Exceptions to Caregiver and Approved Visitor Procedures

These are the only exceptions to the Dartmouth-Hitchcock caregiver and approved visitor procedures.

These exceptions will be managed by door screeners when existing notification and authorization steps are followed. Inpatient and ambulatory staff will use “caregiver exception codes” for the patient or caregivers to provide upon arrival.

An individual provider may not override or otherwise contradict these procedures. Immediate requests for exceptions in unique circumstances may only be made by, and in consultation with, the inpatient unit nurse leadership or outpatient clinic nurse manager or practice manager.

Patients requiring caregivers

A “caregiver” is defined as a family member, friend, or other support person whose presence is required for physical, cognitive, or other support (such as a driver for sedated outpatients) associated with the patient's health care.

Patients who otherwise would not be able to navigate to their appointment without the active support of a caregiver (for example cognitively impaired or physically challenged patients) are permitted to have 1 caregiver accompany them.

Pediatric patients

As space and other conditions permit, inpatient pediatric (including neonatal) patients may have up to 2 adult primary caregivers (parents or legal guardians) with them. During hospitalization, the 2 designated caregivers should be the same 2 people to the greatest extent possible. The designated caregivers for hospitalized pediatric patients with possible or diagnosed COVID-19 should remain with the patient in the patient's room during the patient's stay.

Ambulatory (outpatient) pediatric patients are permitted 1 adult primary caregiver for a clinic visit. We will work with our patients' parents or guardians to accommodate special circumstances, but exceptions must be approved by the appointment provider prior to arrival for the visit.

Labor and delivery patients

1 caregiver or partner may be present through labor, delivery, and post-partum care at DHMC.

Outpatient prenatal patients

Prenatal patients are welcome to bring 1 adult caregiver or partner with them to their prenatal and ultrasound visits.

Emergency Department

  • Pediatric patients (under age 19) may have 2 adult primary caregivers (parents or legal guardians)
  • Patients 65 years and older may have 1 visitor per patient stay
  • Patients at end of life may have 2 visitors
  • Patient requiring a caregiver due to a medical condition may have 1 family member accompany the patient to triage. The triage nurse will determine if the family member may stay

Perioperative patients

For adult patients receiving same-day care in our interventional areas, 1 caregiver is allowed into the facility in order to accompany the patient during their check-in and pre-procedure preparation (as appropriate). The caregiver must remain in the local waiting area during the procedure, and be available for consult as required. Pediatric patients may have up to 2 caregivers accompany them for their procedure.

These same-day care areas include:

  • The CHaD PainFree program
  • Cardiac catheterization and electrophysiology labs
  • Endoscopy
  • Interventional radiology (the use of minimally invasive, image-guided procedures to diagnose and treat disease.)
  • Selected radiology studies
  • Surgical procedures

For patients with planned admission after the interventional procedure, the caregiver will have the option of departing once the procedure has started. The caregiver will receive a telephone update from the provider or they may remain in the waiting area and consult with the provider in person upon completion of the procedure. If the caregiver elects to remain for the in-person consult, they will not be allowed to visit the patient until they have been recovered and admitted.

Family meetings

For family meetings, 2 family members (as designated by the patient) may attend. When applicable, 1 of the attendees should be the surrogate or stand-in decision maker or Designated Power of Attorney (DPOA). 1 additional person may attend to support the DPOA. Both family members may attend the meeting in person. Other interested family members may be present by phone.

Once the family meeting has concluded, if the patient is not designated “for comfort measures only” (CMO), each of the 2 people present for the family meeting can visit the patient for up to 30 minutes.

Patients at the end of life

Patients at the end of life are defined as:

  • Patients who are expected to die within 24 hours, as determined by the attending physician of record; patients who are designated as “for comfort measures only” (CMO)
  • All patients at the Jack Byrne Center for Palliative & Hospice Care

3 total designated visitors are allowed. All 3 visitors may be in the room at one time. “Rotation” of visitors is not allowed. There are no exceptions for larger groups of visitors.

Official hospital or clinic volunteers

Employees of Dartmouth-Hitchcock and volunteers are considered “essential employees.” As such, they are exempt from the visitor procedures.