How to be a better informed patient.

Consumer Reports did a survey of patients and their nurses after hospitalization, and came up with some common sense tips on how to improve your chances of a successful hospital stay. First, here are some polite ways to remind your doctor he didn't wash his hands before coming into the room -

'I didn't see you clean your hands, so would you please do it in front of me?'

'Did you wash your hands before you came in? You know I need to make sure.'

' Would you mind washing your hands one more time before we proceed with care?'

'Doctor, I didn't see you wash your hands. Did you do that outside?'

Here are the rest of my excerpts from their article.

“start by getting an up-to-date list of the hospitals, physicians, and specialists in your plan's network. And if you're going to have surgery, don't forget the anesthesiologists.”

“Another important piece of information that's often difficult to get: the ratio of nurses to patients.”...“In our survey, 31 percent of nurses reported that in an average hour on a shift they provided direct care for six or more patients.”

“Errors in medication are a leading cause of preventable injury to hospital patients in this country, and research suggests that mix-ups are especially likely during "care transitions," when patients are admitted, are transferred from one ward to another, or are discharged from the hospital.”

“But it is estimated that less than 2 percent of hospitals in the U.S. have comprehensive electronic records systems”

“ Keep an up-to-date list of your current medications and dosages, including over-the-counter drugs and dietary supplements, in your handbag or wallet at all times. (Include your emergency contact information and your primary-care provider's.) Nurses in our survey said that's one of the most important things you can do to help ensure better hospital care.”

“If your hospital admission is planned, pack a small bag of personal items, including some family pictures to comfort you, and books, magazines, and a portable music player with headphones to help pass the time.”

“A new breed of physician known as a hospitalist, a specialist trained specifically to practice in-hospital medicine, might be in charge of your care….hospitalists are often portrayed as doctors who work "for the hospital and not the patient, an employee focused on efficiency and rapid discharge rather than continuous medical care." To allay any concerns, feel free to ask the hospitalist to consult with your regular doctor before you agree to have particular tests or procedures and to keep the lines of communication open.”

”do your best to take along a knowledgeable family member or friend to run interference for you when you are too sick or too sedated to advocate for yourself.”

”Use the call button for urgent requests…But be aware that 34 percent of nurses in our survey said they had to take longer than 5 minutes to respond at least once in their most recent work week because of inadequate time or not enough staff or other resources.”

”And be nice. In our survey, just 33 percent of nurses strongly agreed that patients respect nurses' contribution to their care; 78 percent said patients and relatives might find that being respectful to hospital staff would "help very much" in getting the best hospital stay.”

"By far the best way of preventing that is to wash your hands. But it's easy to forget. So you might want to pay attention to whether or not the doctor or nurses wash their hands or use that alcohol-based hand-sanitizer stuff."

”Eleven percent of surveyed nurses said that in their most recent work week, they observed "incorrectly administered medication or dosage," …Patients should take steps to protect themselves. Forty-six percent of nurses said it would help very much if patients checked the medications being administered to them during their stay.”

”Patients we interviewed said it sometimes took a lot of persistence to get answers…"We had to constantly ask questions like, 'What about this?' 'What happens if this happens?' 'Is there another way to do this?' 'What else can we do?' "

”Research suggests that those who don't understand their patient discharge plans or how to manage their drug regimen are at increased risk of developing a drug interaction or some other problem that lands them right back in the hospital.”

“People gave most hospitals low ratings for patient discharge instructions…One key step is called "medication reconciliation," which consists of comparing the medications you took in the hospital with the ones you were previously taking at home to make sure you leave with the medication regimen you need, no more, no less.”

“ a study… found that almost 20 percent of nearly 12 million Medicare patients discharged from the hospital were readmitted within a month. In half of the nonsurgical cases, researchers found no bill for a follow-up visit to a physician's office, suggesting that inadequate post-discharge care might have contributed to the return hospital trip”