Advocacy. It's a concept that's established to support others and assist with speaking out on someone's behalf.

Like at many hospitals, patient advocates at Adena Regional Medical Center, Chillicothe, OH, are an integral part of the overall community of caring and healing. Contributing a large part to the patient experience, the patient advocate acts as a liaison between the patient and healthcare provider and assists with a number of issues surrounding medicine, policies and the law.

Jean Harral, MS, BSN, RN, a 30-plus year employee at Adena, serves as the hospital's patient advocate, focusing on delivery of care issues and assisting patients with service recovery, complaints and grievances, and interpretive services for patients who don't speak English.

"Patients turn to us for help when they don't know where else to go. Helping them can be challenging but it also is very rewarding," said Harral.

Being an Advocate 

Patient advocacy gives a nurse an opportunity to utilize clinical knowledge, interpersonal skills and critical thinking while working closely with the patient/family, physicians, staff and others. As problems are investigated, process issues may be identified. The correction or revision of policies or processes then prevents other patients/families from facing similar issues.

"I feel my job gives me a wonderful opportunity to take part in practice and process changes that create better solutions for our patients," Harral said. "Working with our patients, I am able to hear directly about what issues might be present and have the connections and tools to make improvements in order to better serve our patients and the community."

A nurse working in this role, suggested Harral, should have good problem-solving skills, clinical knowledge of a wide variety of areas, excellent communication skills, and work well independently and with others. (See sidebar: Advocacy Strategies.)

Patient advocates, added Harral, are knowledgeable in the Centers for Medicare & Medicaid Services regulations concerning patient grievances and often are responsible for coordinating efforts for their organizations to maintain compliance with these.

Barriers & Solutions

Because patient advocates work in many areas, they must be knowledgeable in a wide range of healthcare areas and issues, said Harral. This includes the clinical specialties, the people who work there, and the issues and policies involved.

"We are often asked to assist in issues outside our scope or organization, i.e., the community or other organizations," said Harral. "Therefore, it is helpful to develop a large resource base. Time management is always a challenge because each day is different and often unpredictable. Experience and networking with peers internally or externally are also helpful."

To solve some of these barriers, Harral works closely with hospital departments, employees and physicians on specific issues designed to improve and sustain positive patient experience environments.

"Making changes to benefit our patients certainly takes a team effort," Harral said. "At Adena, we take this seriously and work together to address issues and decide what methods are most appropriate for improvement. We value the feedback we receive from our patients and customers and utilize this to make improvements in order to provide better care and service. Patients should feel confident their voices are heard and that a system is established at Adena to seriously evaluate and address issues that are brought to our attention."

Jenni Dovyak works for Adena Regional Medical Center, Chillicothe, OH.

Advocacy Strategies

A few points that can be helpful advocacy strategies in working with patients/families: 

• Keep your message clear, simple and concise. The patient/family is already in a stressful situation and may not be thinking clearly. Keeping a straightforward approach will cause less confusion. 
   
• Identify the best way to communicate and then use the proper channels. Verbal communication is immediate, and you have the opportunity to answer questions and clarify your message, but there is no written record. Written messages often help; find out the preferred way to send it: e-mail, fax or traditional mail. 
   
• Be accurate: Do your research so facts are correct. You do not need a mountain of data, but the data you do present needs to be iron-clad in its accuracy. The corollary to this is to never make up an answer. "I don't know" is an acceptable answer. "Let me find out and I'll get back to you" is even better. 
   
• Don't forget your manners. Be polite. Introduce yourself by name. When meeting with the patient/family, thank them for their time and attention.