Patient and Family Advisory Councils: Making Inroads in Hospitals

Two years ago, the percentage of Patient and Family Advisory Councils (PFACs) in hospitals was estimated at 40 percent by the Agency for Healthcare Research and Quality and confirmed by the Partnership For Patients. According to the Beryl Institute, that figure has risen to 55 percent as the case for PFACs gains momentum giving patients and family members a voice in a broad range of departments within hospitals.

An increasing amount of anecdotal evidence points to PFACs’ impact. At Kaiser Permanente, the No One Walks Alone initiative prompted a substantial reduction in falls. At GRHealth, where a number of PFACs exist, a problem with medication errors in the neuroscience unit was reduced by 62 percent through better explanations and descriptions. Colorado’s Longmont United Hospital reduced readmission rates by training council members to make home visits after the patients’ discharge.

PFACs have an important impact on hospitals. Here are 10 tips for a successful PFAC.

1. Use metrics before and after implementing a project. Without metrics the project success will be difficult to measure.
2. Track all projects and their results. The success of a council is based on monitoring every project and the outcomes.
3. Report on results and distribute to leadership. In Massachusetts, where PFACs are mandated, annual reports are required. Although yearly reporting is a good idea, more regular communication with leadership is recommended, so they are consistently reminded about the impact that PFACs have.
4. Implement all projects with a specific and proven process. Too often projects are implemented in an ad hoc method. Every PFAC suggestion should incorporate a methodology for adoption. For example, if through a PFAC suggestion, brochures are now displayed in the waiting room, the action of photocopying and placing the brochures in their display cases should be included in someone’s job responsibilities.
5. Recharge if the PFAC is struggling by using a guide or consultant. Occasionally, PFAC members perceive that they don’t have a strong voice or are thinking of quitting the PFAC. Plenty of resources are available to ensure that PFACs are strong.
6. Train PFAC members on committee participation, so they are valuable contributors. Not everyone knows how to participate with impact in meetings. Short education sessions for current and/or prospective members should go a long way to developing valuable participation.
7. Involve patients and family members on all hospital committees. Hospitals with successful PFACs don’t stop with patients and family members on councils. They include patients and family members on all hospital committees.
8. Survey leadership about the PFACs’ impact. One of the ways to remind leadership about the existence of PFACs and gauge their opinions about PFACs is to periodically survey leaders about their impression of the councils.
9. Spread the word about the availability of the PFAC for research and feedback for hospital projects. As departments become more aware of the PFAC success, they will tap the members to obtain feedback on projects.
10. Treat PFACs as valuable consumer research tools that can have enormous impact on a hospital’s operation, safety and patient experience. Similar to other industries, healthcare should embrace PFACs as important consumer research techniques that are necessary to ensure that the patient and family members’ expectations are met and even exceeded.

While 45 percent of hospitals still don’t have a PFAC, an increasing amount of hospitals are recognizing the value of the patient’s voice in saving money, improving safety and enhancing the patient experience.