Patient Advocate: Patients need to be partners in their care
A few weeks ago, the World Health Organization observed “World Patient Safety Day 2023” with this theme: “Elevate the voice of patients!”
Only by engaging patients, families and caregivers, the WHO says, can we make a dent in the seemingly intractable problem of medical error.
“Evidence shows that when patients are treated as partners in their care, significant gains are made in safety, patient satisfaction and health outcomes,” according to the WHO.
They're singing my song.
As a patient advocate, I am always preaching the importance of patients and their families partnering with their health care providers to ensure better outcomes. It's clear to me that the health care system, for all of its good intentions and hard work, can't reduce medical errors on its own.
By now, the notion that medical error is the third leading cause of death in the U.S. has been thoroughly debunked — that conclusion was reached by extrapolating data in ways it wasn't meant to be. That said, we can't diminish the scope of medical error, dismiss its consequences or ignore its causes.
Medical error comes in many forms. Here are a few:
• Errors of commission (when somebody does something wrong)
• Latent errors (those not discovered until later)
• Errors of omission (when an action that should have been taken wasn't)
• Near misses
• Never events (things that should never happen, like bedsores or wrong-site surgery)
• Negligence (failure to meet the standard of care)
It's hard to know how many medical errors take place each year because many go unnoticed — if there wasn't an adverse outcome — or unreported. One of the most common, though, is medication errors, such as the wrong drug, wrong dosage or error in administration.
The Joint Commission, which accredits and certifies health care institutions, recommends systems and processes to minimize error — such as confirming, before a scalpel makes an incision during surgery, that the right patient is on the table and they're operating on the correct part of the body.
I've never met a doctor who was blasé about making mistakes — it can ruin their careers and their lives, along with that of their patients. Still, errors happen because systems and processes can't always make up for fatigue, inattention or the time pressures placed on health care professionals in the current health care landscape.
You may not be able to eliminate 100 percent of the risk of medical error, but you can become a partner in the effort, as recommended by the WHO. Here are my tips:
• Keep on hand a summary of your health conditions, allergies, surgeries, physicians and all medications. Show your family where to find it in the event of an emergency or hospitalization so medical staff can quickly get up to speed.
• Avoid hospitalization if you can so you can avoid hospital-acquired infection, which afflicts nearly 1.7 million patients annually, according to the U.S. Centers for Disease Control and Prevention.
• If you or a loved one has to be in a hospital, don't go it alone. Organize shifts among relatives to ensure the patient is always accompanied. But only enlist those who are observant, calm and communicate well.
• Your doctor or nurse should introduce themselves when they enter your room. Jot down their names and shifts, and pay attention to what they're telling you.
• It's OK to “speak up for clean hands,” says the CDC, not only during hospital stays but also office visits. Try: “I'd appreciate it if you washed your hands.” There's likely alcohol sanitizer by the sink as well.
• If you think something is wrong, listen to your gut and speak up. And if you aren't being listened to, ask to meet with the hospital's patient advocate, whose job it is to keep the hospital from being sued.
• Don't chat with the nurse when they're dispensing your meds. Ask them to review each medication before you receive it.
• Errors often happen during transitions, such as admissions or discharges. Exercise vigilance and make sure you understand instructions. Get a written copy of your discharge instructions so you know when to visit your doctor again and how to take any medications.
We have a long way to go with patient safety. When plane crashes were more common in the '70s, the federal government created the National Transportation Safety Board. We need that for health care, along with a national reporting system. There's also great potential with electronic health records and artificial intelligence to flag potential errors before they occur.
Until that all happens, though, patients and their families can be their own best safety advocates.
• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (312) 788-2640 or email teri@northshorern.com