment, and prognosis in terms the patient can reasonably be expected to
           understand. When it is not medically advisable or feasible to give such
           information to the patient, the information should be made available to the
           next-of kin, or other person designated by the patient upon acceptance for
           care except when existing law does not permit the release of information
           without written consent of the patient.

       7. The physician responsible for the care of the patient, or a designated
           employee, will make certain that the patient is aware of the person who is
           responsible for coordinating the patient's care.

       8. The physician will, prior to the initiation of any procedure with a recognized  
           element of risk, provide the patient with sufficient information for the patient to
           form  the basis of a reasonable request for such procedure. Except in
           emergencies such information should include the specific procedure  and/or
           treatment, the medically significant risks involved, and the probable duration
           of incapacitation. Where medically significant alternatives for care and
           treatment exist, or when the patient requests information  concerning medical
           alternatives, this information will be provided. The patient also will be told the
           name of the person responsible for the procedure and/or treatment. In the
           case of a patient that is considered to be mentally incapable of making a
           rational decision and request for a procedure, the sponsor or legal guardian
           will be provided with significant information to form a basis of a reasonable
           request for such procedure to be performed on the patient.

       9. The patient may elect to refuse treatment. In this event, the patient must be
           informed of the medical consequences of this action. In the case of a patient
           who is mentally incapable of making a rational decision, approval will be
           obtained from the guardian, next-of kin, or other person legally entitled to give
           such approval.

    10. The privacy of the patient, including matters concerning the patient's own
          medical care program, will be respected. Case discussion, consultation,
          examination, and treatment are confidential and should be conducted
          discreetly.

    11. All records and communications pertaining to the care of the patient must
          be treated as confidential.


    12. The healthcare facility, within its capacity, will be responsive to the request
          of the patient for service, as determined to be medically appropriate.

    13. In the event any investigative (Research) procedures are contemplated
          involving a patient, the patient will be fully advised and informed consent
          secured. The patient will not be included in the investigative procedures if
          such informed consent is not given. Any exception to the rule must be
          submitted to review by an approved mechanism which clearly provides
          protection of the patient's interests (i.e., Ethical Review Committee). No
          attempt will be made to influence the patient to give consent if he/she is
          reluctant to do so. In the case of patient that are considered mentally
          incapable of executing an informed consent, approval will be obtained from
          the guardian, next-of kin, or other person legally entitled to give consent.

    14. The patient will be provided continuity of care within the applicable laws and
          policies which govern the Veterans Administration and within the resources
          available. The patient's physician, or a designated employee, will provide
          appropriate guidance and recommendations for further medical care to the
          patient who is being discharged from the Veteran Administration medical care
          program.

     15. In the hospital setting, the physician responsible for the care of the patient,
          or the designated employee, will insure that discharge planning is initiated
          early in the period of hospitalization. The patient will be assisted, where
          necessary, in making appropriate plans for follow-up medical care,
          rehabilitation, and living arrangements after the episode of hospitalization.

    16. The patient will be provided with this healthcare facility rules and guidelines
          which apply to his/her responsibility as a patient.

    17. It is important that each employee recognize that the veteran patient has, in
         effect, pre-paid health care coverage by virtue of service in the Armed Forces
         of this country, and, has fully earned the right to medical care.

   18. All of the above concerns are equally applicable to veterans placed in
         Personal Care Homes and Community Nursing Homes under VA contract.
         The VA, non-VA staff and sponsors providing patient care in the community
         setting are expected to willingly assume responsibility for carrying out all
         elements of the Code of Patient Concern.

No set of guidelines alone will insure that the patient receives the kind of care and treatment that the Veterans Administration is committed to give. It is imperative, therefore, that each employee be concerned about each patient as a human being, and carry out the spirit and intent of this Code of Patient Concern.