EDITOR'S NOTE: This article was originally published in the June 2007 issue of Kiplinger's Retirement Report. To subscribe, click here.
Should Bill Wright ever require hospital care, he's determined that he will not be harmed by a medical mistake. Wright, 76, a retired college-admissions dean who lives in Kent Island, Md., intends to take with him an updated medical history, which includes past procedures, a list of his medications and contact information for his physicians. He's also identified a list of family and friends who are willing to take turns, he says, "to keep an eye on what's going on" during a hospital stay.
Wright is not being unduly nervous. Nearly 100,000 people die each year in U.S. hospitals because of medical error. Another 90,000 patients die from infections that they pick up in the hospital, according to the Centers for Disease Control and Prevention.
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"Hospitals can be pretty chaotic places," says Carolyn Clancy, director of the federal Agency for Healthcare Research and Quality. So patients themselves need to take measures to guard against medication mistakes, infections and carelessness, such as serving a high-salt meal to a patient who's on a salt-free diet.
The first step to reduce your chances of being victimized by errors is to choose the right hospital. Research shows that patients tend to have better results when they are treated in hospitals that have significant experience with their medical conditions. Several Web sites, including the federal government's www.hospitalcompare.hhs.gov, list hospital performance based on patient volume by procedure, death and complication rates and other important data.
Don't Be Shy, Ask Questions
Once you're in the hospital, you need to ask questions. If you're being taken for a test, make sure the attendants have the right patient. Inquire why a CAT scan or other procedure is being performed and then ask for an explanation of test results. Having such information is a check on the system just in case the record never makes it to your file or into your doctor's hands. "Patients who ask questions and who are engaged in their care have better outcomes," Clancy says.
It's also a good idea to ask a close friend or relative, or perhaps several on a rotating basis, to act as an advocate, says Wright. An advocate can ask questions if you're uncomfortable doing so or ask additional questions. It's also a good idea to have someone else in the room when you're speaking to medical personnel to reduce confusion later.
Wright became impassioned about patient safety after reading about several horrific mix-ups. He now teaches a patient safety course at a community college. He suggests that the advocate keep a journal tracking test results, treatments and all medications. These notes can serve as a guide to the patient and to the next person on duty.
Medication errors are among the most common types of mistakes. Carry an updated list of all of your medications and prescribed dosages. Make sure that any medicine given to you has your name on it, either on the label or on the prescription-order sheet. Another precaution is to ask the health-care workers if they've washed their hands before treating you. Although hand washing can prevent the spread of infections, studies show that medical personnel don't wash their hands regularly or thoroughly. Before going into the operating room, make sure you and your surgeon are clear on what will be done, Clancy says. Surgeries performed on the wrong site are rare, but they do happen.
Before you leave the hospital, ask the nurse for a copy of your care plan. The plan should include instructions on follow-up visits and on medicines you should take after you leave the hospital. To prevent harmful drug interactions, ask whether you should stop taking medicine you were taking before you entered the hospital.
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