No one wants to be admitted to a hospital unless it’s absolutely necessary. Between the often long waits in the emergency department, the lack of privacy, and the onslaught of professionals coming in and out of your hospital room, it’s usually not a pleasant experience. Sometimes there’s no choice: a trauma or accident happens, a symptom becomes unbearable or a procedure is necessary that cannot be performed elsewhere. But among the reasons you may dread going to the hospital, it’s not likely that you fear for your own safety or even your life. However, a new report from the Office of the Inspector General of the US Dept of Health and Human Services may have you thinking twice about going to a hospital, regardless of the circumstances.

According to this report, out of the nearly one million Medicare patients discharged from hospitals in October 2018, over 250,000 of them (nearly 25%) experienced a harmful event during their hospital stay, and 10% of those events contributed to the deaths of patients. Almost half of those events were considered “preventable.” As the CEO of The Leapfrog Group (an organization devoted to hospital patient safety) said, “None of us would drive a vehicle or check into a hotel if we thought we had a one in four chance of being harmed by the experience.” Yet each and every day, older adults are admitted to hospitals and put at risk of “adverse events” (that could cause permanent harm, death, or require life-saving interventions) or experience temporary events that could have been much worse had someone not caught them. This new report concludes there is “still a significant way to go in terms of improving patient safety” even though safety measures were put into place after an earlier report in 2008 found similar statistics for harms posed to hospital patients. While hospitals can be penalized through Medicare payments to encourage better safety practices, it appears the majority of actions posing threats to patients (such as medication mix-ups) don’t trigger such penalties.

In fact, a recent article in Kaiser Health News points out how frequently medication mistakes may occur in hospital settings. Computerized medication cabinets can allow nursing staff to grab the wrong medication for a patient, as the technology permits inappropriate medication to be accessed if a spelling mistake occurs on entry or insufficient letters are typed to identify the exact drug. While efforts are underway to correct for the possibility of such mistakes, that will require time and money, both of which are rare commodities in hospitals these days. In fact, a Tennessee nurse was recently prosecuted for such a mistake (a controversial rarity, as these matters are usually handled by professional disciplinary boards) in a case where the patient died as a result of her mistake. While she was convicted, she was sentenced to probation and permanently barred from ever practicing nursing again. Most of these medication mistakes are never reported yet for patients they can pose a serious and potentially fatal risk.

These “events,” therefore, demand that as a hospital patient (or family member of a hospital patient), you need to be vigilant, ask questions and confirm the medications you are being given, the reasons for those medications, the procedures that are being undertaken on your behalf and any other factors that may affect your physical or cognitive well-being. That’s a tall order, especially since time is often of the essence and family caregivers are often still barred from the bedside due to Covid restrictions. Tara Parker-Pope from The New York Times recently described a personal experience of calling on a hospital patient advocate as a way to get questions and requests answered in a hospital. As well, agebuzz’s own patient advocacy expert, Julie Buyon, has written extensively on how you must be a “powerhouse patient” to make sure you are an informed and active participant in the care you receive, either in a hospital or in a community setting.

Perhaps the best we can hope for is that in the future, fewer of us are likely to ever land in a hospital. According to a recent article in STAT, given how dangerous and expensive hospitals can be (did you know that the average hospital stay costs over $2500/day?), we may all be better off avoiding them as much as possible. As one expert declared, “Unless hospitalization is absolutely imperative to receiving proper care, people are almost always better off avoiding a hospital stay.” The good news is that the health care system is moving in that direction. In particular, beyond outpatient ambulatory practices and remote monitoring, more and more hospitals are developing programs to send hospital equipment to your home.  And through telemedicine, digital monitoring, and regular nursing visits, your concerns can be addressed and your surroundings will likely be safer, not to mention the likelihood of better food and family visits. So stay tuned for more opportunities to stay home and out of the hospital.