UNION HOSPITAL
Patient Safety Tools: Speak Up Program

The "Speak Up" program, sponsored by the Joint Commission on Accreditation of Healthcare Organizations, urges patients to get involved in their care. Such efforts to increase consumer awareness and involvement are supported by the Centers for Medicare and Medicaid Services. This initiative provides simple advice on how you, the patient, can make your care a positive experience. Research shows that patients who take part in decisions about their health care are more likely to have better outcomes.

Speak up if you have questions or concerns, and if you don't understand, ask again. It's your body and you have a right to know. Don't be afraid to ask about safety. If you're having surgery, for example, ask the doctor to mark the area that is to be operated upon, so that there's no confusion in the operating room. Don't be afraid to tell the nurse or doctor if you think you are about to receive the wrong medication. Don't hesitate to tell the healthcare professional if you think he or she has confused you with another patient.

Pay attention to the care you are receiving. Make sure you're getting the right treatments and medications by the right healthcare professionals. Don't assume anything. Tell your doctor or nurse if something doesn't seem quite right. Expect healthcare workers to introduce themselves when they enter your room and look for their identification badges. A new mother should also know the person to whom she is handing her baby. If you are unsure, ask. Notice whether your caregivers have washed their hands, and don't be afraid to gently remind a doctor or nurse to do this. Know what time of day you normally receive medication. if this doesn't happen, bring this to the attention of your nurse or doctor. Make sure your doctor checks your wristband or asks your name before administering any medication or treatment.

Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan. Ask your doctor about the specialized training and experience that qualifies him or her to treat your illness. Gather information about your condition. Good sources include your doctor, library, respected websites and support groups. Write down important facts your doctor tells you, so that you can look for additional information later. Ask your doctor is he has any written information you can keep. Read all medical forms and make sure you understand them before signing. If you don't understand, ask your doctor or nurse to explain. Make sure you are familiar with the operation of any equipment that is being used in your care.

Ask a trusted family member or friend to be your advocate. Your advocate can ask questions that you may not think of while you are under stress. Your advocate can help remember answers to questions you have asked, and speak up for you if you cannot. Ask this person to stay with you, even overnight, when you are hospitalized. You will be able to rest more comfortably and your advocate can make sure you get the right medications and treatments. Make sure this person understands your preferences for care and your wishes concerning resuscitation and life support. Review consents for treatment with your advocate before you sign tham and make sure you both understand exactly what you are agreeing to. Make sure this person understands the type of care you will need when you get home. Your advocate should know what to look for if your condition is getting worse and whom to call for help.

Know what medications you take and why you take them. Medication errors are the most common health care mistakes. Ask about the purpose of the medication and ask for written information about it, including its brand and generic names and the side effects associated with taking it. If you do not recognize a medication, verify that it is for you. Ask about oral medications before swallowing, and read the contents of intravenous (IV) fluids. If you are unable to do this, ask your advocate to do this. If you are given an IV, ask the nurse how long it should take for the liquid to "run out." Tell the nurse if it seems to drip too fast or too slow. Whenever receiving new medication, tell your doctors and nurses about allergies you have, or negative reactions you have had to medications in the past. If you are taking muliple medications, ask your doctor or pharmacist if it is safe to take those medications together. This holds true for vitamins, herbal supplements and over-the-counter drugs as well. Make sure you can read the handwriting on any prescriptions written by your doctor. If you can't read it, the pharmacist may not be able to either.

Use a hospital, clinic, surgery center, or other type of healthcare organization that has undergone a rigorous on-site evaluation against established, state-of-the-art quality and safety standards, such as that provided by JCAHO. Before you leave the hospital or other facility, ask about follow-up care and make sure that you understand all of the instructions.

Participate in all decisions about your treatment. You are the center of the healthcare team. You and your doctor should agree on exactly what will be done during each step of your care. Know who will be taking care of you, how long the treatment will last, and how you should feel. Understand that more tests or medications may not always be better. Ask your doctor what a new test or medication is likely to achieve. Don't be afraid to seek a second opinion. The more information you have the options available to you, the more confident you will be in the decisions made.

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