I handed the woman in the audience the microphone, “I advocate for children every day in my job and parents are giving their children medication that makes them aggressive,” she told the crowd of 300. “Parents must speak up and not just give their children medication without questioning their care.” Her eyes welled up and she began to cry. “We need this education!” The audience applauded her courage. These sentiments were shared throughout the day at the Guam conference where I spoke for an entire day on Saturday, March 6 teaching the people of Guam how to be patient advocates for themselves and their family.
Medical professionals from the Naval Hospital, the local community hospital, nursing school and community members gathered to learn how to “Speak Up and Be Part of Your Healthcare Team.” This conference was being sponsored by the Guam Healthcare and Hospital Development Foundation founded by my host Peter Sgro. People of the villages of Guam were going to learn that they can speak up and it wasn’t going to be considered “disrespectful” to question their medical care and treatment.
The conference covered the true stories of medical injuries of patients and the families who have contacted PULSE over the years. We discussed F.I.L.M.S., Falls, Infections, Literacy, Medication and Surgery safety and communication. After each topic, I asked if anyone had an experience they wanted to share “because by sharing experiences we can learn how to prevent them from happening again”. Encouraging transparency with no fear or embarrassment and talking about their experience should help encourage future conversations. The morning session was the first time most of the people in the room ever heard of the Institute of Medicine report of 1999, where studies show that as many as 98,000 people die in hospitals every year from preventable medical errors.
The morning session covered communication and listening skills as a patient, family member or a provider. We practiced listening and reviewed the feelings and needs the patient has and the feelings the doctor might have being questioned by a patient. Reminding the audience that I was only there for a short time, it was up to them to keep this conversation going.
One man stood at the microphone and said he is afraid of speaking up and asking the doctor to wash his hands. “He may hurt me if I do,” he said sharing an obvious concern that others in the audience kept to themselves. I asked him why he thinks he will be physically harmed if he was polite. Handing the microphone to a physician in the audience, I asked him “can you tell this man how he can ask you to wash your hands without offending you”? The physician, from the local naval hospital dressed in his crisp, white uniform stood up and addressed the man directly. "Would you ask a food handler to wash if you saw they didn’t wash before touching your food”? When the man replied he would, the doctor reminded him it should be no different talking to his doctor.
The audience was eager to learn communication as a patient or to help family members as their advocate. I shared with them ways they can be involved with keeping medication records, lists of allergies and past procedures.
The afternoon session started with a proclamation from Guam’s 19 Mayors declaring March 7 – 13 Patient Safety Awareness Week. They never before celebrated Patient Safety Awareness Week but now had a reason to.
The Proclamation reads in part:
- One in five Americans report having experienced a medical error.....
- Medical errors lead to unnecessary readmission's to hospitals and thousands of deaths each year....
- Reports support the position that having patients and their families become a member of their own healthcare team results in better outcomes.....
- We encourage patients and their families to take a more active role in their on healthcare to ensure their safety and well being....
- Our island's ability to solve its health care crisis depends in no small part on whether our political and private sector leaders can articulate a shared vision of the kind of healthcare system that will meet the needs of all thoise who call Guam home..............
In the afternoon, we viewed the video “The Faces of Medical Error, From Tears to Transparency; The Story of Lewis Blackman.” Lewis was a 15-year-old boy who died from medical error at a South Carolina Hospital. The viewing of the video was followed by a panel discussion of five medical professionals answering questions about how this could happen and what steps are being taken to prevent a death like this from happening again. The audience seemed relieved when I asked a pharmacist on the panel if she ever heard of the story of Lewis Blackman and she said “yes” it has been used as a teaching tool for pharmacist. Again, I reminded the audience about how talking about problems such as Lewis’ death is how we will keep them from happening again.
Earlier in the week I did a press conference, radio show and television talk show. Before the radio program a man walked into the room where Peter and I sat waiting. This man was so happy that he didn’t need the triple bypass surgery he expected. The visiting cardiologist on Guam told him that his scheduled triple bypass was no longer needed. This man believe that prayer, prayers he told us his church offered, friends and family offered and his wife went out to seek for him.
With so few specialty doctors, there is only one cardiologist on Guam who makes the decisions. Many residents wait for visiting doctors to come and diagnose or treat a problem. In this case, I am sure it wasn’t prayer that changed the plan for this man’s medical care.
Sadly, patients often have to leave the island to get care. Families are often left behind because of the high cost to travel. Peter tells me the story of a young boy being treated for cancer on the mainland leaving his family behind. Having loved ones close by is supposed to help patients heal faster. Though they proudly display the American flag, there is such a primitive way about Guam’s healthcare system. Someone mentioned that it’s not much different than a third world country.
Guam may well be one of the most beautiful places in the world with such beautiful beaches, magnificent trees and warm weather. A small island of 160,000 people it was hard to not go someplace that Peter was not recognized or greeted. But, hidden under all that beauty is community desperate for information and knowledge on things we take for granted – our rights to speak up for safe, quality care.