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Avoiding Medical Error

by The Duke University Medical Center


Most of us strive as therapists to help our clients/patients so much that they do not need conventional medical treatment, but here's some good advice from the Duke University Medical Center for when they do:


Health care professionals dedicate their lives to keeping patients healthy and safe. But medical errors can happen despite the best intentions—-in fact, a couple of years ago, the Institute of Medicine estimated that between 44,000 and 98,000 patients die each year as the result of medical mistakes. These errors can occur when planned treatment is not done in the right way or if the wrong plan was used initially. They can occur anywhere in the health care system—-hospitals, clinics, outpatient surgery centers, doctors' offices, nursing homes, pharmacies, and in your own home. Errors can involve medicine, operations, tests, diagnosis, equipment, and laboratory reports. They can happen during the most routine tasks, such as when a hospitalized patient on a salt-free diet is given a high-salt meal or when home medications are not taken correctly.


Most errors result when the systems required to deliver today's complex health care do not work or are not used correctly. But errors also can occur when doctors and patients have problems communicating. You can help by becoming actively involved in your own care. Here are some specific suggestions to help you be a partner in safe health care.

General Tips:

  • Speak up if you have questions or concerns. You have a right to ask questions of anyone who is involved in your care.
  • Make sure that all health professionals involved in your care have the important health information about you. Do not assume that everyone knows everything about you. You and your primary care provider may have been partners in your health care for many years, but another physician or nurse might be seeing you for the first time.
  • If you have a test done, don't assume that no news is good news. Ask about the results, including what the results mean and if you need additional follow-up care.
  • Clearly identify yourself to your providers. If you are issued an identification band, keep it on. If you have difficulty hearing, tell the person that you have difficulty hearing and double-check that it is your name being called. If you have a common name, ask to have the birth date checked in the record to reduce the chance of mistaken identity.


Medication Safety

  • Tell your doctor, pharmacist and nurse about everything you take. This includes prescription medicines, over-the-counter medicines, and dietary supplements such as vitamins, herbs or other alternative therapies. At least once a year, bring all of your medicines and supplements with you to your doctor, nurse or pharmacist for evaluation. Have them list these treatments in your records.
  • Tell your doctor and pharmacist when you start or stop taking any new medications, vitamins, herbs or other therapies so they can check for drug interactions.
  •  Tell your doctor, pharmacist or nurse about any allergies or adverse reactions you have had to medicines, herbs, chemicals or foods.
  •  When your doctor writes a prescription, make sure you can read it.
  •  Ask for information about your medicines in terms you can understand. Some questions you may wish to ask include:
    •     What is this medicine for?
    •     How am I supposed to take it and for how long?
    •     Is this medicine safe to take with other medicines, herbs or dietary supplements?
    •     What food, drink, or activities should I avoid while taking this medicine?
    •     What side effects are likely?
    •     What do I do if they occur?
  • Instead of relying on your memory, ask for printed information about the side effects and drug interactions that your medicine could cause, as well as printed directions for taking the medicines.
  • When you pick up your medicine from the pharmacy, make sure it is the medicine your doctor prescribed. If the medicine is one that you have been taking and it looks different, ask the pharmacist to double-check before taking the medicine.
  • Be sure you understand the directions on your medicine label. For example, ask if "four doses daily" means taking a dose every 6 hours around the clock or just during regular waking hours.
  • Ask your pharmacist for the best device to measure liquid medicine. Household teaspoons often do not hold a true teaspoon of liquid, so use specially marked syringes or marked measuring spoons to measure the right dose.
  • If the medicine requires a special device (for example, an inhaler), be sure you understand how to use it correctly. Practice in front of your care provider to demonstrate that you are using the device properly.
  • Dispose of needles/syringes in special protective containers only.

After A Hospital Stay

  • When returning home after a hospital stay, ask your doctor, nurse or pharmacist to explain the treatment plan you will use at home.
  • This includes learning about your medicines and finding out when you can get back to your regular activities.
  • Be sure to ask questions if you do not understand any part of your plan.
  • Be sure that follow-up care is scheduled (if necessary) and that other medical needs are addressed before you go home.

Duke University Medical Center has lots more good advice on its web site.