The hospital is one of the most dangerous places you'll ever go. Patients are exposed to bacteria and viruses... subjected to tests and procedures with high risks...and drugs that should be closely monitored-but sometimes aren't.

Between 44,000 and 98,000 Americans die annually from hospital errors. Although hospital patients can't control everything that happens in the hospital, they can lower their risks more than they realize.

Example: Use only a hospital that's accredited by the Joint Commission on Accreditation of Healthcare Organizations. This type of accreditation means the hospital is evaluated every three years to ensure that it meets the best standards in cleanliness, infection control, drug administration guidelines, etc. More than 15,000 health-care facilities are accredited-but many others aren't. To check, go to www.qualitycheck.org, or call 530 -792-5800. Other ways to stay safe...

Pick The Best Hospital

Teaching hospitals affiliated with major medical universities tend to have the latest technology and best-trained staff. If you require major surgery (such as a transplant operation) or have a life-threatening condition (such as an aortic aneurysm or pancreatic cancer), a teaching hospital is your best option. Smaller hospitals are fine for patients with "routine" health problems, such as pneumonia or a broken leg.

Warning: In the summer months, teaching hospitals are largely staffed by new residents and interns. Their lack of experience can adversely affect patient care. If you can, avoid teaching hospitals during the first two weeks of July, when the new school year begins. Other points to consider...

Is it a "magnet" hospital? Medical centers with outstanding nursing programs earn this designation from the American Nurses Credentialing center (800 -284-2378, www.nursecredentialing.org). Patients in these hospitals benefit from improved care...less staff turnover...and high-quality physicians, who are more likely to work at a hospital with magnet status.

Are there full-time intensivists and hospitalists? Intensivists are doctors who specialize in treating critically ill patients. Hospitalists are doctors who treat only hospital patients. Both types of specialists provide superior hospital care and don't maintain private practices "on the side."

How often does the hospital perform the procedure you're undergoing? The best our comes usually occur at hospitals where a given procedure is performed most often, on average.

Examples: A top-flight hospital will perform at least 500 open-heart procedures annually 100 carotid-artery grafts or surgeries...and 25 mastectomies.

Choose The Best Surgeon

Only use a surgeon who is board certified in the specialty that is related to your operation -neurosurgery, cardiac surgery, etc. Look for the letters "FACS" (Fellow American College of Surgeons) after his/her name. This means that the surgeon has been evaluated for competence and ethical standards.

Helpful: Call the hospital anesthesiology department, and ask one of the anesthesiologists which surgeon he would pick. (Anesthesiologists often are free between 3 pm and 5 pm.) They know all the surgeons and have no reason not to give a straight answer.

Once you have some recommendations, choose a surgeon who does only a few types of procedures. Research has shown that surgeons who specialize-in nerve-sparing prostate surgery, for example-have better results and fewer complications than the national average.

Caution: Don't shave your surgical site before surgery. You'll wind up with thousands of invisible nicks that increase the risk for infection. Let the operating room staff do it. They use special creams that prevent nicks.

Important: Ask the anesthesiologist to provide a blanket (if it won't get in the way) to keep you warm during surgery. patients who maintain n o rm o t b e r m i a (normal body temperature) have a lower risk for infection and other complications.

Prevent Hospital Infections

Each year, an estimated 2 million hospital patients develop an infection. With the emergence of antibiotic-resistant bacteria, even a minor initial infection can be fatal.

We all know the importance of hand washing, so insist that visitors (including nurses and doctors) wash their hands before touching you. A quick rinse doesn't help. Studies show that you must wash vigorously with soap and warm water for at least 15 seconds to remove all bacteria. As an alternative, hand-sanitizing gel, which is now located outside many hospital rooms, may be used by visitors.

Other self-defense strategies...

Keep a bottle of hand-sanitizing gel at your bedside. Use this hand cleanser yourself before eating.

Beware of the TV remote control. One study found that remote controls in hospitals have three times more bacteria than doorknobs or nurse call buttons. To protect yourself, cover the TV remote with a new medical glove. you'll still be able to change the channels.

Ask about the stethoscope. Doctors and nurses are supposed to clean their stethoscopes with alcohol between patients-but some get too busy and forget. Uncleaned stethoscopes have been linked to hospital infections.

Drug Protection

Drug mistakes-giving the wrong drug, a dangerous drug combination or the wrong dose often occur in hospitals. Ask your primary-care doctor to supervise all of your health care, including drug prescriptions. If that isn't possible, ask one of the hospitalists to do it. Patients with one supervising doctor face fewer risks.

Each time you're given medication: Show your ID bracelet. To ensure that you're getting the right drug (medical test or procedure), ask the nurse to check your ID wrist bracelet.

Ask the nurse to tell you what each drug is and why you're taking it. Don't take a drug unless you're sure it's the one that you're supposed to be taking. If you're receiving a medical test or procedure, confirm that it's the correct one.

Finally, ask a family member or friend to help monitor your daily care. This is especially important if the patient is not able to do so.

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