The Worst Times of Year to Go to the Hospital

November 16, 2010 (Press-News.org) Thinking of scheduling that hip replacement next summer? Based on two recent studies, you might want to have the surgery done in the spring or fall instead, when your chances of medication errors, hospital born infections and other preventable medical errors are lower.

The July Effect

Every July, a new batch of first year medical residents walks through the doors of academic hospitals around the country. And every July, the rate of medication errors in these same institutions rises exponentially, giving rise to what has been dubbed "the July effect."

A study recently published in the Journal of General Internal Medicine found that counties with teaching hospitals experience a sharp increase in medication errors like clockwork every July - which just happens to coincide with the arrival of new residents and the departure of many of the seasoned staff members on summer vacations. Comparatively, the researchers found that counties without teaching hospitals did not experience the same increase in medication errors, and that their error rates remained the same throughout the summer months.

The study also found that the number of surgical errors at the teaching hospitals did not increase with the number of medication errors. The reason for this is because first year residents do not perform surgeries, but they do write prescriptions, leading to the spike in medication errors.

Weekends, Holidays and Other Days to Avoid

In addition to avoiding elective surgeries in July, patients should try to avoid other days that have been found to be higher risk for medical errors, including:
- Major holidays, like the Fourth of July, Christmas, Thanksgiving and New Years
- Four day weekend holidays, like Labor Day and Memorial Day
- Spring break
- Summer vacation

Weekends also are bad times to be admitted the hospital. Hospitals tend to staff lighter at night with less experienced personnel. While staff physicians rotate being on call and may only be a phone call away, the residents and other staff calling the shots at the hospital on weekends will be the ones who have the first contact with the patient -- and that may be the most critical contact. A study published in the CHEST Journal found that patients admitted to the Intensive Care Unit on the weekends were 8 percent more likely to die than patients admitted during the week.

Additionally, lower staff levels on the weekends also make it more difficult for the health care providers who are working to get necessary testing, treatments, therapies and medications to the patients. In some cases, certain treatments may not even be available on the weekends, forcing patients to wait until Monday morning.

For the same reasons, nights also have been found to be bad times to go to the hospital. A 2007 study found higher incidents of infant deaths, heart attacks and medication errors during the nighttime hours. A 2008 study published in the Journal of the American Medical Association (JAMA) looked at 87,000 cardiac patients and found that those who had a heart attack on the weekends or at night were significantly less likely to survive than those who had heart attacks and received treatment during the week.

What You Can Do to Protect Yourself from Medical Errors

While a patient having an elective surgery, like a knee or hip replacement or cosmetic procedure, will have more leeway in choosing the time to have the surgery, patients who need emergency care will not be able to pick and choose the timing of their care. So what happens if the patient arrives at the hospital during July, a holiday weekend or at night?

There are certain things patients can do to help protect themselves from becoming the victim of a hospital or other medical error, including:
- Speak up. It is important for patients to be proactive about their health care, which includes asking questions when they don't understand something or want to know more about their other options. No question is too dumb and second opinions are always available.
- Be smart about medications. Patients should keep a list of their current medications with them, including any over-the-counter or herbal medications as well as vitamins. The list should be given to every doctor who prescribes a new medication to help prevent bad drug interactions. Patients also should ask their doctors to explain what each medication is for, what side effects to watch out for and what to do if they miss a dose.
- Bring a friend. Patients should ask a friend or family member to go to the hospital with them. If one is not available, then patients can ask the hospital to appoint a patient advocate. Patient advocates can help monitor their care and ask questions the patients may not have thought of. They also can listen to the doctor's instructions on the proper way to care for an incision or take medication in case the patient later forgets.
- Demand cleanliness. Not only is it ok for patients to ask everyone who has personal contact with them in the hospital to wash their hands and use new gloves, but it is a necessity in order to help prevent the spread of hospital-born infections, including potentially deadly staph infections.

Conclusion

The Institute for Health Care Improvement estimates that there are more than 15 million medical mistakes made each year. While patients may have little control over the time and day they need care or even who their providers are, they can be active participants in their health care.

If you or a loved one has been the victim of a medication error, surgical error or other preventable medical error, contact an experienced medical malpractice attorney today.

Article provided by Cirignani Heller & Harman, LLP
Visit us at www.cirignani.com