Jayne Lee smiles as she recalls the unusual way a patient at FirstHealth Moore Regional Hospital reminded hospital employees to wash their hands when they entered her room.

The woman, whose friend had contracted an infection at another hospital, wore a sign around her neck. It said: "Please remember to wash your hands."

Although admittedly an extreme measure, "it was nice to see a patient involved in her own care," Lee concedes.

Lee, who is the director of Infection Control and Patient Safety at Moore Regional, would like to see all patients take such an active interest in their health care.

So would the Joint Commission, the accrediting agency for American health care institutions, which encourages patients to join physicians, nurses, therapists, technologists and other hospital employees as active members of their health care team.

That message is an important part of the Patient Handbook that patients at each of the three FirstHealth hospitals (in Troy, Rockingham and Pinehurst) get when they enter their hospital rooms.

The book isn't left on a bedside table, Lee says, but is handed to the patient by a nurse who then comments on it and may even highlight sections that are appropriate to the patient's admission.

If the patient is too sick to respond, the information goes to a family member.

The "Patient Safety" section of the handbook notes the "vital role" each patient should play in making his/her care safe by "becoming an active, involved and informed member" of the health care team. According to Lee, the process begins with the identification bracelet that every patient gets at admission.

Identifying information includes the patient's name and birth date. A nurse or other hospital employee who is following procedure will check the bracelet before beginning any treatment or administering any medicines. An involved patient will make sure the staff member does just that.

"You really need to pay attention," Lee says. "It's important for patients to be involved in their care."

In addition to being asked their names and dates of birth, patients about to undergo surgery can expect to be asked -- several times -- "what are you here for" and "what is the surgical site" to ensure they are having the correct surgery.

"It's in the patient's best interest," Lee says. "It's part of the safety process."

In 2002, the Joint Commission, along with the Centers for Medicare and Medicaid Services, launched the national Speak Up campaign, which urges patients to take a role in preventing health care errors. That program encourages:

Speaking up if you have questions or concerns, and asking again if you don't understand.

Paying attention to the care you are receiving and making sure you're getting the right treatment and medications by the right health care professionals. In other words, don't assume anything.

Educating yourself about your diagnosis, the medical tests you are undergoing and your treatment plan.

Asking a trusted family member or friend to be your advocate.

Knowing what medications you take and why you take them since medication errors are the most common health care mistakes.

Using a hospital, clinic, surgery center or other type of health care organization that has undergone a rigorous on-site evaluation against established quality and safety standards, such as those provided by the Joint Commission.

Participating in all decisions about treatment.

According to Lee, personal health care involvement should begin in the home. She advises keeping track of all medications by regularly checking the medicine cabinet and disposing of unused medications or those that have expired.

It is also important to bring all medications, or at least an up-to-date list, to all medical appointments as well as to the hospital, she points out.

"It's not unusual for a patient to bring in a bag full," she says. "People will also bring in pills that are out of date."

Once hospitalized, patients and their families will be notified about the availability of the hospital's Rapid Response Team -- a nurse, a respiratory therapist and a doctor who are trained to help when there are signs that a patient's condition is worsening. The purpose is to provide help before a medical emergency occurs.

If help is needed, the patient or family member can call the hospital operator (by dialing "0") and ask for the Rapid Response Team.

"It's like calling 911 when you are in the hospital," Lee says. "The team will respond and listen to your concerns and decide what to do next."

That may mean ordering laboratory tests, X-rays or medications, or even moving the patient to the intensive care unit.

Also important to the patient safety process is technology. To ensure medication safety, for example, Moore Regional uses AdminRX, a medication administration system that uses scanned bar codes to help ensure a patient's "five rights" -- the right care, the right drug, the right dosage, the right time and the right route.