Preventing patient safety incidents requires patients to be involved in their own care. This is because they are at the centre of the diagnostic, investigative, therapeutic, and monitoring phases of their healthcare journey. In her book The Patient’s Guide to Preventing Medical Errors, Karin Janine Bernsten discussed various steps patients can take to prevent harm to themselves as they go through the healthcare system. All her recommendations highlight the need for patients to be cautious at all times during their assessments and treatments, and to be alert to the various ways by which they can be inadvertently harmed.

One of the key recommendations Bernsten made was for patients to ‘never assume that important information‘ about them ‘has been communicated between health professionals‘; for this reason, she advised patients to bring along to their consultations ‘an updated clearly typed or written medication list and doses‘. She also urged patients to ‘watch out for over-fatigued clinicians‘ who are more likely to make unintended mistakes, and to ensure that their prescriptions are legible. She also cautioned patients not to ‘overate bedside manners over competence, especially of surgeons who she said the patient should ask specifically for their track record and complication rate. Another suggestion she made to patients was to follow up on their test results and not to assume that they are normal.

An important theme that Bernsten addressed was the importance of patients requesting second opinions when they are not satisfied with the first opinion, or when they are not comfortable with the advice given to them. She particularly advocated seeking a second opinion when the disease in consideration is rare; when the doctor is not an expert in the diagnosis; and when the doctor is not familiar with an alternative treatment. She went further to urge seeking a third opinion if the second opinion differs significantly from the first.

Next week we will look at speaking up and whistleblowing in preventing human error.