Medical Errors and You: Tips to Keep You Safe

Everyone has a role in making health care safe -- doctors, nurses, technicians and healthcare executives work together to come up with measures that should help keep you safe and avoid medical errors during your hospitalization or even during simple diagnostic procedures. In recent years healthcare organizations across the country are working to make health care safety a priority.

You, as the patient, can also play a vital role in making your care safe by becoming an active, involved and informed member of your health care team. In the case of adolescents and young who may very well be anxious and confused about facing chronic illness, serious medical condition or emergency, parents, family members and adult friends can help keep their loved one safe by also becoming actively informed and involved during medical visits and hospital stays. An Institute of Medicine (IOM) report has identified the occurence of medical errors as a serious problem in the health care system.

The IOM recommends, among other things, that a concerted effort be made to improve the public's awareness of the problem. The Joint Commission on Accreditation of Healthcare Organizations, urges patients to get involved in their care and sponsor the "Speak Up" program. Their efforts to increase consumer awareness and involvement are supported by the Centers for Medicare and Medicaid Services.

The "Speak Up" initiative provides simple advice on how you, as a patient or your parents and friends with your permission and acting as your advocates can make your healthcare experience a positive one. Research shows that patients who take part in decisions about their healthcare are more likely to have better outcomes. Outline here are the principles of the "Speak Up" program.

SPEAK UP ~~ IF YOU HAVE QUESTIONS OR CONCERNS OR IF YOU DON"T UNDERSTAND ~~ ASK AGAIN

• It's your body and you have a right to know. Your health is too important to worry about being embarrassed if you don't understand something that your doctor, nurse or other healthcare professional tells you.

• Don't be afraid to ask about your safety. If you're having surgery for example, ask the doctor to mark the area that is to be operated upon, so that there is no confusion in the operating room.

• Don't be afraid to tell the nurse or the doctor if you think you are about to receive the wrong medication.

• Don't hesitate to tell the health care professional if you think she or he is confusing you with another patient.

PAY ATENTION TO THE CARE YOU ARE RECEIVING.

Make sure you're getting the right treatments and medications by the right health care professional.

• Don't assume anything !

• Tell your nurse or doctor if something doesn't seem quite right.

• Expect health care workers to introduce themselves when they enter your room and look for their identification badges.  A new mother, for example, should know the person to whom she is handing her baby. If you are unsure, ask!

• Notice whether your caregivers have washed their hands. Hand washing is the most important way to prevent the spread of infections. Don't be afraid to gently remind a doctor or nurse to wash their hands BEFORE touching you.

• Know what time of day you normally receive a medication. If it doesn't happen, bring this to the attention of your nurse or doctor.

• Make sure your nurse or doctor confirms your identity, that is checks your wristban or asks your name, before he or she administers any medication or treatment.

EDUCATE YOURSELF ABOUT YOUR DIAGNOSIS, THE MEDICAL TESTS YOU ARE UNDERGOING AND YOUR TREATMENT PLAN.

• Ask your doctor about the specialized training and experience that qualifies him or her to treat your illness (and be sure to ask the same questions of those physicians to whom he or she refers you).

• Gather information about your condition. Good sources include your doctor, your library, respected websites and support groups.

• Write down important facts your doctor tells you, so that you can look, for additional information later. And ask your doctor if he or she has any written information you can keep.

• Thoroughly read all medical forms and make sure you understand them before you sign anything. If you don't understand, ask your doctor or nurse to explain them.

• Make sure you are familiar with the operation of any equipment that is being, used in your care. If you will be using oxygen at home, do not smoke, or allow anyone to smoke in the home while oxygen is in use.

ASK A TRUSTED FAMILY MEMBER OR FAMILY FRIEND TO BE YOUR ADVOCATE.

• Your advocate can ask questions that you may no think of while you are under stress.

• Ask this person to stay with you, even overnight, when you are hospitalized. You will be able to rest more comfortably and your advocate can help make sure you get the right medications and treatments.

• Your advocate can also help remember answers to questions you have asked , and speak up for you if you cannot.

• Make sure this person understands your preferences for care and your wishes concerning resuscitation and life support.

• Review consents for treatment with your advocate before you sign them and make sure you both understand exactly what you are agreeing to.

• Make sure your advocate understands the type of care you will need when you get home. Your advocate should know what to look for if your condition is getting worse and whom to call for help.

KNOW WHAT MEDICATIONS YOU TAKE AND WHY YOU TAKE THEM.

Medication errors are the most common health care mistakes.

• Ask about the purpose of the medication and ask for written information about it, including it's brand name and generic name -- writte them down --also ask about potential side effects and allergic reactions to the medication, specially if you have never taken it before.

• If you do not recognize a medication, verify that it is for you. Ask about oral medications before swallowing, and read the contents of IV (intravenous) Fluids bags. If you are not well enough to do this your advocate should do this for you.

• Whenever possible make advanced arrangements to have a personal advocate (trusted family member or friend) with you most of the time during your hospital stay.

• If you are given an IV as the nurse how long it should take for the liquid to "run out". Tell the nurse if it doesn't seem to be "dripping" properly (for example if it's going too fast or too slow).

• Whenever you are going to receive a new medication, tell your doctors and nurses about all your allergies or negative reactions to medications you may have had in the past.

• If you are taking multiple medications, ask your doctor or pharmacist if it is safe to take those medications together. This holds true for vitamins, herbal supplements and over the counter drugs too.

• Make sure you can read the handwritting on any prescriptions written by your doctor. If you can't read it, the pharmacist may not be able to either.

USE A HOSPITAL, CLINIC, SURGERY CENTER, OR OTHER TYPE OF HEALTH CARE ORGANIZATION THAT HAS UNDERGONE A RIGOROUS ON-SITE EVALUATION AGAINST ESTABLISHED, STATE-OF-THE-ART QUALITY AND SAFETY STANDARDS SUCH AS PROVIDED BY THE JOINT COMMISSION.

• Ask about the health care organization's experience in treating your type of illness. How frequently do they perform the procedure you need and what specialized care do they provide in helping patients get well ?

• If you have more than one hospital or other facility to choose from, ask you doctor which one offers the best care for your condition.

• Before you leave the Hospital or other facility, ask about follow-up care and make sure that you understand all of the instructions.

• Go to Quality Check at http://www.jcaho.org/ to find out whether your hospital or other health care organization is accredited.

PARTICIPATE IN ALL DECISIONS ABOUT YOUR TREATMENT

You are the center of the health care team. You and your doctor should agree on exactly what will be done during each step of you care.

• Know who will be taking care of you, how long the treatment will last, and how you should feel.

• Understand that more tests and medications may not always be better. Ask your doctor what the new test or medications are likely to achieve.

• Keep copies of your medical records from previous hospitalizations and share them with your health care team. This will give them a more complete picture of your health history.

• Don't be afraid to seek a second opinion. If you are unsure about the nature of your illness and the best treatment, consult with one or two additional specialists. The more information you have about the options available to you, the more confident you will be in the decision made.

• Ask to speak with others who have undergone the procedure you are considering or must have. These individuals can help you prepare for the days and weeks ahead. They also can tell you what to expect and what worked best for them as they recovered.

GENERAL TIPS TO REMEMBER

• Remember that there is no stupid question or concern.

• If anyone in your healthcare team is too busy to answer your questions or clarify your concerns and spend the time necessary to make you feel comfortable ask to speak to their supervisor.

• In the case of your doctor or surgeon request an appoinment just to talk and go over your concerns if necessary.

• Make sure the necessary consent forms identify your healthcare proxy and/or advocate. Many hospitals have a universal form you can sign upon admission that specifies who you have designated as your healthcare proxy or advocate. Whenever possible, make sure you ask for this form before you are admitted.