When Linda Kenney of Boston went to the hospital in 2007 for ankle replacement surgery, she expected a short hospital stay followed by about six weeks of low activity.
Instead, she went home with a bacterial infectionacquired while in the hospital. Within weeks, she required intravenous antibiotics and was rehospitalized. It took another year before she finally recovered.
Kenney said that at he time, she thought to herself, "This can't really be happening. It was like someone upstairs was playing a really sick joke on me."
As the founder and president of Medically Induced Trauma Support Services , Kenney, 46, is no stranger to patient safety issues. She had a catastrophic medical complication in 1999 while undergoing anesthesia that caused her to go into cardiac arrest. Doctors were forced to crack her chest open to save her life. Out of that experience, she founded MITSS and became a tireless patient safety advocate.
Despite all her knowledge since that experience, Kenney recognizes that she still became vulnerable when she went for her surgery in 2007. In hindsight, she said, it would have been helpful to have someone there with her and help her ask questions. She said there were questions she wished she had asked. The complications from her hospital stay increased her risk of dying sooner and are all-too-common occurrences in hospitals today.
As a resident physician in a major academic hospital, I often see firsthand the challenges of a hospital stay. Patients sometimes stay longer than they should and often don't ask enough questions or know the medications they take daily. These aspects can affect your care negatively. Despite the herculean efforts of the hospital, physicians and nurses to care for you, the hospital can be a risky place for you at your most vulnerable time.
When you get sick and are admitted to the hospital, you expect and deserve the best care. The hospital is a challenging place with difficult-to-understand procedures and tests and plenty of "unknown unknowns." Things can go wrong due to systemwide problems or human error.
When it comes to your health, you play an important and active role in your care. Here we offer our tips on how to survive your hospital stay.
Don't Overstay Your Welcome
While a hospital is the ideal place when you need life-saving care, it can also create the perfect storm of risks to your health.
Hospital-acquired infections, deadly blood clots, falls and many other "complications," can result from your hospital stay. Every day that you stay unnecessarily exposes you to these risks.
The federal government has recognized these hospital risks, and Medicare has now stopped reimbursing hospitals for "preventable" complications that happen to you in the hospital.
"With every moment spent in the hospital, the risk of medical mistakes ... goes up," said Dr. Marie Savard, ABC News medical contributor and author of "How to Save Your Own Life."
Savard added that patients who recover at home generally regain their mobility more quickly, and have less risk of developing blood clots. Blood clots are the most common cause of preventable death in hospitals. Each day that you stay immobile in the hospital increases your risk of developing these life-threatening clots.
Know Your Allergies and Medications
Carry the most up-to-date list of your allergies with you, along with another list that contains information on all medications you are taking, and their dosages.
"The details of any past reaction are also important, perhaps even more than just a list of 'allergies' because many patients -- and their doctors -- relate they are 'allergic' based on any adverse experience," said Dr. Franklin Adkinson, a professor in allergy and immunology at Johns Hopkins School of Medicine in Baltimore.
You may be denied the best drug for you because you thought you had an allergy when you didn't. Adkinson noted that he is "afraid the greater risk in most U.S. hospitals is that patients will be denied the use of valuable drugs because of past experiences, which may be labeled as allergy, or misinterpreted as dangerous, when in fact the patient can tolerate retreatment with minimal risk."
He noted that if your physician knew the details of your reactions in the past, he or she could assess your risk of receiving a drug. Ask your primary care physician to print for you a list of your medications and dosages and the conditions for which they're prescribed. Always carry this list with you and give a family member a copy.
Observe and Always Ask Questions
Your care depends on many people: from nurses who see you the most to doctors who make most of the decisions about your care. When it comes to your health, you are your own best advocate, and you have a right to know what's being planned for you in terms of procedures, tests and what will need to happen for you to be safely discharged from the hospital.
Build a strong relationship with your care team. Good nurses will be your advocates. No test or procedure done in the hospital is without risks, and understanding these risks is important.
Also, having a family member or friend who can write down questions and your plan of care can be crucial. Savard advised that a "health buddy" can be very helpful. This health buddy would stay "with you in shifts as close to 24/7 as possible -- [and provide] a set of eyes and ears to minimize mistakes, increase your comfort and reduce a feeling of helplessness, and to observe and ask questions."
Always ask why a test is being done and about the possible side effects for that test. You have a critical role to play in your care -- become a partner in your health.
Don't Let Medical Errors Happen to You
In 1999, the Institute of Medicine estimated that between 44,000 and 98,000 Americans die each year in hospitals due to medical errors. Although this number has been disputed, there is no denying that medical errors are a serious problem that can affect your hospital stay.
Of these errors, medication-related errors are one of the most common hospital errors, with estimates of 400,000 drug-related injuries in hospitals each year.
"It is important for patients to know accurately their current medications and doses, as well as any past experiences, such as past allergic reactions, that might affect a decision to use a drug again," Adkinson advised.
Confirm the names and dosages of medications that are given to you by your nurse; if you are getting a new drug, ask why it's being given and how long you will be on it. Having your personal health records and any recent discharge summaries from hospitals stays can be helpful in avoiding medical errors. Additionally, you should know why every test or procedure is being performed on you in order to avoid unnecessary tests.
Pick the Right Hospital for You
People end up at hospitals for a variety of reasons, but which hospital you go to for your care can make all of the difference.
"It is extraordinary how much variation exists between the quality of care at hospitals," said Dr. Rick May of HealthGrades.com, an organization that evaluates and rates hospitals. The site allows you to compare death rates for a variety of conditions -- from heart attacks to pneumonia to surgeries -- at hospitals across the country.
"One hospital has great outcomes, low complication rates, and across the street another hospital can have high complication rates, with the same doctors working at both facilities," May said. "It comes down to those hospitals that have taken the time and effort and put serious efforts into building systems that focus on providing the highest quality care to every single patient every single time."
It's also clear that some hospitals perform better than others, on average, when it comes to treating certain conditions. "Where hospitals fall down is when they don't know the best practices out there, or they may know them but not have systems in place to make that happen," May said.
The consensus opinion is that if you are having a procedure or surgery, choose a hospital that has significant experience in caring for your condition. Web sites like whynotthebest.org, USNews.com, and HealthGrades.com can help patients deal with these complex issues.
When it comes to choosing the right hospital for you, do your homework and follow the advice of your family, friends and doctors, in addition to an assist from the Internet.