How safe is your hospital?

A few times in the past year I was asked by someone which hospital in Manila they should bring a relative for treatment. My usual answer was: “I really don’t know because I have not been hospitalized there. If you have a relative or friend who has been confined in a Manila hospital, ask their opinion.”

Since my wife and I retired in Aklan in 2010, I have been studying how one can find the best hospital in our country. Unfortunately, I cannot find any source or website that grades hospitals according to their performance, unlike in the United States where a nonprofit organization, Leapfrog Group, conducts such a grading.

When you buy a new car you can easily know how safe it is, as well as its gas consumption. We should be able to tell how safe a hospital is with corresponding ease.

In the United States many hospitals have a good safety record. Sadly, however, there are also many that do not pass the test. As many as 440,000 people die every year because of preventable errors in hospitals. Forty-one percent of the 2,500 general hospitals in the United States have received grades of “C,” “D” or “F” (“A” being the best). Some hospitals have hidden dangers that are extremely difficult to know.

One out of every 25 patients in an American hospital develops an infection during his/her stay. This should not happen at all. A Medicare patient in the United States has a one-in-four chance of experiencing injury, harm or death in a hospital. In any given day, more than 1,000 patients will die in hospitals because of preventable errors.

Unfortunately, there is no safety study or pertinent statistics on hospitals or medical offices in our country.

What can you do? If you are a member of a hospital board or medical staff, please start safety studies on such matters as hospital-acquired infection rate, number of accidental falls from the bed, average number of days of hospital stay for common diagnoses like heart attack, appendicitis, pneumonia, meningitis, etc., and number of patients readmitted within a month.

If you, a patient, see what you think is an error made in a hospital, talk immediately with one of the nurses or your physician. Request the nurse to write your concern on your medical chart and what you think might be the mistake. You should not argue, but be respectful and assertive.

If the error happens to you, it is best to talk with your physician and have it investigated to resolve the matter. You should be clear that you expect an answer or explanation on how it will affect you and how it can be prevented. After your discharge from the hospital, make an effort to reach your physician or the nurse who is familiar with your experience if they have not contacted you at all.

If after several days no one has called you, contact the customer service or family relations department. Most hospitals with high-quality service have such departments, or a suggestion box or hot line that receives such reports. Use it so a similar problem will not be repeated.

If you submit to an X-ray (or other tests), ask the nurse when the result will be available. If it was requested as an emergency procedure, it is called a “stat x-ray,” and the physician should know the result usually within a couple of hours. In the event that there is something critical in your x-ray, your physician will tell the nurse and request some more tests, or give you another medication. You can ask the nurse for the result.

On your first day of hospitalization, ask for a list of the names of your medications. The first time you will take a pill or capsule, remember its name, color and shape, and how often you will get it. Make sure you mention all of your allergies to your physician or nurse, including allergies to food, dyes, smell and over-the-counter medications.

If you have just delivered a baby, make sure that a member of your family goes along when someone is taking your baby for a supposed blood test or x-ray. Sometimes, someone pretending to be a nurse or physician will do that, with the intention of stealing your baby.

Observe the cleanliness of the floor, windows and toilets. The smell and appearance of a toilet is a good indication of a well-run hospital.

In a good hospital you will notice that all nurses, physicians and other hospital personnel wash their hands before and after they see a patient.

Most of the time, it is your physician who will decide which hospital you should be admitted for treatment. But if I am the patient, I would want to stay in a hospital with a “smart” electronic medical record system. Such a system records the average patient stay for operations involving the coronary artery, appendicitis, gall bladder, etc., the number or percentage of patients coming back for hospitalization within a month, or whether the number of autopsies done is increasing every year.

Dr. Leonardo L. Leonidas ([email protected]) retired in 2008 as assistant clinical professor in pediatrics from Boston’s Tufts University School of Medicine, where he was recognized with a Distinguished Career in Teaching Award in 2009. He is a 1968 graduate of the University of the Philippines College of Medicine and now spends some of his time in the province of Aklan.