Impending Hospitalization

Caveat: This has nothing to do with Estate Planning, Taxes or Trusts. It has to do with our clients.

Take-Away: We often know when a client has a chronic or life-threatening illness who is about to undergo surgery, and/ or is facing an imminent hospitalization. Knowing at least some of the basics about patient safety gives us the opportunity to provide practical and possibly life-savings advice at a time when it can accomplish the most for our client.

Background: For 8 years I was on the local hospital board of trustees, the last two as its chair. From that experience I came into first-hand contact with the pressing issues of patient safety in hospitals. Every hospital seriously takes patient safely and seeks to constantly improve the quality of patient care. Hospital committees spend countless hours reviewing outcomes and ‘near misses’ and work to achieve improvements with objective benchmarks. In recent years the outcome of a patient’s hospital stay took on even more significance when the Affordable Care Act shifted Medicare and Medicaid reimbursement away from a focus solely on the services a hospital provides to a patient instead to the quality of that patient’s care, i.e. pay for performance. But despite the continuing ethical obligation to provide the highest level of care to its patients, and the new financial emphasis on the quality of patient outcomes, hospitals are still places where mistakes are made daily. A recent Journal of Patient Safety article estimated that over 440,000 deaths occurred in US hospitals per year that could have been prevented. It has recently been asserted that preventable medical error may now be the third leading cause of death in the US, more than respiratory disease, accidents, stroke and Alzheimer’s. http://blogs.scientificamerican.com/guest-blog/the-real-cause-of-deadly-medical-errors/.

As part of my ‘late-night-reading’ last weekend I ran across a handout it was suggested that clients be given prior to their hospitalization. I share that handout with you which you might consider using when a client anxiously prepares for a hospitalization. It’s obvious purpose is to empower clients and their family members to assure that the best care possible is given to the patient when in the hospital.

We understand that you are facing hospitalization and perhaps an operation. This is a challenging and perhaps scary time for you. We believe that the following information can help make this encounter with the medical world safer and more productive for your health.

THE BEST OVERALL, GENERAL ADVICE IN THE MEDICAL CARE REALM IS TO TRUST, BUT VERIFY.

DO NOT ASSUME:

That you will reliably hear about test results. Establish a time by which you will be notified. Do follow up if you have not heard the results.
That medical professionals will communicate with each other about you. Do not be afraid to remind them about tests done, or information previously given.
That all tests ordered or proposed are necessary.
That your diagnosis is correct (40% are wrong.) Get a second-and possibly a third opinion.
That every physician will actually read your chart. You may have to repeat your story many times. Keep track of your symptoms as well as so that you are able to accurately share with your physician what may be critical information.
That the physician will listen carefully and actually hear what you say.
That everyone in the hospital practices good hand hygiene. Critically important is to remind EVERYONE who comes into your room or in contact with you to wash or gel their hands thoroughly.
That surfaces in your room are sterile. Use antiseptic wipes to wipe down bedrails, the call button, television controls, etc.

The source of this list is attorney Myra Gerson Gilfix of Palo Alto California, Estates and Trusts, September 2017, page 42.