Most people don’t know that this week is National Patient Safety Awareness Week, a special week dedicated to making health care safer. Why do we need it? Why is it important?
Up to 440,000 people die in the U.S. every year because of preventable health care harm. The deaths come after indescribable human suffering. Infections, blood clots, falls, serious skin ulcers and surgical and medication errors are examples of events that can cause tragic health care outcomes.
Preventable health care harm is the third leading cause of death, after heart disease and cancer. After three years, the number of people who die from health care errors grows to about 1.3 million, equivalent to Maine’s population. Of course, not all of this harm happens in Maine, but the magnitude of this problem is mindblowing.
Many more uncounted patients are disabled, some permanently, as a result of health care harm. Their lives irreversibly are changed. They become unable to work or provide for themselves or their families, become reliant on others for many things and are financially ruined. Some lose everything they ever owned because of health care debt. Bills for serious harm can quickly climb to many hundreds of thousands of dollars, and, yes, harmed patients are expected to pay. Some patients even get calls from collections agencies.
Why should we care?
Every single person with whom I have had a “patient safety” conversation has shared his or her own story of health care harm. Everybody has a story.
Must we accept that health care can be a crapshoot? Absolutely not. We need to hold the health care industry, providers and caregivers accountable for this harm and for making necessary improvements. We pay for and deserve safe, high-quality care when we are sick or injured. We need to protect ourselves and our loved ones from avoidable harm that can lead to disability, death and financial devastation. Zero harm is the only acceptable goal.
There are many steps we as patients can take to educate and empower ourselves and to stay safe. One of the most important is choosing our caregivers, facilities and care wisely.
There are a number of hospital and physician rating systems available. Hospital Compare, Consumer Reports Hospital Safety ratings and Leapfrog are a few reliable hospital rating systems. Healthgrades and Physician Compare rate providers and clinicians. CompareMaine is a homegrown, consumer-friendly, expanding website from the Maine Health Data Organization that offers health care quality and cost information. Get Better Maine is a product of the Maine Health Management Coalition that continues to expand.
Patients can ask questions about any and all recommendations. The five Choosing Wisely Questions are appropriate for any medical recommendation.
— Is it necessary?
— What are the risks?
— Are there alternatives?
— What happens if I do nothing (watchful waiting)?
— How much does it cost?
If a clinician is put off by these questions, move on. This becomes more of a challenge in an emergency situation, of course.
The Shared Decision Making model also offers tools that can help patients participate in their own health care decisions based on the best evidence and their own preferences. Your care is up to you, and decisions should be made by you in partnership with your clinician. Patients get the final word.
Possibly the most important thing anyone can do is to bring a trusted loved one or friend along to any health care encounter to serve as a supporter and advocate. If for any reason you are unable to speak, your advocate will speak in your best interests. An advocate can also help you to remember things you may have missed during the visit or hospital stay.
If you are uncomfortable with your clinician’s care or advice, diagnosis or recommendations, and you cannot partner with him or her, consider a second opinion.
If patients do not take an active role in their care, their care becomes the decision of the provider. That may work out for some, and of course it may not for others. Therein lies the gamble.
We must take control of our own health and health care as patients. We all want the same things: health care that is customized for us, safe, effective and affordable.
Kathy Day of Bangor is a registered nurse and a patient safety advocate.