Patient Relations Representative

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Under the supervision of the Manager of Patient Relations, the Patient Relations Specialist is responsible for problem resolution, preemptive interventions, and serving as an internal consultant to assigned areas for maximizing patient satisfaction. In addition, the Patient Relations Specialist is responsible for partnering with appropriate unit leadership on process and system improvements. The incumbent must be knowledgeable in and comply with regulatory provisions concerning patient rights, as casework is under scrutiny by regulatory agencies, including the Centers for Medicare and Medicaid Services (CMS), the State of Connecticut Department of Public Health, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The Patient Relations Specialist collaborates with multi-disciplinary teams to create a patient and family-centered care environment, resolve patient and family issues, and enhance patient service excellence in assigned areas. The Patient Relations Specialist partners with patients, families, and hospital staff to collaborate on system changes and serves as a role model in all Patient and Family Center Care initiatives for the institution. Provides specific avenues through which patients may seek solutions to problems, concerns, unmet needs, and grievances. Serves as an advocate for patients and their families as needed. Partners with hospital and management staff at all levels of the organization to promote and negotiate positive outcomes and coordinated care for patients and families. Partner with medical staff to coordinate family meetings to promote efficient, clear communication related to patient care. In addition, the Patient Relations Specialist can partner with the Grievance Coordinator on the CLEAR disclosure process for significant safety events that occur. Patient Relations Specialists adhere to the sound principles and ethics of patient representation and CMS guidelines for complaint and grievance resolution. In addition, they identify opportunities and work with staff to implement patient satisfaction and service excellence initiatives by addressing patient concerns, and through trend analysis of patient feedback data.

EEO/AA/Disability/Veteran

Responsibilities

• 1. Interprets patient rights for patients, families, and staff. Ensures the understanding and adherence by both hospital staff and patients to the hospital's philosophy on patient rights and responsibilities.
• 1. Represents administration, as delegated by the Board of Trustees, and responds to, researches, and resolves the complaints and grievances of patients following the guidelines for Conditions of Participation set forth by CMS.
• 1. Interprets the Hospital's philosophy, policies, procedures, and services to patients, their families, and guests, providing timely, accurate, written documentation and follow-up.
• 1. Works effectively and competently with a diverse patient and staff population and responds to patient and staff calls for assistance. Is available to respond to patient calls at all times during the Hospital workday.
• 1. Monitors and assists staff with family waiting lounges to ensure they are safe and meeting the needs of families. Makes rounds on waiting areas as necessary to support families.
• 1. Identifies and evaluates patient's perception of services. Strives to reach consensus. Promotes the establishment and maintenance of meaningful relationships with hospital staff to enhance the delivery of health care. Serves as a liaison between identifying and articulating both the patient's and the staff's perspectives.
• 1. Communicates with nursing leadership to identify patient and family issues requiring intervention.
• 1. Researches and resolves patient issues as appropriate, following departmental timelines and standards. Answers inquiries and solves complaints with the involvement of appropriate hospital staff members, acting as an intermediary to hospital staff and administration on behalf of patients and their families.
• 1. Responsible for patient complaint and grievance management, maintains patient-specific files and complaint tracking systems, consistent with hospital policy and departmental standards for documentation. Formulates written responses for appropriate signatures. Gathers and collects information for severe or sensitive grievances and escalates to the Patient Grievance Coordinator for further investigation and resolution.
• 1. Works in collaboration with other members of the Patient Relations team and promptly investigates patient property issues and maintains systems for tracking loss complaints and associated reimbursements. Resolves lost property complaints efficiently, keeping patients informed of the status of the resolution. Exercises sound financial management practices in researching complaints and mitigating losses.
• 1. Channels collected data and information about patient care concerns, needs, and problems to appropriate departments, and the Manager, in order to make recommendations for changes in hospital procedures and practices. Meet with patients, patient families, and physicians to collect appropriate data.
• 1. Works collaboratively with unit-based staff to implement service recovery initiatives.
• 1. Participates in hospital-wide efforts to enhance service excellence initiatives. Acts as an advisor to assigned areas to develop and implement process improvement initiatives.
• 1. Performs statistical analysis of patient satisfaction data. Facilitates efforts to analyze trends in data, which support corrective action. Serves as a member of unit and service line teams to assist with the implementation of patient satisfaction initiatives.
• 1. Organizes and facilitates family meetings for complaint and grievance resolution.
• 1. Provides patients with information related to appropriate services and resources within Yale-New Haven Hospital and the surrounding community.
• 1. Assists with supervision and training of volunteers assigned to Patient Relations.
• 1. Participate in continuing education programs to improve negotiating, mediating, consensus building, and interpersonal skills.
• 1. Actively partners with the Grievance coordinator with the CLEAR program to support the staff, patient, and family for significant safety events, when appropriate.
• 1. Collaborates closely with the safety and quality team for case review and follow-up when appropriate.
• 1. Attends and participates in assigned areas Patient and Family Experience meetings.
• 1. Rounds on assigned units and partners with leadership to promote early identification of potential patient/family issues.
• 1. Identifies any complaints or grievances with reference to litigation and refers them to patient relations leadership, risk, and legal.
• 1. Partners with Protective Services and unit leadership to de-escalate aggressive behavior and assist with the implementation of limit setting.
• 1. Performs other responsibilities and ad hoc projects as requested.

Qualifications
EDUCATION

Bachelor's degree required in Human Services, Social Work, Nursing, Psychology, or a related field required. Master's degree preferred.

Experience
Minimum of 3 years of experience in patient advocacy, conflict resolution, or customer service at a healthcare facility or related service industry required. Demonstrated experience in problem-solving, written correspondence/documentation, and the ability to handle sensitive issues with minimal supervision preferred. Experience in patient relations, nursing, or other clinical work preferred.

Special Skills
Excellent interpersonal and communication (both oral and written) skills. Consensus-building skills. Skills to diffuse charged situations. Excellent negotiating skills. Ability to work independently and in a collaborative fashion with other staff. Competency in technology to support patient complaint management and reporting, including Word, Excel, Access, and PowerPoint. Computer literate with an ability to learn a variety of software to facilitate patient satisfaction initiatives. Expertise in statistical interpretation is strongly preferred.

PHYSICAL DEMAND

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. They are frequently required to reach with hands and arms. They are also required to stand and walk. They must occasionally lift and/or move up to 25 pounds. Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, and depth perception. This noise level in the work environment is usually moderate. Must be able to adhere to the requirements of the role. Incumbents as well as external and internal applicants who become disabled must be able to perform the essential job functions with or without the assistance of reasonable accommodation as determined on a case-by-case basis.

YNHHS Requisition ID

158120