[Are you being served? The inter-organizational status and job perception of those responsible for patient rights in general hospitals in Israel].
BACKGROUND
Paragraph 25 of the Patient's Rights Law in Israel requires that every medical facility director in Israel appoint an Ombudsman who will be responsible for patients' rights, receive patient complaints and resolve them. The law aims to strengthen the patient's position vis-à-vis service providers. Therefore, it is desirable that the Ombudsman shall function independently without apprehension or bias.


OBJECTIVE
Eleven years after the law was legislated, the authors researched the following: Were individuals responsible for patient rights appointed in all general hospitals? Who are the position holders? What issues do they deal with? What is the weight of their various responsibilities concerning patient rights, as defined by the law, relative to their other tasks? Do they benefit from organizational mechanisms that assure their independence within the service provider's organization? How do they perceive their job--as "Patient Representatives" (as defined by law), or as representatives of their hospitals?


METHODS
Hence, the authors personally interviewed each of the 26 General Hospital Directors in Israel as well as the Ombudsmen in each of their facilities.


RESULTS
In each of Israel's general hospitals, an Ombudsman responsible for patient rights was appointed. In the majority of cases (82.6%) the Ombudsman was also engaged in an additional managerial or staff position within the organization. As a result, the Ombudsmen are almost entirely dependent on hospital management. The necessary means, by which to fulfill their positions and responsibilities as defined by the law, such as instructing and guiding medical staff regarding the protection of patient rights, have yet to be put at their disposal. The majority of the Ombudsmen view themselves as management representatives. These perceptions do not agree with the spirit of the Patient's Rights Law which is meant to strengthen the patient's position vis-à-vis medical services providers. The authors found a correlation between these views and the fact that Ombudsmen simultaneously hold additional managerial positions and some see themselves as part of their hospitals senior organizational hierarchy. In addition, we found a correlation between their seniority within the organization and their identification with the organization.


CONCLUSIONS
It is recommended that the independence of those responsible for patient rights be strengthened by adding specific stipulations to the law on this matter and that the necessary means needed to fulfill their responsibilities as legislated, be put at their disposal. The authors recommend promoting the independent status of Ombudsmen by not imposing upon them responsibilities other than those for patient rights.
Stern
Zvi
Z
Hadassah Medical Organization, Jerusalem, Israel. zvistern@hadassah.org.il
Mersel
Elie
E
Gedalia
Nahum
N
D006769:Hospitals, General / Q000592:standards*; D006801:Humans; D007297:Inpatients / Q000331:legislation & jurisprudence; D007557:Israel; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D010564:Personnel, Hospital / Q000592:standards; D012941:Social Responsibility