How to get the best possible hospital care

In an ideal world, respectful treatment from health care providers would be the norm. In the real world, you may have to insist on it. Consumer Reports suggests increasing the odds of a good hospital experience with these strategies:

• Choose the right hospital. A study published in the New England Journal of Medicine linked low patient satisfaction with less-than-stellar hospital performance in areas such as pain control, discharge instructions and communicating about medication. And research in the American Journal of Managed Care showed that people who were satisfied with their care after a heart attack, heart failure or pneumonia were less likely to be readmitted to the hospital within 30 days.

• Help providers see you as a person. Once you get to the hospital, chances are you won't know many of the folks taking care of you. Reminding people that you are more than a diagnosis can change that. Bring in pictures, maybe one showing you playing golf or tennis. Add a personal detail when you describe your medical problems to a doctor.

• Invite your doctor to have a seat. In a recent study, Norwegian researchers created simulations in a hospital setting, using real doctors and actors as patients and comparing electronic devices with paper medical records. The patient actors thought the doctors were so busy with their devices that they shouldn't interrupt to ask questions. If you experience that dynamic, you can change it and make it easier to communicate by inviting your doctor to sit down and have a conversation.

• Have your people with you. An advocate can help in a number of ways - for instance, making sure you are comfortable, getting information from the doctor or nurse, helping you make decisions about treatment and speaking for you if you aren't able to speak for yourself.

• Know when errors tend to occur. In a new national Consumer Reports survey of 1,200 recently hospitalized people, patients who thought there weren't enough nurses available were twice as likely to experience some kind of a medical error and 14 percent less likely to think they were always treated with dignity and respect. Shift changes can also create safety hazards, as can care transitions, such as moving from an intensive care unit to a hospital floor. If you know when and where errors are most likely to occur, you can make a special effort to have your advocate be present then.

• Find a "troubleshooter." Navigating the hospital is much easier with an "insider" ally. You or a family member should introduce yourself to the head nurse on duty or seek out the nursing supervisor, attending physician or even a physical therapist or aide with whom you feel comfortable. Then, if something goes wrong, you will have already established a personal connection with someone who knows the system and can help.

• Be assertive and prepared, but always be courteous. Think about what you want to ask your doctors when they rush in for that early morning visit, and say it out loud a few times so that you get what you want from the encounter.

• Write things down. With doctors, nurses, technicians, medical students and social workers in and out of your hospital room, it can be very difficult to keep track of what is being done, especially when you are ill. Consumer Reports recommends listening to what they have to say, asking questions and taking notes.

• If you don't understand something, ask again. Medicine is complicated stuff, and sometimes doctors forget you haven't studied it. "This is so much a part of their lives and their vocabulary. Sometimes they rush through an explanation without realizing that the person in front of them has no clue how to interpret what they just said," says communications specialist Carolyn Thomas. "I simply raise a hand in the 'stop' position, and politely remind them that I haven't been to medical school, so please slow down and translate."