Description

Patient Advocates are faced daily with many challenges - they receive grievances, complaints and concerns from patients, their families and others. It is the nature of the beast to manage difficult situations and help resolve complicated issues with appropriate departments across the facility to mitigate risk and improve the overall patient experience.  A successful Patient Advocate not only does right by the patient, but does the right thing, the right way in accordance with the healthcare facility’s policies, state laws, and by the CMS Grievance Guidelines and other federal regulatory agencies.

The goal of this 90 minute module is to provide participants with fundamental information and regulatory updates as it relates to the collecting, responding and resolving of grievances and complaints as well as the legal and ethical responsibility of the Patient Advocate that are put in place by federal regulatory agencies.

Review:
• The Legal and Ethical Role of the Healthcare Patient Advocate
• Understanding Grievances/Complaints and Concerns
• Responding to Grievances and Complaints
• Resolution and Follow-Up Procedures

By the end of this unit of study learners should be able to:
• Decipher the differences between grievances and complaints.
• Respond to grievances and complaints in accordance with CMS Grievance Guidelines and appropriate regulatory agencies.
• Identify appropriate service department and analyze complaints/ grievances/or concerns with the department for resolution.
• Identify the circumstances which would necessitate the involvement of Risk Management.
• Develop a process for both grievance and complaint resolution.
• Prepare and implement the requirements of the CMS interpretive guidelines across the organization.
Content experts: David Eddinger, RN, MPH, Captain United States Public Health Service, Retired and Lisa Venn, J.D., M.A., CHC, founder of the Advocate Alliance