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The healthcare industry has been incorporating patient feedback into the care delivery improvement process for several years. Increasingly, industry leaders recognize that patients, family members and caregivers represent a powerful resource that, if leveraged properly, can champion patient-centered care.
Recently, a Beryl Institute State of Patient Experience study showed that 42% of hospitals are relying on Patient and Family Advisory Councils (PFACs) to provide better, faster and more actionable patient feedback. To that end, we interviewed PFAC expert and certified patient experience professional (CPXP), Kellie Goodson.
Kellie has co-led a national Affinity Group for the topic of patient and family engagement (PFE) for the Centers of Medicare and Medicaid Services, while also serving on committees for the National Quality Forum and the Institute for Patient- and Family-Centered Care. She has also been a guiding force in the creation and evolution of Sentrics’ own PFAC.
Here’s what she had to say about the role PFACs play in driving patient experience.
Sentrics: The 2021 Beryl study showed that hospitals are looking for ways to bring the patient voice into their patient experience efforts, and PFACs are one of those ways. What are PFACs, and how are they being used?
Goodson: A PFAC is a group of patients or family caregivers who have previously received care at the organization and are invited back to serve on a council to provide real-time, real-experience feedback to the hospital. Healthcare administrators and performance improvement/safety professionals work with these former patients to get advice and feedback to improve their processes and services to give not only a better patient experience, but also to improve quality and safety outcomes for the organization.
How does a PFAC differ from a focus group?
Goodson: Good question. PFACs differ from a focus group in that these are long-term relationships. It’s not a one-and-done opportunity for feedback, like a focus group. By investing their time and energy in engaging a PFAC, the healthcare organization is building a deep relationship with their constituents. They treat the PFAC members as equal partners by not only soliciting their feedback, but also closing the loop on what they’ve done with that feedback. Becoming a PFAC member is a process too. They have to apply, they are interviewed, and they are onboarded—their file looks much like that of an employee.
What are some ways PFAC members support their hospitals?
Goodson: They do more than just sit in a meeting room and provide feedback on their experience of care. They get involved in solving safety and operational issues by serving on hospital workgroups or committees, they help educate staff on the patient point of view, they can even serve on the hospital Board of Directors.
For example, in one hospital in the northwest, one of their PFAC members gives hospital tours to the new medical residents. Another hospital enlisted their PFAC’s help in addressing patient falls. They brought their PFAC into the patient room and asked them to identify hazards and potential fall risks, whether it was the bed, socks, signage. As a result of the PFAC’s feedback, the hospital made changes and there was a subsequent decline in patient falls. Several hospitals I know have a PFAC member serving on their Board of Directors to bring the patient voice to the highest levels of their organization.
CMS is supporting the concept of PFACs and has really pushed for hospitals to have these groups. Organizations that oversee healthcare delivery such as The Joint Commission, Agency for Healthcare Research & Quality, and the National Committee for Quality Assurance are also looking at PFACs as part of patient- and family-centered care approaches to improve quality and safety.
What draws people to serve on a PFAC?
Goodson: These are voluntary roles and individuals serve because they are passionate about the patient experience. Some do it because they had a really good experience and they want to give back to a hospital that may have saved their life, or where they received really good care; they serve out of gratitude. Alternatively, there are PFAC members who have experienced harm or care that was suboptimal, and they want to help the hospital improve. Either way, there’s a lot of passion to make the organization the best it can be when it comes to this type of volunteerism.
According to the Beryl study, a large percentage of hospitals don’t have a PFAC: Why is that?
Goodson: PFACs are growing in popularity, but they’re not a new concept. Hospitals have had them in the past, but many didn’t sustain them. There may have been a change in leadership, organizational philosophy or other factors such as staff time and resources that caused it to disband. Recently, COVID has caused many PFACs to be put on hold.
If an organization doesn’t have one, it’s missing out on a huge opportunity to include the voice of their community in how they deliver care. Having a PFAC takes the guesswork out of the planning phase, strategies, and execution. Without it, you’re only guessing at the wants, needs and preferences of patients.
What are some barriers to creating and sustaining a PFAC?
Goodson: One of the barriers is budget—even though PFACs aren’t a large budget item, they take staff time and resources to implement and sustain.
Another common barrier is not knowing how to find people with whom the hospital can be open and transparent. Some healthcare organizations are concerned that a PFAC could open the hospital up to criticism, but actually, the opposite is true. These individuals become cheerleaders for the organization. They often are the people talking to their communities about how hard a hospital or organization is working and how complex healthcare can be to fix.
Another barrier is the myth that patients and families can’t understand the complexities found in healthcare. Keep in mind, a whole lot of healthcare delivery is about customer service, processes, and protocols—and people understand that. They don’t have to understand the clinical science or every nuance inherent in the healthcare system to be able to provide value.
Drawing on your past experiences, can you share some best practices you’ve seen in hospitals that fully leverage their PFACs?
Goodson: Here are several best practices I’ve observed:
- Use the hospital grievance system to find potential PFAC members. This is a great source to identify people who have already worked through a problem with your hospital, so you know their approach to constructive criticism and how they present themselves in meetings.
- Engage your PFAC members. The more you engage PFAC members, the more valuable they become. One of the reasons some PFACs fail is they did not work on enough projects or did not expose them to the workings of the hospital—they kept them in the conference room. To be successful, liberate PFAC members from monthly meetings in conference rooms. Put them on the workgroups or committees, include them in rounding activities on patients, give them a seat on the Board of Directors even.
- Leverage them for learning and innovation. PFAC members bring holistic experiences with them to help make your organization better. They will share experiences from other industries that healthcare should consider. They are not constrained by traditional boundaries we’ve drawn – they think outside the box and often think of much simpler and less costly solutions than we do.
You helped Sentrics build its own PFAC for its E3 patient experience platform. How common is that among healthcare technology companies?
Goodson: I don’t know of any other healthcare technology company that has a PFAC. Sentrics is definitely well ahead of the industry.
There are many companies that use focus groups, including Sentrics. But when we talk about having a long-term relationship and people committed to your company’s mission and your vision, as Sentrics has with its E3 PFAC, it allows the relationship to become more fruitful and more valuable. Each PFAC member has unique perspectives and opinions; we have very robust conversations in our PFAC meetings.
Other healthcare IT companies may say they involved the patient voice in the development of their product but it’s not built on long-term relationships.
For a hospital, why does choosing a PFAC-certified healthcare technology vendor matter?
Goodson: The value of working with a PFAC-certified technology partner is that the hospital can know with certainty that the product already has been vetted by a group of patients and family caregivers. They don’t need to take the extra step. They can have confidence knowing that the voice of the patient was integral in the design, development, and enhancements of the product.
How did Sentrics find its PFAC members?
Goodson: It was a multi-step process. We looked at the Sentrics customer list and identified organizations with PFACs. We wanted to look for PFAC members from existing customers who had previous experience or familiarity with the E3 platform. But we also drew upon my own personal network of individuals active in hospital PFACs. We welcomed members who did not have experience with the platform because we wanted to hear their voices too. We have a very diverse PFAC from across the country, all of whom serve on their local hospital PFACs.
How is the Sentrics E3 PFAC helping improve the product, patient engagement and patient experience?
Goodson: At Sentrics, our PFAC has given us invaluable insight into the patient perspective as we continually work to enhance our product. As a result of the PFAC’s input, we have made small but noticeable changes to the User Interface/User Experience (UI/UX) of the product, are enhancing the underlying technology and brainstorming features that will add value in the future.
Each component of the E3 platform receives feedback. We then make changes based on that feedback until we gain the PFAC’s seal of approval. We are very proud to be able to say that as a PFAC-certified technology, E3 is truly patient-tested and patient-approved!
No other interactive patient experience technology provider is going to such great lengths to incorporate the user into the technology.
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