Patient Representatives Have Rx for Satisfaction
The morning after Beverly Holmes had surgery at Circle City Hospital in Corona, she remembers saying that a shampoo was high on her wish list. But the doctor’s orders didn’t coincide with her wish, so Holmes was feeling glumly resigned when the unexpected happened.
Linda Pearson, the patient representative at the 99-bed hospital, had heard Holmes’ request for a shampoo. She went to a nearby drugstore, bought some dry shampoo and presented it to Holmes.
For Pearson, the trek to the drugstore was all in a day’s work, a small part of an activity-filled shift that she’s been taking in stride for the past six years.
Patient representatives like Pearson have become trouble-shooting internal public relations experts in today’s competitive hospital environment. For patients, the expertise of a patient representative can mean the difference between cold coffee and hot, between a smooth hospital stay and one filled with red tape. And, for hospital administrators, it can mean the difference between satisfied patients and disgruntled ones.
In addition to making patient stays as comfortable as possible, some say patient representatives reduce the likelihood of malpractice claims by keeping open lines of communication between patients and their care givers.
In 1978, only 950 United States hospitals had patient representatives, according to Alexandra Gekas, director of the National Society of Patient Representatives, an organization that operates under the umbrella of the Chicago-based American Hospital Assn. Today, 3,300 hospitals--52% of the total nationwide--have such employees.
In addition, 28 state societies--including the California Society of Patient Representatives, which Pearson heads as president--are affiliated with the national group. “Growth has been steady in spite of tough economic times for hospitals,” Gekas said in a telephone interview.
Growth has been spurred, Gekas believes, by technological advances that make health-care delivery more complicated for patients to understand and by a growing awareness among hospital administrators of the need to compete for patient dollars.
As the number of patient representatives has increased, their role has evolved markedly. No longer are they limited to “hostess” tasks such as taking action on complaints about food. “Fifty-three percent of hospital ethics committees have a patient representative as a member,” Gekas said.
Not all patients are aware of the services patient representatives provide but some patient reps think that’s changing. “Many older patients have not heard of patient representatives, but some younger ones already ask to see one when they’re in admitting,” said Corinne Holmes, a social worker who also serves as the patient representative for the 145-bed Lake View Medical Center in Lake View Terrace.
Because their job is relatively new, patient representatives have varied experience and education and disagree among themselves about optimal training. “I think patients relate better when you say, ‘Hey, I’m a layman, too,’ ” contends Larry Stevens, a patient representative at the 570-bed Loma Linda University Medical Center and one of few men in the profession.
Yuri Ogawa, one of seven registered nurses who work as patient representatives at the 1,120-bed Cedars-Sinai Medial Center in Los Angeles, disagreed. “When you have a medical background, it really is quite helpful to explain hospital policies and procedures to patients and families.”
Yet, patient representative programs share universal goals of improving patient comfort and satisfaction. “When I started,” noted Stevens, who’s been on the job nine years, “the administrator told me, ‘Larry, treat our patients like your relatives.’ ”
In a typical day, patient representatives deal with concerns ranging from the mundane to the dramatic. Complaints about cold food, overheated or overcooled rooms, drafty hospital gowns, employee attitudes and noisy corridors have been heard by most patient representatives.
Occasionally they are called on to talk to patients’ families, to arrange rides to the hospital for family members and perform other services for them. “Each day is unique,” Ogawa of Cedars-Sinai has found.
They learn to expect the unexpected and to act quickly. Pearson once responded to an emergency call and found that a husband welcoming his wife back from surgery had suffered a heart attack and fallen to the floor.
“His wife’s reaction was to fly out of bed (to help him),” Pearson remembered. Working around medical personnel, Pearson comforted the wife, explained the situation to the wife’s roommate and later, when the husband’s condition had stabilized, reassured him that his wife was doing well.
Often, a patient representative needs only to listen. “Patients need to vent,” Pearson noted. “It’s a frightening environment.” To a hospitalized patient, no complaint is minor.
Most work directly under the hospital administrator, enabling the patient representatives to perform their tasks without extensive supervision or approval.
“That’s important,” Pearson explained, “because when you go into patients’ rooms, they want to know what authority you have, and if you can get things done.”
They also encourage patients to communicate with their physicians and other care givers and sometime help them do so by setting up meetings between them. “My philosophy is, if I do my job right, the patient and the health-care provider are going to feel they resolved the problem, not I,” Stevens said.
A Bill of Rights
Educating patients about their “bill of rights” is another important function of patient representatives. “Patients have to learn to speak up for their own rights,” noted Melba Rardin, the assistant administrator in charge of patient relations at the 498-bed St. Joseph Medical Center in Burbank.
No statistics are available to prove that patient representative programs reduce the frequency of litigation against hospitals. Reducing malpractice “is not the principal thrust (of patient-rep programs),” Stevens maintained, “but it is a byproduct that occurs.”
Typically, other hospital employees initially view patient representatives as the enemy. “In the beginning,” Holmes of Lake View said , “the staff thought I was the snooper, lurking around with a little notebook, the one who was going to rat on them to administration.”
Over time, the patient representatives say, other employees usually discover that patient representatives can be valuable, time-saving allies. “Nurses are so busy giving care they don’t always have time to sit down and console a patient who’s upset,” Pearson said. “We do.”
