Ombudsman/Mediator

The HealthCare Ombudsman/Mediator functions as a trained alternative dispute professional offering patients, family members, staff & providers a conflict management program to resolve patient/ provider healthcare disputes early & quickly thereby improving patient safety & reducing the costs of health care dispute resolution. Serves as a trusted & informal information resource, communication channel, complaint handler, facilitator, consultant & practitioner for dispute resolution. Acts to seek fair & equitable solutions to patient/provider problems & for suggesting dispute resolution processes for addressing & managing conflicts & for policy & procedural changes. Brings issues to senior leadership to address care delivery improvement efforts. Promotes effective relationships/communication between patients & providers.

Essential Functions:
- Program Implementation: Implements the healthcare ombudsman/mediator (HCOM) program.
- Establishes annual work plan & performance metrics to demonstrate program effectiveness, including but not limited to: patient & provider satisfaction, cost savings, cost avoidance in lawsuits averted, increased productivity, savings in management time, increased personnel resources & the promotion of patient safety initiatives.
- Develops & implements an on-going communications program, including informational materials for patients & family, staff training & awareness building & materials for external audiences.
- Patient/Provider/Staff Ombudsman/ Mediator Process: Serves as a dispute resolution practitioner whose major function is to provide confidential & informal assistance to patients & providers in resolving patient care issues, which includes the following.
- Receives inquiries for dispute resolution, listens impartially & questions the patient/staff to help put the problem into perspective.
- Conducts informal fact-finding & gathers information, including any general background information that may be helpful to understand the overall context of the dispute & assesses the overall gravity of the situation, & meets w/ the parties to discuss issues.
- Based on an analysis of the situation, recommends options to assist the parties in the resolution of their dispute.
- Serves as an impartial & independent third party for clients, focusing upon patient care issues.
- Facilitates contact w/ other appropriate local/regional departments as necessary (e.g. Legal or Member Services) Collaboration & Problem Solving: Develops collaborative relationships w within the Medical Center & Regional departments to provide & facilitate a fair, open & creative atmosphere.
- Provides feedback to senior management by tracking & analyzing types of patient & provider concerns, & in collaboration w/ appropriate stakeholder groups.
- Identifies opportunities for improvement to policies & practices which contribute to systemic conflicts, concerns & complaints.
- Provides internal consulting services to providers on communication & dispute resolution strategies, designed to improve individual & organizational effectiveness.
- Analysis & Reporting: Maintains data set to support the evaluation of the effectiveness of the program.
- Analyzes aggregate data/information from HCOM case experience concerning patterns of complaints.
- Identifies & informs upper management of patterns & trends affecting patient care.
- Knowledge Management: Actively participates w/in the KP patient safety/risk management community, by sharing successful practices & disseminating learning's (in collaboration w/ Regional & National Risk Management functions).
- This job description is not all encompassing.