What is a health advocate and why would anyone ever need one?

Imagine your mother has a stroke. Within 2 weeks, you learn that your mother needs surgery for a perforated bowel or she could die, plus she’s in terrible pain. This happened to my mother 13 years ago. She had the surgery, but then she had one complication after another. Preventable medical errors with serious consequences occurred again and again. It became a nightmare that seemed like it would never end.

How could this happen? Healthcare was supposed to take care of her and we thought it would. I didn’t appreciate how much harm could come along with that care, even with my nursing background. But what happened to my mom is not all that unusual! I wish I had known what a health advocate was back then, and that we needed one.

There are endless statistics to describe the problems that can happen to a patient in the health care system, especially in the hospital. According to an Institute of Medicine workshop summary report, 1/3 of patients are harmed in some way during a hospital stay¹—that’s 10,000 people every day who have serious complications from medical errors.² It’s estimated that 400,000 patients die from medical errors each year.³ That is the third leading cause of death in the US after heart disease and cancer!⁴

 There are so many types of errors, that I will mention just a few:

• Most notable are procedure related errors. A sad example is what happened to Joan Rivers, who stopped breathing during a diagnostic procedure. Another example would be an injury or complication of surgery.

• There are medication errors, including wrong dose, wrong medication, or medication omission.

• Hospital acquired infections (HIAs) can cause longer hospital stays, readmission, and death. The two most common HIAs are pneumonia and infection of the intestinal tract.

• Here are two of many kinds of errors in communication. First, communication between providers can go awry when any kind of patient transfer takes place within a hospital or when a patient is transferred to another facility. Incomplete instructions given to a patient about medication, activity, or self-care is just one example of a communication error between a provider and a patient.

Why is this happening? Why are there so many errors? You’ve heard it—our health care is the best in the world! While excellent care can be found, our health care system is broken. Here are just a few reasons that so many medical errors take place:

• Information flow becomes a problem when providers are caring for patients with incomplete information because information has not followed the patient. This is just one result of fragmentation of care, when a patient is cared for by many health care providers and specialists, not always to the patient’s benefit, because the providers may not have communicated adequately with each other or records are not available. An apt analogy is “too many cooks spoil the broth.”

• Lack of transparency is rampant when it comes to cost and quality comparisons. For instance, if you wanted to compare the cost and quality of hip replacement surgery at 2 local hospitals, you would not be likely to find that kind of information anywhere or from anyone.

• Health care is big business, yet 1/3 of health care spending does not improve health! That’s about 750 billion dollars!¹

There are so many more reasons!^1,4,5,6

There is a lot of innovation in health care to try and fix the system. But humans that are overworked and the business of health care still get in the way of quality care. Fixing what’s broken will take time and Herculean efforts. One solution for individuals right now is health care advocacy.

What is a health advocate? A health advocate is someone who helps you make sense of your medical situation and helps you understand your treatment options, including their risks and benefits. A health advocate supports you as you make decisions about your health care in partnership with your health care providers. The more involved and engaged people are in their own health care, the better their health and outcomes.⁷ When a health advocate accompanies you to the doctor’s appointments or to the hospital to act as a second set of eyes and ears and facilitate that provider/patient partnership, then patients are able to spend their time healing and getting healthy.

You can be your own advocate—educate yourself and your family; get and stay healthy so you can avoid hospitalization! Be knowledgeable whenever you seek health care of any kind.

Sometimes family members are great health advocates, but others may not have the knowledge, time, or persistence to be helpful enough. You might ask your health care provider to be your advocate, however not all can or will take on this role.

You can use a hospital advocate in certain situations, such as patient navigators employed by hospitals specifically for breast cancer patients, however the potential for a conflict of interest exists as they work for the hospital, not you.

A private health advocate works independently for you and you alone, when managing your care becomes too much. A professional health advocate has experience and knowledge about the health care system that they impart to empower you to stay safe and feel more confident in deciding the direction of your health care. You’ll know that you’re doing all you can to get the best possible care, providing you with peace of mind when you need it the most.

I’ll tell you more about my mom in future blog posts. Learn how to stay healthy and use health care wisely, staying out of the hospital if you can. However, if you are diagnosed with a chronic condition or get sick and have to be hospitalized, become a health advocate for yourself, or find one to help you! It will make all the difference.

1. What’s Possible for Health Care. (2013, March). [Infographic]. Retrieved November 24, 2014, from http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America/Infographic.aspx
2. McCann, E. (2014, July 18). Deaths by Medical Mistakes Hit Records. Retrieved from http://www.healthcareitnews.com/news/deaths-by-medical-mistakes-hit-records
3. James, J.T. (2013, September). A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. Retrieved from http://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx#
4. Allen, M. (2013, September 19). How Many Die from Medical Mistakes in U.S. Hospitals? Retrieved from http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals
5. AHRQ’s Patient Safety Initiative: Building Foundations, Reducing Risk. (2003 December). Agency for Healthcare Research and Quality, Rockville, MD. Retrieved November 24, 2011, from http://www.ahrq.gov/research/findings/final-reports/pscongrpt/psini2.html
6. Stange, K.C. (2009, March). The Problem of Fragmentation and the Need for Integrative Solutions. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653966/
7. James, J. (2013, February) Patient Engagement [Health Policy Brief]. Retrieved from http://www.rwjf.org/en/research-publications/find-rwjf-research/2013/02/patient-engagement.html