The viral video of a University of Maryland hospital patient being discharged onto a Baltimore street on a cold January evening wearing only a hospital gown and socks shocked thousands of viewers. This alarming incident should prompt state legislators to consider the need for better protection of hospital patients — some of our most vulnerable consumers.
Many people are surprised to learn that Maryland has repeatedly ranked in the bottom 10 percent of 50 states in U.S. hospital patient satisfaction surveys conducted by the federal Centers for Medicare and Medicaid Services. The surveys measure important indices of patient satisfaction including: discharge information, care transition, communication with doctors and nurses, responsiveness of staff, pain management, communication about medicines, cleanliness and quietness.
Furthermore, an October patient safety study by the watchdog organization Leapfrog ranked Maryland as 48th in the U.S. in patient safety. Patient safety metrics included hospital acquired infections, injuries, trauma and medical errors, such as operating on the wrong limb.
Why does Maryland rank so poorly in hospital patient satisfaction and safety compared to other states with fewer resources? While multiple factors are probably involved, one cause is clearly the weakness of our current law to protect patients’ rights.
Twenty-seven states have a comprehensive and transparent bill of rights for hospital patients. Maryland does not. Instead, Maryland has a 1978 law, dubbed the Patient’s Bill of Rights, with only two sentences to it. One addresses distribution of the rights, while the other says only that “a patient has a right to expect and receive appropriate assessment, management, and treatment of pain as an integral component of the patient's care.”
Specific rights are not listed and instead are deferred to the Joint Commission (formerly the Joint Commission on Accreditation of Hospitals), a group that has recently come under scrutiny by investigative reporters at the Wall Street Journal for their lax accreditation process.
According to the Joint Commission, only hospitals are allowed to have access to the list of patient rights, not patients themselves, though Maryland’s 40 year old law says they must be made “available to each patient.” In other words, the patient must know that the rights exist in order to ask for them.
Not surprisingly, this weak law is inconsistently applied in Maryland hospitals. Thus, depending on where you are a hospital patient, you may be told a different set of rights. Such variability can lead to social injustice and patient neglect.
In the 2018 legislative session, the Maryland General Assembly once again has the opportunity to update and improve the Patient’s Bill of Rights in three key ways:
- First, the bill will mandate that patient rights are communicated to all hospital patients in a language and manner they understand.
- Second, hospital patients throughout the state will have the same core rights; they will no longer vary from hospital to hospital.
- And third, the bill will require training of all medical personnel in patient rights to raise awareness and to make those rights a part of the hospital culture.
The American Association of University Women is proud to support the 2018 Patient’s Bill of Rights, along with 12 other advocacy organizations. As the largest group of hospital patients and primary caregivers, women are disproportionately affected by the lack of a transparent and consistent Patient’s Bill of Rights. According to the Family Caregiver Alliance, about two-thirds of caregivers are women. Women have the greatest number of hospital stays, representing about 60 percent of the total patient populations. Moreover, women over 55 are the most rapidly increasing demographic of hospital patients.
But this important bill affects virtually everyone in the state of Maryland. Who has not had a loved one hospitalized, or themselves been hospitalized? As hospital patients, we should know what our rights are. If passed by the Maryland General Assembly, the bill will promote dignity and respect for hospital patients, ensure patients are part of the decision making process about their own health care and lead to better outcomes for patients and hospitals.
Del. Karen Lewis Young (Karen.Young@house.state.md.us) is a Democrat representing Frederick County in the Maryland House of Delegates. Eileen Menton is president of the American Association of University Women (AAUW) – Maryland; and Dr. Anna Palmisano is a member of AAUW Kensington-Rockville and Marylanders for Patient Rights.