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By Liz Szabo, USA TODAY
It was 4 a.m., but Gillian Trumbull was wide awake.
Trumbull, 24, said she has learned the value of staying alert in the hospital. The Chicago woman has suffered since birth from a rare heart condition that sends her to the hospital at least once a month. With so many hospital visits, she has thwarted several potentially dangerous medical mistakes. VIDEO: Things you should know | Patient-safety resources On that morning in a Chicago hospital four years ago, Trumbull was waiting to be taken for a heart test. Instead, an employee announced he was taking her for dialysis, a treatment for kidney failure. The employee — who had confused Trumbull with the patient in the next bed — ignored Trumbull's protests and began wheeling her out the door. "We were halfway down the hall before someone heard me yelling," says Trumbull, then 20. "A nurse manager stopped him and said: 'She's pretty lucid. I think she knows what she's saying.' " Experts say Trumbull's experience is all too common. About 34% of people say they or their families have experienced a medical error, the Harvard School of Public Health says. Half of those with chronic illnesses have been affected by an error. ON DEADLINE: Share your experiences; how do you protect yourself? Patients need to act Hospitalized patients can expect to experience at least one medication error a day, says the Institute of Medicine, which advises Congress on health policy. Though some mistakes are harmless or quickly corrected, others can be deadly. Forty-four thousand to 98,000 Americans a year die from medical errors. Hospitals around the country are taking steps to reduce medical mistakes. But with so much at stake, many experts say patients and their families also need to take a larger role in ensuring their safety in the hospital. The Joint Commission, which accredits hospitals, has launched a program called Speak Up to encourage patients to follow Trumbull's example. "The medical care we deliver is so complex, we cannot get it right without you," says the Cleveland Clinic's Michael Roizen, who co-wrote You: The Smart Patient: An Insider's Handbook for Getting the Best Treatment with surgeon Mehmet Oz and The Joint Commission. "One way that you can help us is by checking everything we do." Oz acknowledges that doctors haven't always encouraged this kind of interaction from patients. Studies show that doctors interrupt their patients after only about 23 seconds, he says. Patients, too, often assume they should simply follow their doctors' orders, says Dennis O'Leary, the commission's president. "Much of the problem is being afraid to ask, and doctors not behaving well when asked," O'Leary says. "There are still some doctors who can't handle this. But it's your body." Patients should feel free to ask that their family members or advocates be involved in their care, says Jim Conway, senior vice president of the Institute for health care Improvement. Conway recalls hospital staff who told him to "take a seat" when his wife needed care. "I said, 'Absolutely not,' " says Conway, former chief operations officer at Boston's Dana-Farber Cancer Institute. "We've only known each other for 45 years, so I suspected I could have been helpful in my wife's care." Some of the greatest dangers to patients are invisible. Nearly 2 million U.S. patients catch an infection from the hospital each year, and about 90,000 die, according to the Centers for Disease Control and Prevention. Yet only about 35% of hospital employees consistently wash their hands each time they prepare to touch a patient — a basic step to preventing infection, O'Leary says. Errors happen to anyone Even doctors aren't immune from the risks. Leonard Mermel, a professor at Brown Medical School in Rhode Island, says his mother picked up a hospital "superbug" — a new breed of hard-to-treat infections that resist even strong antibiotics. While his mother was hospitalized, Mermel was dismayed to see that staff members were ignoring a sign instructing them to take precautions to avoid spreading the infection, such as putting on gloves and gowns before entering her room. "Being on the other side, and seeing what goes on, is a humbling experience," Mermel says. As Trumbull has learned, errors can happen anywhere — even for the best-prepared patients. During an emergency room visit recently, she arrived with a brief summary of her medical conditions, allergies and other key details. She wears a MedicAlert bracelet, which also lists her allergies, and warned her doctor four times that she's allergic to morphine. When a nurse arrived with pain medication, Trumbull checked the name of the medication before accepting it. It was morphine. "I think my doctor probably heard me, but he forgot," Trumbull says. "Who knows how many patients he was taking care of?" Trumbull has tried a variety of ways to protect herself — not always successfully. Once she was in the hospital with dangerously low blood pressure. She knew she had to lie horizontally to avoid passing out. "I put up a dry erase board in my room that said 'COMPLETE BED REST,' " she says. "But twice, nurses came in and said, 'Let's get you in the shower' or 'Let's go for a walk down the hall.' I could have been in the hospital three or four more days from someone making a mistake." Yet patients such as Trumbull, for all of her difficulties, have the potential to make hospitals safer for everyone, says Oz, a surgery professor at New York-Presbyterian Hospital/Columbia University Medical Center. "If we can get just 10% of people to be smart patients, it will change the system. People will know that sloppiness won't be tolerated. And it will drive quality."
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