Procedures for Hospital Admission
Requests for patients
We aim at providing better medical services in cooperation with patients. To build up trustful relations with patients we request the following points:
- Let us know the condition of a patient as accurately as possible.
- Please ask questions until you fully understand it if our explanation is difficult.
- Please be sure to follow the rules this guide shows.
- Please refrain from disturbing the other patients' medical care.
Preparations and Procedures before Hospital Admission
- Hospital admission is determined by a doctor depending on a patient's condition and bed occupancy.
- Please visit the hospital at the date and hour designated by a doctor for hospital admission. If the date should change due to the bed matters, you will be informed in advance. The patients who have already scheduled for hospitalization will be informed of the admission date and hour by bed management staff on the previous day of a date of admission (on Fridays of a previous week for those who plan to admit on Mondays).
- Please consult with your doctor if you cannot come to the hospital at the designated date and hour or you would like to cancel your hospitalization.
Procedures on the Day of hospital Admission
Please bring the following items and come the Hospital Admission Desk "5" on the 1st floor at the appointment date and hour.
|Application for hospital admission||The document handed over at the time the appointment for hospital admission was made.|
|Request slip for Visitors||The document handed over at the time the appointment for hospital admission was made.|
|Health insurance card||If you have the "Certificate of Eligibility for Ceiling-Amount Application," too, please show it together with health insurance card.|
|Medical certificate||If you have a "Medical Certificate of Elderly People," "Medical Certificate of Infants," "Medical Ticket on Welfare," "Medical Certificate of Physically Handicapped People" and the document related to the Workmen's Compensation, please show such (a) document(s).|
|Patient ID card|
|Your hanko or seal||* Please affix a seal on the application form for hospital admission.|
|Medicine currently taken||For details refer page 10.|
* No guarantee fee is charged for hospital admission.
- Fill a patient's or householder's name in the column of applicant on the application form for hospital admission.
- If you apply for public support while staying in hospital, please contact the Hospital Admission Reception on the 1st floor.
- Due to the limited space, please do not park your car while you are admitted into hospital.
Necessary items for hospital life
|Underwear, pajamas (front-open type if you are receiving operation)||3 or 4 pieces|
|Gown or jacket||1 or 2 pieces|
|Face towels, hand towels||3 or 4 pieces|
|Bath towels||1 or 2 pieces|
|Toilet articles (washbowls, tooth brush, soap, shampoo, hair brush, etc.)||if necessary.|
|Tissue paper||1 box|
|Non-slip room shoes (please avoid using slippers for risk of falling)||1 pair|
|Cups or glasses (shatter-proof ones)||if necessary|
Name display on each item is helpful.
The quantities mentioned above suit for staying about a week.
- Chopsticks are prepared in the hospital.
- For patients who will undergo an operation, nurses will explain the necessary items after your admission.
- Daily goods necessary to hospital life are available at the Kiosk on the 1st floor or from rental service providers (for a price), and also can be purchased at automatic vending machines (for details see page 13).
To infant patients
- Please prepare extra 2 or 3 pieces of clothes.
- The toys disturbing other infants, expensive or dangerous ones, are not supposed to admit into the hospital. Please consult a nurse if you bring any of them.
- Since snacks are given to infant patients at 3 o'clock in the afternoon, please refrain from bringing snacks in the hospital.
- Please let a nurse know the information about food allergies an infant patient has at a time of hospital admission.
Your attending doctor
Upon your admission, a doctor who provides medical treatment with you is determined and makes his/her effort to perform better medical service in cooperation with the director of respective medical department. If your doctor is absent, a team consisting of more than one doctor is formed to tackle with problems.
Your nurses continue taking care of yourself as a team.
Outing, going home for the night
For outing and going home for the night, permission from your doctor is necessary. Please consult your doctor or nurse in advance.
- For smooth medical care, please refrain from outing/going home for the night as much as possible.
- If you have to have outing/going home, please consult your doctor. Then, you have to fill in the Application for Outing/Going Home.
- The hospital, if you leave the ward (for example, to go to Kiosk), please let a nurse know. If you expect to come back to the ward later than the planned time, please contact the ward.
- In case of outing/going home without notice or unpunctuality in the return time applied, we may ask the police to search for a patient's whereabouts.
Regular rooms accommodate 6 people per room. (In principle, no request for bed location is accepted, at a window side or a corridor side.) Depending upon the medical department, private rooms (an individual room or a 2- person room) are available. For the charges of private rooms, see the accompanying sheet "Bookmark of Hospitalization Expenses."
Request of patients
- Depending on other patients' conditions, your room request cannot be always met even if you make the request at the time of appointment, on the day of admission, or for changing rooms after admission.
- Please understand you may have to move to other room while you are in a private room due to other patient's disease condition. In addition, your request for a room or bed location may not be fulfilled in respect of necessary medical treatment.
- Facilities like shower, toilet, etc. are installed in part of private rooms; 320 patients' ward (equipped with toilet) and 420 patients' ward (equipped with toilet and shower).
Name wrist band
We ask all the inpatients to wear a wrist band for safe medical care. In every occasion we need confirmation of patient's identity, including drip infusion, injection, blood transfusion, test, treatment, paper handling, etc., we confirm a patient's name by the use of his/her wrist band. Your cooperation is needed for this purpose.
Name display on room door and bed side
To provide safe medical services, your name is displayed on the room door and the bed side. If you feel it inconvenient or unnecessary, please consult a nurse.
To Make a Stay in Hospital Comfortable
- Please refrain from bringing valuables and large amount of money into your room. Keep valuables like cashes by yourself. In principle, we do not keep cash and valuables.
- Please do not bring dangerous articles like knives and others.
- Please cooperate to separate trash. Do not throw away cutlery into a trash in the room and let a nurse know.
- To protect a patient's privacy, we do not answer to any phone inquiry about a patient and do not receive any messages from outside the hospital. If you need to contact somebody, please make the contact by yourself. We just inform a patient of the fact that he/she was called.
- Lights-out time is 9:30 p.m. Please refrain from lighting up or watching a TV after the lights-out.
- The hospital is entirely smoke-free.
How to use a card-system pay TV and refrigerator
- To watch television you need a prepaid TV card and a set of earphones.
- A TV card is available at a vending machine located in the elevator hall on each floor. (Please use a bill of JPY 1,000.) You can have TV viewing for about 15 hours (900 minutes) with a card of JPY 1,000. (BS broadcasts cannot be viewed.)
- Earphones are available at the vending machine in front of the Medical Consultation Desk on the 1st floor.
- To use a refrigerator, the TV card works as it does with a TV.
- You can use the refrigerator for 24 hours with a card of 200 degrees (JPY200).
- Please note that you cannot have a card balance refunded on the refrigerator use.
- A fee adjustment machine is placed in front of the Medical Consultation Desk. You cannot get the card balance refunded if it is less than 9 degrees.
- For details please see the instruction sheet equipped with a bedside cabinet.
- A cashbox is designed to be locked with a card key. (Please carefully keep your valuables, cash cards and health insurance card.)
About the use of mobile phones
You can use your mobile phone in a designated area like a Day room on each floor. Please be considerate of others when you use a mobile phone.
About the use of electric appliances
- Electric appliances you can bring in and use are as below. (As the usable appliances are different in the ward on the 3rd floor, please check with a nurse.)
|Appliances||Place for use||Remarks|
|Note PC including Tablet||Day room (Internet access is possible with your own cabled Wi-Fi-PHS)||If approved by doctor|
|Radio, Radio-cassette, CD/DVD player||Bedrooms, Day room (Only battery operation in a Day room)||Allowed only with earphones|
|Electric razor||Bedrooms, Toilet in the ward|
|Dryer||Toilet in the ward|
|Electric tooth brush||Bedrooms, Toilet in the ward|
|For other appliances please consult your doctor or nurse.|
The appliances that you cannot bring in
TV, heater, electric stove, portable refrigerator, coffee maker, electric pot, juicer, oven toaster, etc.
- Usable hours
From 6:00 a.m. to 9:30 p.m.
- Cautions for using
- Do not disturb other patients.
- Be sure to switch off after the use.
- Follow staff's instruction.
- Cases the use is not permitted
- If a doctor or nurse judges a patient is badly affected in a respect of medical treatment,
- If other patients feel uncomfortable from the use of (an) electric appliance(s),
- If the device has danger of fire,
- If the machine is out of standards
- If a certain reason arises other than above.
- Electricity fee
- Management of (an) electric appliance(s) brought in.
A patient is responsible to keep the appliance(s) he/she has brought in. Please note that the hospital is free of any responsibility if some troubles or defects should occur. The same applies to a case where PC data vanishes due to power failure.
The hospital takes care of all the inpatients' nutritional care. The meals are prepared considering the nutritional balance for each patient. The salt amount of salt in ordinary meals is less than 10 grams per day.
Kinds of a meal
There are an ordinary care meal, a special care meal and a test meal. An attending doctor selects appropriate one for the patient's condition. If you do not accept a certain food due to allergy, please let a ward nurse know.
|Breakfast||7:40 -||For breakfast, steamed rice is basically served, but bread is served upon request. Ask a nurse.
For details, please see a menu on the bulletin board.
* Chopsticks are prepared.
* From a medical cure point of view, some food may be restricted.
* When you would like to bring in food by necessity from outside, please consult a doctor or nurse.
Meals for special occasions
Japanese habitual food is taken in a menu with the special occasions and seasonal events including Shougatsu (new year holidays), Setsubun (winter end ceremony), Hinamatsuri (girls' festival), etc.
For lunches on weekdays from Mondays through Fridays, two selections are offered to the patients who usually take ordinary or expectant mothers' meal. (Please note, however, that your selection may not be available because some wards do not adapt this service or some kinds of food are not appropriate to your medical care.)
Meal fee (Standard charge)
One meal costs JPY 260.
* If you have any questions about meals, please talk to a nurse. A managerial dietician will make a call at you to answer to the questions if as necessary.
* If you need nutritional guidance, please consult your doctor. Several classes are open for diabetic diet, low-salt diet and nephritic patients' diet as well as individual nutritional guidance. Please use these classes.
To the patients who currently take any medicine
When you are admitted to the hospital, please bring the medicine currently taking. If you have the following documents indicating the content of your medicine, please bring both of the following to the hospital.
This is a special notebook which describes the names of medicine you received from a hospital or a pharmacy, dose method, instruction of use, etc.
Description Sheet on Each Medicine
This is a printed sheet you received from a hospital or pharmacy which describes the names of medicine, direction of use, beneficial effects, etc.
About trouble prevention and in a case of disaster
Safety box is the size that can accommodate purse and accessories. Safety box is equipped on the bedside table. Please be locked always, for theft prevention.
Each floor has Emergency exits.
Please follow the instructions of staff at the time of disaster.
Please do not use the elevator at the time of the evacuation.
Elevator will stop when the earthquake occurs.
For reasons of security or safety, we have a surveillance camera in some rooms and at the hospital entrance.
About public nuisances
- Please note that if a certain patient's act of public nuisances described below can be thought to be a serious obstacle against the operation and management of hospital, The patient may be refused to continue receiving medical services and forced to discharge from the hospital.
- Cause a problem for medical treatment like violence verbal abuse, loud voice, intimidation, sexual harassment, etc. against other patients or hospital staff.
- Go outside the hospital without permission.
- Give damages against the buildings, facilities and equipment.
- Enter other rooms or off-limits area.
- Drink or smoke in designated non-smoking area.
- Bring in dangerous articles.
- Violate against the hospital rules and regulations mentioned in the guide for hospital admission.
About Discharge and Changing Hospitals
This hospital is operated as a disaster emergency hospital with an advanced medical service mission.
Because of this, if the patient's symptoms are stable and if the doctors judged it completes the inpatient care at the hospital, you are asked to discharge or change to other medical institutions, etc.
Thank you for your understandings and cooperation about this.
About the Discharge of the hospital
- Unless special circumstances happen, as a principle, 10:00AM is time limit of discharge.
- Discharge of the hospital depends on the decision of your doctors.
- After the discharge of the hospital, the patient who needs further treatment is asked to receive medical treatments at the institutions from where they were sent to this hospital.
- For the patients hospitalized in emergency who do not have an introduction from other medical institutes, we would introduce patient a local medical institution or a hospital in places you like, for the after treatments.
About the changing hospitals
- Patients with stable symptoms and conditions are asked to change to a suitable medical institute consulting with the medical institution who introduced this hospital.
- About discharge, we this hospital respect the wish of the patient and try to introduce an appropriate medical institution. Patient may be consulted in an early stage.
When Certificates etc. are required
If you need a medical certificate or other certificates, after the discharge, please fill out an application form at the 1st floor (6) in the document desk. Usually it takes 2 weeks for delivery. If any other person is to apply, a letter of proxy is required.
* If you need documents during the hospitalization, please come to the 1st floor in the document desk (6) with the hospital ID card and fill out the application form.
Reception time: Weekdays 9: 00-16: 00, Sat 9: 00-12:00
* In order to improve our services, please cooperate to answer the questionnaire when you discharge from the hospital.
* If you have opinions and requests, please fill your comments in the form of "your comments" to feedback to the hospital and put it into the feedback box. The box is located on the first floor.
Payment of Expenses
About the calculation of the Expenses
Hospital expenses made up of the medical expenses, meals, special charges, document fees etc. Calculation of the expenses follows to the health insurance. For more information, please see the separate bookmarks for the hospitalization.
* Unlike the hotels and other accommodation, count of the stay starts from the midnight time 0:00 in the hospital. Expenses of 1 night and 2 days hospitalization will be calculated as two days.
Payments during the hospitalization
- During the hospitalization, the invoice of previous month will be delivered to you around 10th every month.
- Payment will be accepted at the cashier desk (8) on the first floor.
|Monday to Friday||9:00-17:00|
* Since the cashier is crowded in the morning time, it is appreciated if you come between 14:00 and 16:00 during weekday.
Payment at discharge
- The hospital invoice will be available in the morning at your ward. Please make the payment at the Cashier desk (8) on the 1st floor.
- Outpatient booking tickets for next time will be given to you together with a receipt. Please keep the receipt since they are needed as a proof of medical expenses and for tax medical deduction.
- [Discharge card] will be given to you. Please give that to a nurse of the ward and follow with the discharge process.
- Patients who cannot make the payment at discharge from the hospital. Please contact with the cashier (8) on the first floor.
- Please note that we may need to charge you additions fees after leaving hospital due to various reasons.
You can use Credit card payments at the office, in addition to cash payments, payment by Bank transfer (bank transfer fees would be at patient) and Cash by registered mails.
Mizuho bank Shibuya branch Ordinary deposit account
Account No. 250379
Account name :
Toukyoutoritsu Hiroobyouin Kigyousuitouin
Cash by registered mail
2-34-10, Ebisu, Shibuya-ku,
Tokyo Metropolitan Hiro Hospital
Medical affairs division
* When the transfer is made, please fill the name and registration number of the patient on the transferor form.
Contact: medical affairs Division telephone 03-3444-1181 (Main) Ext. 202
Facilities and Services in Hospital
Public telephone (each ward, etc.)
Please use the public telephone calling cards.
International calls are available at odd-numbered floors.
Coin-operated laundry (each ward)
They are located in each ward. (Use a laundry (exclusive use) card. Washing: 200 yen for 1 time; Drying: 100 yen for 1 time, 30 minutes)
Hiroo library (2nd floor)
This is a library filled with books mainly donated. You can use it at free. Please return the books after reading to the library without fail.
Patient information corner (2nd floor)
There are medical books, etc.. Please use it freely.
Reception of rental service (1st floor)
The hospital necessities such as clothing, towels, and slippers can be rented with the fee.
ATM services (front entrance at 1st floor)
You can withdraw money with cards of such city banks from ATM. You may be charged for handling fee.
|Sunday, National holidays||Not in service|
Shop (1st basement floor)
Household goods, towels, underwears , earphones, newspapers, magazines, etc. are sold. Moving sales to the Ward are also available. Courier services are accepted as well.
* Different operation time for new year holidays.
|Saturday, Sunday, National holidays||7：00～21：00|
Restaurant (1st basement floor)
Set menus, dishes, drinks, etc. are available.
* Different operation time for new year holidays.
|Saturday, Sunday, National holidays||1：00～16：00|
Barber shop in the hospital (1st basement floor)
You need to make a reservation and pay the fee. (Direct-dial telephone 03-3449-7758)
Cleaning service in the hospital (1st basement floor, laundry room)
It can be used with the fee. Please ask your nurse.
Vending machines for various things
Tea, milk, juices, etc. (1st basement floor); night wears, towels, disposable diapers, etc. (1st floor).
To Families and Visitors
For the treatments and rest of the patients, followings are the visiting time in principle. Thank you for your understanding and cooperation.
|130ward, 810ward||Please ask at the wards|
|The other wards||11：00～21：00|
* Please consult your nurse about after-hours visits.
Flow of the visiting
- Please take the visitor's procedure at the reception of the side of the front, 1st floor.
- Please visit the room with a "meeting badge" on chest.
- Please return the" meeting badge" to the reception desk when you go out of the hospital.
Requests for the visitors
- Since there are risks of accident and infection, entries to the patient's rooms are prohibited for the families with children (less than 6 years old and less than 12 years old for only the children's ward).
- Visitors may be declined or asked for waiting for a while due to patient's condition, medical, nursing etc.
- Visiting under the influence of alcohol is strictly prohibited
- Please refrain from staying long and in large numbers for other patients as possible.
- Please eat and drink only in the dayroom, and use mobile phones only at the places allowed.
- Patients are sensitive to smell due to the condition of health and the effect of medicines. Please refrain from using perfumes or hair dressings.
- Fresh flowers may cause an allergy. Into Pediatrics, Pulmonology, Emergency Center and Intensive care unit, please do not bring them.
- If you have a cold or sicknesses, please refrain from visiting.
- We may set a limit of visiting in the time of infection disease epidemic such as flu.
Accompanied by families
It is not necessary to have a family accompanied in the hospital since the nurses in the hospital are taking care of the patients. However, if you like, due to medical conditions, or other circumstances, you can consult with your doctor or nurse.
You can send e-mails from home-pages of the hospital to the hospitalized patients. Please enter from top-page and access to the e-mail section.
Medical consultation room, Discharge coordination department and Nursing consultation room (1st floor)
We have a consultation service to the families of the patients hospitalized or having treatments in the hospital.
(Ext.) 2017-2019・2036(Medical consultation)
(Ext.) 2424 (Discharge coordination Department)
(Ext.) 2470 (Nursing consultation)
- Fears and worries caused by disease or injury.
- Troubles with your family and works.
- Subjects accompanied by the discharge from the hospital
- Medical expenses and the living cost.
- The social insurance and welfare system.
Social workers will take care of the consultation on the living for free.
(An advance reservation is needed)
Discharge coordination Department, Nursing consultation
- Preparation of home care before discharge
- Introduction of the visit nursing stations
- Introduction of nursing care, medical equipment and handlings.
- How to care.
- Home medical care and others
Nursing consultation is free of charge. However, you may be charged "home teaching management fees" depending on the consultation.
Patient consultation counter (on the 1st floor, Medical affairs section)
For the improvement of services to the patients, your opinions and complaints about the treatments in the hospital are welcomed.
Please call to the staff of General information, service counters, nurse's station. Your voices will be conveyed to the persons responsible.
(An advance reservation is needed)
About Personal Information
To offer the medical care with confidence to the patients in this hospital, personal information is handled as described below.
Handling of the personal information
The purpose of using personal information of the patient is posted at the waiting Hall on the first floor, in each ward and Web site. (As follows)
The personal information are properly managed and we do not give the information to third parties or use it beyond the purpose of use without your consent unless it is required by the law.
Protection of Personal Information
You can refuse to tell visitors your room or ward. Please ask ward nurses.
Hospital room and bed name
You can hide your name displayed at the hospital room.
Please ask ward nurse.
* Please fill out the form of admission procedures.
Disclosure of the personal information
You, as a patient, or legal representative of the minor or adult patient, can request disclosure of the information of the patient held by the hospital.
Method of disclosure
- Browsing and viewing
Free of charge
- Issuance of a duplicate
It is charged depending on the type and quantity of the disclosed documents.
* Please contact the medical office on the first floor for more information.
Handling of Patients' Personal Information
In the hospital
- Improvement and medical services provided to patients, etc.
- Medical insurance affairs
- Ward management of hospitalization etc.
- Accounting & finance
- Report of medical accidents etc.
- Cooperation to the medical training held in the hospital
- Case studies aimed at improvement of the quality of medical care
Use for the information outside of the hospital
- Cooperation with other hospitals, clinics, pharmacies, home-visit nursing care station, nursing service providers
- Responses to referrals from other medical institutions, etc.
- Requesting for opinions and advices for patients from doctors outside
- Subcontracting to sample inspection services, etc.
- Explanation of the condition to the family, etc.
- Insurance contract
- Submission of medical remuneration statements (claims) to the agency of payment.
- Responses to referrals from the payment review organization or insurer
- Notification of the results related to the entrusted company, health business operators, etc.
- Notification or consultation of Medical doctor compensation contributions insurance to professional organizations, insurance companies and etc.
- Offer the information to external auditing organizations
- Basic materials for the maintenance and improvement of medical care services and operations
Using Samples Obtained through Medical Care for Research Purposes
Samples of treatments, upon agreement in advance, will be utilized in future research (a comprehensive agreement).
The samples will be handled to protect individual terms and conditions. Furthermore, "gene analysis associated with hereditary nature" is exempt from this comprehensive agreement as below.
Targeted samples, etc.
- Medical records
- Imaging information (x-rays, endoscopic photography, etc.)
- Biopsy samples for diagnosis
- Tissue removed during surgery
- Test samples (blood, urine, etc.)
- Gifts to officials are strictly prohibited.
- Please write patient's name always on mails to hospitalized patients.
- Please accompany interpreters with patients who cannot speak Japanese as much as possible to provide proper medical care.
- We, as a teaching hospital, accept trainees, medical students and pharmacy students, nurses, including midwifery students, certified nurses, emergency medical technicians and paramedics.
Please note that nursing, laboratory, surgery, etc. of the patients in the hospital are observed sometimes.