Communication is the foundation of patient safety and quality care.  Whether it be communication between care givers or between healthcare provider and patients.  Patients are being empowered to ask questions, to review instructions, to advocate for themselves and to take a more active role in their care.  Having a basic understanding of given treatment plan, including medication regimen, is critical to the welfare of a patient.  Knowing the treatment plan- more importantly knowing the “why” of the treatment plan- helps patients ensure compliance and ensure continuum of care.   For example, if patients are aware of why a given medication is ordered they will make better decisions regarding compliance.  If patients have to make a choice financially between taking a medication or a movie hopefully it will be an INFORMED decision.

Many patients are re-admitted to the hospital due to not following treatment plan or medication regimens or not asking questions for clarification.  A patient recently discharged from a hospital was told to take newly prescribed medication “as directed”.  These two little words were disastrous.  First, the patient did not have good command of the English language (an interpreter should have been provided at time of discharge).  Second, the instructions were for a medication called coumadin (a high risk drug that needs to be closely monitored).  Third, the patient’s pharmacist filled the medication script and put a label on the container that read “take as directed”.  This patient did not take any of the medication for two days because she was waiting for direction.  Direction from who?  The physician had no intentions of calling this patient.  Fortunately, Home Care nursing staff visited this patient and identified the problem and worked through getting defined “as directed”. 

Effectively communicating to patients is the physician/health care provider responsibility.  The goal is not just talking to, but ensuring the patient understands what is being said.  Some patients may be intimidated, shy, or just not knowledgeable enough to ask questions.  The Joint Commission developed a program entitled “Speak Up” which was designed to empower the public to assist and demand quality care.  While not new, the Speak Up initiative is very applicable still. 

·         Speak up if you have questions or concerns, ask again.

·         Pay attention to the care you are receiving, don’t assume.

·         Educate yourself about your diagnosis, treatment plan.

·         Ask a trusted family member or friend to be your advocate.

·         Know what medications you take and why.

·         Use a hospital, clinic, or other medical center that has rigorous on site evaluations against state of art quality and safety standards.

·         Participate in all decisions about your treatment. 

Patients can take more control of their treatment and be a true team play in their care, but it requires a trust and respect by  both the patient and care giver.  Encourage patients and their families to “Speak Up”.  Encourage questions and discussion.  Encourage patients to repeat back directions provided.  By having a clear conversation and treatment plan that is “bought into” and understood by all parties the likelihood of medical error or omission in care is dramatically reduced.