herjua

(Pub­lished in the Huff­in­g­ton Post May 8, 2015)

 

Being hos­pi­tal­ized today presents a seri­ous dilem­ma to both patients and fam­i­lies. You need hos­pi­tal care because of some con­di­tion or dis­ease. But you may also need pro­tec­tion from the hos­pi­tal and the harm that can occur.

One night sev­er­al years ago, when my moth­er was in her fourth month of hos­pi­tal­iza­tion and in crit­i­cal con­di­tion, I noticed that she hadn’t received her evening med­ica­tions. It was get­ting late. The pills and open vials of med­ica­tion had been sit­ting in the cor­ri­dor out­side her room for some time.

When the nurse final­ly arrived well after 10 p.m, I expressed con­cern about the med­ica­tions that were left exposed in the hall­way. She replied with a sneer, “You just want every­thing to be so per­fect for your moth­er, don’t you?” I gave the only response I could: “You bet I do.” It’s the same answer that any daugh­ter or son would sure­ly give in sim­i­lar cir­cum­stances.

In many hos­pi­tals, it’s not just that the care is less than per­fect. It can be down­right harm­ful. Med­ical errors in the hos­pi­tal set­ting are the third lead­ing cause of death in Cana­da and the Unit­ed States. Some 15 mil­lion patients suf­fer some form of harm in U.S. hos­pi­tals every year. In Cana­da, one in every nine patients will acquire an infec­tion while in the hos­pi­tal. Thou­sands die from hos­pi­tal acquired infec­tions every year.

Being hos­pi­tal­ized today presents a seri­ous dilem­ma to both patients and fam­i­lies. You need hos­pi­tal care because of some con­di­tion or dis­ease. But you may also need pro­tec­tion from the hos­pi­tal and the harm that can occur as a result of every­thing from med­ica­tion errors and pres­sure ulcers to sponges left inside the body after surgery . The elder­ly, as so many of our par­ents are fast becom­ing, are espe­cial­ly vul­ner­a­ble to hos­pi­tal harm.

What to do?

Since becom­ing involved in the patient safe­ty move­ment in Cana­da and the Unit­ed States, I have read thou­sands of pages of med­ical research and lit­er­a­ture on the sub­ject. I’ve talked with world renowned experts and lis­tened to the tragedies of count­less fam­i­lies look­ing to share their sto­ries so that what hap­pened to their mom or dad, daugh­ter or son will not hap­pen to oth­ers.

Here are three take-aways from my expe­ri­ence that can help patients and fam­i­lies suc­cess­ful­ly nav­i­gate a safer hos­pi­tal jour­ney.

»A safe patient is an informed patient.
An informed fam­i­ly is often nec­es­sary when old­er par­ents are hos­pi­tal­ized.
Learn about the real­i­ties of med­ical errors in hos­pi­tals and how they can occur. Check out the facts about your hos­pi­tal if they are avail­able, such as infec­tion rates and post-surgery death rates. Look around: does the hos­pi­tal seem clean? Do health­care work­ers con­stant­ly san­i­tize their hands or do they cut cor­ners? Hand hygiene before and after patient con­tact is crit­i­cal in pre­vent­ing the spread of dis­ease and infec­tion. Google the hos­pi­tal for any com­plaints or news items of inter­est.

There are good online sources from respect­ed health­care orga­ni­za­tions that will help patients and fam­i­ly mem­bers under­stand their rights and what steps they need to take pro­tect them while in the hos­pi­tal. A start­ing point for these resources can be found here.

If you have any doubts about what you learn or see, you may need to become even more involved with the patient’s care. You might need, as I did, to become vir­tu­al­ly embed­ded as a mem­ber of your loved one’s care team. That is your right as a close fam­i­ly mem­ber.

»A safe patient is an engaged patient.
When patients can­not be ful­ly engaged with their care and the deci­sions being made, that respon­si­bil­i­ty becomes the family’s.

Doc­u­ment, doc­u­ment, doc­u­ment. Keep a com­pre­hen­sive jour­nal of your loved one’s hos­pi­tal stay from start to fin­ish. Always have it with you while vis­it­ing. Make detailed notes about what is hap­pen­ing around you if you think it could impact the patient. Any sig­nif­i­cant inter­ac­tions with doc­tors, nurs­es or oth­er health­care pro­fes­sion­als need to be jour­nal­ized. Always get their names and write them down, along with details about any con­ver­sa­tion. Med­ical records don’t always tell the whole sto­ry when it comes to hos­pi­tal harm. Vital infor­ma­tion may be left out. If you have your own accu­rate record, that can help in forc­ing prop­er dis­clo­sure and account­abil­i­ty.

»A safe patient is a pro­tect­ed patient.
Fam­i­lies are key to the pro­tec­tion of loved ones. Look for warn­ing signs. What is hap­pen­ing with mom or dad? Do they seem not quite right? Has some­thing changed in their cog­ni­tive or phys­i­cal func­tion­ing? You are the expert on what is nor­mal for your fam­i­ly mem­ber. Trust your instincts. You may pick up ear­ly warn­ings of a loved one’s dete­ri­o­rat­ing con­di­tion before it is not­ed by health­care pro­fes­sion­als. Make your con­cerns crys­tal clear. Find out if there is a rapid response pro­to­col in the hos­pi­tal that will allow patients or fam­i­lies to imme­di­ate­ly sum­mon help when it is urgent­ly need­ed. Don’t wait for the dam­age to become irre­versible.

In my mother’s case, I noticed a seri­ous change in her demeanor and respon­sive­ness. She was hav­ing trou­ble breath­ing. Her care team insist­ed she was fine and made it clear there were oth­er patients in the ICU who need­ed more atten­tion. Lat­er than night, she suf­fered a car­diac arrest. She was revived, but was left per­ma­nent­ly dis­abled and requir­ing 24/7 care. That is a life-changer for any fam­i­ly.

There is no more pre­cious gift you can give your mom or dad than the gift of hos­pi­tal safe­ty. My mother’s doc­tors repeat­ed­ly warned that her demise was immi­nent. With­out a vig­i­lant fam­i­ly, it would have been.

Even though she returned home a tiny shad­ow of her for­mer self and had been left by the hos­pi­tal in a mal­nour­ished state, she has become a tow­er­ing bea­con of the indomitable will to sur­vive that has inspired oth­ers. This will be her fifth Mother’s Day since her dis­charge from the hos­pi­tal.

We call it Mother’s Day. But the truth is her love and enjoy­ment of life are real­ly a gift to me. Every day.

Hap­py Mother’s Day, Mom.