Patients and their families can play a significant role in ensuring good quality care and preventing medical errors. Questions you ask and decisions you make can improve your medical outcome and your overall hospital experience. Even if you are rushed to the hospital, and thus cannot prepare for your stay in advance, many of these tips can help make your stay better and ensure a healthier outcome.

What medications will I need during my stay, and what rules apply?

Ask your doctor to make a list of the medications you are likely to need, with notations about the dosage, the color and shape of the pills, whether they should be taken with food, and what other restrictions may apply. Take your notes with you, so that you can make sure you get the medications you need at the doses prescribed. During your stay, if medications arrive that you don't recognize-or you don't get a medication when you expected-ask questions.

How will I access pain medication?

Plan your pain medication needs in advance. Talk to your doctor, and outline the process you will have for access to pain medication. Improperly managed pain can extend a patient's recovery period, and certainly reduces patient satisfaction. Ask your doctor whether a regular schedule of pain medication or access to a self-administered system will be appropriate for your hospitalization.

Who will be in charge?

Arrange for a single doctor to be in charge of your care to minimize conflicting orders. If you have a long medical history, go over that medical history with the doctor and highlight the most important facts that you know. Ask that doctor to stop by your room once a day, and use that visit to ask any questions you have.

How can I ensure that a friend or family member can participate in my care?

Most of us are not at our level best when hospitalized for illness or injury. Several people told The Good Life that it was important to have someone else watching over their hospital care. But patient confidentiality rules, designed to protect your medical information from strangers, might limit what a friend can do. Decide who you want to have access to all your care information, and make sure you have signed any forms required by the hospital. If you don't have a family member or a friend who can be with you twenty-four hours a day, you might consider hiring a private-duty nurse to fill the gaps. Your insurance may not cover the cost, but it could be worth the expense if it heads off problems.

How do I keep track of what's going on?

It would be worthwhile to keep a written record of treatments you receive and significant changes in your condition. Note questions you have for nurses and physicians, and write down the gist of their answers. If you're not up to this record-keeping, ask your family member, friend or private nurse to do it.

What are "clinical pathways" and how can they help?

For many procedures, hospitals have standard procedures in place from the time you enter the hospital till your discharge. Ask for a copy of the clinical pathway. You will have a clear idea what to expect from your treatment, and you can ask questions if your care seems to be wandering off the "path."

Will you draw it on me?

Ask your doctor to mark the surgical site on your body before surgery. This is one tested way to make sure you don't wake up, like Tammie Abrego, with a surgical scar in the wrong place. (See main article, "How Safe is Your Hospital?")

Will I benefit from antibiotics an hour before surgery?

Ask your doctor whether your surgery can be complicated by infection, and if there's a risk of infection, ask whether you should get antibiotics in the hour before surgery as recommended by a number of physician and quality-of-care organizations.

Are you controlling the spread of infection?

Don't feel embarrassed to ask hospital staff whether they have washed their hands before they touch you or treat you. If you don't see staff people wash their hands or don gloves before treating you, they may be carrying infection from another patient or part of the hospital. Studies show that handwashing is a good way to reduce hospital infection, but that compliance with procedures is sometimes low.

Do I still need this catheter or this IV fluid?

Devices like intravenous or urinary catheters provide a pathway for infection to invade the body. As you start to recover, ask whether you still need such devices and follow-up if they are not removed at the time you expect.

Should I read my chart?

If you are feeling up to it, read your chart or ask your friend or family member to read it for you. Your chart should contain full information about your medication, test results, and recovery. You may not understand all of it, but if anything seems unexpected, ask about it when the doctor visits.

Should I ask for a discharge planner?

Most hospital stays are shorter than they used to be, and this is not necessarily a bad thing. But if you are feeling rushed out before you are ready (you still can't keep food down, you feel feverish or faint, you just took your first oral medication), ask your doctor if the discharge is premature. Ask to speak to a discharge planner and find out if your insurance plan has terminated approval for additional hospital time. You or a family member may have to call the insurance company.

-Kathy Mitchell