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Coney Island Hospital Emergency Room
Mario Tama  /  Getty Images file
As many as 98,000 deaths occur each year due to all kinds of medical mistakes.
updated 6/25/2012 6:41:00 PM ET 2012-06-25T22:41:00

Apart from interfering with your beach vacation, there's another, more serious reason to steer clear of summer surgery if you can: a 10% spike in fatalities at teaching hospitals in July, confirmed by a new Journal of General Internal Medicine study. David Phillips, PhD, the study's lead author and professor of sociology at the University of California, San Diego, speculates that the "July effect" may occur because that's the month when new doctors-in-training begin their residencies.

The fatalities aren't the fault of poor knife skills botching operations, though -- rather, they're due to mistakes made prescribing and administering patient medications, both surgery-related and not.

All told, as many as 98,000 deaths occur each year due to all kinds of medical mistakes--the equivalent of a fully packed 747 crashing every other day. According to a congressionally mandated study on Medicare recipients, during 2008, 1 in 7 hospital patients experienced at least one unintended harm that prolonged his or her stay, caused permanent injury, required life-sustaining treatment, or resulted in death.

So what can you do to make sure this doesn't happen to you or someone you love? Plenty, say doctors, nurses, and researchers. Read on to find out where to start.

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Infections that are acquired after checking into the hospital kill 31,000 patients a year, which nearly rivals the number of breast cancer deaths annually, says Peter Pronovost, MD, PhD, the author of Safe Patients, Smart Hospitals. What's more, most of these could easily have been prevented.

1. If you have a choice of hospitals, ask if your doctor knows your options' infection rates, which are measured using "catheter days," meaning every 24 hours that a tube is inserted in a patient's blood vessels. "The best hospitals' rates have been zero in one thousand catheter days for a year or more," says Dr. Pronovost. "If it's risen above three, I'd be worried."

2. Check your doctor's experience
The more often a doctor has performed a procedure, the more familiar she is with its variations and complications and the higher her success rate is likely to be. Confirm that your physician is board certified in her specialty (check the American Board of Medical Specialties at abms.org), but also ask her how many times she's treated your condition.

Secrets Your Doctor Keeps From You

3. Say no to Fridays and weekends
Weekends, nights, and holidays are not the optimal times for operations. Even the lead-up to the weekend can be problematic: "For elective surgery, avoid a Friday afternoon operation slot if possible," advises a surgeon in a busy Midwestern hospital who asked not to be named. "The operating room staff may be fatigued and less able to concentrate then."

It gets worse on the weekend. Stroke patients treated in hospitals on Saturday and Sunday were 16% more likely to die than those treated on weekdays, found a recent study from the University of Toronto. Staffing tends to be lighter then; getting lab results takes longer; and on-call docs have to drive in from home.

When you're scheduling surgery, time of day matters: Ask for the second or third slot of the morning. "Any kinks in the team's coordination or machinery are worked out, and the staff's still well-rested," explains Matthew Buchanan, MD, an orthopedic surgeon in Falls Church, VA.

4. Ask about your electronic records
Often, in a busy hospital, complicated medication orders are dictated quickly to harried staffs, so they can frequently be a source of error. If possible, use a hospital with electronic records, which can reduce prescription slipups sevenfold, according to a recent Weill Cornell Medical College study. When information is entered, the computer alerts staff to potential problems by beeping, freezing, and/or flashing a warning message to prevent improper dosages, incorrectly filled prescriptions, and dangerous drug interactions. Only 17% of hospitals have such a system for medications, but it's worth checking for: After the Lucile Packard Children's Hospital at Stanford in Palo Alto, CA, adopted one, its death rates dropped by 20%.

5. Bring your own bottles
The bottles we mean are strictly Rx. Doctors suggest you bring your actual prescriptions to the hospital--don't just write down the names. "You cut chances of blunders such as missed doses and interactions when the staff sees what you're taking," says Tanya Froelich, MD, an assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center.

6. Request a blood-clot screening
One in 100 patients admitted to a hospital dies of venous thromboembolism--a potentially deadly blood clot that forms in a vein--but half of those lives could have been saved with simple preventive measures available everywhere. When you're admitted to the hospital, you should be screened--particularly if you'll be recovering from cancer, heart disease, or any other major illness, says Frederick Anderson Jr., PhD, who wrote about the topic in the American Journal of Medicine. But half of at-risk patients don't get basic clot-prevention help, such as compression stockings or heparin therapy--so double-check with your doctor that your risk has been adequately assessed and the appropriate measures taken.

7. Don't go it alone
When you're a patient in the hospital, you're likely to be worried, stressed out, and under sedation at times, so it's helpful to have your relatives and friends with you to act as your advocates. "I love it when someone close to the patient is there," comments Ralph Brindis, MD, clinical professor of medicine at the University of California, San Francisco. "They can ask questions the patient hasn't thought of, and--because they know their loved one--they understand what she'd be anxious or unclear about." By acting as extra eyes and ears for you, this team can keep track of your treatment and may prevent errors that would otherwise go unnoticed.

8. Get the surgery plan (before you go under)
Your surgeon should call a time-out before your procedure so the operating team can make sure everyone knows who you are, why you're there, and the correct site of the procedure. Things can still go wrong, however, when a surgery requires multiple incision sites or if the team skips procedural steps during an emergency. To be safe, ask your surgeon to draw the proposed incisions right on the body part that will be operated on so you can see them while you're still awake, recommends Dr. Buchanan.

9. Don't get shortchanged by shift changes
The chance of medical mishaps shoots up during shift changes, says Arthur Aaron Levin, MPH, director of the Center for Medical Consumers. Before your current nurse leaves, request time to review your chart and what treatment you're supposed to get next. And meet with your new nurse, too, to ask any questions you have, advises Caitlin Brennan, RN, PhD, a postdoctoral fellow at Case Western Reserve University Frances Payne Bolton School of Nursing.

10. Demand a hand-wash
Potential for infection lurks everywhere in a hospital, so ask everyone to wash their hands before touching you. Sanitary gel dispensers should be available just outside or inside your room, but if you're not sure they've been used, keep your own gel by your bedside, rub some on before shaking hands, and offer it to visitors, says Lawrence C. Chao, MD, an ophthalmologist in Irvine, CA.

11. … and a regular room-cleaning
Typically, a room is completely washed down between patients, but if you're there for a few days, ask that frequently touched areas be disinfected. It's not always done but should be, says Lisa McGiffert, director of Consumer Union's Safe Patient Project. "Everything in the room could potentially spread infection," she says.

12. Avoid these two surprising germ magnets

The elevator: It's a favorite shot on Grey's Anatomy--but ever notice how no one washes her hands before pressing the buttons? When you're up again, use a tissue when handling publicly pawed buttons and knobs.

The Healthiest Time To do Everything

Your doctor's tie or necklace: Doctors may come into contact with all kinds of deadly germs and can spread them to you. In a 2004 study, 20 out of 40 doctors' ties were found to be contaminated with dangerous bacteria. And a separate Emory University study found harmful staph bacteria on 17 out of 84 stethoscopes. Ask physicians to tuck dangling ties or necklaces into their coats, and have alcohol wipes at the ready to disinfect anything (like pens or medical instruments) that's touched by many hands and may be contaminated with health hazards.

13. Prevent dangerous falls
Up to 30% of falls result in serious injury--and in hospitals, they often occur when you're en route to the bathroom. Call for help if you're unsteady on your feet. And even if you're not, skidproof socks help on slippery hospital floors. Bring your own or ask an aide for a pair.

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Copyright© 2012 Rodale Inc.All rights reserved. No reproduction, transmission or display is permitted without the written permissions of Rodale Inc.

Video: 6 ways to avoid harmful hospital mistakes

  1. Closed captioning of: 6 ways to avoid harmful hospital mistakes

    >>> what you're about to hear is depressing and very surprising. as many as 98,000 deaths a year are caused by all kinds of medical mistakes. according to one study, 1-7 hospital patients experienced unintended harm, wow.

    >> what can you do to make sure that doesn't happen to you? "prevention" editor in chief is here and dr. taz is here. how are you?

    >> good. happy we're not in the hospital.

    >> yeah. more and more we are hearing about these kinds of things.

    >> if you have choices, you say it's a good idea not to have surgery in july or on the weekends, if it's up to you.

    >> right. if you have a choice, right. not only does it mess up your summer vacation but there is a 10% spike at fatalities at teaching hospitals in july. experts think this is because when doctors in training begin their residencies, it's in july. weekends are a problem because you have life staffing, doctors on call at their home. you're never going to get a lab result. doctors are people, too. don't be the first surgery in the morning or the last in the day.

    >> i would want to be the first one. no?

    >> the problem is in the morning you still have lighter staffing. when there's lighter staffing, you've got people with a lot on their plate. there is more room for that human error piece of the surgery or procedure.

    >> often in the hospital, there is a shift change. doctors or a nurse come and go.

    >> i worked in a hospital for years. shift change can work for a patient because you get a fresh set of nurses and doctors to look at your care. the problem is in the hand-off where there is miscommunication when one nurse checks out to the next or one doctor checks out to the other doctor. key to the patient, introduce yourself. make sure you know who your new doctor and nurse is and review the care and plan.

    >> and know what medication you're taking.

    >> exactly.

    >> if they are bringing you something different, you can point it out to them.

    >> friends and family in the room weapon with that because sometimes you're out of it.

    >> it takes a prevention village. you're stressed, you're sick, you're not your usual calm and charming self. you want friends and family at the bedside not only to answer questions, but to be your eyes and ears. you can return the favor when you're needed to help your friend.

    >> what if you have a crazy mother?

    >> we can talk sidebar.

    >> i don't. some people family members can be a big distraction.

    >> they raise the temperature.

    >> offer one more suggestion to that. i've seen where this could save lives. have a spokesperson but maybe a written health plan . where you have somebody coming into the room and they can know your medication and he'll jis without having to guess. i've been where even the spokesperson is not clear about what's going on. it can result in a loss of life.

    >> a lot of rooms are germy. you say tell them to wash their hands.

    >> here is the thing. don't be afraid of looking like the crazy lady , howard hughes germaphobe. they are crawling dangerous bugs. have the alcohol wipe and say use this.

    >> they wouldn't come back to see you?

    >> you would rather look pushy and push up daisies.

    >> i didn't realize we are quite the germ magnets, but there are germs on things we carry room to room. most of us have good habits wiping them down.

    >> it's the tone you use.

    >> it's a relationship. it's establishing the relationship.

    >> not like a good staph infection . thank you, ladies.

    >>> the remarkable journey of chef

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