Advice From Your Advocates
Advice From Your Advocates
Hospital Safety Secrets for Caregivers: Protecting Elders in Healthcare
What if we told you that up to 400,000 Americans die each year from preventable harm in hospitals?
That shocking statistic is just the beginning of what Dr. Julie Siemers, founder of LifeBeat Solutions, reveals in this eye-opening conversation.
In this episode of Advice From Your Advocates Podcast, Elder Law Attorney Bob Mannor speaks with Dr. Julie Siemers about the critical issues surrounding patient safety and medical harm in healthcare. They discuss the alarming statistics of preventable harm, the importance of family involvement in healthcare advocacy, and the need for effective communication between healthcare providers and families.
Dr. Siemers pulls back the curtain on the "Wizard of Oz" healthcare system, explaining how communication breakdowns cause 70% of patient harm events. The dangers are particularly acute for elderly patients and those with cognitive impairments, who may be misdiagnosed with "quick onset dementia" when they actually have treatable conditions
Whether you're navigating care for an elderly parent, preparing for your own hospital stay, or simply want to understand the hidden risks in our healthcare system, this episode provides critical knowledge and practical tools. Subscribe to hear more conversations that empower you to advocate effectively for yourself and your loved ones in complex healthcare situations.
Host: Attorney Bob Mannor, CELA, CDP
Guest: Dr. Julie Siemers
Executive Producer: Savannah Meksto, CDP
Assistant Producers: Samantha Noah, Shalene Gaul
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Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
We also help families dealing with dementia, Alzheimer’s disease, Parkinson’s disease, and other illnesses that cause memory loss. We take a comprehensive, holistic approach, called Life Care Planning. LEARN MORE...
You're listening to Advice from.
Speaker 1:Your.
Speaker 2:Advocates a show where we provide elder law advice to professionals who work with the elderly and their families.
Speaker 1:Welcome back to Advice from your Advocates. I'm Bob Banner. I'm a certified elder law attorney in the state of Michigan and I am excited about our guest today, Dr Julie Seamers. She is the founder of LifeBeat Solutions, but that's not it. She has a lot of other things. She has a book called Surviving your Hospital Stay and a TEDx presentation called how Not to Die in the Hospital. Dr Julie, welcome to our podcast. Thank you, I appreciate being here. So I like to start off with just having you tell us a little bit about yourself and your journey and how you got to where we are today.
Speaker 2:Yeah, it's been a long one. I started nursing school right out of high school, which was for over four decades ago, spent a lot of time working in the hospital and various departments the medical surgical floor, the ER, the trauma center. I spent 10 years as a flight nurse on the helicopter in Las Vegas and then I transitioned over to nursing education in 2009. And that really began my journey into patient safety, because what I discovered in my research for my master's and then my doctoral project was that medical harm occurred at astounding numbers and I truly think we're undercounting because we don't have national reporting mandates, but the current figure is between 250,000 to 400,000 patients die of preventable harm in the hospital every year.
Speaker 1:Wow, break that down for me, because it's just really hard to even process that information. How does this occur? What are the things that are the biggest red?
Speaker 2:flags. There's multiple categories of what we call medical harm or medical mistakes categories of what we call medical harm or medical mistakes, and what I will say is that I truly believe in all this research that I've done. It's not an individual yes, it may be the nurse that gives the wrong medication but it is systems errors that contribute to mistakes being made, and part of the problem is we don't have transparency in healthcare. If there's a lawsuit brought against a hospital, 80% of those hospitals make the family sign a nondisclosure so they can't share what happened. And every time we keep something secret, or what I call behind the Wizard of Oz curtain of healthcare, then we can't fix the problems. And so there's diagnostic errors, there's medication errors, there's what is called in the literature failure to rescue. So it's a myriad, a big host of things that can go wrong when situations line up.
Speaker 1:You know it's really interesting. I've seen this just from being in the hospital, my mother being in the hospital and sort of just the lack of coordination, right, the lack of coordination where I was, you know, prescribed pretty much the same drug with three different prescriptions and I would presume like I was smart enough to figure it out. But if I would have brought it to the pharmacy I presume they would have stopped it. You know that somebody would have caught it a long line. But with my mother it was they put her on a treadmill after they had just given her some medication. That would be, you know, counter to that, and it was just a lack of coordination between all of the people that are involved in a hospital setting. Is that a lot of what's going on with what you're talking about?
Speaker 2:Yes, you bring up a really good point. The Joint Commission tells us for years now that the number one cause 70% of patient harm events are caused by communication breakdowns Exactly what you just gave as an example. So the communication breakdown can be between the healthcare team themselves doctor to doctor, doctor to nurse but I have to say we've got to include the family in there. They have to be part of the healthcare team, meaning you know your family member better than anyone and those nuances or subtleties that you notice are changes are so crucial to report to the healthcare team. Hey, this is different from my mom, because their healthcare team is busy. They're not going to clue into those things that raise concerns for you.
Speaker 1:This is a very good point. My area of expertise often leads me to having a large percentage of my clients that have some form of dementia, and dementia is not always well understood, even by doctors and in the hospital, especially in the emergency room, and one of the things and I could go on for three hours about this but one of the things that comes up is delirium. So delirium appears and presents itself as full-on Alzheimer's, full-on dementia. But yesterday mom wasn't like that, yesterday grandpa wasn't like that. But the caregivers, the nurses, the doctors are seeing this present in this way. Often and I don't mean to be critical, but often they're not taking into account what the family is telling them is that was not what happened yesterday. It is. This is new information. We need to be treating this as a new symptom, not as a well, this is just an old person with dementia.
Speaker 2:Absolutely. That is so crucial and important because, especially in the population and demographics that you're talking about, we can't group them, as healthcare providers, into one category. That's just not going to serve the patient, because the range, as you said, the scale can vary patient to patient. And you also brought up a really good point. New changes are essential because we need to determine, as the healthcare team is there something physical going on like electrolyte imbalances or dehydration or low oxygen? What is causing? Yeah, maybe it's a medication interaction too, and so we need to be aware of those, and if we don't have the family's input, we're kind of walking in the dark.
Speaker 1:I've seen this so many times where the family was told this was quick onset dementia, which is, that's a possibility. It usually means vascular dementia. It usually means some kind of stroke or something like that. Honestly, probably nine times out of 10, quick onset dementia means there is a physical reason that could be fixed, that could be treated. That's not, you know, permanent and everything else where they go in for a significant change in the cognitive ability and the diagnosis is just oh, that's just well, now they have dementia. Well, maybe, but that's actually more unusual than other explanations.
Speaker 2:Yeah, alterations and levels of consciousness can happen for multiple reasons, and even to young people. It gets a little off track when we group somebody just because of their age category, into which. Sodium is the electrolyte that I just teach my nursing students. N, which is the periodic table for sodium. N is neurological, so if it's too high or too low it can actually cause confusion, seizures, coma and death. And so, yes, we've got to look at the other causes instead of what I call the cognitive bias and assuming it's this, you know, just dementia with you about how bad things are sometimes.
Speaker 1:What I like about all of your information is you have information about how do we as a family fix this, how do we prepare for this? So how can caregivers and families better prepare for a hospital stay?
Speaker 2:I think the first piece is awareness, and we did talk a lot about patient harm because it's statistically very scary, but accurate and true. If we're aware and then we become informed, educated, then we are empowered and that means, again, you know your family member the best and thank goodness they've got family as advocates, I feel, for these patients that don't have anybody. But that awareness is then leading to what your actions will be. For example, if you're and we call it nowadays medical gaslighting, if you're dismissed by the healthcare team, you must become not a passive participant but an active participant in the healthcare system and that means speaking up.
Speaker 2:It can be very intimidating because we still have a culture in the US where the doctor knows best that mentality and a lot of families can feel like well, the doctor's had 12 years of medical training, I don't know anything, I'm just a lay person. Or the nurse has four or five or six years of training that I don't have. But I really feel that patients' families are so essential to bridge that healthcare gap and speaking up when you feel something is wrong or you want to bring it to their attention is so crucial to make sure that they get the best care. I talk about this in my TEDx talk. Bridging the communication is the only way that we're going to be able to bridge that gap of communication failures that really result in patient harm. So if there's only one thing you take from this tips and tricks from this podcast about how to communicate better and speak up, because your family members health may really depend on your voice yeah, this is something that I feel that we've gotten less comfortable with as a society.
Speaker 1:It's disappointing to me because my personality is just ask questions, ask lots of questions. Where I think society has gotten frustrated is they look at questions as being adversarial, and it's not at all. It's honestly. When I'm working with a legal client, the more questions they have, the better I am at formulating a plan for them. If they ask no questions at all, it's going to be a little bit more generic than it is if they ask a thousand questions. I want the questions and unfortunately, as a society, I think sometimes we look at questions as being adversarial as opposed to well, let's just really ask lots of questions so that we can get clarity.
Speaker 2:well, let's just really ask lots of questions so that we can get clarity. Yeah, I think that's a great point and what I recommend too is coming from a place of curiosity when you ask those questions, and I think that sets the stage to let the healthcare team know that you want to be an active partner, that you are definitely engaged in getting the best outcomes for your family member. And you're right, the more questions you can ask, the better. And so coming prepared with a notepad, if that's your comfort, and taking notes and then asking for clarification If the doctor says well, now your mom has congestive heart failure and goes on to, we're going to do an echocardiogram and we're going to give a diuretic and that's Greek to you you have no idea what they just said.
Speaker 2:But understanding is so important because if you understand the pathophysiology or what actual congestive heart failure is, we know that they get fluid overloaded. So then we're more likely to help mom or dad stick to a low sodium diet or whatever, make sure they take their medications and that kind of thing. So it really is a community taking care of a patient together. That's how it should be.
Speaker 1:I saw I read this article recently and it was discussing that in the United States we're very good at dealing with the crisis case and very bad at dealing with the chronic case. You know, often if it's a chronic matter it's not an emergent matter. There are multiple ways to deal with that. Right, there could be better diet, better exercise. There could be things that could be done other than prescribe this drug, and that is not the standard of the industry in the medical field right now. It is we assume you're not going to change your lifestyle. Well, given the option, some people will change their lifestyle, but if they're not informed of that, that is a huge. You know, if it's just about okay, now we're going to take this drug to treat this and now we have to take other drugs to treat the symptoms from that drug, it is a huge problem when some people would have been willing to change their lifestyle to better deal with whatever that health care issue is.
Speaker 2:Yeah, to improve your health. Really good point and very accurate. In fact, it really isn't a health care system, it's a disease care system, and unfortunately, medical school curriculums are largely determined by big pharma, and that's part of it. We also know that many medical schools I think it's only 20% actually get a course in nutrition, and so that is not the first thing that doctors will think of. I mean, yes, there are some, for sure, but their go-to is get out the prescription pad. You know which? You're right, we should have that choice to understand and to know. You know our diet and our exercise is probably responsible for 95% of chronic diseases, and so if we know we want to feel better, then what can we do?
Speaker 1:Yeah, all right, I'm going to shift gears here a little bit, and this is a question that I feel like this is a bit controversial, just because we have three hospitals within a five-mile radius of my office, three different hospital networks, and the question is does the hospital you're admitted to play a major role in the type of care that you receive?
Speaker 2:Absolutely, and I'll tell you, for your audience, to go to the website hospitalsafetygradeorg. Put in your zip code and you can find the safety and quality rankings of every hospital in your area. They're rated A through F, just like your grades on your college papers or high school papers A, excellent and F they're flunking, and there are five main categories and subcategories, so about 32 overall categories where you can see red, yellow, green. How does this hospital rank in infections, hospital acquired infections? How does this hospital rank with dangerous blood clots, all those things that can happen in the hospital you can find on that website and say, in fact I'll give you an example. I was talking with a lady the other day about this topic. She's seven months pregnant. She put in her zip code and she found the hospital she was going to go to to have this baby was a ranked a C. And she looked further and said there's an A hospital only 30 minutes away. I'm going to go to that one because your chances of better outcomes are obviously at the higher ranked hospitals. It matters.
Speaker 1:I'm curious about that, because how are those rankings determined? Are they determined by patient input? Is it determined by government reviews? I'm always to be honest with you. I'm always skeptical of those types of reviews because I don't know where the information. How do they make those rankings?
Speaker 2:Yeah, this organization is a nonprofit organization. I think they've been around now for a couple of decades but they take reportable data that hospitals have to report into CMS Center for Medicaid and Medicare Services for outcomes. I mean, we have to report infection rates and so the data that will say this hospital had X amount of cases of MRSA and that's you know. Compared to national data or even state data, this hospital's not doing well. They need to wash their hands more often, et cetera.
Speaker 1:That feels like a very valid process for the analysis. You look at the actual data, so that's helpful. Tell me about the use of technology Now. Everything is changing with AI and every profession is changing. With regard to this, and in the law field, it is very much the people you know. Some people are ignoring it, some people are embracing it, some people are overly enthusiastic about it and maybe abusing it, and so is that true in the medical field also.
Speaker 2:We've had great technology advancements in the last couple of decades, but it also part of those advancements have brought new problems. For example, the electronic health record is mandated now for all hospitals, but that in itself has created documentation challenges. Here, physicians and nurses both say they spend more time trying to document correctly and in the right place than they used to on paper charts. And another thing that was supposed to be put in place for safety, such as medication alerts. For example, there's statin drugs that shouldn't be taken with grapefruit juice. That's a valid alert.
Speaker 2:But sometimes there's so many alerts that don't even pertain to that patient specifically or that are just there's way too many of them, and the healthcare team just ignores all of them, and so then they miss the real critical alerts that could have prevented a huge mistake that harmed a patient. So there's the good and the bad. Ai, I think, is really going to help healthcare once we can implement it in a way that augments the human capacity, because we know healthcare workers are overwhelmed with how critically ill patients are and how many patients they're caring for. But AI has the opportunity, let's just say, to look at different parameters in the patient's chart and raise a red flag, for example, if the patient's white blood cell count is elevated and now their temperature's elevated and their respiratory rate is elevated, they can put all those data points together before the healthcare provider can do that cognitively and say I think this patient may be becoming septic, let's take a deeper dive and start some antibiotics, or whatever the case may be.
Speaker 1:And I think that's the value of AI is helping to narrow down things. So you gave the example of all the warnings you get. You know, not only is it the healthcare workers that are probably overwhelmed with the number of warnings that are given, it's the patients too. And so if AI can be helpful in really, instead of just having you know anytime you get the prescription, you get the three pages of warnings and everything else and nobody reads it If AI was able to really help to narrow down this is important. Here's all the other stuff.
Speaker 2:Right. Pay attention to this.
Speaker 1:Yes, this has been a very interesting conversation. I really appreciate the work that you do, your TED Talk, your book, the company that you have. What are the key takeaways?
Speaker 2:I'm very hopeful that we definitely can change the trajectory of the healthcare system by becoming more involved and informed. And it honestly doesn't take a nursing degree to understand the highlights to help you with your family member. It may take some research because, again, to understand we've got to learn more than we know now. But using your voice to communicate and articulate what's going on is so important. And one thing I will add is if you feel that you're being dismissed and you're concerned, use the cuss words Concerned, uncomfortable, scared and a safety issue. Say that again Concerned, uncomfortable, scared or a safety issue. So you could say well, I'm really concerned that my father's breathing isn't the same as it used to be and it's scaring me. Can we have someone else come, please take a look, or could you reassess him again? You have to speak up to get their attention sometimes.
Speaker 2:But the other key to that is if you start with a bedside nurse, if you're in the hospital or long-term care and you're not getting action or interventions and you are still really concerned, you have to escalate up the chain of command. So in the hospital it's the bedside nurse, the charge nurse, the nursing supervisor who's over all of nursing for that shift in the hospital, and then there's patient advocacies, there's risk management, the physician themselves, and the top of that chain is the at least at the hospital, is the administrator on call. So that's nights, weekends, holidays included. And if you're not getting action, and you're concerned, and you're worried for a reason, keep escalating, keep being persistent, be present, be polite and be persistent.
Speaker 1:That's some of the best advice I've ever heard with regard to dealing with the healthcare industry. Honestly, it is. You don't have to be an expert, you have to use your voice. You should be polite. As soon as you start not being polite, you get put in a different category, right? Wouldn't you agree with that, that, if? You're not polite, they're not going to. You're put in a different category yes, that is so true and then persistent.
Speaker 1:You know, I think that's the most important thing speak up, ask questions, be polite, be persistent. You're gonna get better care that way, and that's true in pretty much everything in life. You know, this is important for health care, but it's pretty much true for everything in life. This is important for healthcare, but it's pretty much true for everything in life. Yes, fully agree. I so much appreciate the time that we've had with you today. Dr Julie Seymour's, author of Surviving your Hospital Stay and the TEDx talk how Not to Die in the Hospital, which I love those titles and the founder of LifeBeat Solutions. Thank you so much for informing our audience.
Speaker 2:You're welcome and thank you for having me. Just to make you aware, for your audience too, I have an app coming that will help patients and their families. It's one thing to read a book, but it's another thing to have it at your fingertips when you need the help. Oh, what are those cuss words? So that'll be coming soon and I can let you know when that drops.
Speaker 1:Love it, so we'll definitely get that to me and we will promote that out to our audience. Thank you so much. Thank you. So if you enjoyed this podcast today, don't forget to subscribe. You can find us at anywhere that you listen to podcasts and advice from your advocates. We're very happy about the success of Advice From your Advocates recently, with the number of downloads and just the general popularity of it. So don't forget to subscribe so that you get the interesting conversations like the one that we had today. Thank you so much and we'll see you next time. Thanks for listening. To learn more, visit manorlawgroupcom.
