We have all been there right? What hat should I wear at work today? The pretty hat? The thinking cap? Or maybe the hard hat? The role of the patient advocate can sometimes be confusing. We all agree that we need to support the initiatives of our hospitals while also supporting our patients and families. How can we keep ourselves whole?
Over the past year and a half, the advocates have been working with a new initiative; Proven Experience. If the patient perceives that their experience was less than satisfactory, they can request their co-pays to be waived or refunded. Proven Experience is a promise of providing the best patient experience for every patient every time. When doing the investigation on the issue brought forth by the patient we often hear “all care was appropriate”. But what does “care” mean? To the medical team, care may mean that all medical protocol was followed and the outcome matched the protocol. To the patient, care may mean more than the “medical” care. It’s about how they were treated as a person. Did they receive all the information required to make an informed decision? Did we respect the patient and follow our C.I.CARE initiative? Often it is the compassion and the communication that our patients tell us that we are lacking. The team discusses the request with the patient and arrive at a mutual conclusion ending with the refund of the out of pocket expense. Because the perception of the outcome may differ, we may choose we wear our hard hats!
Since the roll out of the refund program we have almost doubled the issues we handle monthly resulting in adding additional staff. The relationships between the advocates and the various departments that they interact with have become stronger. Particularly, the departments of Finance, internal audits, service lines and legal. This is due mainly to our development of a more collaborative agreement with a win/win for our patients. We are looking to improve telephone wait times, appointment wait times, smooth transitions and bills that are understandable. Kindness and compassion are integral in the journey to recovery for our patients. The patients are bringing their experiences to the team hoping to make it better the next time. Perhaps we have always taken care of these issues before but now the refund has new meaning. Research in the future will show us if customer loyalty is obtained because of improving the experience.
The frustration has been in the reliance of other areas to help us determine what the refund will look like. Information needs to be gathered from the patient, the teams and finance. Billing of insurances, waiting for information from various departments can delay the final response to the patient.
When we do have time to catch our breath we need to look at the repetitive issues, develop a strategy and truly fix the challenges. Data needs to be reviewed and solutions must be developed. We have a variety of hats to choose from every day. Often times we may need to change our hat to meet the needs of our patients while also meeting our own needs. Thinking caps are required.
Becky Ruckno is the Director, Patient Liaisons and Interpretive Services with Geisinger Health System.