Questions to ask to ensure the best care

Maryanne McGuckin, a former faculty member of the University of Pennsylvania, is president of McGuckin Methods International and a member of the World Health Organization's Global Patient Safety Challenge. She wrote this for the "Field Clinic" blog at www.philly.com/fieldclinic.

Last month, I discussed the use of checklists as a means of empowering consumers about their role in helping prevent health-care associated infections. Readers wanted to know more about the checklist and how it can help empower them to seek safer care.

Start by finding the best health-care facility or doctor for your treatment. It would be easy for me to give a few links to data sources comparing hospitals, doctors or infection rates, but I know from our research many of these sites are not user-friendly or informative. For example, showing you your hospital did as well as the national rate on some service is not helpful.

What is helpful? It is as basic as asking the right questions of the right people, to avoid later saying, "If only I'd known." If you want information on a hospital's infection rate, call the hospital and ask to speak to someone in the infection control department. Ask:

What is the hospital's infection rate and how does it compare with the national average?

What is the infection rate for your surgical procedure and how does it compare with the national average?

Is the hospital having any cluster or outbreak of certain infections such as MRSA or c. difficile?

For the first two questions, ask for specific percentages. Don't accept just "as good as." If the first person you reach cannot answer these questions, ask who can.

There will always be situations where choice of provider or health-care facility is directed for one reason or another, such as certain complex procedures or insurance, but you should still ask the three questions.

Once you or a relative faces the prospect of hospitalization, there are more specific steps you can take to ensure safe, high-quality care. These eight measures are not meant to be all-inclusive. Every patient's needs and care are unique.

But knowing where to start can help consumers take specific action in a situation that might otherwise seem overwhelming.

You'll find more information in my book, The Patient Survival Guide: 8 Simple Solutions to Prevent Hospital and Healthcare Associated Infections.

If you or a loved one will be in the hospital, take this list along and don't be afraid to share it with caregivers.

When hospitalized:

Make sure you are bathed daily.

Tell all health-care workers and visitors to wash or sanitize their hands when they enter your room.

Tell your doctor if you have recently been hospitalized, admitted to a nursing home, exposed to or treated for MRSA, or have an infection.

Identify someone to be your advocate who understands "rapid response" if you need swift attention.

Discuss informed consent and ask your surgeon about infection rates and antibiotics.

Check your skin around an IV for any redness or swelling.

Urinary catheters should be used only when necessary, not for convenience.

After discharge, check your wound site for any redness, swelling, or drainage.