Image: Surgeon © Sean Justice, Corbis

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1. "Oops, wrong kidney."

In recent years, errors in treatment have become a serious problem for hospitals, ranging from operations on wrong body parts to medication mix-ups.

At least 1.5 million patients are harmed every year by medication errors, according to the Institute of Medicine of the National Academy of Sciences. One reason these mistakes persist: Only 15% of hospitals are fully computerized with a central database to track allergies and diagnoses, says Robert Wachter, the chief of the medical service at the University of California, San Francisco, Medical Center.

But signs of change are emerging. More than 3,000 U.S. hospitals, or 75% of the country's beds, signed on for a campaign by the Institute for Healthcare Improvement to implement preventive measures such as multiple checks on drugs. In the first 18 months of the campaign, these hospitals had prevented an estimated 122,300 deaths.

Though the system is improving, it still has a long way to go. Patients should always have a friend, relative or patient advocate from the hospital staff at their side to take notes and make sure the right medications are being dispensed.

2. "Getting out of the hospital doesn't mean you're out of the woods."

A study released recently by Resources for the Future, a nonprofit group that conducts independent research on public health issues, says infections of sepsis and pneumonia acquired in the hospital may kill 48,000 people each year. What's more, the study shows, these infections cost $8.1 billion to treat and lead to 2.3 million total days of hospitalization.

Such revelations, along with the recent increase in antibiotic-resistant bugs and the mounting cost of health care, have mobilized the medical community to implement processes designed to decrease infections. These include using clippers rather than a razor to shave surgical sites and administering antibiotics before surgery but stopping them soon after to prevent drug resistance.

For all of modern medicine's advances, the best way to minimize infection risk is low-tech: Make sure anyone who touches you washes his or her hands. Tubes and catheters are also a source of bugs, and patients should ask daily if they are necessary.

3. "Good luck finding the person in charge."

Helen Haskell repeatedly told nurses something didn't seem right with her son Lewis, who was recovering from surgery to repair a defect in his chest wall. For nearly two days she kept asking for a veteran -- or "attending" -- doctor when a first-year resident's assessment seemed off. But Haskell couldn't convince the right people that her son was deteriorating.

"It was like an alternate reality," she says. "I had no idea where to go." Thirty hours after her son first complained of intense pain, the South Carolina teen died of a perforated ulcer.

In a sea of blue scrubs, getting the attention of the right person can be difficult. Who's in charge? Nurses don't report to doctors but rather to a nurse supervisor. And your personal doctor has little say over radiology or the labs running your tests, which are managed by the hospital. Some facilities employ "hospitalists" -- doctors who act as a point person to conduct the flow of information. Most hospitals now have rapid-response teams -- specialized personnel who can rush to the bedside to assess a declining patient. Haskell urges patients to know the hospital hierarchy, read name tags, get the attending physician's phone number and know how to reach the rapid-response team. If all else fails, demand a nurse supervisor -- likely the highest-ranking person who is accessible quickly.

4. "Everything is negotiable, even your hospital bill."

When it comes to getting paid, hospitals have their work cut out for them. Medical bills are a major cause of bankruptcy in the U.S., and when collectors are put on the case, they take up to 25% of what is reclaimed, according to Dr. Mark Friedman, the founder of billing consultant Premium HealthCare Services. That leaves room for some bargaining.

If you're among the uninsured -- who can pay up to three times more for procedures -- it doesn't hurt to ask for a deduction. Some hospitals provide a 35% to 40% discount for uninsured patients, says Candice Butcher, the CEO of Medical Billing Advocates of America. Hospitals frequently work with patients offering payment plans or discounts. But to get it, you have to knock on the right door: Look for the office of patient accounts or the financial-assistance office.

If you don't have insurance and are scheduled for a colonoscopy in a week, Butcher suggests doing some research to find out how much that procedure typically runs in your area. The site Healthcare Blue Book lets consumers check health care prices by ZIP code. You can use that as a negotiation tool. But remember, "if the hospital agrees to your price, you need to get it in writing and get it signed," Butcher says.