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Patient safety starts with you

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Patient involvement reduces medical errorsHealth care is not always as safe as we would like it to be. More than 10 years ago, the Institute of Medicine came out with a groundbreaking report that found that as many as 44,000 to 98,000 people die in American hospitals each year as a result of medical errors. What can consumers do to make sure they have a safe experience when they get health care?

Medical errors happen when what was planned as part of medical care does not work out, or when the wrong plan was used in the first place.) While there have been many efforts to improve safety over the last decade, progress is slow. Medical errors can happen anywhere you get your health services: in hospitals, clinics, a doctor’s office, nursing homes, pharmacies, and even in the patient’s home.

The best way you can help prevent errors is to be an active member of your health care team. That means taking part in decisions being made about your health care. Research shows that patients who are involved with their care tend to get better results. You can get better and safer care by asking questions about your diagnosis, treatment options, how you’re being cared for, and any medications prescribed for you.

Become an informed consumer.

Before seeking care, gather information about the illness or condition that affects you. Use reliable sources (like government Web sites such as the National Guideline Clearinghouse, Centers for Disease Control and the National Institutes of Health). Research options and possible treatment plans.

Choose a doctor, clinic, or hospital experienced in the type of care you require. For example, see the website developed by the Centers for Medicare and Medicaid Services, Hospital Compare, for information on comparing hospitals.

Keep track of your own medical history and your medications.

Write down your medical history, including medical conditions you have, illnesses, and hospitalizations. Keep track of all your medications (both prescription and over the counter) and dietary supplements (vitamins and herbs). This is called a personal medication record (PMR). There are several formats for keeping a PMR, and you should pick what works best for you.  Share all this when you visit the doctor, or go to the hospital or clinic.

Be a part of the team.

It’s your job to work with your doctor or other health care providers. Clear communication between patients and those that are taking care of them is critical to improving safety and reducing the risk of medical errors.

Make sure you share your health history and medication use with your team. The PMR is a good way of doing that.

Make sure you understand the care and treatment you are going to receive. Ask questions! The Ask Me Three program from the National Patient Safety Foundation encourages patients to ask their team these three important questions:

  1. What is my main problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

Follow the treatment plan agreed upon by you and your doctor. Make sure you receive the instructions verbally AND they are written down for you.

Get a partner.

Involve a family member or friend in your care. Ask a family member or friend to be with you in the hospital or come along to appointments to speak up for you if you can’t. They can help you understand care instructions and be your advocate when it’s time to make decisions. It helps to have a second set of ears, especially if you are nervous or distracted about your condition.

More tips for: hospital stays

 

  • Don’t be afraid to remind doctors and nurses about washing their hands before working with you. You are part of the health care team and it is okay for you to remind them. Hand washing is one of the best ways to stop hospital infections, including the MRSA infection, which can be very serious.
  • If you are having surgery, make sure that you, your doctor and surgeon all agree and are clear on what exactly needs to be done. Some surgeons sign their initials directly on the site to be operated on before surgery.
  • If you have an intravenous catheter, to prevent infection tell you doctor or nurse if the bandage comes off or there is soreness around the catheter.
  • If you have a urinary catheter, make sure it is removed as soon as possible to prevent an infection. Ask your health care team every day if it can be removed.
  • Quit smoking. Patients who smoke get more infections.
  • When you are being discharged, ask your doctor to explain the plan to you, and write it down so that you understand what you need to do. Research shows that at discharge, doctors think their patients understand more than what they really do about what they should do when they are at home.

 

More tips for: medications

 

  • Make sure ALL your health care providers know ALL the medications, both prescription and OTC, as well as dietary supplements such as vitamins and herbs, that your are taking. Keep a Personal Medication Record (PMR), make sure it is up to date, and share it with your health care provider.
  • Tell your health care providers about any allergies and adverse reactions you have to medications.
  • When your health care provider write you a prescription, make sure you can read it and know what medicines you are being prescribed.
  • Ask about your medicines when you are prescribed them and when you receive them. Ask:
    • What is it for?
    • How long do I need to take it?
    • What side effects are likely, and what should I do if I have them?
    • Can I take it with other medicines and dietary supplements?
    • Is there any food or alcohol that I need to avoid while taking?
  • When you pick up your medicine at the pharmacy, ask if this is the medicine that was prescribed. Most medication errors involve the wrong drug or wrong dose.
  • If you have questions about the directions on the medicine label – ask!  Medicine labels can be hard to understand.  For example, does “three doses daily” mean take a dose every eight hours around the clock, or just during waking hours?

 

For more on this subject

National Patient Safety Foundation

Agency for Healthcare Research and Quality (AHRQ)

AHRQ's Questions are the Answer

Fact sheets on Health Care Associated Infections (English, Spanish, and Large Print)

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