Speak Up

Everyone has a role in making healthcare safe, including doctors, healthcare executives, nurses and healthcare technicians. As a patient, you can help make the care you receive safer by being an active, involved and informed member of your healthcare team.

An Institute of Medicine (IOM) report says that medical mistakes are a serious problem in the healthcare system. The IOM says that public awareness of the problem is an important step in making things better.

The “Speak Up™" program is sponsored by The Joint Commission. It agrees that patients should be involved in their own healthcare. These efforts to increase patient awareness and involvement also are supported by the Centers for Medicare & Medicaid Services.

This program gives simple advice on how you can help make healthcare a good experience. Research shows that patients who take part in decisions about their healthcare are more likely to get better more quickly. To help prevent healthcare mistakes, patients are urged to speak up.

Speak up if you have questions or concerns. If you still don’t understand, ask again. It’s your body and you have a right to know.

• Your health is very important. Do not worry about being embarrassed if you don’t understand something that your doctor, nurse or other healthcare professional tells you. If you don’t understand because you speak another language, ask for someone who speaks your language. You will have the right to get free help from someone who speaks your language.
• Don’t be afraid to ask about safety. If you’re having surgery, ask the doctor to mark the area that is to be operated on.
• Don’t be afraid to tell the nurse or the doctor if you think you are about to get the wrong medicine.
• Don’t be afraid to tell a healthcare professional if you think he or she has confused you with another patient.

Pay attention to the care you get. Always make sure you’re getting the right treatments and medicines by the right healthcare professionals. Don’t assume anything.

• Tell your nurse or doctor if something doesn’t seem right.
• Expect healthcare workers to introduce themselves. Look for their identification (ID) badges. A new mother should know the person to whom she hands her baby. If you don’t know who the person is, ask for his or her ID.
• Notice whether or not your caregivers have washed their hands. Handwashing is the most important way to prevent infections. Don’t be afraid to remind a doctor or nurse to do this.
• Know what time of the day you normally get medication. If you don’t receive it, tell your nurse or doctor.
• Make sure your nurse or doctor checks your ID. Make sure he or she checks your wristband and asks your name before he or she gives you your medicine or treatment.

Educate yourself about your illness. Learn about the medical tests you get and your treatment plan.

• Ask your doctor about the special training and experience that qualifies him or her to treat your illness.
• Look for information about your condition. Good places to get that information are from your doctor, library, respected websites and support groups.
• Write down important facts your doctor tells you. Ask your doctor if he or she has any written information you can keep.
• Read all medical forms and make sure you understand them before you sign anything. If you don’t understand, ask your doctor or nurse to explain them.
• Make sure you know how to work any equipment that is being used in your care. If you use oxygen at home, do not smoke or let anyone smoke near you.

Ask a trusted family member or friend to be your advocate (advisor or supporter).

• Your advocate can ask questions that you may not think about when you are stressed.
• Ask this person to stay with you, even overnight, when you are hospitalized. You will be able to rest better. Your advocate can help make sure you receive the right medicines and treatments. Please include your nurse in the decision to have your advocate spend the night with you. We want to make sure appropriate accommodations can be made.
• Your advocate also can help remember answers to questions you have asked. He or she can speak up for you when you cannot speak up for yourself.
• Make sure this person understands the kind of care you want. Make sure he or she knows what you want done about life support and other life-saving efforts if you are unconscious and not likely to get better.
• Go over the consents for treatment with your advocate before you sign them. Make sure you both understand exactly to what you are about to agree.
• Make sure your advocate understands the type of care you will need when you get home. Your advocate should know what to look for if your condition is getting worse. He or she should also know who to call for help.

Know what medicines you take and why you take them. Medicine errors are the most common healthcare mistakes.

• Ask about why you should take the medication. Ask for written information about it, including its brand and generic names. Also ask about the side effects of all medicines.
• If you do not recognize a medicine, double-check that it is for you. Ask about medicines that you are to take by mouth before you swallow them. Read the contents of the bags of intravenous (IV) fluids. If you’re not well enough to do this, ask your advocate to do it.
• If you are given an IV, ask the nurse how long it should take for the liquid to run out. Tell the nurse if it doesn’t seem to be dripping right (too fast or too slow).
• Whenever you get a new medicine, tell your doctors and nurses about allergies you have, or negative reactions you have had to other medicines.
• If you are taking a lot of medicines, be sure to ask your doctor or pharmacist if it is safe to take those medicines together. Do the same thing with vitamins, herbs and over-the-counter drugs.
• If you have a written prescription, make sure you can read the handwriting on prescriptions written by your doctor. If you can’t read it, the pharmacist may not be able to either. Ask somebody at the doctor’s office to print the prescription, if necessary.
• Carry an up-to-date list of the medicines you are taking in your purse or wallet. Write down how much you take and when you take it. Go over the list with your doctor and other caregivers.

Use a hospital, clinic, surgery center, or other type of healthcare organization that has been carefully checked out. For example, The Joint Commission visits hospitals to see if they are meeting its quality standards.

• Ask about the healthcare organization’s experience in taking care of people with your type of illness. How often does it perform the procedure you need? What special care do they provide to help patients get well?
• If you have more than one hospital to choose from, ask your doctor which one has the best care for your condition.
• Before you leave the hospital or other facility, ask about followup care and make sure that you understand all of the instructions.
• Go to Quality Check to find out whether your hospital or other healthcare organization is accredited. Accredited means that the hospital or healthcare organization meets patient safety and quality standards.

Participate in all decisions about your treatment. You are the center of the healthcare team.

• You and your doctor should agree on exactly what will be done during each step of your care.
• Know who will be taking care of you. Know how long the treatment will last. Know how you should feel.
• Understand that more tests or medications may not always be better for you. Ask your doctor how a new test or medication will help.
• Keep copies of your medical records from previous hospital stays and share them with your healthcare team. This will give them better information about your health history.
• Don’t be afraid to ask for a second opinion. If you are unsure about the best treatment for your illness, talk with one or two additional doctors. The more information you have about all the kinds of treatment available to you, the better you will feel about the decisions made.
• Ask to speak with others who have had the same treatment or operation you may be having. They may help you prepare for the days and weeks ahead. They may be able to tell you what to expect and what worked best for them.
• Talk to your doctor and your family about your wishes regarding resuscitation and other life-saving actions.
• The hospital will inform the patient of the name of the physician who has primary responsibility for care, treatment or services.

Reproduced with permission of The Joint Commission.