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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...


 


Introduction

www.thebestmedicalcare.com

The first precept of medicine is - Do No Harm.

Tragically, medicine does cause harm, 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.

empoweredpatientcoalition.org

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.


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Alarming Statistics

www.propublica.org

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 study says.

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.

www.ahrq.gov - Agency for Healthcare Research and Quality

Patient 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 patient safety.

health.usnews.com

Victor Montori from Mayo Clinic's 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.


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Patient Empowerment

www.bravewell.org

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.

www.thebestmedicalcare.com - A guide for the intelligent patient and for their caring doctor.

www.consumer.ftc.gov

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, others:

  • 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.

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Doctor and Patient Communication

www.thebestmedicalcare.com

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 plain language.

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

www.cfah.org - 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 coordination.

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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 care system

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 with physicians.

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 - www.advoconnection.com

www.patientadvocate.org

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.

Patient Advocate 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.

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Exploring Your Options

www.effectivehealthcare.ahrq.gov

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 care.

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 you.

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 for you.

  • 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.

health.usnews.com

Here are some tips that can help avert unwanted outcomes:

Do your 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 studies.

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 Foundation.

To find a new doctor, get referrals from other physicians and from your friends. Allow plenty of time. Finding a doctor in your health insurance network 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.

www.choosingwisely.org

Choosing Wisely® aims to promote conversations between physicians and patients by helping patients choose care that is:

  • Supported by evidence

  • Not duplicative of other tests or procedures already received

  • Free from harm

  • Truly necessary

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 together.

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 complete listing of tests when they are needed and when they are not…Choosingwisely - Doctor Patient Lists


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When to Get a  Second Opinion

www.consumerreports.org

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.

www.patientadvocate.org

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.

Patient Rights: 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 treatment.

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

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Choosing a Doctor

www.consumerreports.org

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 professionals.)

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: Doctors, 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 your doctor…

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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.

www.ucomparehealthcare.com

Free reports help you compare health care providers so you can make an informed health care decision... Our free Doctor reports show:

  • Demographic information

  • Education

  • Area of specialty

  • Certification

  • Disciplinary actions

  • Things to consider

  • ...and more

Review critical medical information that will help inform you. Topics cover:

  • Overview

  • Specialist

  • What Questions to Ask

  • How to Prepare for the Procedure

  • What to Expect

  • Treatment Options

www.abms.org - American Board of Medical Specialties: 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 - www.certificationmatters.org

Administrators 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 recently.

American College of Surgeons: If you need to have surgery, check out this information from the American College of Surgeons on the qualifications you 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.

Best Doctors: 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.

National Council of State Boards of Nursing: This 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.  

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Find the Best Hospital in Your Area

www.ahrq.gov

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 some research.

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 reviewing hospital "report cards" 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 of surgeries…

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 health.

These sites will help you find the finest hospitals -- in your state, and across the country:
  • Hospital Compare
    Use this tool from the U.S. Department of Health and Human Services to compare the quality of care hospitals provide.
  • Health Grades
    See ratings for hospitals according to specialty, such as cardiac  surgery, cardiology, orthopedic surgery, women’s health, and more.  
  • The Leapfrog Group
    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.  
  • UCompareHealthCare
    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.  
  • Hospitals Worldwide
    Search through a database of worldwide hospitals to find contact details and websites.
  • 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.
     
  • health.usnews.com
    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.

www.medicare.gov

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 healthy weight.)

  • Find out what special services each nursing home offers.

  • View the results of health and safety inspections.

Hospital Compare –

  • 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.

Home Health Compare

  • 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.

Dialysis Compare -

  • Find out what kinds of dialysis services each facility offers.

  • 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 controlled).

  • Find out whether each dialysis facility offers other services such as home dialysis training or evening appointments.

Physicians Compare - 

  • 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).

Medicare Plan Finder - Use this tool to:

  • Search for drug and health plans.

  • Personalize your search to find plans that meet your needs.

  • Compare plans based on quality ratings, benefits covered, costs, and more.

  • Enroll in a plan.

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Patient Safety Resources

empoweredpatientcoalition.org

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 right 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 quality.

The Empowered Patient® Hospital Guide For Patients and Families - This guide is designed to help patients and families prepare for the issues involved in hospital care.

 Download 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 info@empoweredpatientcoalition.org

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

Hospitalization


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

Surgery


Be Prepared For Your Surgery

Questions To Ask A Surgeon After A Procedure
Surgical Patient Checklist
Surgical Fires

Adverse Events


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

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Patient Safety - Protecting Yourself From Medical Errors

www.ahrq.gov - Agency for Healthcare Research and Quality

Tips to Help Prevent Medical Errors - 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 results.

Medicines

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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 medicine?
  1. When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?
  2. 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.
  3. 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.
  4. 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.

Hospital Stays

  1. 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.
  2. 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.

Surgery

  1. 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.

  1. 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.

Other Steps

  1. Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.
  2. 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 hospital.
  3. Make sure that all your doctors have your important health information. Do not assume that everyone has all the information they need.
  4. 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.
  5. 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.
  6. If you have a test, do not assume that no news is good news. Ask how and when you will get the results.
  7. 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 www.effectivehealthcare.ahrq.gov.

    Ask your doctor if your treatment is based on the latest evidence.

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How to Complain—and Get Heard

www.ahrq.gov 

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 hospital.

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 the Joint Commission  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.

Patients can submit a complaint to The Joint Commission by e-mail at complaint@jointcommission.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.

Where and How to File Complaints

empoweredpatientcoalition.org

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 Medical Board

www.med.ohio.gov 

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 complaint form.

To Report an Adverse Medical Event

empoweredpatientcoalition.org

To File a Complaint against a Nurse

www.ncsbn.org

Boards of 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 - https://www.ncsbn.org/163.htm

To File a Privacy Complaint

www.hhs.gov

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.

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Protecting Yourself Guide After Hospital Stay

www.ahrq.gov

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.

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Protecting Yourself When Taking Medications

www.safemedicines.org

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.

www.fda.gov

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.

www.ismp.org - 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.

QuarterWatch 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.

www.fda.gov

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.

www.fda.gov

Drug Safety and Availability - Information for consumers and health professionals on:

  • new drug warnings

  • drug recalls

  • drug shortages

  • drug label changes,

  • and other safety information

  • Mobile App for Recalls

www.consumermedsafety.org

Learn more about how to take medicines safely. Download the Your Medicine, Play It Safe Booklet.

Find additional information at empoweredpatientcoalition.org - Fact-Sheets-a-Checklists Medication-Safety

www.drugwatch.com

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.

Counterfeit Medicine Alerts

www.fda.gov

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 counterfeits.

 

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How to Get Medication Prescription Assistance

www.consumer.ftc.gov

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.

Emails, ads, and websites for companies that guarantee free or low-cost prescription drugs for a hefty fee upfront are scams...

The 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.

While all 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.

Prescription Assistance Programs

Partnership for Prescription Assistance
1-888-477-2669

Access to Benefits Coalition

RxAssist

For Medicare Beneficiaries

Social Security Administration
ssa.gov/prescriptionhelp
1-800-772-1213
(TTY: 1-800-325-0778)

Finding a Free or Low-cost Clinic

Health Resources and Services Administration
1-888-275-4772
(TTY: 1-877-489-4772)

Partnership for Prescription Assistance Free Clinic Finder
1-888-477-2669

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Resource Guide to Keeping Your Home through Disease

www.mortgagecalculator.org

Chronic, and 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 the information they need to ensure they’re able to keep their home as they seek and receive treatment.

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Preventive Screenings: What’s Recommended, What’s Covered by Medicare

blog.planprescriber.com

To keep in your best shape and catch problems while they’re easier to treat, you need preventive screenings for a variety of health conditions. See Preventive Screenings Medicare

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Informative Resources

www.wddty.com - What 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.  

www.bravewell.org

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..

World Health Organization (WHO) - Health Topics – from A-Z

 

FDA Product Regulations

 

www.healthfinder.gov - Search tool sponsored by the Office of Disease Prevention and Health Promotion - Features health news and informative health educational links. 

The goal 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 sources of health information.

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 date range.

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 conditions.

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Health Hot Line Contacts

healthhotlines.nlm.nih.gov - 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.

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