June 18, 2008

1. Insist on hand-washing
“Before you’re touched, the first question should be, ‘Did you wash your hands?’” stresses Peter Pronovost, MD, of Johns Hopkins University School of Medicine in Baltimore. It’s a must before any provider puts in or removes an IV or a catheter, gives you medication, or changes a dressing.

2. Find a hospital that’s high-tech
See if your hospital is investing in technology that cuts error rates, says David Bates, MD, from Brigham and Women’s Hospital in Boston. Things to look for: the use of a CPOE—computerized physician order entry—system, which reduces drug errors; bar codes on drugs to lower dispensing mistakes; and smart IV pumps for delivering intravenous medication accurately. Also, check to see if the intensive care unit has “smart monitoring,” a computer that alerts staff when help is needed.

3. Do a background check before you go
Find out if your hospital ranks high in safety with The Leapfrog Group and Hospital Compare ratings. Conduct your own survey of friends, family, coworkers, and neighbors too, so you can find out what they think of area hospitals.

4. Make friends with your hospitalist
“The majority of hospital patients in the United States are no longer cared for by their primary care doctors, but by a hospitalist. She should act as your advocate and coordinator of care in the hospital,” says Robert Wachter of the University of California, San Francisco. (If you aren’t assigned one, ask your primary care doctor to play that role.) It’s a good sign if your hospital also assigns you a nocturnist; these MDs specialize in caring for patients at night, when hospitals have skeleton staffs, which increases the risk of errors and treatment delays.

5. Be friendly—but not too friendly
Stay congenial, but save the chitchat until after the staff has administered meds or checked your vitals. Even little interruptions can be distracting enough to cause a slipup.

6. Insert yourself in the loop
Anytime something has being done to you—a nurse hanging medication (for an IV), an orderly wheeling you out for a test—you should understand why, Dr. Pronovost says. If you don’t, ask to speak with a physician.Next: Get a Patient Advocate

Back to Your Guide to Preventing Medical Mistakes Intro

By Lorie A. Parch
Additional reporting by Kimberly Holland and Brittani Tingle

Related Links:
How to Avoid Becoming a Medical Mistake
Skills to Use in the Hospital
Five Surgeries to Avoid

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