Practice Makes Perfect: Tips For Safer Healthcare

NQF's Safe Practices offer guidance to patients

WASHINGTON, April 7 /PRNewswire-USNewswire/ -- Healthcare in the United States isn't as safe as it should be. Preventable errors cost the U.S. an estimated 98,000 lives and $17 billion to $29 billion per year in healthcare expenses, lost worker productivity, lost income, and disability. While healthcare spending grows more than 7 percent per year, it is estimated that patient safety is improving by only 1 percent.

Despite dire statistics, there are pockets of improvement and steps patients and their doctors can take to help ensure they receive the safest care possible.  In hospitals, clinics, and emergency rooms patients and healthcare providers can use the National Quality Forum's (NQF) endorsed list of 34 "best practices" to improve healthcare safety. The Practices - covering areas like medication use, leadership, radiation safety, and healthcare associated infections - are used by healthcare systems across the country. The Safe Practices are evidence-based improvement strategies for those who provide, purchase, and use healthcare to ensure that harm is reduced and care is safe.

Safe Practices are also a guide for patients and their families to get involved to achieve safer care. Patients who are engaged as active partners in their healthcare team are vital to achieving better health outcomes and lower costs.

• Repeat in your own words.  After your doctor tells you about a procedure, medications, symptoms, or other details about your care, repeat it to back to him or her in your own words.  

Communication failures between patients and healthcare providers are at the root of systems failures and human errors that lead to harm.  Ensuring you understand your diagnosis, treatment options, and upcoming procedures can help you make informed decisions about your care.  (Safe Practice #5: Informed Consent)

• Ask for your discharge plan.  Before you leave the hospital ask your doctor if he or she has given a copy of your discharge plan to your primary care physician. Also ask your nurse or doctor for your own copy of your discharge plan. The plan should be as concise as possible and you and your primary care physician should understand the next steps in your care.

Transfer from a hospital to primary care or a community setting is often an unsystematic, fragmented process that creates high risk for adverse events.  The lack of communication and coordination among care settings often puts patients at risk.  The use of a hospital discharge plan has been shown to decrease re-hospitalization.  (Safe Practice #15: Discharge Systems)

• Keep a list of your medications.  Ask your doctor for an accurate, up-to-date list of the medications you are taking.  Keep it with you and present it to specialists, hospital physicians and other healthcare professionals you visit.  

An estimated 1.5 million preventable adverse drug events occur each year.  A recent study showed 96 percent of patients failed to recall one or more of the medicines they had been prescribed during their hospital stay.  Sharing your medication list with the hospital team can help prevent miscommunication and prescribing errors, and encourage that you leave the hospital with the right medications.   (Safe Practice #17: Medication Reconciliation)

• Ask your doctor to wash his/her hands.  At the beginning of any exam or procedure, ask your doctor or other healthcare professional if he or she has washed their hands. When you're a patient or visitor in a healthcare facility wash your hands or use hand sanitizer regularly.  

Hand hygiene is one of the most important and effective interventions in preventing transmission of pathogens in healthcare facilities.  However, some studies have observed a hand washing compliance rate of less than 50 percent. Patients can reduce the spread of pathogens by washing their own hands and asking health professionals to wash theirs. (Safe Practice #19: Hand Hygiene)

• Get and keep your test results. If you've had a test done at a clinic or hospital, follow-up with your doctor to get the results and keep a copy for yourself.

Critical information about medical history, diagnostic test results, treatments, and procedures are often not communicated to everyone providing care for a patient.  Even more common, such information is often not communicated among care settings.  One study of diagnostic testing in primary care found approximately 25 percent of medical errors involve failures in reporting test results.  Patients can help reduce errors by keeping copies of their test results and sharing them with their other care providers.  (Safe Practice #12: Patient Care Information)

About Safe Practices

The NQF-endorsed Safe Practices are tools to help unite healthcare providers, purchasers, and consumers to more rapidly identify and adopt established techniques and routines that reduce errors and improve care. The evidence-based practices endorsed by NQF build on six years of work defining and refining strategies that improve the safety of healthcare.  NQF recently updated the 34 Practices and the accompanying manual that outlines implementation strategies and guidance for involving patients and families in safe care.

Safe Practices are part of NQF's ongoing work to improve safety in healthcare.  NQF also endorses a list of Serious Reportable Events, or events that should never happen in healthcare such as wrong site surgery or leaving a foreign object in a patient during surgery.  This list of Serious Reportable Events works in tandem with Safe Practices.  By reporting serious events, the healthcare system can learn how to make care safer.  

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (www.qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.

SOURCE National Quality Forum