One out of every five people say that they or a family member experienced a mistake in a doctor's office or hospital, or were given the wrong medication or dose. That startling statistic comes from a new Commonwealth Fund 2001 Health Care Quality Survey released this past April. About half (51 percent) of those who experienced an error reported it as serious.

The majority of medical errors fall into five major categories:

• Equipment failures
• Misread lab reports
• Mismatching of blood during transfusions
• Misread prescriptions
• Wrong-site surgery

As many as 98,000 deaths each year may result from medical errors according to the 1999 report "To Err is Human" by the Institute of Medicine. That more than are caused by motor vehicle accidents, breast cancer, and AIDS combined. The report estimates that these medical errors cost the United States approximately $29 billion each year.

Medical errors must and can be prevented. Safety measures must take place on all levels from doctors and hospital systems to patients and insurers. Follow these 12 steps to make sure the health care you receive is safe and effective whether it is an office visit or a hospital stay.

• Be your own advocate and ask questions. Make sure you understand the purpose of a treatment or medication.
• Make sure that every health care professional involved in your care has your important health information. Do not assume that everyone knows everything.
• Bring someone with you as a second pair of eyes and ears. They may be able to remember things you don't and they can monitor your care while you're under the effects of anesthesia.
• If you have a test, do not assume that no news is good news. Ask about the results.
• Make sure your doctor knows about every medication you are taking including prescriptions, over-the-counter medicines and dietary supplements such as vitamins and herbs.
• Make sure your doctor knows about any allergies and adverse reactions you have had to medicines.
• When your doctor writes you a prescription, ask that the purpose for the medication be included and make sure you can read it.
• Double-check that you have the correct medication when you pick up your prescription at the pharmacy.
• If you need surgery, choose a hospital where the procedure or surgery is performed on many patients.
• During a hospital stay, make sure everyone who tries to give you medications checks your hospital ID bracelet every time.
• Check your health care professional's fingernails. It's a good sign of his or her cleanliness. Don't be embarrassed to ask them to wash their hands before they touch you.
• If you are having surgery, make sure that you and the health care professionals treating you all agree and are clear on what exactly will be done.

The American Academy of Orthopaedic Surgeons (AAOS) takes patient safety very seriously. AAOS sponsors the "Sign Your Site" program, which calls for a national effort among surgeons, hospitals and other health care providers to mark the operative site with their initials in order to eliminate wrong-site surgeries. AAOS also has a Patient Safety Committee that reports directly to the Board of Directors at the Academy and a Patient Safety Coalition that is currently developing programs to improve patient safety on national, state and local levels.