In a report released today (December 16, 2014), Consumer Reports shares insights from a survey of 1,200 people who were recently hospitalized. SPM is not surprised by the findings, which include the fact that patients who said they received respectful treatment by hospital clinicians reported fewer medical errors and better experiences in their hospital stays.
This could be a landmark that helps to shift the paradigm on hospital safety and medical errors, given that Consumer Reports is read by a much more diverse audience than is JAMA or NEJM or BMJ. Getting information on how to manage a hospital stay in front of patients and families *before* they get hospital treatment – information that isn’t just a procedure brochure from their surgeon, as helpful as that can be about the reason for the hospital stay – is critical to increasing patient safety.
One message that comes through loud and clear: engagement may be the buzzword, but accountability is the watchword, for both clinical teams and patients. We all have to participate. Which we can only do if we’re fully informed.
Reading through the report online, which we encourage everyone to do, serves up these key points:
- Choose the right hospital. An analysis of data from Consumer Reports’ Ratings of almost 2,600 hospitals supports the idea that patient satisfaction and patient safety are connected. The full story [ed. note: in February 2015 issue of Consumer Reports] contains a chart of the hospitals that scored high and low in both areas.
- Help providers see you as a person. Once you get to the hospital, chances are you won’t know the folks taking care of you, so it’s important to remind them you are more than a just a diagnosis. Share personal things about yourself, such as photos and stories and add personal details when you describe your medical problems to a doctor.
- Invite your doctor to have a seat. The increased use of electronic devices by medical staff to collect data is having a real impact on doctor-patient communication. A patient can change this dynamic by inviting their doctor to sit down and have a conversation, making it easier to communicate.
- Have “your people” with you. In the Consumer Reports survey people who had family or friends as their health advocate were 15 percent more likely to say they had been treated with respect and 12 percent more likely to recommend their hospital to others.
- Know when errors are likely to occur. If you know when and where errors are more likely to occur, such as at shift changes or transitions such as moving from ICU to a hospital floor, be sure to have your advocate present. It can also be helpful to have an “inside troubleshooter” and an often untapped resource is the hospital ombudsman, or patient advocate, an intermediately between patients and staff, available at many facilities. Fewer than half of those surveyed by Consumer Reports knew such a person was available, and almost no one, just 4 percent, asked to see one.
- Keep the concept of partnership in mind. There is a good and a bad way of challenging your doctor. The notion that “you are the expert when it comes to your body and the doctor is the expert when it comes to medicine” is a good rule of thumb. There should be a spirit of teamwork that includes shared observations, knowledge and information and asking questions – but not making accusations.
- Write things down. With doctors, nurses, technicians, medical students and social workers in and out of your room, it can be very hard to keep track of what they are all doing, especially when you are ill. Keep a journal and pen, or an e-device, ready at your bedside to take notes and write things down to share.
- If you don’t understand something, ask again. Medicine is complicated and full of technical terms and sometimes doctors, who are immersed in it, forget you haven’t studied it. Feel comfortable to politely remind them that you may need them to slow down and translate into plain English, so you can fully understand.
There’s also a terrific short video accompanying the piece, which is worth sharing all on its own.
SPM salutes Consumer Reports, and the Gordon and Betty Moore Foundation (who funded it) for this report, and for their recommendations. This is how paradigms shift.
Thanks Casey for this helpful recap of such an interesting and important subject.
I was pleased to be interviewed for this CR report (not surprisingly, in the “Don’t Worry About Being a Pest” paragraph!) but I hasten to add that even being a “pest” does not necessarily guarantee patients “fewer medical errors and better experiences” in hospital.
In my case, my annoying question in mid-heart attack to the ER doctor who had just misdiagnosed me with acid reflux was:
“But doc, what about this pain down my left arm?”
Even I knew that arm pain is not a symptom of indigestion, yet I was still chastised by an exasperated ER nurse for being a pest, specifically daring to question the doc (as described in the report). I was so embarrassed after her dressing down that I fairly slunk out of that hospital ER that morning.
That type of professional reaction to patients who are “pests” is precisely what keeps us meek and silent in spite of helpful patient engagement lists like this one.
Agree completely, Carolyn, and I’m delighted that you posted a comment saying exactly what you did.
The video accompanying the piece includes the following statement, “Be assertive. Be courteous, but be assertive.”
I had to go as far as risking an assault charge (courteous assertiveness didn’t work) while my mother was receiving less-than-optimal hospital care that put her life at risk back in the mid ’90s sometime. She lived another 7 years, 6 of them pretty good …