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Health Care Patient Navigator News

interviewed Sheryl Kurland, April 22, 2010

Preventing missed appointments with specialists

Doctors, patients try to close gap between primary and specialty care


As Health Care Reform Looms - Take Measures For Surgery Safety

Whether for better or worse, our country is on the verge of major health care reform. In times of rapid change like now, the risk of medical mistakes heightens. According to the Institute of Medicine, an estimated 98,000 hospital patients are killed every year as a direct result of medical malpractice, constituting one of the leading causes of preventable death in the United States; surgical mistakes are high among the common causes.

Examples of surgical errors are: mistaken identity, surgery performed on the wrong body part or wrong site or side, receiving the wrong procedure at the correct surgical site, surgical instruments left inside the body after surgery, and unneeded surgery related to misdiagnosis. The best thing you can do to prevent becoming a statistic is take an active role and empower yourself. Use this safe-surgery checklist to help avoid the devastating consequences of becoming a victim:

1. Do you need this surgery and do you need it now? As trustworthy you may be of your doctor, it never hurts to obtain a second and, perhaps, a third opinion. Then, weigh your surgery options and make informed decisions.

2. Upon checking in for surgery, read your ID bracelet. Is all of the information accurate? If not, get it corrected both on the bracelet and in your medical record.

3. Be impolite. Prior to surgery, ask medical professionals who want to touch you if they have just washed their hands. Even go so far as to ask them to wash their hands in your presence. The Centers for Disease Control and Prevention states that "Keeping hands clean is one of the most important ways to prevent the spread of infection and illness." Similar sterilization rules apply to medical instruments. For example, stethoscopes should be sterilized with alcohol. If it's not happening before your very eyes, request it.

4. Prior to surgery, a member of the surgical team should confirm with you and identify the type of procedure you're having, the site of the surgery on your body, and your consent to have it done. The surgeon should be the one, and the only one, to mark the operative site and do so with a permanent marker-type pen.

5. A pulse oximeter, a medical device that indirectly measures the oxygen saturation of a patient's blood, should be placed on one of your fingers. When the pulse oximeter is positioned on your finger, ask "What is my oxygen saturation?" to assure someone looks at the oximeter and makes sure it's functioning.

6. Have you ever had trouble being anesthetized? If yes, inform the anesthesiologist and the surgeon.

7. Do you have any drug allergies? Inform a member of the surgical team and tell them to write it down in your surgical data. Do the same for any other important details regarding your medical history or problems that the surgical team needs to be aware of. Any minor-seeming detail about a patient's life can result in potentially disastrous surgical errors.

8. Check that the surgical team has your important x-ray files for display in the operating room. This effort helps prevent mistakes such as wrong-organ removal.

9. Begin antibiotic treatment prior to surgery. Studies show that the rate of infection may be reduced by 50% or more if a patient is administered a preventive antibiotic within one hour prior to surgery (the initial cutting). And, double-check that the antibiotic you take is the one your doctor prescribed.

10. Don't be embarrassed or hesitant to postpone your surgery if there are inaccuracies or things seem helter-skelter in the pre-surgery complex and/or during pre-surgery procedures. Never feel intimidated to question things. It's your body, and your right.

11. Have an "advocate" - your protector, enforcer, and defender - with you. Ask someone you trust - a friend, relative or a professional patient advocate - to take you to and from the surgery facility, and be with you at the hospital or surgery facility the entire time.

12. Get post-surgery orders explained to you and your advocate not only verbally but also in clearly written take-home instructions. Ask questions if there's something you don't understand.

14 Ways to Prevent Mistakes With Medication

Keep a current and comprehensive list of all of the medications you are taking. Include not only those obtained by prescription, but also over-the-counter medications such as cold remedies, aspirin, vitamins and herbal supplements. On this list, also include any allergies you have to medications, and any other allergies you have.

  1. 1.Whether you use one or multiple pharmacists, be sure that all have a copy of your medications list (see #1).

  2. 2.When you go to any doctor, give the doctor a copy of your medications list (see #1).

  3. 3.When a doctor gives you a written prescription, ask him the name of the medication, its purpose, and dosage. Have him point to the information on the prescription paper. In haste, sometimes a doctor may forget to write the "milligrams" or "frequency," etc. By having him "read" the prescription to you, he will catch any information accidentally skipped.

  4. 4.If you can't read the doctor's handwriting on the prescription, there is high likelihood that the pharmacist won't be able to either. Is the number a "7" or a "2"? Is your name spelled clearly and correctly? Politely ask the doctor to rewrite the prescription to ensure the pharmacist can follow the instructions. If the doctor is insulted, just tell him you're trying to save him or his staff the time of returning a pharmacist's phone call later on to clarify the prescription. This request is also crucial because often a doctor's nurse will handle pharmacy calls, and she may misread the doctor's illegible handwriting which could result in your getting the wrong medicine.

  5. 5.Ask your doctor "What are the common side effects of this medication?" This will make you aware of potential complications.

  6. 6.Ask your doctor: "What should I do if I experience any of the side effects you named or others?" This will give you a clear action plan, rather than waiting out what could be precious time to see if the side effects dissipate or the potential panic of trying to obtain medical care quickly.

  7. 7.Ask your doctor: "Do I need to take this medication with or without food?" A drug-food interaction can occur if directions are not properly followed; the food you do or do not eat can affect the ingredients in a medicine you are taking so the medicine cannot work the way it should. For example, taking some medicines at the same time that you eat may interfere with the way your stomach and intestines absorb it. The food may delay or decrease the absorption of the drug. On the other hand, some medicines are easier to tolerate when taken with food.

  8. 8.Ask your doctor: "Will or can this drug interfere with any of the other medications I take?" (Be certain he has your most recent medications list.) Your doctor may need to make adjustments to prevent potential problems. For supplemental information, there are a variety of internet sites in which you can research drug interactions.

  9. 9.Keep a photocopy of the prescription for yourself. You can ask the doctor's front office staff to make a copy for you when you check-out.

  10. 10.When you pick up your medicine at the drugstore (or receive it in the mail), refer to your photocopy of the prescription to make sure it is what the doctor ordered.

  11. 11.If you use a drugstore, when you pick up the medicine and the pharmacist inquires if you have any questions, ask the pharmacist to go over the medicine and dosage requirements. Even though your doctor already provided this explanation, hearing the information a second time will only help ensure you take the medication safely and accurately.

  12. 12.Don't mix medicine into hot drinks because the heat may keep the drug from working. And, never take medicine with alcoholic drinks.

  13. 13.Don't stop taking your medication just because you "feel better." Complete the entire required dosage (unless instructed otherwise by your physician). If you arbitrarily quit, there is high probability your symptoms or illness will return.


September 4, 2010

Tips to Help A Senior Prepare For A Doctor Appointment

Professional Women’s Group Health and Wellness Program

Last night was our second of the three part Health and Wellness series. We received wonderful information from Sheryl Kurland and Roxane Abelow of Orlando Patient Advocates (, whose passion for educating people in regard to their health and their rights as patients was inspiring!

My favorite part was the goody bags- everything in it had a specific message. Toy mazes were included to demonstrate the maze that the health care system can present. Even the adorable balloon flowers had a message- that even when you have to stretch yourself, you can make something beautiful happen!


Navigate the Medical Maze

How Not to Become a Medical Error Statistic

Our one hour seminars of insights and tools, are information packed and geared to making you a more knowledgeable and empowered patient.

Here is what others have to say about our presentation:

“valuable ... they are still talking about it”

“colorful and entertaining presentation ... memorable”

“packed with specific information ... every person could benefit”

“delivered with such a fun attitude”

Roxane Abelow and Sheryl Kurland present Navigating the Health Care Maze at the University Club of Winter Park October 2010

Developing a Positive Patient-Provider Relationship

Sheryl Kurland, January 7, 2011, Journal of Participatory Medicine


Call in radio show

Stay away from this on the holidays (Hint: it isn't alcohol)