Up to 440,000 Americans die each year after suffering a medical error while in the hospital, research shows. That makes those errors the third-leading cause of death in the U.S., behind heart disease and cancer.

What’s more, every year an estimated 722,000 people in the U.S. develop infections during a hospital stay, and about 75,000 die, according to the Centers for Disease Control and Prevention.

Here are the most important hospital safety steps you can take, according to Lisa McGiffert, director of Consumer Reports’ Safe Patient Project:

1. Insist on Clean Hands

Ask everyone who walks into your room whether they’ve washed their hands (and if they’re doing it at your sink, ask them to scrub for 40 to 60 seconds). Simply rubbing on alcohol-based hand sanitizer is not enough to destroy certain bacteria, such as the dangerous C. diff. Read our special report, "How Your Hospital Can Make You Sick."

2. Have a Friend or Family Member With You

Hospitals are often chaotic places. Having someone else on hand can help you catch mistakes, ask questions, and keep notes. The most important times to have a companion on hand for hospital safety are on weekends and holidays, when staff is reduced, and when shifts change, which is when errors often happen. Having a companion with you can also ensure that the staff sees you as a real person, and treats you with respect.

3. Keep a Record

Keep a pad and pen within arm’s reach so that you (or your companion) can write down when doctors see you, which drugs you receive and when, and any questions you have. If you spot something that seems unusual or that seems to jeopardize hospital safety—such as a medication you don’t recognize—write that down or take a picture of it with your phone. You can also use your phone to record your thoughts or your conversations with nurses and doctors. “Just explain that you are recording so you can remember later,” McGiffert says. “Hospital staff should have no reason to object.”

Read our special investigation, "What You Don't Know About Your Doctor Could Hurt You."