Although there are any number of how-to-take-charge-of-your-hospital-stay books on the market, this book explains that, to a very large extent, we have no choice but to trust our hospital. Even if a family member accompanies us, we still place our health and safety in the hands of others. Regardless of whether our hospital care is good or bad, once we become patients, trust them we must. Whatever we do to insure trustworthy hospitals must therefore be done before the fact.

SOME OF THE ISSUES ON WHICH THIS BOOK FOCUSES ARE:

Hospital Mistakes: The National Institute of Medicine has reported that medical errors may cause 100,000 deaths annually and more than 10 times that amount of injuries or complications. The American Medical Association disputes those numbers, replacing them with 5,000 to 15,000 deaths. The discrepancy between the two reflects how one defines a medical error. Both sets of numbers should give anyone considerable pause before entering such a high-risk facility as a hospital, and they do.

Rising Costs and Declining Service: In the tradition of discount shopping chains, an abundance of minimally trained workers take care of "customers" while an abundance of managers, consultants and marketing experts take care of business. ...the public, more from a sense of powerlessness than apathy, may accept hospital care as just another business enterprise, albeit one that holds considerable power over our lives. We have an odd relationship with our community hospital that is at once both adversarial and fiduciary.

The Inferior Economics of Inferior Service: Many of the hospitals that are failing are not doing so because they are impossible business enterprises; they are failing because they don't take care of their patients. Current cost-containment practices may ultimately create far greater costs through patient complications, increased lengths of stay, hospital errors, malpractice insurance, staff turnover and other extremely expensive outcomes.

Lack of Professional care: Approximately 500,000 registered nurses with active licenses are not practicing. Another 500,000 work only part-time. This represents more than one third of the entire registered nurse population. The most common reason nurses give is the poor practice conditions in hospitals.

EXCERPTS FROM CREATING HOSPITALS WE CAN TRUST

"We all share the responsibility for creating hospitals we can trust...The public must not allow themselves to be intimidated by what only appears to be a complex industry. They must be well informed enough to distinguish meaningful information from rhetoric and make reliable judgments about quality and the criteria for good care. They must examine the systems in their community hospitals basing their efforts on the principle that good hospital care is best assured before one becomes a patient."

"...We can create hospitals that will serve their patients well and at the same time retain the necessary profitability for growth and modernization."