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The Wall Street Journal today reviews the book Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care from the Inside Out. According to the review, the book explores the many safety problems with the medical system. Ironically, the system charged with making sick people well is very good at making sick people sicker.

For example, central line catheters, used to provide fluid or medication, is a major source of death in hospitals. They’re necessary to use, but they’re not well handled on a systematic basis. “Each year roughly 80,000 patients in the U.S. get central-line infections, many linked to failure to follow preventive measures, and 30,000 to 60,000 die.” The author’s checklist, proven to safe thousands of lives is simple–“wash hands; use sterile gowns, gloves and masks; clean the insertion site with antiseptic; avoid placing catheters in the groin (where infection risk is higher); and remove a catheter as soon as it is no longer needed.”–but it’s not followed.

Doctors are resistant to change, apparently. Or at least they’re resistant to critique.

Our health care system has lots of flaws, though pointing them out can make it too easy to forget how good it is to heal the otherwise terminally ill. Still, these and other stories have convinced me that when working within the health care system, it’s important to know what care you want and demand to receive it.

For caregivers, this is especially true. It is too easy for doctors and staff to ignore the elderly person who is perceived to complain about everything or to be too mentally deficient to pay attention to. The health care system is great, but also a royal mess. Patients need to enter it with eyes wide open.

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