Hospital patients should be prepared

. . . for everything, says ‘ Checklist’ writer

Elizabeth Bailey learned what could go wrong in a hospital the hard way: by watching her elderly father endure a long in- patient nightmare.

Her dad got too much of one drug , not enough of others and the wrong food ( heavy sweets for a diabetic). One day, he was missing for six hours, and on another he ended up in restraints on a psychiatric ward ( he suffered mental confusion from his mismanaged medications and poorly controlled blood sugar).

“There were mistakes all the time,” says Bailey, who was a music video producer. “I felt like I was on a very poorly run film set.” She realized her family needed a system to handle the chaos.

Six years later, she has turned that system into a book: The Patient’s Checklist: 10 Simple Hospital Checklists to Keep You Safe, Sane & Organized. And she is no longer a video producer: At age 50, she is a graduate student in health advocacy and a patient representative at a New York City hospital.

Her mantra: “You want to go in hoping for the best, but you have to prepare — I don’t want to say for the worst — but you have to prepare for everything.”

Among her checklists:

Before- you- go list. One tip: Organize a schedule for friends and family to be with you. Especially crucial: having someone with you the night after a surgery ( even if you must hire someone).

What- to- bring list. Included: an “economy- sized hand sanitizer.” You should plant that next to your bed so that you can frequently clean your hands — and not- so- subtly remind everyone else to do likewise. That may lower the risk that you will pick up a nasty infection.

Daily medication log. She provides a chart to keep track of the name, timing and dosage of every drug you get. That’s because drug mix- ups are among the biggest risks you face in a hospital.

Some patients may worry that showing up with multiple checklists ( and that giant bottle of sanitizer) may antagonize doctors, nurses and other staffers.

But they shouldn’t, says Peter Pronovost, director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality in Baltimore. Pronovost has developed checklists to help health care providers avoid errors that harm patients. Arming patients with their own lists is a great idea, he says. In fact, he recently posted his own set of checklists for patients at his blog ( armstrong institute.blogs.hopkinsmedicine.org).

“Patients can have enormous impact,” he says. “Most doctors and nurses really want what’s best for patients,” and they increasingly want patients and families to be part of the safety team.

Trisha Torrey, a patient advocate from Baldwinsville, N. Y., says that she hasn’t read Bailey’s book but that it comes at a time when more patients are realizing they must take more active roles. That can be tough in a hospital, she says: “There is no more vulnerable feeling, no more loss of control.”

A few checklists — coupled with an ability to see and treat health care providers as fellow human beings — may help a lot, she says.

Bailey agrees that “a spirit of collaboration” is essential. That’s one reason she puts learning the names of all of your doctors, nurses and aides high on one of her lists.

“People are people,” she says. “They want to work with you.”