Wednesday, March 21, 2012

A Patient Advocate

The Many Roles of a Patient Advocate

A patient advocate isn’t always someone who sits at the patient’s bedside and in many cases watches them sleep, or someone who helps with bill payment, insurance coverage or medical chart explanations.  A patient advocate can wear many different hats and, if patient advocacy is something you want to do, I suggest you think about the best way you can help.
I received a phone call this week from a social worker who received a call from one of her clients who was hospitalized.  The client didn’t want to have a procedure the hospital wanted the patient to have.  If the patient didn’t get the shock treatment, the patient would be institutionalized the hospital staff told the patient.  This is something the patient feared.
The social worker called PULSE of NY to find out how to find a patient advocate within the hospital to help her client.  I explained that if there is one, just call the switchboard and ask to speak to the patient representative or patient’s advocate and she would be connected.  If there isn’t one, she will get connected to the person doing that work, which may be in the quality department or nursing department.
The social worker said she couldn’t find the contact information on the website; something I have found frustrating for years.  The social worker didn’t want to get too involved because she understood the HIPAA laws.  (HIPAA, HIPAA, HIPAA!!)
I went on to explain that she can play an important role right over the phone and HIPAA had nothing to do with it.  Here’s what I explained she should do:
Get the patient advocate / representative from the hospital involved.  Ask NO questions about the patient.  Just explain who you are and that you are encouraging further conversation between someone in the hospital and the patient.  Immediately after contacting the patient representative the social worker should call the patient and let the patient know that contact has been made.  Have the patient contact the social worker while the patient and the advocate / nurse or doctor are in the room.  The patient can hand the phone to them and ask the hospital staff to explain to the social worker what is happening or put the call on speaker – no HIPAA violation if the patient does it.
Now, the social worker and the patient can have a conversation and together decide what is best for the patient.  The social worker, acting as an advocate can help build that bridge for better communication.  The additional time spent with the social worker, in many cases is a welcome relief to hospital staff if they are not making headway with a patient.
Now at least they will feel they are getting actual informed consent or, if the patient still refuses treatment, they know they did everything possible.
There are two sides to every story.  The social worker is only hearing what the patient wants to tell her.  There may be alternatives the patient didn’t hear or the patient may be acting out.  Whatever it is, the patient needs a trusted, neutral, supportive and calming voice to help the team get through this.  In many cases patient may not have family to help them through a hospitalization but that doesn’t mean there is no support.  With phones available in every room or patients with cell phones, friends, families and even patient advocates can be helpful from miles away.

2 comments:

Patient Follow Up said...

Great ideas all put in one blog post. Need to bookmark this page for future reference.

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