You are here: Home Managing Your ... Hospitals 101 Hospitals: How To ... Summary
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.


The following information can be startling and concerning. It should not be used as a reason not to enter a hospital when needed. Instead, it should be used to help encourage you to take the steps you can take to minimize error and infection.

  • According to a Harvard Medical Practice Study, medical errors are responsible for injury to as many as 1 of every 25 hospital patients. A report by the Institute of Medicine estimates that 44,000 to 98,000 patients die in the hospital each year due to medical error.  
  • According to the Agency for Healthcare Research and Quality, the single most effective method of preventing medical error is to be an active member of your healthcare team.  This includes understanding your diagnosis and playing an active role in the planning and administration of your treatment.  The assistance of your health advocate will be invaluable during this time.

To minimize some of the most common medical errors which occur in a hospital and to avoid picking up unnecessary infections, consider the following advice. More information about each point  is contained in the other sections of this article.

Basically, it helps to understand that your job is to be vigilant and assertive.

  • One of the easiest ways to do this is to have a friend or family member serve as a patient advocate, particularly for those times when you are not feeling well. 
    • To learn about being vigilant and assertive, click here.  
    • To learn about the role of a patient advocate, click here
    • To learn how to choose a patient advocate, click here.
  • Make sure every health care provider washes his or her hands, or wears gloves, before providing you with any medical procedure or care. (Alcohol based cleansers are not enough, by themselves, to kill today's potentially deadly germs). If it helps you to assert yourself, consider saying something like the following: "You really seem to be working hard today and are under a lot of pressure. I hope you don't mind me reminding you to please wash your hands." (To learn more about hand washing, click here.)
  • To learn how to help keep the room as germ free as possible, click here.
  • Keep germs away from your lips, nose and eyes..For example, keep your hands away from your face as much as possible. For additional tips, click here.
  • Watch for medication errors. 
    • To learn how in general, click here.
    • To learn about keeping instruments germ free, click here.

Before you make any major decisions, consider getting a second opinion -- just as you would outside the hospital. To learn how, click here.

Written with:
Skip Moskey, Limerick, ME
Herbert Spiers, Ph.D., New York, NY

Your Job: Be Vigilant. Speak Up.

Be Vigilant

Rather than relying on other people who are very busy, you can be a major factor in making sure you do not become a victim of medical error. The way to do this is to be vigilant  and to speak up.

Being vigilant means being aware of why the person has approached you, being sure that you are both on the same page about what is to be done and why, and watching that the person follows safety procedures such as putting on fresh gloves before touching you or cleaning his or her hands with a super cleanser.

Being vigilant does not mean that you should be paranoid or fearful.

  • No one is out to get you. 
  • Hospitals and people who in the hospital are there to help.

However, the people who make up a medical staff are human. Humans make errors. This is what is to be guarded against. 

Speak Up

It can be difficult to speak up in general, much less in a hospital setting where you depend on the people you speak up to for your care. However, your health and possibly your life are at stake.

When speaking up, a spoonful of honey will catch more flies than a gallon of vinegar. For example, you may have the situation where it doesn't look like the person has disinfected his or her hands and will be touching you. Consider saying something like: "I know you're busy this morning, so I'm just reminding you to please disinfect your hands before doing the exam."

If you have a question about how to speak with doctors, see the Survivorship A to Z document about maximizing your time with a doctor. Also see our videos on the same subject. 

If you remain uncomfortable about speaking up, ask a family member, friend, or even a professional patient advocate to do it for you.

Have A Patient Advocate With You As Much Of The Time As You Can

A patient advocate is generally a family member or friend who helps you in a medical setting such as an appointment with a doctor or while in a hospital.  Patient advocates can be an important member of the team that helps post diagnosis. A patient advocate can:

  • Help monitor your care. This can be particularly important if you cannot or are just not up to monitoring your care at a given time. 
  • Help prevent infection by checking to see that everyone follows disinfection procedures before touching you.
  • Take notes about medications, treatments, and doctors who visit. This can be particularly important when it comes time to review the hospital bill. Hospital bills are known to often contain mistakes - and the mistakes are seldom in a patient's favor. (To learn more, click here.)
  • Complain for you if you are unable to or don't feel like it. 
  • Look out for new symptoms that you may develop. 
  • Keep control of your visitors when what you most are in need of is rest.  
  • Share information about you with other people.  
  • Can help take care of your personal needs.

To learn more about patient advocates, including who to choose, click here.

Be sure to let your doctors know that they can talk freely with your advocate about your condition.  If staff says they cannot talk to the person because of legal privacy concerns, ask for a HIPAA form. HIPAA is the law that governs medical privacy. A HIPAA form gives the hospital and staff permission to speak with the person or people you choose. 

NOTE: The Family Caregiver Alliance provides practical information and support for caregivers ( offsite link

How To Enforce Hand Washing

The Facts

Proper hand washing is one of the most effective methods of preventing the spread of germs. Still, studies repeatedly indicate that doctors, nurses and other caregivers fail to follow this essential practice and that bad hand hygiene is a leading cause of preventable health care related infections.

Most hospital rooms are equipped with wall mounted cleansing dispensers, bowls for hand washing or alcohol based swabs. Gloves are usually attached to a dispenser in the room. The equipment has no effect if not used.

What To Do

If you do not see your health care provider wash his or her hands with soap or anti-bacterial liquid, or put on fresh gloves before touching you, you can politely ask that the person do so.  Washing hands with an alcohol based product by itself is not enough because such products do not kill all potentially deadly germs.

Any procedure that "breaks the skin" increases your chances of developing an infection. It is particularly important to make sure that the doctor or nurse applies a fresh set of gloves before performing any invasive procedure, such as drawing blood, starting/adjusting an IV, or inserting/adjusting a catheter.  

Family members and visitors should also wash their hands upon arrival.

At first, it may be embarrassing to ask staff and your visitors to take these steps for your safety. When you keep in mind how important it is to your well being, you'll get the hang of it. To learn more, see offsite link or offsite link 

How To Make Sure Your Room Is Kept Germ Free

  • Practice good hygiene when sharing a semi-private or group room. For instance:
    • Spray the toilet seat with a disinfectant such as Lysol before you use it. 
    • Keep your toothbrush covered when not in use.
  • Be sure your room is cleaned daily and that your sheets are changed daily. If there is a spill or other situation which could create a problem, you can ask that the room be cleaned without waiting for the daily cleaning.
  • If the cleaning person skips places or doesn't do a good job, gently let the person know. If that doesn't correct the situation, let the nurse know. If that doesn't work, ask a friend or family member to complain for you up the hospital's administrative chain.

How To Keep Germs Away From Your Lips, Nose And Eyes

You can ingest germs you pick up from the bed rails or items near your bed. You can protect yourself by taking the following steps:

  • Keep your hands away from your lips, nose and eyes  It takes practice, but is worth the effort.
  • Wash your hands before eating. Preferably use warm water and soap and wash for at least 20 seconds. If soap and water isn't available,  use commercial hand cleansers. They kill most germs.  
  • Do not place your food or utensils on any surface except your plate.
  • Ask friends or family to bring wipes containing bleach to clean the items around your bed, including the railings and whatever else you touch.
  • Don't use someone else's pillow.

How To Watch For Medication And Other Errors

Medication errors are among the most common medical errors made in the hospital setting. 

While some errors are simply out of your hands, you can personally take the following steps to avoid medication errors:

  • Take a list of all your medications to the hospital.
    • The list should include all prescription, over-the-counter (OTC), natural / herbs, and alternative / complementary drugs. 
    • Be certain to include notes about all allergies and adverse reactions you may have experienced with any medication. See List of Medications for more information about preparing the medication list.
  • Supply a copy of your medications list to each of your treating doctors, including your attending doctor, surgeon and anesthesiologist.
    • To reduce the chance of error, do not rely on your doctors to communicate this information to each other. It is best if you have one doctor who is in charge of coordinating your care with the other doctors. If there isn't one, choose and ask the person if that is okay. If so, inform all the other doctors to keep the doctor up to date.
    • Inform your doctors of any additional medical diagnosis you may have. For example, if you have a history of stomach ulcers or liver disease.
  • Ask your doctor in advance for the name and purpose of every drug you are to receive. It may be useful to ask for a physical description of the drug, including color, shape, and size. Make a list of the drugs. If you know what to expect you will feel more confident asking questions. 
  • Before any medication is adminstered:
    • Insist that the person giving you the medication identify you each time you receive a medication. The person should either state your name or check your hospital identification bracelet. This will help insure that you are not given a medication intended for someone else, or a drug for which you have a known allergy.
    • Ask the name of the drug and its purpose. Ask whether there are special instructions -- such as a drug that should only be taken with food. These questions will keep you better informed and will require the person giving you the drug to double-check what you are being given.
    • If a medication that looks different than what you are used to taking, or is different than the description you were given, speak up. Perhaps it is a generic version, or the brand or dosage has been changed, or maybe someone has made a mistake. It is always better to be safe than sorry.
  • Before receiving any test or procedure, ask if it includes the use of dyes or medicines. Remind the doctor or nurse if you have any allergies.
  • If you are on an intravenous (IV) infusion medical pump, ask if the hospital has a "smart pump." Regular pumps can be defective or malfunction. A smart pump performs a "test of reasonableness" to check that programming is within pre-established institutional limits before infusion can begin.
  • If you are allergic to particular medications such as penicillin, it can't hurt to write a note and tape it above your bed so anyone about to give you a drug sees it.

NOTE: Details that matter can get lost during a transition from one person, facility or department to another. This includes hospital shift change where someone has to catch up on what has been going on. The National Patient Safety Foundation says many situations become clearer with just three key questions: What is my main problem? What do I need to do? Why is it important for me to do this?

How To Do What You Can To Keep Instruments Germ Free

If instruments will be used on or around you, it is advisable to watch them being taken out of protective packaging.

If there is no packaging, ask if the instruments have been sterilized since the last use.

Ask your doctor if his or her stethoscope has been sterilized since the last use.