Patient advocates assist with navigating healthcare complexities
By Rhonda Alexander
With the increasingly complex world of healthcare, it’s easy for patients to get entangled in the red tape, frustrations and runarounds that are so often part of sorting out medical care.
Enter patient advocates, who are enlisted to help patients conquer their complicated health and financial challenges. Though it’s not exactly a new field, patient advocates have reemerged as a helpful resource for consumers who are sorely in need of their assistance.
“Patient advocates have been in existence since the days of Florence Nightingale,” says Ilene Corina, president and founder of PULSE of NY, a nonprofit organization in Long Island that works to improve patient safety and reduce the rate of medical errors.
The National Patient Safety Foundation defines a patient advocate as a “supporter, believer, sponsor, promoter, campaigner, backer or spokesperson.”
“This is an emerging practice to help people navigate through the healthcare system,” explains Anne Llewellyn, RN, and director of education and training at Dorland Health and the Professional Patient Advocate Institute in Florida. “People get overwhelmed when they are dealing with illness, and they have to also think about the practicality of copays, medical bills and making sure to see the approved network provider,” Llewellyn says.
Whether the problem is associated with billing, benefits, complex medical issues or anything in between, patients are expected to manage the business end of healthcare in a way they never had to before. Sometimes that can lead to frustrations, as patients don’t always know where to turn for answers. Patient advocates can help.
So, what exactly does a good patient advocate do? “Everything is based on being a liaison between the patient and anyone at the hospital who may have a concern,” says Teri Brenner, patient advocate for Advocate South Suburban Hospital in Hazel Crest.
Being a patient advocate is all about issue resolution, Brenner says. When concerns come from a patient or family member, she will meet with them to help resolve problems—up to and including in-patient care. She approaches every grievance, concern and complaint from the standpoint of, “[If] this [were] my family member, how would I want it addressed? This is what a patient advocate should do,” says Brenner.
Bedside care is one of the main concerns addressed by Corina in her role as a private patient advocate with her nonprofit organization.
“A lot of mistakes happen at the bedside,” she says. She also strongly believes that it’s important to always keep the patient apprised. That’s one reason her organization holds trainings and half-day workshops that educate family and friends about patient safety in the hospital.
“Providing tools to patients to help them improve the care they receive empowers the consumers to be their own advocates,” Corina says. “A good advocate works with the entire staff and treats everybody respectfully.”
The patient advocate umbrella is broad. Advocates help with planning care, educating patients about different aspects of care, working to ensure patient safety and quality of care, and assisting the patient or family members with the necessary forms to establish power of attorney for medical decisions.
“You can spend hours with patients to help them unravel red tape in order to understand the finer points of health insurance policies, benefits, home care, medication plans, housing and everything in between,” says Susan Sinitean, a patient advocate for St. Alexius Medical Center in Hoffman Estates.
Patient advocates are great resources. Knowing where to find them isn’t as challenging as one might think.
Llewellyn recommends her organization, Professional Patient Advocate Institute. Advoconnection.com is another resource for anyone seeking the services of a patient advocate, as well as for anyone considering a career in patient advocacy. Also, the Patient Advocate Foundation is a free group that works directly with the consumer to assist in all aspects including billing, and care requests.
The National Association of Professional Geriatric Care Managers and National Patient Safety Foundation also offer services to assist patients with needs ranging from billing issues to care requests and many other advocacy services.
Having someone with the right experience, the appropriate resources and the time to resolve issues makes a significant difference in a patient’s life and outlook.
“Many of the professionals who come to our organization for certificates in patient advocacy have healthcare experience, such as nurses, social workers, rehab professionals and other healthcare professionals.”
Another plus is having a good, working knowledge of the healthcare industry.
“The complexity of issues you come into contact with in the process of helping patients navigate the winding road that is healthcare necessitates having experience in a lot of areas related to healthcare that may have nothing to do with clinical expertise,” Sinitean says.
Originally published in the Summer/Fall 2014 print edition.
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