Medical negligence and other errors are one of the leading causes of death and injury in America. It has been estimated that as many 98,000 people die in U.S. hospitals each year as the result of medical errors. That means that more people die each year in America from medical errors, than in motor vehicle accidents.The Agency for Healthcare Research and Quality (AHRQ) is one of twelve agencies within the Department of Health and Human Services and is charged with the improvement of the quality, safety, efficiency and effectiveness of health care for all Americans.
A 2000 Patient Fact Sheet issued by AHRQ provides 20 tips to help prevent medical errors and it is worth revisiting these suggestions today.
The AHRQ describes medical errors as errors that happen when something that was planned as a part of medical care doesn’t work out, or when the wrong plan was used in the first place. Not all medical errors involve negligence and can occur anywhere in the health care system, including the hospital, clinics, outpatient surgery centers, doctor’s offices, nursing homes, pharmacies and even the patient’s home. These errors can involve many things, but frequently involve prescription medicines, surgical errors, misdiagnosis or failure to diagnose, medical equipment failures, lab reports and other record keeping errors, and even errors committed during routine tasks – like a hospital patient on a specific diet given the wrong food.
Some errors also occur when the doctor and patient have problems of communication – including the provision of sufficient information to the patient to make informed decisions. According to the AHRQ, uninvolved and uninformed patients are less likely to accept the doctor’s choice of treatment and less likely to do what they need to do to make the treatment work.
Following is a summary of the agency’s 20 tips to help patients prevent medical errors:
1. 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 all medicines you are taking. This includes prescription and over-the-counter medicines, and dietary supplements such as vitamins and herbs.
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 are unable to read your doctor’s handwriting, your pharmacist also might have trouble reading it.
5. Ask for information about your medicines in terms you can understand. Do this 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?
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. Research shows that 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. Being told how to use the devices helps even more.
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. A study found that written information about medicines can help patients recognize problem 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.
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.
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. Research shows that at discharge time, doctors think their patients understand more than they really do about what they should or should not do when they return home.
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.
14. Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.
15. Make sure that someone, such as your personal doctor, is in charge of your care. This is especially important if you have many health problems or are in a hospital.
16. Make sure that all health professionals involved in your care have important health information about you. Do not assume that everyone knows everything they need to.
17. 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.
18. 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.
19. If you have a test, don’t assume that no news is good news. Ask about the results.
20. Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources.