Being in a hospital is a scary and frightening time, and it’s easy for those of us at the frontlines — doctors and nurses — to forget that as we go about our busy work days. Patients are at a very low point in their lives and will remember everything about their hospital stay, including all their interactions, for a very long time.
As someone with a keen interest in improving the health care experience for our patients, I’ve noticed the same scenarios play out time and again in often vastly different hospitals. We are, of course, rightly in the era of patient-centered care, and as professional and dedicated as doctors and nurses are, it’s still a very wise idea for patients and families to take control of their care as much as possible and make sure everything is going as it should be. Here are seven must-ask questions for every patient and family member:
1. Have you got all my medications correct? Medication reconciliation is the process by which your home medication list is confirmed, and then the medicines that you are supposed to still be on is continued. Most people, especially the elderly who are frequently on a dozen or more medications, understandably won’t remember their complete list. This can likewise be difficult for the medical team to trace down. Therefore, make sure everyone knows them and bring all your pill bottles into the hospital if necessary. Accurate medication reconciliation, as simple as it sounds, has been a problem in every single hospital I’ve ever worked in.
2. Be clear on risks and benefits of everything. Be sure to go through all of these with your physicians. Get a second opinion if needed. It’s your body after all. Know everything before signing that consent form, and don’t be embarrassed about any question whatsoever.
3. A clear plan every day. Your medical team should communicate this to you each day you’re in the hospital. Know what the plan is and also who your main doctor is (usually an internal medicine doctor). Be careful of “Too Many Cooks in the Kitchen Syndrome,” when a lot of different specialists may be involved in your care. Don’t let things get confusing! Certain simple things can be utilized, like writing on a whiteboard at the end of your bed.
4. Wait times. Don’t assume that just because you’ve been told that an investigation or test has been scheduled, and been left NPO (not eating), that it’s all scheduled nicely! Double-check and be sure. With hospitals being as busy as they are, things can slip through the net — especially on weekends and Mondays.
5. Abnormal tests. Whether it’s a blood test or an imaging study, be fully informed of these. Write them down and tell loved ones. Many of these abnormal tests will certainly need following up after you leave the hospital.
6. Rest. Hospitals should be healing temples, where it’s easy to recuperate in a peaceful environment. One of the first and most common complaints I hear when I enter a patient’s room first thing in the morning is that they couldn’t sleep due to a noisy and hectic environment. While it’s impossible for hospitals to be completely quiet and devoid of commotion, things can usually be done to help with the situation if resources allow — such as switching rooms, not checking your vital signs at night if you’re stable or stopping a machine from constantly beeping. Along the same lines, hospital food (another crucial thing our bodies need for healing), is probably the second most common complaint I hear. Sometimes your diet can be changed, as long as it isn’t completely at odds with your medical condition. Bottom line: speak up and don’t suffer in silence.
7. Discharge rush. Unfortunately, discharge from a hospital is all too often a rushed and haphazard affair. There’s too much at stake to let this happen to you. Insist on crystal clear discharge instructions including follow-up with physicians, abnormal tests, medication changes, and what to do if you have additional symptoms.
Many people find it very difficult to speak up and might be concerned about seeming pushy or aggressive in a hospital environment. But asking questions and ensuring you get the care you deserve, especially when your health is at stake, is simply too important. Don’t be intimidated by hospitals or your doctors. One of my favorite quotes states: “Things may come to those who wait, but only things left by those who hustle.” The same applies to your health care. Those who ask the right questions, insist on knowing their choices, and expect high standards — end up with the best care, outcomes and most time with their doctors and nurses. Those who take a back seat are unfortunately prone to the opposite.
Suneel Dhand is an internal medicine physician and author of three books, including Thomas Jefferson: Lessons from a Secret Buddha. He is the founder and director, HealthITImprove, and blogs at his self-titled site, Suneel Dhand.
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