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Improving the Safety of Your Healthcare (being an educated patient, advocating for yourself, safe and patient-centered care)

For Metro Maryland Ostomy Association

Noel E. Eldridge, MSNoel E. Eldridge, MSnoel.eldridge@ahrq.hhs.govneldridge202@yahoo.com

301 427-1156301 427-1156202 641-5959202 641-5959

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What is Patient Safety What is Patient Safety Improvement Trying to Achieve?Improvement Trying to Achieve?

Our goal is to prevent harm to patients as Our goal is to prevent harm to patients as they receive medical care. For example…they receive medical care. For example… Adverse Drug Events (overdose, wrong drug, Adverse Drug Events (overdose, wrong drug,

drug interaction, etc.)drug interaction, etc.) Wrong or Mixed-up Procedure, Test, or X-rayWrong or Mixed-up Procedure, Test, or X-ray Patient Falls and Wandering PatientsPatient Falls and Wandering Patients Healthcare-acquired InfectionsHealthcare-acquired Infections Problems with Medical Devices – Problems with Medical Devices –

Malfunctions or Accidental MisuseMalfunctions or Accidental Misuse

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Books for Patients amazon.comBooks for Patients amazon.com

Take This Book to the Hospital With You: A Consumer Guide to Surviving Your Hospital Stay

(4.5 stars)(4.5 stars) by Charles B. Inlander by Charles B. Inlander

Buy this book with Buy this book with How to Get Out of the Hospital Alive

(4.5 stars)(4.5 stars) by Sheldon P. Blau, Elaine Fantle Shimbergby Sheldon P. Blau, Elaine Fantle Shimberg

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II’’m not a doctor or a nursem not a doctor or a nurse

Information here is based:Information here is based: On personal experiencesOn personal experiences Reading and learning about adverse Reading and learning about adverse

events in healthcare on my jobs over events in healthcare on my jobs over the last 12 yearsthe last 12 years

Listening to lots of doctors and nursesListening to lots of doctors and nurses

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Participating in Other SettingsParticipating in Other Settings

What do bus passengers have to do?What do bus passengers have to do? Get on the correct bus & pay the fareGet on the correct bus & pay the fare Follow basic bus rules – stay behind white line, Follow basic bus rules – stay behind white line,

dondon’’t talk to driver while bus is in motion, dont talk to driver while bus is in motion, don’’t t do anything crazy like leaning out of an open do anything crazy like leaning out of an open windowwindow

Keep track of where you are -- look out of the Keep track of where you are -- look out of the window so you can ring bell at correct place to window so you can ring bell at correct place to get offget off

Not like the extremes of being an airplane Not like the extremes of being an airplane passenger or driving your own carpassenger or driving your own car

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Patients Participating in Patients Participating in Patient SafetyPatient Safety

Hospital inpatients shouldnHospital inpatients shouldn’’t have to do a t have to do a lot. Primary responsibility for inpatients is lot. Primary responsibility for inpatients is with hospital and healthcare providers.with hospital and healthcare providers.

Why?Why? People are sick in the hospital – even sicker People are sick in the hospital – even sicker

than they used to be.than they used to be. Many sick people arenMany sick people aren’’t at their best mentally t at their best mentally

(I know this firsthand).(I know this firsthand). Sick people receiving healthcare shouldnSick people receiving healthcare shouldn’’t t

have to be vigilant about it. (my opinion)have to be vigilant about it. (my opinion)

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What Patients Can Do (1)What Patients Can Do (1) Before Surgery: Participate in informed Before Surgery: Participate in informed

consent that is really informed and really consent that is really informed and really consent. consent. (Think mortgage, not rental-car (Think mortgage, not rental-car agreement.)agreement.)

Ask your surgeon: Ask your surgeon: • Exactly what will you be doing? Exactly what will you be doing? • About how long will it take? About how long will it take? • What will happen after the surgery? What will happen after the surgery? • How can I expect to feel during recovery? How can I expect to feel during recovery? • Tell the surgeon, anesthesiologist, and nurses Tell the surgeon, anesthesiologist, and nurses

about any allergies, bad reaction to anesthesia, and about any allergies, bad reaction to anesthesia, and any medications you are taking.any medications you are taking.

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What Patients Can Do (2)What Patients Can Do (2)

Ask questions until you understand to Ask questions until you understand to the extent that you care to understand.the extent that you care to understand.

Try hard not be accusatory as you ask Try hard not be accusatory as you ask questions, doctors and nurses intend to questions, doctors and nurses intend to help…and most of the time thathelp…and most of the time that’’s what s what will happen (or at least no harm).will happen (or at least no harm).

Pay attention to the extent possible.Pay attention to the extent possible. Willingly participate in safer systems – Willingly participate in safer systems –

e.g., done.g., don’’t complain about being asked t complain about being asked your name 3 times by 3 different people.your name 3 times by 3 different people.

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What Patients Can Do (3)What Patients Can Do (3)

Before an Office Visit: Make a written list Before an Office Visit: Make a written list of symptoms, questions, etc., to review of symptoms, questions, etc., to review during visit or interaction with clinician.during visit or interaction with clinician.

Tell the doctor the truth about your Tell the doctor the truth about your symptoms and history. symptoms and history.

Take your medicine or tell the doctor if Take your medicine or tell the doctor if you stop.you stop.

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What Patients Can Do (4)What Patients Can Do (4)

Ask your doctor to provide you with a list of Ask your doctor to provide you with a list of the medications he/she has prescribed for you the medications he/she has prescribed for you – and keep it up to date. Add on any non-– and keep it up to date. Add on any non-prescription drugs that you take regularlyprescription drugs that you take regularly

When thereWhen there’’s a s a ““betterbetter”” choice – actually choice – actually choose the better specialist, hospital, health choose the better specialist, hospital, health plan, etc. But, one problem is defining better plan, etc. But, one problem is defining better – more timely, nicer, smarter, more up-to-– more timely, nicer, smarter, more up-to-date, safety-conscious, good listener, good date, safety-conscious, good listener, good referrer, gentler, etc.referrer, gentler, etc.

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Other Steps to Safer Health CareOther Steps to Safer Health Carefromfrom www.ahrq.gov/consumer/5steps.htmwww.ahrq.gov/consumer/5steps.htm

Get the results of any test or Get the results of any test or procedure.procedure. Ask when and how you will Ask when and how you will get the results of tests or procedures. get the results of tests or procedures. Don't assume the results are fine if you do Don't assume the results are fine if you do not get them. Call your doctor and ask for not get them. Call your doctor and ask for your results. Ask what the results mean for your results. Ask what the results mean for your care.your care.

Make sure you understand what will Make sure you understand what will happen if you need surgery.happen if you need surgery. Ask your Ask your doctor, "Who will manage my care when I doctor, "Who will manage my care when I am in the hospital?"am in the hospital?"

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Special Ostomy TopicsSpecial Ostomy Topics

Hydration (drink more water)Hydration (drink more water) Potential for Blockages (carefully consider what Potential for Blockages (carefully consider what

you eat – based on physician advice and your you eat – based on physician advice and your own experience -- and remember to chew)own experience -- and remember to chew)

Skin Care is Very ImportantSkin Care is Very Important Potential for Hernias or AbscessesPotential for Hernias or Abscesses Get Follow-ups as Recommended by your Get Follow-ups as Recommended by your

Physician(s) or NursesPhysician(s) or Nurses Ask if a Hospital has WOC Nurse(s)Ask if a Hospital has WOC Nurse(s)

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Other Patient Safety TipsOther Patient Safety Tips

Agency for Healthcare Research and Agency for Healthcare Research and QualityQuality http://www.ahrq.gov/consumer/20tips.htm http://www.ahrq.gov/consumer/5steps.pdf

New: Guide to Patient and Family New: Guide to Patient and Family Engagement in Hospital Quality and Engagement in Hospital Quality and SafetySafety http://www.ahrq.gov/professionals/systems/ho

spital/engagingfamilies/patfamilyengageguide/

The GuideThe Guide’’s sections include—s sections include— Information to Help Hospitals Get Started Addresses:

Strategy 1: Working With Patients and Families as Strategy 1: Working With Patients and Families as AdvisorsAdvisors  

Strategy 2: Communicating to Improve QualityStrategy 2: Communicating to Improve Quality   helps improve communication among patients, family members, helps improve communication among patients, family members,

clinicians, and hospital staff from the point of admission.clinicians, and hospital staff from the point of admission. Strategy 3: Nurse Bedside Shift ReportStrategy 3: Nurse Bedside Shift Report  

supports the safe handoff of care between nurses by involving supports the safe handoff of care between nurses by involving the patient and family in the change of shift report for nurses.the patient and family in the change of shift report for nurses.

Strategy 4: IDEAL Discharge PlanningStrategy 4: IDEAL Discharge Planning   helps reduce preventable readmissions by engaging patients helps reduce preventable readmissions by engaging patients

and family members in the transition from hospital to home.and family members in the transition from hospital to home.

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