The patient representative role and sources of power.

Because the 1990 accreditation standards of the Joint Commission on Accreditation of Healthcare Organizations call for the establishment of patient grievance procedures, this study examines the possibility of patient representatives serving in that capacity. Members of the National Society of Patient Representation and Consumer Affairs were surveyed to examine current roles of patient representatives--in particular, their handling of complaints, the types and sources of their power, the potential for conflict of interest as an institutionally employed advocate, and requirements for and barriers to successful job performance. The study reveals a great variation in the activity profiles of patient representatives. Additionally, it shows that the staff in place is professionally capable of moving in many directions and that departments have become the patient grievance mechanisms called for by the Joint Commission, depending on the hospital's management philosophy as reflected in allocation of authority and resources.