Speak Up for Patient Safety

At MD Anderson Cancer Center, employees and patients are encouraged to help each other to improve healthcare safety. As a patient, you are an essential member of the healthcare team, and your healthcare providers are valuable sources of information for your safety questions.

MD Anderson Cancer Center supports the Speak Up™ program sponsored by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The Speak Up™ program urges patients to get involved in their care. The following tips provided by JCAHO through their Speak Up™ program highlight ways patients can have a safe healthcare experience.

Speak up if you have questions or concerns, and if you don’t understand, ask again. It’s your body and you have a right to know.

• Your health is too important to worry about being embarrassed if you don’t understand something that your doctor, nurse, or other healthcare professional tells you.
• Don’t be afraid to ask about safety. If you’re having surgery, for example, ask the doctor to mark the area that is to be operated upon, so that there’s no confusion in the operating room.
• Don’t be afraid to tell the doctor or nurse if you think you are about to receive the wrong medication.
• Don’t hesitate to tell the healthcare professional if you think he or she has you confused with another patient.

Pay attention to the care you are receiving. Make sure you’re getting the right treatments and medications by the right healthcare professionals. Don’t assume anything.

• Tell your nurse or doctor if something doesn’t seem quite right.
• Expect healthcare workers to introduce themselves when they enter your room or look for their identification badges. A patient, for example, should know the person who is giving him or her medicine or operating their medical equipment. If you are unsure, ask.
• Notice whether your caregivers have washed their hands. Hand washing is the most important way to prevent the spread of infections. Don’t be afraid to gently remind a doctor or nurse to do this.
• Know what time of day you normally receive a medication. If it doesn’t happen, bring this to the attention of your doctor or nurse.
• Make sure your nurse or doctor confirms your identity, that is, checks your wristband or asks your name, before he or she administers any medication or treatment.

Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.

• Ask your doctor about the specialized training and experience that qualifies him or her to treat your illness (and be sure to ask the same questions of those physicians to whom he or she refers you).
• Gather information about your condition. Good sources include your doctor, your library, respected websites and support groups.
• Write down important facts your doctor tells you, so that you can look for additional information later. And ask your doctor if he or she has any written information for you to keep.
• Thoroughly read all medical forms and make sure you understand them before you sign anything. If you don’t understand, ask your doctor or nurse to explain them.
• Make sure you are familiar with the operation of any equipment that is being used in your care. If you will be using oxygen at home, do not smoke or allow anyone to smoke near you while oxygen is in use.

Ask a trusted family member or friend to be your advocate.

• Your advocate can ask questions that you may not think of while you are under stress.
• Ask this person to stay with you, even overnight, when you are hospitalized. You will be able to rest more comfortably and your advocate can help to make sure you get the right medications and treatments.
• Your advocate can also help remember answers to questions you have asked, and speak up for you if you cannot.
• Make sure this person understands your preferences for care and your wishes concerning resuscitation and life support.
• Review consents for treatment with your advocate before you sign them to make sure you both understand exactly what you are agreeing to.
• Make sure your advocate understands the type of care you will need when you get home. Your advocate should know what to look for if your condition is getting worse and whom to call for help.

Know what medications you take and why you take them. Medication errors are the most common healthcare mistakes.

• Ask about the purpose of the medication and ask for written information about it, including its brand and generic names. Also inquire about the side effects of the medication.
• If you do not recognize a medication, verify that it is for you. Ask about oral medications before swallowing, and read the contents of bags of intravenous (IV) fluids. If you’re not well enough to do this, ask your advocate to do this.
• If you are given an IV, ask the nurse how long it should take for the liquid to “run out.” Tell the nurse if it doesn’t seem to be dripping properly (that it is too fast or too slow).
• Whenever you are going to receive a new medication, tell your doctors and nurses about allergies you have, or negative reactions you have had to medications in the past.
• If you are taking multiple medications, ask your doctor or pharmacist if it is safe to take those medications together. This holds true for vitamins, herbal supplements and over-the-counter drugs, too.
• Make sure you can read the handwriting on any prescriptions written by your doctor. If you can’t read it, the pharmacist may not be able to either.

Use a hospital, clinic, surgery center, or other type of healthcare organization that has undergone a rigorous on-site evaluation against established, state-of-the-art quality and safety standards, such as that provided by JCAHO.

• Ask about the healthcare organization’s experience in treating your type of illness. How frequently do they perform the procedure you need and what specialized care do they provide in helping patients get well?
• If you have more than one hospital or other facility to choose from, ask your doctor which one offers the best care for your condition.
• Before you leave the hospital or other facility, ask about follow-up care and make sure that you understand all of the instructions
• Go to Quality Check at www.jcaho.org to find out whether your hospital or healthcare organization is accredited.

Participate in all decisions about your treatment. You are the center of the healthcare team.

• You and your doctor should agree on exactly what will be done during each step of your care.
• Know who will be taking care of you, how long the treatment will last, and how you should feel.
• Understand that more tests or medications may not always be better. Ask your doctor what a new test or medication is likely to achieve.
• Keep copies of your medical records from previous hospitalizations and share them with your healthcare team. This will give them a more complete picture of your health history.
• Don’t be afraid to seek a second opinion. If you are unsure about the nature of your illness and the best treatment, consult with one or two additional specialists. The more information you have about the options available to you, the more confident you will be in the decisions made.
• Ask to speak with others who have undergone the procedures you are considering. These individuals can help you prepare for the days and weeks ahead. They also can tell you what to expect and what worked best for them as they recovered.

This information was provided by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). For more information, visit their website at www.jcaho.org.