Patient Fact Sheet ..
20 Tips to Help Prevent Medical Errors
Medical errors are one of the Nation's leading causes of death and
injury. A recent report by the Institute of Medicine estimates that as
many as 44,000 to 98,000 people die in U.S. hospitals each year as the
result of medical errors. This means that more people die from medical
errors than from motor vehicle accidents, breast cancer, or AIDS.
Government agencies, purchasers of group health care, and health care
providers are working together to make the U.S. health care system safer
for patients and the public. This fact sheet tells what you can do.
What are Medical Errors?
Medical errors happen when something that was planned as a part of
medical care doesn't work out, or when the wrong plan was used in the
first place. Medical errors can occur anywhere in the health care
.. They can happen during even the most routine tasks, such as when a
hospital patient on a salt-free diet is given a high-salt meal.
Most errors result from problems created by today's complex health care
system. But errors also happen when doctors and their patients have
For example, a recent study supported by the Agency for Healthcare Research and
Quality (AHRQ) found that doctors often do not do enough to help their patients
make informed decisions. Uninvolved and uninformed patients are less likely to
accept the doctor's choice of treatment and less likely to do what they need to
do to make the treatment work.
What Can You Do? Be Involved in Your Health Care
The single most important way you can help to prevent errors is to be
an active member of your health care team.
That means taking part in every decision about your health care.
Research shows that patients who are more involved with their care tend
to get better results. Some specific tips, based on the latest
scientific evidence about what works best, follow.
Make sure that all of your doctors know about everything you are
taking. This includes prescription and over-the-counter medicines, and
dietary supplements such as vitamins and herbs.
At least once a year, bring all of your medicines and supplements with
you to your doctor. "Brown bagging" your medicines can help you and your
doctor talk about them and find out if there are any problems. It can
also help your doctor keep your records up to date, which can help you
get better quality care.
Make sure your doctor knows about any allergies and adverse reactions
you have had to medicines.
This can help you avoid getting a medicine that can harm you.
When your doctor writes you a prescription, make sure you can read
.. If you can't read your doctor's handwriting, your pharmacist might not
be able to either.
Ask for information about your medicines in terms you can
understand-both when your medicines are prescribed and when you receive
What side effects are likely? What do I do if they occur?
Is this medicine safe to take with other medicines or dietary
supplements I am taking?
What food, drink, or activities should I avoid while taking this
When you pick up your medicine from the pharmacy, ask: Is this the
medicine that my doctor prescribed?
.. A study by the Massachusetts College of Pharmacy and Allied Health
Sciences found that 88 percent of medicine errors involved the wrong
drug or the wrong dose.
If you have any questions about the directions on your medicine
.. Medicine labels can be hard to understand. For example, ask if "four
doses daily" means taking a dose every 6 hours around the clock or just
during regular waking hours.
Ask your pharmacist for the best device to measure your liquid
medicine. Also, ask questions if you're not sure how to use it.
Research shows that many people do not understand the right way to
measure liquid medicines. For example, many use household teaspoons,
which often do not hold a true teaspoon of liquid. Special devices,
like marked syringes, help people to measure the right dose. Being told
how to use the devices helps even more.
Ask for written information about the side effects your medicine
If you know what might happen, you will be better prepared if it
does-or, if something unexpected happens instead. That way, you can
report the problem right away and get help before it gets worse. A study
found that written information about medicines can help patients
recognize problem side effects and then give that information to their
doctor or pharmacist.
If you have a choice, choose a hospital at which many patients have
the procedure or surgery you need.
.. Research shows that patients tend to have better results when they are
treated in hospitals that have a great deal of experience with their
If you are in a hospital, consider asking all health care workers
who have direct contact with you whether they have washed their hands.
Hand washing is an important way to prevent the spread of infections in
hospitals. Yet, it is not done regularly or thoroughly enough. A recent
study found that when patients checked whether health care workers
washed their hands, the workers washed their hands more often and used
When you are being discharged from the hospital, ask your doctor to
explain the treatment plan you will use at home.
This includes learning about your medicines and finding out when you can
get back to your regular activities. Research shows that at discharge
time, doctors think their patients understand more than they really do
about what they should or should not do when they return home.
If you are having surgery, make sure that you, your doctor, and your
surgeon all agree and are clear on exactly what will be done.
.. Doing surgery at the wrong site (for example, operating on the left knee
instead of the right) is rare. But even once is too often. The good news
is that wrong-site surgery is 100 percent preventable. The American
Academy of Orthopaedic Surgeons urges its members to sign their initials
directly on the site to be operated on before the surgery.
Other Steps You Can Take
Speak up if you have questions or concerns.
.. You have a right to question anyone who is involved with your care.
Make sure that someone, such as your personal doctor, is in charge
of your care.
This is especially important if you have many health problems or are in
Make sure that all health professionals involved in your care have
important health information about you.
Do not assume that everyone knows everything they need to.
Ask a family member or friend to be there with you and to be your
advocate (someone who can help get things done and speak up for you if
.. Even if you think you don't need help now, you might need it later.
Know that "more" is not always better.
It is a good idea to find out why a test or treatment is needed and how
it can help you. You could be better off without it.
If you have a test, don't assume that no news is good news.
Ask about the results.
Learn about your condition and treatments by asking your doctor and
nurse and by using other reliable sources.
.. For example, treatment recommendations based on the latest scientific
evidence are available from the National Guidelines Clearinghouse at
Ask your doctor if your treatment is based on
the latest evidence.
.. More Information
more online information
about medical errors. A Federal report on medical errors can be accessed
and a print copy (Publication No. OM
00-0004) is available from the AHRQ Publications Clearinghouse: phone,
1-800-358-9295 or E-mail:
.. AHRQ Publication No. 00-PO38
Current as of September 2000
Internet Citation: .. 20 Tips to Help Prevent Medical Errors. Patient Fact Sheet. AHRQ
Publication No. 00-PO38, February 2000. Agency for Healthcare Research and
Quality, Rockville, MD.