SHCA 9 Identified Domains of Practice

Gaining knowledge and skills around improving the patient experience is crucial to not only our function as Healthcare Consumer Advocates, but as collective voices reaching for an ever-improving patient experience. To aid in the development of fellow advocates and the overall profession, SHCA has identified 9 Domains of Practice as being key skills and knowledge for advanced competency in the role of a patient and consumer advocate:

1. Patient Rights

Bioethics
The Healthcare Consumer Advocate is aware of the philosophical issues and principles surrounding medical practices; is involved with ethical decision making related to the continuation or completion of treatment particular to the end of life; is involved with policies for informed consent, capacity/competency, confidentiality, procuring and donating organs and other tissue, and mechanisms protecting patients and their rights during research, investigations, or clinical trials.

Legal ethics
Knowledge of the following legal issues relative to medical ethics:

Advance Directives
Ethics Committee
Patient Bill of Rights

It is essential that the Healthcare Consumer Advocate possess knowledge of these subjects, including any federal or state laws pertaining to these issues, as well as any pertinent Joint Commission or other regulatory agency standards.

1.1 Bioethics
1.2 Advance Directives
1.3 Ethics Committee
1.6 Patient Bill of Rights
1.7 Knowledge of legal issues relative to medical ethics
1.8 Knowledge of federal and state laws and other regulatory agency standards

2. Grievance & Complaint Management

The Healthcare Consumer Advocate receives grievances, complaints and concerns from patients, their families and others; analyzes the grievance/complaint/concern with appropriate service departments for resolution and responds to the grievance/complaint according to CMS Grievance Guidelines* and appropriate regulatory agencies. When a possible liability is introduced through customer complaints, the institutional risk management personnel are involved as appropriate. Grievances/complaints/concerns are summarized and compiled for reports to management toward future improvement of customer service.

2.1 Receives grievances/complaints/concerns from patient/families and others
2.2 Analyzes the grievance/complaint/concern with appropriate service departments for resolution
2.3 Responds to the grievance/complaint according to CMS Grievance Guidelines and appropriate regulatory agencies
2.4 Involves Risk Management when a possible liability is introduced
2.5 Issues are summarized and compiled for reports to management and for future improvement

3. Measuring Patient Satisfaction

The Healthcare Consumer Advocate has the knowledge and ability to use various measurement tools, integrate data and prepare meaningful reports, and insures the use of that information, demonstrating how patient satisfaction data impacts the way the organization delivers care.

3.1 Uses valid measurement tools
3.2 Integrates data
3.3 Prepares reports
3.4 Demonstrates how patient satisfaction impacts how the organization delivers care

4. Interpersonal Communications

The Healthcare Consumer Advocate transmits and receives information about patient-focused issues with clarity and skill, involving all interested parties; develops a personal rapport with patients, families, and all healthcare providers for the benefit of the patient. The Healthcare Consumer Advocate expresses ideas effectively, both in speech and writing, and is a skilled listener able to represent the perspectives of others.

4.1 Communicates patient-focused issues with clarity and skill
4.2 Involves all interested parties
4.3 Develops a personal rapport with patients, families, and all healthcare providers

5. Customer Service/Service Excellence

The Healthcare Consumer Advocate is familiar with theories and practices involved in developing integrated customer service initiatives, which may include any of the following:

Hiring Practices
Management Practices
Performance Appraisals
Policies and Procedures
Reward and Recognition
Staff Education

5.1 Involved in developing customer service initiatives
5.2 Staff Education
5.3 Hiring Practices
5.4 Performance Appraisals
5.5 Management Practices
5.6 Policies and Procedures
5.7 Reward and Recognition

6. Mediation/Conflict Negotiation

The Healthcare Consumer Advocate intervenes in conflicting relationships involving the interests of patients and others in the healthcare environment; promotes reconciliation, compromise, or settlement. While resolving conflict, the Healthcare Consumer Advocate keeps the welfare of the patient in the forefront, realizing that the patient is often the least able party to successfully represent him/herself in a competing or opposing relationship.

6.1 Intervenes in relationships of conflict
6.2 Involves interested parties (family, staff, physician, others)
6.3 Promotes reconciliation, compromise or settlement

7. Crisis Intervention

The Healthcare Consumer Advocate works to manage crisis situations and focus efforts toward the well-being of the patient/family and the stabilization of the crisis/event. When indicated, the appropriate hospital staff is accessed.

7.1 Manages crisis situations
7.2 Focuses on the well-being of the patient/family
7.3 Stabilizes the crisis event

8. Data Management

The Healthcare Consumer Advocate collects patient opinions and/or grievances/complaints/ concerns and other relevant statistical material; compiles information for retrieval and decision making. He/she handles written materials using organizationally directed or prescribed data security, often using computerized methods. These issues are moved forward for performance improvement by the organization.

8.1 Collects patient grievances/complaints/concerns
8.2 Compiles information for retrieval and decision making
8.3 Handles written material using organizations security procedure/policy
8.4 Data collected moved forward for performance improvement

9. Healthcare Management

Global Perspectives
The Healthcare Consumer Advocate has knowledge of and seeks active involvement in the changing healthcare environment. Every opportunity should be taken to contribute to both local and national issues in the healthcare domain. The viability of the Healthcare Consumer Advocate role is contingent upon the ability to pro-actively anticipate change. Global topics include:

Financing/Reimbursement
Healthcare Environment
Changes
Legislation
Managed Care
Third Party Payers

Organizational Management
On an organizational level, the Healthcare Consumer Advocate maximizes every opportunity to be involved in management and quality improvement efforts, bringing into focus the patient at all times in areas such as:

Accreditation
Budgeting
Policies, Procedures and Institutional Practices
Quality Improvement Programs

*Reference: CMS Interpretive Guidelines for Patient Grievances A-0041 §482.13.
(See SHCA website www.shca-aha.org/shca-aha/resources/cms.html)