Patient Advocate

Your final base salary will be determined based on your education, experience, licensure, and internal equity considerations. Offers are typically made below the top of the range to support future salary growth.

JOB SUMMARY:

Champion of the patient experience, responsible for the management of patient complaints and grievances, patient relations and compliance with accreditation standards related to patient rights, and regulatory agency requirements related to management of patient complaints & grievances. Regulatory and accreditation agencies include but are not limited to: The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COPs), Massachusetts Department of Public Health (DPH), and Massachusetts Board of Registration in Medicine (BORM) requirements for annual and semi-annual reporting.

Coordinates the management of patient complaints & grievances as well as patient compliments, such as the intake, investigation, resolution, documentation and reporting of each complaint as well as compiling aggregate data on a monthly basis and distributing reports to key stakeholders in a timely manner, working closely and in collaboration with risk management and the electronic event reporting system. Applies “Just Culture” principles to the investigation process and supports and promotes a non-punitive culture and a learning environment. Facilitates resolution of complaints and grievances of patients, family members and visitors in collaboration with risk management, direct care providers and supervisory and management staff.

Serves as the staff support to the Patient & Family Advisory Council, facilitates and coordinates the meeting schedule, meeting agendas in collaboration with the VP, Quality & Patient Safety. Facilitates scheduling related to presentations education sessions, and assures minutes are completed in the appropriate format and completed and submitted within two weeks following each meeting.

Develops an annual plan for improvement of customer service and the patient experience and submits an annual report on activities, progress toward goals and achievement of goals.

DUTIES AND RESPONSIBILITIES:

Patient & Family Complaints and Grievances:

• Responds promptly and courteously to customer (internal and external) complaints, grievances and requests. Responses to complainants must be completed in a timely manner in accordance with the complaint / grievance policy.
• Employs active listening the techniques and de-escalation techniques during interactions with patients and families. Communicates what can be done before communicating what cannot be done.
• Investigates complaints and grievances and works collaboratively with physicians, directors and managers of the involved units to develop a response to the complainant and an action plan to address identified opportunities for improvement.
• Composes letters, memos, etc., to patients, visitors, physicians, and hospital leadership as necessary ensuring grammatical accuracy and according to the terms of the complaint / grievance policy.
• Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs, and ages.
• Respects patient/customer privacy and confidentiality. Accepts responsibility and accountability for own actions with appropriate follow through. Fulfills commitments.
• Follows appropriate lines of communication to effectively resolve difficult patient / family / physician / staff situations.
• Provides oversight of all steps related to the management of patient complaints, grievances, and complements, such as the intake, investigation, resolution, and documentation and reporting of patient complaints. Assures compliance with regulatory agencies and assures alignment and coordination of patient relations activities.
• Applies “Just Culture” principles to the investigation process and supports and promotes a non-punitive culture and a learning environment. Facilitates resolution of complaints and grievances of patients, family members and visitors in collaboration with risk management.
• Provides oversight of files related to patient complaints and compliments and assures compliance with policy and procedures that includes documentation of patient, family, and visitor concerns, complaints and grievances: such as patient demographics, area or unit of the hospital involved, synopsis of the incident or concern, actions taken to resolve, and outcome and enters into complaint database.
• Consistently presents a positive attitude in working with internal and external customers.
• Identifies complaints and compliments for compilation of confidential information regarding practice profiles for inclusion in physician files for OPPE and credentialing, and to comply with TJC and the Massachusetts BORM.

Patient Rights

• The PA, in collaboration with risk management, assures compliance with accreditation and regulatory standards related to patient rights. Regulatory and accreditation agencies include but are not limited to: The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COPs), Massachusetts Department of Public Health (DPH), and Massachusetts Board of Registration in Medicine (BORM) requirements for annual and semi-annual reporting.
• The PA maintains awareness of changes in the accreditation standards and regulations regarding patient rights, in collaboration with risk management.

Patient and Family Advisory Council

• The PA serves as the staff support to the Patient & Family Advisory Council, facilitates and coordinates the meeting schedule, meeting agendas in collaboration with the VP, Quality & Patient Safety.
• The PA facilitates scheduling related to presentations education sessions, and assures minutes are completed in the appropriate format and completed and submitted within two weeks following each meeting.
• The PA Distributes meeting materials to the council in advance of each meeting.
• The PA compiles information for and writes the PFAC annual report for submission to the Massachusetts Department of Public Health as required, and initiates review and approval of supervisor prior to submission and distribution.

Data Management, Program Planning & Evaluation

• The PA develops an annual plan for improvement of patient relations, customer service and the patient experience, based on experience, data, scan of new and changing regulations and accreditation requirements.
• The PA prepares a written summary of activities, and improvements and progress toward goals in patient relations, customer service and patient experience.
• The PA analyzes complaint and grievance data on a monthly basis and in collaboration with risk management, validates data and the dashboard prior to distribution to key stakeholders.
• The PA Assists prepares/writes a monthly executive summary of patient complaints, grievances and compliments that serves as a cover sheet for the data/dashboard that displays the data. The data is prepared for a wide variety of audiences, including teams, committees, staff, physicians, managers, directors, lead leaders and board members, in collaboration with risk management.

GENERAL COMPETENCIES:

ENVIRONMENT OF CARE (SAFETY)

• All new employees are required to attend New Employee Orientation, to include the safety topic, and must complete the annual Safety Training.
• Uses all equipment in a safe manner.
• Identifies and reports all safety hazards throughout the Hospital.
• Reports injuries and accidents and/or errors to patients and visitors in a timely manner.
• Completes and forwards an Incident Report when indicated using the Hospital’s reporting system.
• Responds to fires and/or fire drills using the appropriate procedure.
• Follows the Tobacco Free Environment Policy. (Policy # 01-057)
• Manages waste and hazardous materials in the proper manner.
• Uses the Safety Data Sheets when needed.
• Performs appropriately in actual or simulated Internal Emergency Preparedness episodes.
• Performs appropriately in actual or simulated External Emergency Preparedness episodes.
• Uses proper body mechanics and lifting techniques.

QUALITY/PATIENT SAFETY/PERFORMANCE IMPROVEMENT

• Strives to exceed Quality and Safety benchmarks quarterly and annually, as established from the Annual Operating Plan (AOP).
• Abides by service, quality, safety and productivity standards.
• Supports the Agency for Healthcare Research and Quality (AHRQ) Safety Culture Survey and the Implementation of Improvements, as indicated in the AOP. Develops action plans as required.
• Identifies problems/issues/risks and formulates effective solutions to mitigate them. Uses Hospital notification system for reporting such problems/issues/risks.
• Participates in Performance Improvement activities such as Root Cause Analysis or Healthcare Failure Mode and Effect Analysis (HFMEA) when appropriate and required.
• Implements solutions borne out of a Root Cause Analysis or HFMEA when appropriate.
• Leverages the Lean methodology to document and continually improve processes when applicable.

SECURITY

• Assumes responsibility for a clean and safe work environment.
• Wears one’s Identification Badge at all times while at work.
• Adheres to policies relating to computer security.

PATIENTS RIGHTS, CONFIDENTIALITY & ETHICS

• Maintains patients’ rights, privacy and confidentiality in all aspects of the job, including those relating to diagnosis and patient records.
• Promotes and employs ethical actions at all times with patient’s families and others.
• Adheres to the policies and procedures of the Corporate Compliance Program.

SERVICE EXCELLENCE

• Performs as a team member utilizing the LGH values of quality, service, integrity and compassion.
• Demonstrates excellent customer service by conducting daily activities, communications and interactions in a cooperative, positive and professional manner as dictated by the Hospital’s Service Excellence 7 Standards of Behavior.

COMPETENCY & PERSONAL DEVELOPMENT

• Identifies and communicates learning, competency and personal development needs to the supervisor.
• Actively identifies and participates in educational activities that meet one’s educational needs, as approved by the supervisor.
• Uses newly found knowledge and skills in one’s role.

AGE RELATED COMMUNICATION & SAFETY

• Communicates in a manner appropriate and respectful to the comprehension level of the patient and/or family.
• Maintains a safe environment specific to the age group served.

INFECTION CONTROL

• Follows standard of universal precautions and use of appropriate personal protection equipment.
• Works to reduce the risk of health care acquired infections through compliance with current Centers for Disease Control (CDC) hand hygiene guidelines.
• Standard Precautions area utilized during patient contact and when handling contaminated materials, when necessary.
• Is knowledgeable of and demonstrates compliance with all National Patient Safety Goals in preventing healthcare acquired infections.
• Adheres to infection control and safety policies.

ATTENDANCE AND PUNCTUALITY

• Maintains the responsibility for punctuality and attendance to ensure optimal operation of the department.
• Meets Hospital attendance policy as defined in the Hospital policy manual.
• When an unscheduled absence from work is necessary, the department is notified according to department policy.
• Submits requests for Paid Time Off, days off, etc. in accordance with department policy.

EDUCATION AND RELATED EXPERIENCE:

Required:

• Bachelor’s or Associate’s Degree in business, public health, behavioral science or related field required.
• Five years of relevant experience in customer relations, patient relations or a clinical health care environment.
• Excellent interpersonal skills, excellent written and oral communication skills, and ability to interact successfully with physicians, senior leaders, nurses clinical and non clinical staff required.
• Skilled social work assessment and planning, successful experience using de-escalation techniques
• Ability to work under minimal supervision, ability to adapt quickly to changes within the work environment required.
• Must be a team player and have proven success applying a team approach and ability to work in conjunction with nurse managers, nurse directors, and staff in a supportive way to troubleshoot and resolve issues. Is able to address difficult situations with tact and diplomacy.
• Knowledge of healthcare environment and regulatory requirements regarding patient rights and management of patient compliant s and grievances preferred. Must be able to communicate patient and visitor rights and responsibility to patients, family members and staff.

Preferred:

• Master’s Degree in business, public health, behavioral science or related field preferred.
• Lean certification and experience preferred.