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Advocates Speaking Up For Patients

Brenda Bush, left, a Saint Luke's Hospital patient advocate visits Dawn Brock who is on bed rest.
Kelley Weiss
Brenda Bush, left, a Saint Luke's Hospital patient advocate visits Dawn Brock who is on bed rest.

By Kelley Weiss


Kansas City, MO – As healthcare insurance policies are continually changing, doctors are trying to squeeze in more patient visits and Baby Boomers are aging the role of the professional patient advocate is emerging. A patient advocate makes sure the sick get the care they need. KCUR's Kelley Weiss reports.

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Dawn Brock came to Saint Luke's Hospital from Lawson Missouri more than a month ago to go on bed rest because of her high-risk pregnancy. On a recent Thursday afternoon Brock lay in the bed she's stuck in all day long with the lights off, the radio on and a stack of books and knitting next to her.

One of the hospital's patient advocates, Brenda Bush, regularly comes by to check in. Bush came to Brock soon after she was admitted and is preparing her for her baby's inevitable premature birth - like the fact that he'll be sent to the neo-natal intensive care unit, what she'll need to do for breast feeding, as well as making sure her insurance is taken care of. This attention put her at ease, Brock says.

Dawn Brock: "You have so many stresses and situations that hit you all at once it's very overwhelming and knowing that you have someone there to take care of the medical part of that to where you can worry about the personal part it takes a lot of the weight off your shoulders."

The advocate's role is to make sure the patient gets the care they need - from making a hospital stay comfortable to working as a mediator or explaining an advanced directive to families. Advocates help lots of different people like Brock get through her pregnancy, patients with chronic illnesses or people without family or friends nearby.

Steve Pew, an associate professor at Park University, says part of healthcare advocacy has a business practicality to it - reducing errors and costs while providing the best customer service. That, he says, is where hospital advocates can find themselves in a tough position - acting as "damage control" agents or finding ways to limit long, costly hospital stays. Pew says there is a conflict of interest for advocates employed at hospitals - how do only a few advocates service a large hospital or put the patient's interests first while the hospital pays their salary?

Steve Pew: "They're there to try and fix things that didn't work out right. From our perspective a patient advocate is there to make sure that very little goes wrong in the first place."

Patient advocacy has been around for about 25 years but Pew says today more people are aware that advocates are available and want their services. So, in response to this growing demand, Pew and Laura Lane, executive director of Park University's Professional Development Institute, are starting an eight-week on-line certification program this month to train volunteer or professional healthcare advocates. It's one of the first like it in the country.

Laura Lane says the program is attracting retired nurses, social workers, clergy, lawyers and psychologists to name a few. She says training advocates will take the pressure off families and patients.

Laura Lane: "You have to advocate either on behalf of yourself or someone that you are responsible for caring for. And, what we are doing is now taking the informal pieces of advocacy and formalizing them."

Nancy Davenport-Ennis, CEO and founder of the national Patient Advocate Foundation, agrees that the need for patient advocates is greater than ever. Davenport-Ennis says last year the foundation fielded more than six million calls from people using the non-profit organization's free services. She predicts the demand will only increase.

Nancy Davenport-Ennis: "As you see shrinking dollars in the healthcare delivery community you will see an equal emergence of non-profit healthcare support organizations to fill the gaps."

And, Davenport-Ennis says some of that support will come from for-fee advocates, like Park University is training. Although insurance does not pay for independent advocates - a professional on average costs about $60 dollars per hour - she expects insurance companies will eventually cover it once data shows these advocates can reduce costs.

Back at Saint Luke's, its four full time patient advocates are trying to fill the gaps of the more than 600 bed facility by taking, on average, 3,000 cases a year. Dr. John Yeast, medical affairs director, says healthcare advocates are the communicators between all parties.

John Yeast: "Providing healthcare is technically more complicated than it used to be. It's just an increasing role for advocates. We see that it's almost a 24 hour a day 7 day a week role."

While Dawn Brock, one of two patients Saint Luke's made available for this story, is on bed rest waiting to deliver her baby she says she is grateful for having an advocate. She thinks most people staying in the hospital could also use the service.

Dawn Brock: "Just to know that somebody came by and said this is who I am and do you have any questions about insurance or anything that I can help you with. I think everyone in the hospital could benefit from a patient advocate."

But, Steve Pew, of Park University, says patients cannot forget their own responsibility.

Steve Pew: "Whether you're paying a doctor, a nurse or an advocate you're ultimately responsible if you will for whether you think you're getting the kind of service you need."

And, while advocates help patients get care Pew says they'll fill the need that he predicts will only grow as people realize they have to be informed consumers, even when it comes to health care.

Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.

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