From Dr. Peter Pronovost, Johns Hopkins VP of Patient Safety and Quality
First Steps:
Before:
Choose a doctor who is experienced in treating your condition (especially for surgeries). You can check online and ask the doctor’s office staff for this information.
Do not hesitate to ask for a second opinion, especially before major surgeries.
Plan on having a family member or friend stay with you at the hospital, if possible.
During:
Write your questions down and ask them when your doctors come to check on you.
Ask your doctors about the day’s plan and share any concerns that you may have.
When someone comes to give you medications, ask what medication you are being given and why.
After:
Learn your medications, what each is for, and their side effects.
Learn what symptoms to watch for and what do in case those occur.
To make sure that you got all the information correctly, always repeat back in your own words what you were told and ask all your questions.
Health Care-Associated Infections:
Ask about your hospital’s rates of central-line associated bloodstream infections in the intensive care unit. The best hospitals use the definitions provided by the Centers for Disease Control and Prevention and have rates less than one infection per 1,000 catheter days. A rate above three should cause concern.
Whenever clinicians enter your room, ask if they have washed their hands. Request that visitors also wash their hands often. Washing can be with alcohol gel or soap and water.
If you have any type of catheter, ask every day if that catheter can be removed.
Identification Errors:
If you are admitted to the hospital, check your ID bracelet to make sure all information is correct. Staff should use this bracelet to confirm your name before any treatments or tests.
If you are making an outpatient visit, staff should ask you to confirm your name and another unique identifier, such as your date of birth, before treatments or tests.
Verify that blood and other specimens taken from your body are labeled in front of you.
Hospital Falls:
Ask a nurse about your fall risk level and what steps are being taken to reduce that risk. Keep the nurse call bell, eyeglasses and other items within reach, and wear non-skid footwear.
If you need assistance walking, request help before the need to use the bathroom becomes urgent.
Venous Thromboembolism (Blood Clots):
Ensure that you are screened by clinicians to identify your risk for blood clots.
Given your risk category, ask what treatments you should receive.
Ask every day if you are getting the treatments you should to reduce blood clots.
Communication and Teamwork Errors:
When you enter the hospital, be familiar with what medications you are taking, your allergies, and your complete medical history. Ask what medications you’re being given and why.
Ask to participate in daily interdisciplinary rounds.
If you are confused about something regarding your treatment, ask for a “bedside huddle” with the care team to make sure they come to you to address your concerns.
Ensure you will be able to care for yourself when you leave the hospital by reading back your discharge plan and ensuring that you know your treatment, what risks to watch out for and what to do if they occur and follow-up instructions— which provider you should visit, how soon, and when this provider will receive the records from your hospital stay.
What tips do you have for preventing a mishap at the doctor's office or hospital?


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