Patient Resources & Guidelines|
This Topic Covers: How to be
an informed and empowered patient, learn where to find out about your doctor's
credentials; where your hospital ranks, and more...
The first precept of medicine is - Do No Harm.
Tragically, medicine does
and The Institute of Medicine Report in 2001 showed that medical errors were
the eighth leading cause of death in the USA. This is not surprising,
considering the fact that healthcare delivery is a complex service,
involving several stakeholders and multiple processes.
Indeed, patient safety has become a matter of
serious public health concern in recent years, and the World Health
Organisation has responded by creating the World Alliance for Patient
Safety. Many initiatives have been launched globally, ranging from efforts
to establish the extent of the problem; identifying its root causes;
campaigning for legislative reforms in order to minimise harm caused by
faulty medical devices or poor professional performance;
to empowering patients through raising awareness.
The first step in
becoming informed and empowered is to obtain information and basic skills.
This knowledge will lead to meaningful dialogue with health care providers
and to increased participation by patients and their loved ones. An
increased level of ability and confidence will allow patients to form
effective partnerships with their physicians and to achieve an optimal level
of health and wellness.
In 2010, the Office of Inspector General for Health and
Human Services said that bad hospital care contributed to the deaths of
180,000 patients in Medicare alone in a given year.
Now comes a study
in the current issue of the Journal of Patient Safety that says the
numbers may be much higher — between
210,000 and 440,000 patients each year who go to the hospital for care
suffer some type of preventable harm that contributes to their death, the
That would make medical errors the third-leading
cause of death in America, behind heart disease, which is the first, and
cancer, which is second.
Agency for Healthcare Research and Quality
safety is one of the Nation's most pressing health care challenges. A 1999
report by the Institute of Medicine estimates that as many as 44,000 to
98,000 people die in U.S. hospitals each year as the result of lapses in
Montori from Mayo
Center for the Science of Health Care Delivery, says a lack of collaboration
between providers and patients can be costly for patients and for the health
system. The Institute of Medicine has estimated that up to 98,000 hospital
patients die each year as a result of medical errors, and medication errors
alone account for an estimated 7,000 deaths annually. These errors are also
expensive to our health system, costing between $17 billion and $29 billion
a year, IOM reports.
Take an active role in your own
healthcare. One of the core principles of integrative
medicine is that you, working in partnership with your healthcare provider,
should be the ultimate decision maker regarding any of your own health concerns.
The National Academy of Sciences, one
of country’s most prestigious scientific organizations, urges that,
"Patients be given the necessary information and the
opportunity to exercise the degree of control they choose over healthcare
decisions that affect them." In
addition, the Academy states that the healthcare system should accommodate
differences in patient preferences and encourage shared decision-making.
Being informed will help you make better
healthcare decisions. The better informed you are, the better choices you
will make with regard to your own health. Understanding all your options, and knowing what will
or won’t work best for you is imperative.
Integrative medicine clinics and
institutions provide educational classes and make health information easily
available to individuals and their families
- A guide for the intelligent patient
and for their caring doctor.
Avoiding Shady Sellers and Practitioners:
It's easy to see why some people believe product
claims, especially when successful treatments seem elusive. But pressure to
decide on-the-spot about trying an untested product or treatment is a sure
sign of a fraud. Ask for more information and consult a knowledgeable
doctor, pharmacist, or other health care professional. Promoters of
legitimate health care products don’t object to your seeking additional
information — in fact, most welcome it.
The same goes if you’re considering a clinic that
requires you to travel and stay far from home for treatment: check it out
with your regular doctor. Although some clinics offer effective treatments,
Prescribe untested, unapproved, ineffective, and possibly dangerous "cures"
Employ health care providers that may not be
licensed or have other appropriate credentials
For information about a particular hospital,
clinic, or treatment center contact the state or local health authorities
where the facility is located. If the facility is in a foreign country,
contact that government's health authority to see that the facility is
properly licensed and
equipped to handle the procedures involved. For information about facilities
in Mexico, contact the Secretary of Health (Secretaria De Salud) in the
Mexican state where the facility is located.
Doctor and Patient Communication
When people talk about the need for health literacy,
they often think first about what learners need to do for themselves.
However, there is also a pressing need to teach doctors, nurses and medical
students how to communicate more effectively with low-literacy patients.
It is important for health care providers to
speak the language of the patient - after all, there's little point in
making a brilliant diagnosis if the patient ends up not following the
doctor's advice because he did not understand what the doctor said!
Literacy results from an interaction between the reader
and the writer and it is not fair to criticise a patient's reading skills
without considering the skills of the author. The mismatch between what
people need and what the healthcare system offers is unhealthy and can be
deadly. Too often, there exists a chasm of
knowledge between what doctors know and what patients understand.
Both parties are equally responsible, and to understand why, we need to look
at two concepts - the Curse of Knowledge and the ASK Problem.
"The Curse of Knowledge," otherwise known as the
paradox of expertise, is one of the reasons experts have trouble using plain
language to communicate their ideas to others who do not share the same
level of expertise. Doctors spend a great deal of time with other doctors,
but not enough with patients with limited literacy skills, which means while
they speak fluent "medicalese", they find it hard to talk to patients in
The "ASK" Problem stands for the Anomalous State of
Knowledge. This occurs when the patient does not have the knowledge needed
to ask the right questions to make a sound decision. In order to ask good
questions, we must have fundamental understanding of the problem at hand.
The more complex the nature of the information to be processed, the more
difficult it is to ask the right questions.
To solve these issues, both patients and doctors need
training in how to better communicate with each other. For low literate
patients, remember that the spoken word is far more important than written
communication. Here are some tips for clear verbal communication. None of
this is rocket science - it’s simple common sense. Just pretend you were
explaining diabetes to your 75-year old grandmother who is hard of hearing
and you will know what to do.
True dialogue can only be achieved if health literacy
is received as a goal for both the patient and the provider… A good
interpreter serves as more than just a translator… The use of family and
friends as interpreters is not always in the best interests of the patient.
Unless the situation presents an emergency, there may be issues relating to
confidentiality, conflicts of interest, and a lack of familiarity with
medical terms. Untrained interpreters may miss, add, or substitute
information, and they often do not understand the importance of interpreting
everything the patient says.
Navigating Through the System
- Center for Advancing Health
Many of us lack the skills and knowledge to
find the right care and make good use of it. We vary in our experience with
illness and our abilities, but few of us are prepared to confront the
complex information-and-service-seeking requirements of health care today,
especially when we are frightened and ill. The consequences of our lack of
preparation are delays, poor decisions about providers and treatment,
sporadic follow-through and low adherence to recommended tests and
treatment. This harms us, contributes to poor outcomes and wastes resources:
ours, our employers, and our government's...
Over the years, I have
listened to hundreds of people describe the same experience following the
diagnosis of a serious illness. As the number of physicians, diagnostic test
sites and treatment options have grown, and the lack of seamless,
coordinated care persists, the majority of patients and their loved
ones struggle to find good care and make the most of it.
One solution that has garnered attention is to put in
place individuals with the job title of “patient navigators” to fill the
gaps that ill people often experience in administrative and clinical care
Consulting a Patient
Advocate or Navigator
www.ama-assn.org - American Medical Association
A patient navigator is
someone whose primary responsibility is to provide personalized guidance to
patients as they move through the health care system. The term patient
navigator is often used interchangeably with the term “patient advocate,”
and the role may be filled formally or informally by individuals with
clinical, legal, financial or administrative experience, or by someone who
has personal experience facing health care-related challenges. Navigators
can be employed by community groups, hospitals or insurance companies, or
they may be independent consultants who offer fee-based services to people
who are unwilling or unable to manage complex medical issues on their own.
Patient navigator or patient advocacy services can be
categorized as having one of the following goals:
Reducing healthcare disparities and increasing
access to care
Improving patient outcomes for a specific illness
or chronic disease
Helping patients effectively negotiate the complex
web of administrative and clinical decisions associated with the health
The American Medical
Association (AMA) believes that the primary role of a patient navigator
should be to foster patient autonomy and provide patients with information
that enhances their ability to make appropriate health care choices and/or
receive medical care with an enhanced sense of confidence about risks,
benefits and responsibilities.
Patient navigators can provide patients with guidance
in the health insurance marketplace, which is especially critical for
patients who have low health literacy skills. As such, it is important to
define the appropriate role of a patient navigator as part of a patient’s
health care team—with the ultimate responsibility for patient care residing
How to Find Patient Advocates
aphadvocates.org - The Alliance of Professional Health Advocates is a membership
organization that provides independent patient advocates and navigators
care and case managers who can:
Accompany you to medical appointments or stay by
your beside in the hospital
Help you learn more about your medical condition
and treatment options
Help you make difficult medical decisions
Maintain a healthy pregnancy and raise healthy
babies by working with a midwife, doula or lactation specialist
Lear pain management techniques
Help you navigate the insurance maze
Help you file health insurance claims, and
manage or reduce your hospital and medical bills
Find legal assistance after a medical error
Track paperwork and records
... and many
more services, too
Search for a Patient Advocate -
Patient Advocate Foundation seeks
to inform and empower patients allowing them to
take control of their healthcare. Our team of case managers has
compiled a list of valuable resources that address several topics that help
patients find assistance with medical debt, insurance access, job retention
and many other medical related issues.
PAF Publications -
PAF has produced numerous publications and informational brochures to aid
clarity and provide valuable information to patients. These publications are
devoted to individual health related topics and
target the most commonly misunderstood areas of the medical world.
All viewers are welcome to view or save the PDF
versions, or request a printed hard copy mailed directly to you via our web-form.
On-line Real Time Chat
offers helpful assistance to
patients through personalized web chat. Chat is an on-line, real-time
method of contacting PAF with questions specific to your scenario.
Exploring Your Options
You may also think that being a “good” patient means
doing what your doctor tells you. But the truth is, staying quiet is not a
good idea. By asking questions and understanding your treatment options, you
can share in making decisions with your doctor and receive the best possible
What is a treatment option,
anyway? A treatment option is a medicine or therapy to treat your
problem. A treatment option may be a pill, a shot, exercise, or an
operation. It could even be a combination of things.
The process of fully exploring your options starts with
asking your doctor questions about your diagnosis or condition. The next
step is a full discussion about the available treatments—including the
concerns you have about options and which options might be best for you. It
may seem okay to follow the first treatment your doctor suggests and then
wait to see if it works. But if you take the time to talk to your doctor
about all your treatment options, you may find one that works better for
How can knowing your
treatment options improve your life?
You might feel better—not only about your health problem but also about
your treatment choice and your part in decision making. Telling your doctor
what is important to you can help you find the best medical care and improve
your quality of life. Talking about treatment options may help you find:
A treatment or medical test that could work best
A treatment with fewer side effects.
A treatment that’s better for your budget.
Better control over your health care.
Some people feel nervous about asking their doctor
questions. Remember: You know more about your body, your health, and what’s
important to you than anyone else. Don’t be afraid to speak up. Need help
getting started? We
have tips to help you talk about treatment options with your doctor.
Here are some tips that can help avert unwanted
research. The more you learn about your illness and appropriate
treatment options, the better armed you will be in advocating for better
care. Hospital websites can provide trustworthy resources, as can the Centers
for Disease Control and Prevention and the National Institutes of
Health's MedlinePlus page,
which offers useful information on conditions, treatments and research
Know when to
choose a different doctor. "The relationship with your doctor is like
marriage. If you can't have trust or cannot communicate, it's time for a
divorce," says patient advocate Trisha Torrey, who founded AdvoConnection,
which connects patients to advocates who can guide them through complex
health care situations.
It's also time to part ways if your doctor resents
that you're doing your own research, says Elizabeth Cohen, senior medical
correspondent for CNN and author of "The Empowered Patient.”
A bad fit between a doctor and patient may simply
come down to a clash in personalities. Whatever the reason, if you don't get
along with your doctor, it's time to look elsewhere. You don't need
additional stress when you're sick; it can slow your recovery, says Erin
Moaratty, chief of mission delivery at the National Patient Advocate
To find a new doctor, get
referrals from other physicians and from your friends. Allow plenty of time.
Finding a doctor in
who is taking new patients may be challenging. Give the relationship time to
develop; it can be difficult to tell during a single visit whether a new
physician can meet your needs.
Choosing Wisely® aims to promote conversations between
physicians and patients by helping patients choose care that is:
United States specialty societies representing more
than 500,000 physicians developed lists of Five Things Physicians and
Patients Should Question in recognition of the importance of physician and
patient conversations to improve care and
eliminate unnecessary tests and procedures.
These lists represent specific, evidence-based
recommendations physicians and patients should discuss to help make wise
decisions about the most appropriate care based on their individual
situation. Each list provides information on when tests and procedures may
be appropriate, as well as the methodology used in its creation.
Choosing Wisely recommendations should not be used to
establish coverage decisions or exclusions. Rather, they are meant to spur
conversation about what is appropriate and necessary treatment. As each
patient situation is unique, physicians and patients should use the
recommendations as guidelines to determine an appropriate treatment plan
In collaboration with the societies, Consumer Reports
has created resources for consumers and physicians to engage in these
important conversations about the overuse of medical tests and procedures
that provide little benefit and in some cases harm.
Download a pdf of all specialty society lists. Click here for
listing of tests when they are needed and when they are not…Choosingwisely
- Doctor Patient Lists
When to Get a Second Opinion
Unfortunately, doctors, even your own trusted physician, can miss a
diagnosis, especially nowadays, when they may be under pressure to see many
patients in a short time. Studies indicate that more than 20 percent of
patients in emergency rooms or intensive-care units are diagnosed
incorrectly, and the problem undoubtedly extends to doctors' offices, too.
So it pays to research any diagnosis you receive to learn what questions
to ask, whether you need additional tests, and when to seek a second
opinion. Obese individuals diagnosed with asthma, for example, should ask
whether their breathing problems might actually stem from their excess
weight. Here are several other situations, nearly all of them common, where
you may need to consider a possibly overlooked problem.
In general, avoid surgery unless the problem threatens your health
or disrupts your activities, less aggressive treatments have failed, other
causes have been ruled out, tests show that surgery would help, and there's
little hope of spontaneous recovery. And get a second opinion if you have
the slightest doubt about whether you need the procedure.
Knowing Your Rights and Options:
Making decisions about healthcare is one of the most important in a person’s
life. Many people are told that they have cancer or another life threatening
illness and feel that they must make a decision and begin treatment as soon
as possible. While this may be true in some instances, taking the time to
learn about your disease, getting a second opinion or perhaps even a third
opinion and weighing your options is a very reasonable approach. Proactive
decision making will give you a greater degree of control over your
treatment. Decisions regarding your health
should be made after you have been thoroughly informed about your diagnosis,
prognosis and available treatment options.
Second opinions don’t
hurt and in fact may even help:
It never hurts to get a second opinion. Keep
in mind that doctors are human and they too can make mistakes or be faced
with unusual or challenging cases. When
the first doctor’s opinion is the same or similar to the second doctor’s,
your confidence will be increased. There
is nothing lost by visiting one more doctor just to make sure that the first
doctor’s opinion is correct. With serious illnesses that may require
extended treatment, you should feel confident that you have chosen the most
appropriate treatment for your particular situation. A valid opinion and
appropriate course of treatment is your best option for return to good
health or grasping control of the chronic disease.
While second opinions may be awkward for doctor and patient at times,
studies have shown that
30 percent of patients,
who sought second opinions for elective surgery and 18 percent of those who
were required to obtain a second opinion by their insurance company, found
that the two opinions were not in agreement.
These studies are one more reason why you need to make sure you are educated
properly to make the best decision for your health.
Second opinions are a way to learn about
your diagnosis and choices for treatment options. Some doctors are more
conservative while others tend to be more aggressive. A patient has rights
and one of your most important rights is the ability to get a second opinion
about your diagnosis. Being informed is critical in deciding your choice of
Statistics show that over one third of adults in
the United States will never seek a second opinion and almost one tenth of
newly diagnosed patients rarely, or never understand their diagnosis. A
second opinion means you are consulting with another doctor to confirm a
diagnosis and/or find possible different treatment choices available to you.
It is recommended to get a second opinion immediately to avoid delays in
your treatment and recovery. Seven states currently have health laws
pertaining to second opinions...Read in entirety...www.patientadvocate.org
Also read - Getting a Second
Opinion before Surgery for Medicare Patients
Choosing a Doctor
Choosing a doctor
is one of the most important things you will do in your life. You will trust
this person for his or her expertise, advice and to administer treatment
that may save your life.
And remember that choosing a physician is
just that; a choice. You need to be happy with your doctor and the
treatment-on the medical level and a personal level-that you receive.
Whether you're looking for a primary care physician or a specialist, it pays
to do as much research as you can to ensure that you find the right match.
Get a referral
Try to avoid picking a doctor at random from your health plan's list or out
of the phone book. In a Consumer Reports survey, people who found their
physicians through someone they trusted—a friend, a family member, or
another doctor--had the most favorable experiences. (We found a similar
phenomenon in a survey of consumers who visited mental-health
If you're picking a doctor to care for a specific
condition, ask about how often he or she treats cases similar to yours.
Patients we surveyed who took this step were more satisfied with their care.
You can also ask the doctor about specialty board certification, which
requires advanced training and the passing of rigorous tests.
How to check credentials:
like schoolchildren, are increasingly being put to the test. Experts have
developed practice guidelines detailing how physicians should address
everything from basic preventive care to complex chronic conditions such as
congestive heart failure and diabetes. Researchers are even starting to
measure how well doctors manage their practices, gathering data, for
example, on how quickly patients can get an appointment and how long they
are kept waiting once they have one.
Gordon Moore, M.D., a Rochester,
N.Y., physician who has researched what makes primary health care effective,
says he would like to see "all this information listed right there in the
waiting room for everyone to see, so that patients can make wise consumer
choices and know how good their doctor is at treating the health problem
they're concerned about." While this may become a reality some day, for now
finding the right doctor for you involves cobbling together information from
a variety of sources, including your own observations and interactions with
Doctor Credential Search
The Internet can be a valuable tool not only for researching your medical
conditions, but also for learning more about who's caring for you and your
loved ones. Consult the following sites to educate yourself about how
doctors and nurses get their credentials and other patient concerns.
help you compare health care providers so you can make an informed health
care decision... Our free Doctor reports show:
Area of specialty
Things to consider
Review critical medical information that will help
inform you. Topics cover:
www.abms.org - American Board of Medical
You can search for a new
doctor or check on your current doctor's qualifications with the ABMS, the
umbrella organization for the 24 approved medical specialty boards in the U.S.
Is your doctor board certified? Check here -
in Medicine: This site provides
links to state licensing boards, where you can check your doctors'
credentials. Some states also list doctors who have been taken to court
College of Surgeons:
If you need to have surgery, check out this
information from the American College of Surgeons on the
should look for when choosing a surgeon.
Whether you are referred to a physician for surgical
care, or you make the choice yourself, don't take your surgeon's
qualifications for granted. Make sure your operation is performed by a
competent physician whose specialty is surgery. It could be the most
important decision you make.
American Medical Association DoctorFinder:
Comprehensive information, including educational
history, board certification, and hospital admitting privileges, for the 40
percent of doctors who belong to the AMA.
Each year Best Doctors
surveys tens of thousands of leading specialists worldwide and asks them which
doctors they themselves would go to for treatment. The site's Best Doc Finder
tool allows you to search by specialty in a geographic area. For a fee of $25,
you get two Best Doctors referrals.
Council of State Boards of Nursing:
site has links to the boards of nursing in the U.S. You can consult your state's
board to find out the qualifications for nurses in your state and -- in some
states -- check on whether a particular nurse is licensed.
Doing a little homework before you choose a hospital
can do more than give you peace of mind. Choosing
a hospital that scores well on quality can make it easier—and safer—for you
to recover from a serious event, like having heart surgery, or a
routine one, like having a baby.
As a physician, let me emphasize that
if you need emergency hospital care, go to the
closest hospital. But if you aren't facing an emergency, take time to do
The good news is that there is a lot of information to
help you make an educated choice about which hospital to use. But to get the
most complete picture of the best hospital for your needs, it's helpful to
check several resources. It's also a good idea to ask your doctor and your
friends for their advice and why they prefer Hospital A over Hospital B.
To get an overall view of quality, you might start by
that private groups produce. Hospital "grades" are based on different
measures, and each group emphasizes some over others. For example, some
grade hospitals on what doctors think of them, how many hospitals use
computers to order drugs, and how well patients recover from different kinds
Measuring hospital quality isn't a perfect science.
But we have a lot of information today to help you make an educated
decision. That's the best decision for your peace of mind—and for your
These sites will help you find the finest hospitals -- in your state, and across
See ratings for hospitals according to specialty, such as cardiac surgery,
cardiology, orthopedic surgery, women’s health, and more.
Leapfrog gathers and reports information on hospital quality and patient
safety. Make more informed decisions about where to receive hospital care by
searching for hospitals in your area.
Browse quality and safety measures, check services provided, procedure
volume, and more. Compare multiple hospitals on a variety of measures with
the comparison report option.
Search through a database of worldwide hospitals to find contact details and
The Solucent 100 Top Hospitals Report
This national study identifies superior hospitals in 5 key areas. See how
hospitals ranked in your state, purchase reports, and more.
A Patient's Guide to Best Hospitals -
Picking the right hospital is a daunting task.
U.S. News makes it less painful.
Search for information on any
hospital in the United States. This is a national, nonprofit
organization that "accredits" hospitals to make sure they fully comply
with all of the group's quality standards. Quality Check® is the most
comprehensive listing of health care organizations available today.
Joint Commission accreditation/certification is recognized nationwide as
a symbol of quality and safety that reflects an organization’s
commitment to meeting certain performance standards.
- What does accreditation and certification
mean to me, the health care consumer? As a health
care consumer wouldn’t you want to know if your health care provider is
going above and beyond to ensure the safety and quality of your care?
When a health care organization voluntarily seeks accreditation or
certification, it demonstrates a strong commitment to giving safe, high
quality health care and to continually work to improve that care.
Only Joint Commission-accredited organizations display the Gold Seal of
Approval™. If there is no Gold Seal by an organization, it is not
Joint Commission accredited.
Compare information about the quality of care and
services these providers and plans offer for hospitals, nursing homes,
physicians, dialysis centers and home health care.
Get helpful tips on what to look for when comparing and
choosing a provider or plan.
Nursing Homes –
Compare nursing homes by their five-star rating,
including the quality of care they provide (i.e., whether residents have
gotten their flu shots, had their pain controlled, and maintained a
Find out what special services each nursing home
View the results of health and safety inspections.
Compare hospitals based on the quality of their
care (for example, do they give recommended treatments known to get the
best results for certain conditions like heart attack and pneumonia.)
Get patient survey results to learn more about
patients' experiences at each hospital.
Compare rates of readmission, mortality (death)
rates, and more.
Find out what services each home health agency
offers, like skilled nursing care, physical therapy, speech therapy, and
home health aides.
Compare home health agencies based on the quality
of their care (for example, how well they manage pain, treat wounds, and
keep patients safe).
Get patient survey results to learn more about
patients' experiences with each home health agency.
Find out what kinds of dialysis services each
Compare each dialysis facility based on quality
(for example, find out whether patients had enough waste removed from
their blood during dialysis treatments, or how well their anemia was
Find out whether each dialysis facility offers
other services such as home dialysis training or evening appointments.
Get information on medical specialty, clinical
training, foreign languages spoken, and more.
Find out if your physicians accept the
Medicare-approved amount as full payment.
Find information about other types of health
professionals. (for example Nurses, Physical Therapists, Nutrition
Services and Physician Assistants).
Finder - Use this tool to:
Search for drug and health plans.
Personalize your search to find plans that meet
Compare plans based on quality ratings, benefits
covered, costs, and more.
Enroll in a plan.
Patient Safety Resources
As one of our first projects, the coalition has developed a
detailed and comprehensive patient guide to hospital care which will give
consumers a blue print for interacting with the health care system in ways
that are safe, successful and empowering.
Patients will understand how the system works and be able to
identify key staff members, learn how to ask the
questions at the appropriate time, build invaluable communication and
collaboration skills, and both recognize quality health care and feel
comfortable speaking up if their health care needs improvement. The
consumer and the patient advocate will learn how to reduce the odds of
experiencing medical error and hospital-acquired infection and understand
the tremendous impact they can have on patient safety and health care
Patient® Hospital Guide For Patients and Families -
This guide is designed to
help patients and families prepare for the issues involved in hospital care.
the FREE Hospital Guide
The Quick Reference Guide fact sheets and checklists give patients
the specific tools, resources and questions they need to become capable and
confident members of their healthcare teams.
Terms for Viewing or Downloading: By downloading this
document, I signify my understanding that the copyright holders and The
Empowered Patient Coalition as their licensee retain all rights to the
materials I am downloading. I agree not to modify the document in any
way without express permission from the copyright holders, who can be
contacted at email@example.com.
The Empowered Patient Coalition provides this download
free of charge in the hope of advancing patient safety. In this
spirit, I understand that I may print and distribute the document free of
charge, but I agree not to sell or profit from this document or any portion
thereof, and not to remove the names or copyright information. MUST LOG ONTO
WEBSITE TO AGEE WITH TERMS, BEFORE INFO CAN BE DOWNLOADED….
empoweredpatientcoalition.org - Empowered Patient® "Things Patients
Should Know" Series
Important Questions For Your Hospital Care Team
Keep Your Hospital Room Safe and Clean
Getting the Help You Need In the Hospital
Warning Signs of a Rapidly Declining Patient
Infection Control and Prevention
Prevent Catheter-Associated Urinary Tract Infections (CAUTI)
Recognize And Prevent Surgical Site Infections
Signs Of Sepsis (Severe Bloodstream Infection)
Ventilator-Associated Pneumonia (VAP)
How to Use Antibiotics Safely
Be Prepared For Your Surgery
Questions To Ask A Surgeon After A Procedure
Surgical Patient Checklist
Drugs Associated With Outpatient Medication Errors
Drugs Associated With Serious Adverse Events
Ways Patients Can Help Prevent Medication Errors
Prevent Pressure Ulcers (Bed Sores)
Recognize And Prevent Blood Clots
Safety - Protecting Yourself From Medical Errors
- Agency for Healthcare Research and Quality
Tips to Help Prevent Medical
- Medical errors can occur
anywhere in the health care system: In hospitals, clinics, surgery centers,
doctors' offices, nursing homes, pharmacies, and patients' homes. Errors can
involve medicines, surgery, diagnosis, equipment, or lab reports. These tips
tell what you can do to get safer care.
What You Can Do
to Stay Safe - The best way you can help to
prevent errors is to be an active member of your health care team. That
means taking part in every decision about your health care. Research shows
that patients who are more involved with their care tend to get better
- Make sure
that all of your doctors know about every medicine you are taking. This
includes prescription and over-the-counter medicines and dietary
supplements, such as vitamins and herbs.
- Bring all of
your medicines and supplements to your doctor visits. "Brown
bagging" your medicines can help you and your doctor talk about them and
find out if there are any problems. It can also help your doctor keep
your records up to date and help you get better quality care.
- Make sure
your doctor knows about any allergies and adverse reactions you have had
to medicines. This
can help you to avoid getting a medicine that could harm you.
- When your
doctor writes a prescription for you, make sure you can read it. If
you cannot read your doctor's handwriting, your pharmacist might not be
able to either.
- Ask for
information about your medicines in terms you can understand—both when
your medicines are prescribed and when you get 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
- When you pick
up your medicine from the pharmacy, ask: Is this the medicine that my
- 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 times daily"
means taking a dose every 6 hours around the clock or just during
regular waking hours.
- Ask your
pharmacist for the best device to measure your liquid medicine. For
example, many people use household teaspoons, which often do not hold a
true teaspoon of liquid. Special devices, like marked syringes, help
people measure the right dose.
- 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.
- If you are in
a hospital, consider asking all health care workers who will touch you
whether they have washed their hands. Hand washing
can prevent the spread of infections in hospitals.
- When you are
being discharged from the hospital, ask your doctor to explain the
treatment plan you will follow at home. This
includes learning about your new medicines, making sure you know when to
schedule follow-up appointments, and finding out when you can get back
to your regular activities.
It is important to know whether or not you should keep taking the
medicines you were taking before your hospital stay. Getting clear
instructions may help prevent an unexpected return trip to the hospital.
- If you are
having surgery, make sure that you, your doctor, and your surgeon all
agree on exactly what will be done.
Having 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. Surgeons are
expected to sign their initials directly on the site to be operated on
before the surgery.
- If you have a
choice, choose a hospital where many patients have had 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.
- Speak up if
you have questions or concerns. You
have a right to question anyone who is involved with your care.
- Make sure
that someone, such as your primary care doctor, coordinates your care. This
is especially important if you have many health problems or are in the
- Make sure
that all your doctors have your important health information. Do
not assume that everyone has all the information they need.
- Ask a family
member or friend to go to appointments with you. Even
if you do not need help now, you might need it later.
- 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.
- If you have a
test, do not assume that no news is good news. Ask
how and when you will get the results.
- Learn about
your condition and treatments by asking your doctor and nurse and by
using other reliable sources.
For example, treatment
options based on the latest scientific evidence are available from the
Effective Health Care Web site
Ask your doctor if your treatment is based on the latest evidence.
Complain—and Get Heard
While you are in the hospital: If possible, first bring
your complaints to your doctor and nurses. Be as specific as you can and ask
how your complaint can be resolved. You can also ask to speak to a hospital
social worker who can help solve problems and identify resources. Social
workers also organize services and paperwork when patients leave the
If you are covered by Medicare, you can file a
complaint about your care with your State's
Quality Improvement Organization (QIO)
These groups act on behalf of Medicare to address complaints about
care provided to people covered by Medicare.
Typical complaints QIOs handle are getting the wrong
medication, having the wrong surgery, or receiving inadequate treatment. You
can also find your QIO by calling 1-800-MEDICARE.
If you get an infection while you are in the hospital
or have problems getting the right medication, you can file a complaint with
This group certifies many U.S. hospitals' safety and
security practices and looks into complaints about patients' rights. It does
not oversee medical care or how the hospital may bill you.
can submit a complaint to The Joint Commission by e-mail at firstname.lastname@example.org.
Your e-mail should include the name and address of the hospital, and a
thorough explanation of your complaint.
The Joint Commission also has a complaint
telephone number at (800) 994-6610 where you can speak to a Joint Commission
representative. However, no complaints are taken over the telephone.
The CMS Beneficiary Ombudsman website has information
on these and other rights under the CMS programs. Visit
www.cms.gov or call 1-800-MEDICARE for assistance.
and How to File Complaints
To Report an Health
Provider - State Medical Boards license physicians, investigate
complaints, discipline those who violate their state Medical Practice Act,
conduct physician evaluations and recommend rehabilitation of physicians, if
indicated. By following up on complaints from the public, medical boards are
designed to be a means to enforce basic standards of competence and ethical
behavior in physicians.
The structure and authority of medical boards
vary from state to state. Some boards are independent and maintain all
licensing and disciplinary powers, while others are part of a larger
umbrella agency, such as a state department of health. State Medical Boards
are usually comprised of volunteer physicians and other members who are, in
most cases, appointed by the governor.
Visit the Patient's
Right to Know Website for a Map of State Medical Boards or access the
Citizens for Responsible Care and Research State
Medical Board List
Filing a Complaint with the State
How Do I Submit
A Complaint? Prior to filing a complaint with the Board we
recommend reading the Board’s
Consumer Guide which
contains information about the complaint process.
Complaints can be filed
about a physician, osteopathic physician, podiatric physician, physician
assistant, anesthesiologist assistant, massage therapist, cosmetic
therapist, acupuncturist, mechanotherapist or natropath practitioner
by using the online
To Report an
Adverse Medical Event
File a Complaint against a Nurse
Nursing are state governmental agencies that are responsible for the
regulation of nursing practice. Once a nursing license is issued, the board
monitoring licensees' compliance to state laws and takes action against the
licenses of those nurses who have demonstrated
unsafe nursing practices. Each
state or territory has a law called the Nurse Practice Act which is enforced
by each nursing board. Nurses must comply with the law and all associated
rules in order to maintain their licenses. To file a complaint -
To File a Privacy Complaint
HIPAA (Federal Privacy Law) - Most
patients believe that their medical and other health information is private
and should be protected, and they want to know who has this information. The
Privacy Rule, a Federal law, gives individuals rights over their health
information and sets rules and limits on who can look at and receive health
information. The Privacy Rule applies to all forms of individuals' protected
health information, whether electronic, written, or oral. The Security Rule,
a Federal law that protects health information in electronic form, requires
entities covered by HIPAA to ensure that electronic protected health
information is secure.
If you believe that a covered entity violated your (or someone else’s)
health information privacy rights or committed another violation of the
Privacy or Security Rule, you may file a complaint with the Office for Civil
Rights (OCR). OCR can investigate complaints against covered entities. A
covered entity is a health plan, health care clearinghouse, and any health
care provider that conducts certain health care transactions electronically.
Guide After Hospital Stay
Taking Care of Myself: A Guide for When I Leave the Hospital is
a guide for patients to help them care for themselves when they leave the
hospital. The easy-to-read guide can be used by both hospital staff and
patients during the discharge process, and provides a way for patients to
track their medication schedules, upcoming medical appointments, and
important phone numbers.
When Taking Medications
SAFEDRUG.pdf - S.A.F.E. D.R.U.G. is a “How-To”
guide to help consumers identify and protect against counterfeit medicines.
This eight-step checklist helps consumers judge whether their medications
are safe and provides tips on what to do if a drug has been compromised.
Index to Drug-Specific Information - For patients, consumers, and
healthcare professionals, provides links to safety sheets with the latest
risk information about particular drugs, related press announcements, and
other fact sheets.
- Institute for Safe Medication Practices
List of High Alert Medications
- High-alert medications are drugs that bear a heightened
risk of causing significant patient harm when they are used in error.
Although mistakes may or may not be more common with these drugs, the
consequences of an error are clearly more devastating to patients. Use this
list to determine which medications require special safeguards to reduce the
risk of errors.
monitors domestic, serious adverse drug events reported to the FDA. We
identify trends in drug safety, report signals for specific drugs, and seek
to improve the system.
Medication Safety Tools &
Resources - offers a wide range of resources and information to help
healthcare practitioners in a variety of healthcare settings prevent errors
and ensure that medications are used safely. All of the ISMP tools are free,
downloadable, and easy to use.
The FDA Adverse Event Reporting System (FAERS) is
a database that contains information on adverse event and medication error
reports submitted to FDA.
The database is designed to support the FDA's post-marketing safety
surveillance program for drug and therapeutic biologic products.
FAERS is a useful tool for FDA for activities such
as looking for new safety concerns that might be related to a marketed
product, evaluating a manufacturer's compliance to reporting regulations and
responding to outside requests for information. The reports in FAERS are
evaluated by clinical reviewers in the Center for Drug Evaluation and
Research (CDER) and the Center for Biologics Evaluation and Research (CBER)
to monitor the safety of products after they are approved by FDA.
Drug Safety and
Availability - Information for consumers and health professionals on:
Learn more about how to take medicines safely. Download
Medicine, Play It Safe Booklet.
Find additional information at
empoweredpatientcoalition.org - Fact-Sheets-a-Checklists Medication-Safety
Drugwatch.com reports on the latest information
regarding dangerous drugs and defective medical devices. We give you the
information you need, when you need it. Our Patient Advocates can answer
your medical questions and point you to a specialist. They can also assess
your situation and help you find an attorney.
Drugwatch.com is updated constantly with the latest
news on medical research, recalls and FDA warnings.
Stay informed. Counterfeit medicine is fake medicine. It may be contaminated
or contain the wrong or no active ingredient. They could have the right
active ingredient but at the wrong dose. Counterfeit drugs are illegal and
may be harmful to your health.
FDA takes all reports of suspect counterfeits seriously and, in order to
combat counterfeit medicines, is working with other agencies and the private
sector to help protect the nation's drug supply from the threat of
How to Get
Medication Prescription Assistance
Prescription assistance programs, or PAPs, enable people who can’t afford to
pay for their medications to get them for free or at a reduced price.
Typically, the programs are sponsored by prescription drug companies or your
state. Your financial situation, the cost of the drugs, and whether you have
other prescription drug coverage help determine whether you qualify for a
prescription assistance program.
ads, and websites for companies that guarantee free or low-cost prescription
drugs for a hefty fee upfront are scams...
Partnership for Prescription Assistance (PPA) helps consumers find
prescription drug coverage. After you enter the prescription medicines you
take and answer several questions about your prescription and financial
situation, the site directs you to programs you may be eligible for. You can
apply online, or you can ask your health care provider to do it for you.
Either way, health care providers usually need to approve applications. If
you need information on free or low-cost providers and clinics in your area,
visit the federal Health Resources and Services Administration or use PPA’s
Free Clinic Finder.
Medicare patients can search for Medicare Part D plans on the internet,
those who may qualify for extra help can find more information from the
Social Security Administration.
Partnership for Prescription Assistance
Access to Benefits Coalition
For Medicare Beneficiaries
Social Security Administration
Finding a Free or Low-cost Clinic
Health Resources and
Partnership for Prescription Assistance Free Clinic Finder
to Keeping Your Home through Disease
often debilitating diseases, such as cancer, diabetes, heart disease,
HIV/AIDS, kidney disease, and many others can be devastating for those who
have the illnesses and their families. Not only are the physical symptoms
and side effects of these diseases difficult and life altering, but treating
them can take a huge financial toll on families.
The following is
a resource guide to provide those suffering with a debilitating disease with
they need to ensure they’re able to keep their home as they seek and receive
Preventive Screenings: What’s Recommended, What’s Covered by
To keep in your best shape and catch problems while they’re
easier to treat, you need preventive screenings for a variety of health
Preventive Screenings Medicare
Doctors Don't Tell You
Monthly newsletter gives you the facts you won't read anywhere else about
what works, what doesn't work and what may harm you in both orthodox and
alternative medicine. We'll also tell you how you can prevent illness. Our aim
is to help you make informed decisions about your health before resorting to
drugs or surgery.
This 50-page briefing explains what integrative
medicine is and how it can help transform our health care system... The
report discusses the need for health care that addresses the whole person,
the connection between lifestyles and health, the importance of the doctor
patient-relationship and the need to embrace complexity and connection in
both care and research. Downloadable report located through this link..
Health Organization (WHO)
- Search tool sponsored by the Office of Disease Prevention and Health
Promotion - Features health news and informative health educational links.
of healthfinder.gov is to provide easy to understand health information and
tools to help you and those you care about stay healthy. Learn about quality
guidelines used when developing original content and selecting
www.ahrq.gov - Agency
For Healthcare Research and Quality
The Impact Case Studies Program provides evidence of
how AHRQ’s efforts impact health care outcomes, quality, cost, use, and
access. Users can search for case studies by keyword, State, country, and
The Effective Health Care Program helps consumers,
clinicians, policymakers, and others make more informed health care
decisions by offering tools and resources that compare treatments for common
Health Hot Line Contacts
- The National Library of Medicine is pleased to offer this online
database of health-related organizations operating toll-free telephone
services. The database also includes information on services and
publications available in Spanish.