As some of you will recall, last week I wrote a piece describing my experience at a major suburban hospital. That hospital, I felt, ignored a major concerns arising from a visit--then used its patient advocacy department to avoid responsibility and cast blame on me as having somehow erred in raising the concern in the first place.
The column seemed to have struck a nerve. I received several notes in response, not only from professionals but also patients:
"My senior management's philosophy was for all staff to approach patients and their families with honesty and compassion, to admit when there was an error with or without the patient asking, to take corrective action, and to share the outcome with the patient and family. Often these efforts were channeled through my office, although other facilities use a decentralized approach....Regardless of the type of concern, a kind word and an apology go a long way toward rectifying the situation. The literature shows that patients who ultimately had a positive experience when voicing a concern are more loyal to the hospital than those who did not have a concern in the first place. And even if the hospital believes they met their own standards for care, an apology for the experience not going as smoothly as all hoped is always appropriate."
-- From a 17-year patient advocacy professional
On the other hand, here's a troubling contribution from a professor of nursing and risk assessment and 38 years of nursing practice:
"When the Patient Advocate does not take patient or family member concern seriously, initial feelings of disappointment can quickly escalate. Without proper intervention, patients or family members may express extreme anger, make threats to sue, and complain to licensing or accrediting agencies. They may share their dissatisfaction with the local media. These responses are more common today when the patient and or family feel that they are being "handled" rather than responded to in a respectful, open-minded, concerned and caring fashion."
Patients who experience poor quality care or their family members who report problems are often perceived as "complainers" or "whiners". In fact, I have personally heard nurses and physicians respond to expressed dissatisfaction by the patient or a family member with the comment, "What do they think this is, a hotel?"
So, where does your facility fit in on this spectrum? Are your patient advocates an extension of your legal departments, or can they really bond with patients and help reduce dissatisfaction, meet needs and reduce the risk of lawsuits and the like without being adversarial?
I'd love to hear more comments on this front, as it seems an important one (at least to me!) Write to me anytime at [email protected] to share your views. - Anne