Collaborate with patients and families, Michigan Medicine leadership, and clinical and hospital departments to investigate, document and resolve patient complaints/grievances concerning the quality of care and services.
Collect data relating to patient complaints
- Listen compassionately but objectively to patients.
- Serves as a liaison between patients, families and physicians, when concerns need to be addressed. This may include on-site and in-person visits.
- De-escalation of complainants who exhibit behaviors on red behavioral scale.
- Review letters addressed to Michigan Medicine leadership as well as UMMG leadership, Ambulatory Care leadership, handle Post-Acute Care complaints and grievances, web-site comments and complaints, referrals from Administrator on Call and House Managers to objectively to identify issues.
- Review comments from patient satisfaction surveys objectively for complaints that require follow-up.
- Review lost property reports from the Michigan Medicine Department of Public Safety objectively for items that require follow-up, maintaining communication with the patient.
- Document complaints in an objective manner in the Patient Safety Reporting System (PRSR) that specifically identify the issues to be resolved per CMS guidelines. Assess the level of harm and document in an objective manner. Tag the reports for triage and notification to departments and providers involved in the complaints. Assure data integrity of reports entered as the data is used by Departmental leaders and Chairs to assess for areas of improvement. Their data entry is also used for the National Vanderbilt program on Professional Conduct.
- Accept and review escalated patient concerns triaged from top Michigan Medicine and UMMG leadership.
- May need to provide cross coverage in PRCR UM Health-Sparrow and UM Health-West for vacation coverage, etc.
Identify appropriate follow-up and corrective action
- Solicit feedback and information from involved individuals regarding the patient's complaints, ensuring the integrity of data across a complex organization.
- Investigate the facts regarding complaints, grievance, and lost property reports.
- Assess all complaints and grievances for physical and emotional harm. Continue to manage cases with physical and emotional harm or triage to the appropriate level of service when applicable.
- Maintaining contact with the complainant per CMS and state guidelines, and as appropriate ensure corporate compliance within internal and external regulatory frameworks.
- Analyze the facts to determine appropriate follow up and corrective action as indicated.
- Document all follow up in an objective manner in the PSRS, ensuring the collection of involved party names and attachment of letters sent back to complainant.
- Maintain integrity of RL data entry that populates and displays for many of our Michigan Medicine dashboards.
Independently resolve patient complaints involving significant departmental and organizational resources
- Collaborate with Michigan Medicine Leadership as well as UMMG leadership across the enterprise to improve processes related to the complaint.
- Act as primary resource or support staff in Ambulatory clinics when dealing with escalated patients and families when Ambulatory leadership is unavailable.
- Collaborate with University of Michigan Insurance and Claims Administration office to submit and resolve lost property events.
- Establish rapport with staff and assist in the preparation of reports regarding any incidents that could result in legal action if not resolved.
- Refer patients and their family members to appropriate services and resources.
- Compose patient correspondence including 7-day acknowledgment and closure letters.
- Manage a case load of unique patient complaints in various stages of investigation, follow-up and resolution, meeting CMS guidelines for Complaint and Grievance handling including all incidents of emotional and non-physical harm.
Facilitate system improvements by identifying opportunities for improvement and involving department/unit leadership to improve process/operations using PDCA model
- Analyze PSRS grievance and complaint data to identify and track trends related to patient concerns to identify areas for improvement upon request by a Department.
- Facilitate and participates in process improvement/lean activities specific to the identified issues in collaboration with Michigan Medicine departments and UMMG departments.
- Participate on institutional committees that are involved in the patient experience.
- Collaborate with departments, units, on-site and off-site clinics, to assist in the development, training, and education of improving processes and service recovery efforts at the point of care. All service recovery to follow guidelines established by Office of General Counsel.
- Employees in this position, typically analyze, compare, and evaluate various courses of action and have the authority to make independent decisions, free from immediate direction, within the scope of their responsibilities.
- Annually participate in and analyze Patient feedback data for presentation to Department Chairs, Division Chiefs and Administrative leaders at the Annual Clinical Risk Rounds.