How you can reduce preventable mistakes in your medical care

There are nearly 1.5 million Americans who suffer each year from preventable mistakes.  A report by the Institute of Medicine estimates that as many as 98,000 people die in U.S. hospitals each year as the result of medical errors.

Most of these errors are related to drug mistakes.  That’s the bad news.  The good news is that your doctors and hospitals are trying to reduce these errors by using by using new electronic technologies that should significantly reduce these errors.  But there is a lot that you can do to minimize these mistakes associated with drug mix-ups.

In this article I will provide 17 ideas [editor’s note: referenced from the AHRQ], that are easy for you to use when interacting with your physician or if you are a patient in the hospital can reduce the likelihood of receiving the wrong medication or the wrong treatment.

1. The single most important way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Patients who are more involved with their care tend to get better results.

2. Make sure that all of your doctors know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supplements such as vitamins and herbs. At least once a year, bring all of your medicines and supplements with you to your doctor. “Brown bagging” your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date, which can help you get better quality care.

3. Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you avoid getting a medicine that can harm you.

4. When your doctor writes you a prescription, make sure you can read it. If you can’t read your doctor’s handwriting, your pharmacist might not be able to either!

5. Ask for information about your medicines in terms you can understand—both when your medicines are prescribed and when you receive them.

• What is the medicine for?
• How am I supposed to take it, and for how long?
• What side effects are likely? What do I do if they occur?
• Is this medicine safe to take with other medicines or dietary supplements I am taking?
• What food, drink, or activities should I avoid while taking this medicine?

6. When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed? Nearly three-quarters of medicine errors involved the wrong drug or the wrong dose.

7. If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if “four doses daily” means taking a dose every 6 hours around the clock or just during regular waking hours.

8. Ask your pharmacist for the best device to measure your liquid medicine. Also, ask questions if you’re not sure how to use it. Many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people to measure the right dose.

9. Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does—or, if something unexpected happens instead. That way, you can report the problem right away and get help before it gets worse. Written information about medicines can help patients recognize adverse side effects and then give that information to their doctor or pharmacist.

10. If you have a choice, choose a hospital at which many patients have the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition. If you are going to have open-heart surgery, ask how many procedures the hospital does each year and what is their success rate.

11. If you are in a hospital, consider asking all health care workers who have direct contact with you whether they have washed their hands. Handwashing is an important way to prevent the spread of infections in hospitals. Yet, it is not done regularly or thoroughly enough. A recent study found that when patients checked whether health care workers washed their hands, the workers washed their hands more often and used more soap.

12. When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will use at home. This includes learning about your medicines and finding out when you can get back to your regular activities. At the time of your discharge, your doctors may think you understand what you should or should not do when you return home. If necessary, ask for written instructions regarding your diet, medications, and when you need to make a follow up appointment.

13. If you are having surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done. Doing surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. I suggest you sign your initials with a good felt-tipped pen directly on the site to be operated on before the surgery.

14. Ask a family member or friend to be there with you and to be your advocate (someone who can help get things done and speak up for you if you can’t). Even if you think you don’t need help now, you might need it later.

15. Know that “more” is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.

16. If you have a test, don’t assume that no news is good news. Ask about the results. Ask when you can expert to hear from the doctor or the nurse about the results of lab work and x-ray reports.

17. Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources. For example, treatment recommendations based on the latest scientific evidence are available from the National Guidelines Clearinghouse. Ask your doctor if your treatment is based on the latest evidence.

Bottom Line: Errors in health care will occur but many of these can be minimized and completely eliminated if you and your doctor work together as a team. You must take an active role in your health care. By doing so, you will have better health, better results, and fewer mistakes.

Neil Baum is a urologist at Touro Infirmary and author of Marketing Your Clinical Practices: Ethically, Effectively, Economically. He can be reached at his self-titled site, Neil Baum, MDor on Facebook and Twitter.

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