One Simple Question Is The Key To Patient Focused Care

I recently spoke with a woman in her eighties about her experience with health care. We chatted about everything from the current state of health services in the U.S. to more personal issues like the care of a loved one following a diagnosis of cancer. What struck me the most was her staunch attitude regarding how her care should be within her control and therefore her decision. Unfortunately, this is not an attitude which is common amongst the public, especially not among the elderly. Too often we place our faith (and health) in someone else’s hands, without batting an eye at batteries of tests or arrays of treatments, and never ask the key question, “why”?

Take for example, a seventy-year-old woman who had fallen and was experiencing agonizing pain in her right ankle. After being taken to the hospital, her doctor ordered an x-ray and an orderly promptly took her away. Upon arriving at x-ray, the technicians began to prepare her for an x-ray to her left ankle, as the doctor had ordered. The woman thought this was odd, but followed along with the instructions. When she returned to her bed in the ER, the doctor came in and told her nothing was wrong with her left ankle. The woman replied, “That’s good, because I fell on my right ankle!” The whole process was again completed, this time finding a fracture in her right ankle. When the woman was asked why she did not question the wrong ankle being x-rayed, she gave the common answer that she was following the doctor’s orders and she trusted his judgment.

Due to acute and chronic illness, accidents, misuse of prescription medications, and an abundance of other traumas, 37 million people are hospitalized each year. The amount of patients who die annually from preventable hospital errors is the equivalent of four full jumbo jets crashing each week. Patients are given the wrong medications, administered the wrong treatments, operated on in the wrong location, and acquire infections that could have been avoided. According to AARP’s 2012 article, “Hospitals May Be the Worst Place to Stay When You’re Sick”, these errors annually result in 100,000 preventable deaths.

The reality of the situation is that all medical professionals, whether they are your nurse, surgeon, general practitioner, or physiotherapist, are all human and therefore, will make mistakes. Some systems have been put in place to reduce errors, such as checklists prior to surgery or routine follow-up assessments for catheter placement. Some variables have been eliminated completely, such as using more permanent pens to mark surgical sites in place of pens whose markings easily rubbed off. Programs have added incentives for health care providers in hospitals who wash their hands (surprising and disturbing, but greatly needed). And penalties have been put into place for some hospitals that see rises in preventable errors and hospital acquired infections.

As patient-safety systems are put in place at the local, states, and national level, you, the patient, come in to play as another factor. Many of us blindly trust that medicine can do no harm, when the opposite is true. We live in the age of information and it is important to arm yourself with education. Simply asking the question “why” when starting a new treatment can spur conversation regarding what evidence supports this treatment, or can identify other potential avenues of treatment.

Other methods of advocating for yourself are:
– Having someone accompany you to appointments as an extra set of ears. Anything pertaining to our health can become overwhelming, causing us to not understand or remember everything said. By bringing a buddy or a notebook, you will more clearly recall the crucial points relating to your health, decreasing later confusion.
– If something does not seem right, clarify. Maybe what you have said has been misconstrued or maybe you do not understand what your physician has said. Either way, your clarification will decrease the likelihood of an error occurring.
– Know your health. Many errors occur because people do not give their full histories, lists of allergies, or medications they are currently being prescribed. There is a big difference between “I take a sleep aid” and “I take 10mg of Zolpidem four times a week because I am too anxious to fall asleep”. The second statement not only clarifies the medication, dosage, and frequency, but also may lead to the identification of other health issues at play.

Finally, asking, “why” puts you at the center of your care. After all, YOU are what patient focused care is all about.

For more information about being an empowered patient, check out The Empowered Patient Hospital Guide.

For more safety checklists about everything from taking medications for acid reflux to preventing surgical errors see the safety checklists and the patient friendly resources.