A patient advocate, often called a patient representative, helps patients and their families navigate the complex healthcare system. Their primary purpose is to serve as a liaison, ensuring patients’ needs and concerns are addressed by the healthcare institution. While large hospitals usually maintain a formal advocacy department, smaller clinics or specialized centers may not have a dedicated staff member, meaning availability depends on the specific facility.
Availability Across Healthcare Settings
The presence of a formal patient advocacy service varies significantly based on the size and type of the healthcare institution. Major hospitals, particularly those accredited by bodies like The Joint Commission, are effectively required to have a robust system for handling patient grievances and concerns. This mandate encourages the establishment of a Patient Relations Department, which is the home of the internal hospital advocate.
These internal roles may be titled Patient Representative, Patient Relations Specialist, or Ombudsman, but they share the function of supporting the patient experience. The existence of this department is tied to maintaining accreditation and improving patient satisfaction scores. Therefore, if a facility is a large, accredited medical center, a patient representative is likely to be available.
Smaller facilities, such as critical access hospitals or outpatient surgical centers, are less likely to employ a dedicated, full-time advocate. While these organizations still have mechanisms for complaint resolution, they may not have a designated individual whose sole focus is patient advocacy. If an internal advocate is unavailable or a patient feels their interests conflict with the institution, alternatives exist, such as hiring an independent patient advocate who works solely for the patient.
The Role of Hospital Advocates
The main function of a hospital-employed advocate is to mediate between the patient and the institution, promoting both the patient’s rights and the hospital’s policies. They are frequently involved in conflict resolution, acting as a neutral party to investigate and address patient complaints or formal grievances. For example, they can step in to mediate disputes concerning care quality, staff behavior, or unmet needs during a hospital stay.
Advocates facilitate communication, ensuring patients understand complex medical information, treatment plans, and institutional rules. They help interpret medical jargon and policies related to visiting hours, patient rights, or discharge instructions. By clarifying these details, they help the patient make informed decisions about their care.
Internal advocates are administrative support staff and do not provide hands-on medical advice or clinical care. They can facilitate ethical support by helping patients or families access the hospital’s ethics consultation team for complex medical decisions or end-of-life concerns. Although committed to helping the patient, their allegiance is ultimately tied to their employer, the hospital, which may limit their ability to challenge institutional decisions.
Finding and Utilizing Advocacy Services
Patients needing assistance should first ask a member of their care team, such as a nurse or physician, for contact information for the Patient Relations Department. Many hospitals list the contact details for their advocate or ombudsman on their website or in patient information packets. This is the most direct way to access the service while admitted to the facility.
It is appropriate to contact an advocate for a wide range of situations. These include an unresolved issue with billing or insurance, confusion about discharge instructions, or feeling that a concern is not being heard by the medical team. The advocate can help formalize an issue by guiding the patient through the process of filing a formal grievance against the hospital.
If a hospital lacks an internal advocate, or if the patient feels the internal advocate cannot fully represent their interests due to the institutional tie, other options are available. Patients can hire an independent patient advocate, who is a private professional paid directly by the patient and works with sole allegiance to the client. Many non-profit organizations focused on specific diseases or conditions also offer free or low-cost advocacy support and resources.