I have to admit I was tepid about reading The Patient’s Checklist: 10 Simple Hospital Checklists to Keep you Safe, Sane & Organized. Planning out your next hospital stay is not as exciting as plotting your next vacation. But if you read the preface you’ll be hard-pressed not to finish this book — or at least keep it for future reference.
Some list books make interesting bathroom reading, where you learn some fascinating tidbit and emerge with a whole new conversation starter. This is not one of them. Instead, as author Elizabeth Bailey describes, it gives you the tools to act as your own or your loved one’s “patient’s advocate.”
Bailey offers enticements throughout — reasons you want to be an informed patient and not just a bystander to your care. A few that left me aghast:
» 98,000 preventable deaths a year are caused by medical errors in hospitals.
» Medication errors are responsible for 28 percent of all hospital admissions.
» Each hospital patient is subject to an average of one medication error per day.
» Every six minutes a U.S. hospital patient dies from a hospital-acquired infection.
» Each year 2 million American hospital patients acquire an infection during their stay.
» 52 percent of doctors do not wash their hands between patients.
» Half of all adverse drug reactions are the result of medical error.
These shocking teaser statistics are the bad news that ushers in the good: the checklists, which could greatly reduce the chances of this happening to anyone who implements them. The author’s intention is to guard against simple human error and to encourage simple human kindness, so that the patient is not only “cured” but “healed.”
Bailey breaks down the arcane health-care delivery system to patient tasks focused on three goals: understanding why each action is being done; agreeing that each action is necessary and the appropriate treatment at the time; and being sure that every single action — routine or uniquely complex — is meant for this patient, performed under sanitary conditions, and using the best practices.
The 10 lists are disarmingly simple:
» 1. Before you go: how to be a more informed, prepared and proactive patient
» 2. What to bring: practical and personal, like ear plugs, eye masks and extra socks
» 3. During your stay: suggestions for increasing comfort
» 4. Master medication list: an easy to understand consolidation
» 5. Daily Medication log: right drug, right dose, right schedule, right method, meant for you
» 6. Daily journal
» 7. Discharge plan: home care guide, to break down what is often exceedingly complex
» 8. Insurance: suggestions to help organize and follow through
» 9. Doctor contacts
» 10. Family and friends contact list
Other than childbirth, I haven’t had occasion for staying in hospitals. I don’t relish being a patient, but it’s comforting to think I could retain a modicum of control through list-making.
It would take some courage and fortitude to request and gather the data. Nevertheless, if the statistics hold true, I would expect to see the payback during my stay. The lists make the system comprehensible and bring the patient (or advocate) into the decision-making loop.
I believe patient-centered medical care can greatly improve the chances for better outcomes. Importantly, improving the information flow can’t help but reduce the cost. The Patient’s Checklist is a small but vital step toward the goal that’s been elusive for the American health-care system — higher quality care at lower cost.
— Karen Telleen-Lawton’s column is a mélange of observations spanning sustainability from the environment to finance, economics and justice issues. She is a fee-only financial advisor (www.DecisivePath.com) and a freelance writer (www.CanyonVoices.com).