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CAPC Palliative Care Discussion Forum
Billing and Finance
Palliative Care Advocate Unit basedAuthor: cblough
Date: Nov 12, 2010 9:31 am
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The Patient Advocate is the voice of the individual patient within the palliative care team, represents the patient perspective within the institution as well as to the larger healthcare system.
Through team meetings, referrals, program evaluations, quality assurance and performance improvement assessments, the advocate identifies needs within the hospital and crafts strategies for advocacy across the spectrum:
•Individual case level
•Institution wide
•Community
•System
The Patient Advocate strategically synthesizes training in:
•Physiology
•Program evaluation and assessment
•Law
•Health economics
•Health care policy
•Bio-ethics
•Communication theory and practice
•Understanding the experience of illness
Specifically, the Advocate’s domains include:
•Case Based Advocacy: Help patients/families understand the jargon and arcane practices in the hospital setting; navigate within both health care and benefit “systems”; advocate on patient’s behalf when the patient cannot communicate; represent the patient’s perspective to the institution. Act as agent negotiating variation from standardized practices in order to better meet the distinctive needs and preferences of individual patients.
•Quality Assurance Monitoring: Identify systematic patterns of errors or problems; create, field and analyze departmental and system evaluation and assessments; conduct departmental performance improvement.
•Social Support Coordination: Provide support to patients if family/friend networks are weak, non-existent, or overburdened. Provide support to the family/friend networks through information about internal and external resources. Provide guidance in healthcare decision-making.
•Health Education: Teach and provide information about illness, illness identity, patient resources and support to patients, their families and institution staff. Conduct staff education on communication skills, advocacy, patient centered care, advance directives, narrative medicine et al.
•Systems Analysis: Assess the broader system or ecology of advocacy resources that can be tapped to promote the interests of the individual patient.
•Institutional Collaboration: Build collaborative relationships with other health care professionals both within the institution (particularly with Oncology, Pulmonary and Intensivists) and external organizations including hospices and external patient support/advocacy organizations.
•Information Specialist: Create and maintain information literature for patients and their families, such as information about Palliative Medicine, hospice, end of life concerns, illness specific information, and other capacity building resources.
•Program Innovation: Seek out and introduce into practice innovative tools to assist patients and their families, such as tools to identify end of life values and facilitate the completion of advance directives. Introduce innovative practices that promote humanistic health care and improve patient satisfaction.
While current Palliative Care practitioners no doubt perform some of the activities of an Advocate, it is becoming increasing important to have an appropriately trained individual whose goal is to make health care systems and social institutions responsive to the health needs of individuals and communities through systems change, with an emphasis on the values of social justice and on the needs of the most vulnerable. Every patient needs an advocate, regardless of his or her economic status, education level and support. This recognized need has given rise to concierge medical care and boutique medical practices, to patient navigator programs, and private personal health advocates.
Feel free to contact me if you need clarification or specifics.
Julie Buyon, MA