caregivers] make is that they think hospitals will take care of everything,” says Bailey, a former music video producer who is completing a master’s degree in health advocacy and plans to work with hospital patients. “It’s that psychology of being the passive patient that can be such a problem.” After so many missteps, another person might have quietly taken note never to use that hospital again — or filed a lawsuit. Bailey instead developed “,” a book of 10 checklists that address many of the essentials for a hospital stay, including sections on what to bring with you, medication management, how to make your hospital stay safer and more comfortable, and planning for your discharge. The idea came from Bailey’s work in film production, where she always kept lists spelling out details about crews, shots, equipment and the like. The hospital “reminded me of a really badly run film set, and I just thought, ‘I need to produce this,’ ” she says. “Checklist” has become something of a buzzwordin health care in recent years. Many hospitals have embraced the idea for their staffs, aiming to improve patient safety and quality of care by ensuring that basic but critical steps are taken every time certain activities or tasks are performed. Checklists may cover everything from how to change the sheets on a bed to steps to reduce surgical complications. In a published in the New England Journal of Medicine in 2006, roughly 100 Michigan hospitals that adopted a simple five-step checklist for inserting central-line catheters in intensive-care patients reduced bloodstream infection rates by up to 66 percent over an 18-month period. The checklist included seemingly no-brainer steps such as requiring staff members to wash their hands and wear sterile gowns and gloves. But that’s part of the point: Many procedures are routine, caregivers are busy and small omissions can have disproportionately bad results. “There’s a lot that’s art in medicine,” says , director of the at Johns HopkinsSchool of Medicine, who was the lead author on the NEJM study. “But some things we’ve figured out. Patients are always going to be worried, but checklists allow them to worry about the things that really matter.” According to a published by the Institute of Medicine in 1999, medication errors in hospitals account for up to 98,000 deaths every year. Some experts suggest the number is probably higher. The checklists in Bailey’s book include templates for patients or relatives on managing hospital medications, including a master medication list that describes every drug being taken, the frequency, dosage, prescribing doctor’s name, special instructions and more, as well as a daily medication log where patients can keep track of every pill, injection and IV drip they’re given each day. Another list covers details such as getting to know the names of every nurse and aide, regularly wiping down surfaces such as call buttons and the TV remote with antibacterial wipes, and staying warm andhydrated to promote faster healing. Of course, being an assertive patient may not make you popular with overworked hospital staff. “Oftentimes, my tribe – the physicians or nurses — aren’t very welcoming of questions,” says Pronovost. In such cases, Bailey says, a little diplomacy goes a long way. “I start from the place of ‘We all have a common goal, which is the best possible outcome for this patient,’ ” she says. ” ‘We’re on the same team, and I need to understand my care.’ That’s very legitimate.” Please send questions or ideas for future topics for the Insuring Your Health column to . Categories: , , ,
