NRS 430 Advocacy-Patient Care Discussion
NRS 430 Advocacy-Patient Care Discussion
NRS 430 Advocacy-Patient Care Discussion
NRS 430 Topic 5 DQ 2
Discuss the importance of advocacy as it pertains to patient care. What is the nurse’s role in patient advocacy? Describe a situation in which you were involved with patient advocacy. Explain what the advocacy accomplished for the patient, and what the repercussions would have been if the patient would not have had an advocate.
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Today’s complex healthcare system is increasingly fragmented. Patients seeing multiple specialists scramble to keep track of treatment plans. Confusing medical bills and insurance coverage pose challenges to even the most informed patients. Healthcare advocacy can play a vital role in easing the burden patients experience while navigating the healthcare system.
Issues Healthcare Advocacy Can Address
Managing health care can be challenging at the best of times. For older adults with cognitive impairment or for people battling symptoms of exhaustion, navigating one’s own health care can be daunting. The result? Patients put off getting the care they need or do not seek care at all.
Patients and their caregivers may spend a lot of time poring over insurance forms or other documents written in jargon they find difficult to follow. They can easily misunderstand diagnoses and treatment options. Such misunderstandings can result in the less effective use of medical services. For example, patients may undergo duplicate diagnostic tests, miss appointments, or take the wrong medication dosage.
Hard-to-interpret health insurance coverage sometimes results in patients not taking full advantage of what is available to them. Other times, patients mistakenly pay inaccurate medical bills containing errors or charges that were actually covered by their health insurance plans.
While the national conversation on health care has focused on ways to address these problems, many patients need individual guidance. Healthcare advocates can help.
What Is a Healthcare Advocate?
Healthcare advocates give patients and their families direct, customized assistance in navigating the healthcare system. A healthcare advocate’s role entails:
Helping patients access health care
Educating patients so they can make well-informed healthcare decisions
Guiding patients through their medical care, insurance questions, and administrative and legal tasks
How do patients and healthcare advocates connect? Sometimes patients and their families hire independent health advocates or individuals who work for advocacy organizations. Employers, insurance companies, and hospitals may also offer patients health advocates.
Types of Healthcare Advocacy
The healthcare system’s many layers have created a need for several types of healthcare advocacy. In fact, a Harvard Business Review analysis found that 52 percent of patients in the U.S. cannot navigate the healthcare system’s complexity without help.
Whether assisting patients concerned about an unclear diagnosis or clarifying confusing medical charges, health advocates offer a range of services:
Medical Care Navigation
Medical care navigation services include:
Communicating with healthcare providers
Setting, coordinating, and attending appointments
Speaking up about patient rights
Identifying health resources and making referrals
Explaining confusing medical information
Clarifying diagnoses and conditions
Coordinating care between specialists
Medical Billing Navigation
Services that help patients navigate medical billing can include:
Reviewing medical bills for accuracy
Negotiating bills with providers
Getting billing errors adjusted
Health Insurance Navigation
Assistance in navigating health insurance may include: