I have to admit, it is exciting to be chosen to Modern Healthcares Top 100 Most Powerful People in Healthcare but I’m not sure what the responsibility means.

First, you should know that I am a big fan of Modern Healthcare. The writers of this weekly magazine actually call for my opinion and return calls if I reach out to them. Unlike less popular and “snooty” papers, there seems to be real people working there with manners and courtesy to their readers. I am impressed with any professional writer who asks my opinion because I have not been trained in “political correctness” and very often state my opinion on a topic that may not be what the paper, nor their readers want to read.

I have quoted Modern Healthcare on occasion to my colleagues because I do believe they do their homework. When the information I am sharing about an article I read is not satisfactory to the person I am speaking to, they have gone so far to say that the magazine is not worthy of their time. On the other hand, they too read the magazine and at times been featured in it.

I remember saying to the CEO of a very popular hospital, at a meeting that I was surprised his hospital was not listed in a top hospitals article in Modern Healthcare. He asked to see the paper and after reading it, mumbled something about the magazine being garbage. One of his colleagues asked me what I did to get him so angry. I assume if his hospitals were listed, the magazine would have been a treasure.

This year, Modern Healthcare writes that there were 25,700 names submitted to be the Top 100 Most Powerful People in Healthcare. Nearly 52,000 people voted on the top choices. Out of those 25,700 names there are probably 25,600 who think Modern Healthcare is “garbage”. Probably, many the same people who thought it was a treasure last year when they were featured .

What now? Will being in the list of Top anything help our cause? Will people listen? Will we really be able to change things or make the world a better place because we are listed in the top 100 of anything?

As the president of a grassroots patient safety organization, my roll is, in part to get publicity for the organization and our cause. This is rarely done. PULSE of NY does almost no advertising because of our size and small budget. For that alone, being featured in Modern Healthcare is wonderful . The many letters and e-mails of support I received, many labeled #76!, helped me hear from people I have not heard from in years.

Although I am sure this list won’t suddenly make the world better and may not even open doors, it surely couldn’t hurt. I am grateful for those who voted for me and Modern Healthcare for holding this contest (until, of course I am off the list)

The situation in a hospital is not that a patient should never be left alone, but that the patient’s family should not have to be alone either to deal with the emotional stresses of having a family member hospitalized for a serious, or even a non-serious ailment.

I wouldn’t say there should be a third party around the bed 24/7. That’s just not realistic. I am saying an “advocate” available to the family, not affiliated with the health system is needed. That’s where I come in.

Recently I went to visit a 97 year old woman in a rehab center / nursing home. Her mind is as sharp as someone half her age but she is in rehab following a fall at home.

Her grandson told me her call bell was not working. He has asked for it to be fixed on numerous occasions and each time a report is filed, someone comes in and changes the cord, it works and they leave. Immediately following the “repair” it doesn’t work again.

A 97 year old woman who is considered a fall risk needs a call bell. This is a serious safety issue – period.

Unfortunately this lovely woman soiled herself during the night when no one was answering her call bell, that didn’t work. This angered the family, no doubt, even more.

By the time I arrived, the call bell was changed about 3 times. The family was angry, or so they should be, we now had a dangerous situation; Grandma could easily get up and fall.

When I went to the nurse’s station to report this hazard, I was told that a report will be filed. I wanted to see someone in charge. Soon I was face to face with the person in charge of maintenance. Together we went to grandma’s room and the box was pulled out and replaced. It was a short in the box in the wall. Obvious even to me.

Why did it come to anger and danger when it could have easily been looked at as a problem after the first time the call bell stopped working again? The nurse in charge would have allowed it to continue were I not insistent that someone in charge get involved.

What is also troubling is that the "Director of Plant Engineering', the gentleman who accompanied me to the room, did not know about the numerous complaints. He thought he was not responsible because he didn’t know – but why didn’t he know? What is the communication breakdown that allowed this to go on for so long?

According to the Agency for Healthcare Research and Quality, falls account for 70% of hospital accidents. Effective October 1, 2008, Medicare and many state Medicaid agencies no longer reimburse hospitals for costs associated with treating injuries incurred by patients who fall while hospitalized.

A study of people age 72 and older, the average health care cost of a fall injury totals $19,440.00 according to the Center for Disease Control and Prevention (CDC).

It is therefore my opinion, we may have saved this facility almost $20,000.00. Something to consider when they say they have no funding.

I’m finishing up my last minute packing for my business trip to Hawaii. Before you think Oh boy, she’s got the life, let me remind you I added the word “business” in the last sentence purposely. I do not get pleasure, nor do I seek pleasure in my business trips. You may think that I should, but you are entitled to think what you want. Very few people understand why I feel this way.

I remember years ago I was invited to go to a beautiful Caribbean island to speak in front of a group of pharmacists. I had to get my passport. The planning was longer than I would have liked and the flight (although not nearly as long as Hawaii) was also longer than I would have liked. It was a constant reminder that this is not what I would have planned for vacation. Still you might think - enjoy it while you're there.

During that trip years ago I flew in and arrived at 7:00 pm, enough time for a networking dinner and by 11:00 am I was on my way back to the airport. I love the Caribbean water but never went near it even though it was only yards away. To dip my feet into the beautiful water, or sit on this beautiful sand, would be, for me, a disloyalty to all the patients and family’s I am doing this for. How can I enjoy the ocean, a sunset or the sand when the reason I am there is because people are dying every day from preventable medical errors?

It may be a form of post traumatic stress that is just now becoming recognized following a medical injury. I live with the death of my son daily not just because I do - but because I have chosen, and been given the opportunity to share his story and other stories so I can help make a better and safer health care system.

It could be that I am just a loyal person to this cause or, it could be that I just don’t know how to have a good time and “lighten up” as some folks have told me. But it is very personal, and very important to me, as an individual, that I remember why I was given this opportunity to travel the country and share the tragic stories of those who passed on, or suffer today because of medical injuries. It is not to swimming, sunbathing or having fun – although this time I did pack a bathing suit.

I spoke to Patty yesterday (names are changed). We spoke a few years ago and then lost contact. Her story stayed with me over the years because it is sad and painful but so real.

Her husband was seriously damaged during surgery. He was a businessman she, a businesswoman. They had careers, a home and close family. Following his injury, she became his caretaker and he lost his job, she could barely work and they became poor and lost their home.

When I speak to her, she could be anyone of my friends or family members. Patty is educated and articulate – but she is one of those in the “system” that has failed us as patients.

She waited too long to sue. Her husband’s injury and caring for him consumed her. They expected honest answers from the doctors and hospital. Her husband worked for the hospital. He ran a department. The hospital denied any wrongdoing but still, he went in for treatment and came back an invalid, unable to care for himself, in a variety of ways.

Patty is still angry and feels obsessed with telling her story. But, all too often no one wants to hear it. How can she sound reasonable with all this anger and grief? Now Patty tells me she fears she will die before her husband; no one to care for him and no one to tell his story. Her health is failing and she has years of research and documentation of her husbands care and treatment and why it was inappropriate. She wants to know what she should do with it.

I hear stories like this and feel like a failure myself. How can I help her or others like her? I probably can’t. Can I help others never to be in this situation to begin with? I just don’t know. Do I want to be in the center of the pain and turmoil Patty feels? Yes, I do because it is the reason I continue this work.

I sometimes wonder where I can go with this but hopefully someone will read this with ideas. There are just too many Patty’s out there.