- Patient-centered care is a key component of current health system goals. But amidst patient portals, mHealth engagement apps, and patient satisfaction surveys, how can providers make sure these efforts truly serve the patient? For some healthcare organizations, the answer is a patient advisory council (PAC).
PACs, sometimes referred to as patient advisory boards, are groups of patients, caregivers, hospital leaders, and clinicians who work to identify patient needs. In PAC meetings, patients advise hospital leaders in ways to improve the patient experience and give feedback on current organization efforts.
Below, PatientEngagementHIT.com discusses the importance of patient advisory councils and how to implement a successful one.
Why are PACs important?
PACs are important because they allow patients to express what they need out of their own healthcare. As the industry’s culture and regulatory requirements push organizations toward more patient-centered care, it is crucial that industry professionals consult with patients and their caregivers. This will provide a direct window into patient needs and preferences.
According to a study published in the American Academy of Family Physicians’ journal Family Practice Management, researchers acknowledged that while there is little evidence suggesting the effectiveness of PACs, the studies that do exist show PAC potential.
“Some of that evidence, particularly around outpatient care and practice transformation, is promising,” the researchers said. “For example, one study showed that clinics where patients and providers jointly set clinic priorities were more likely to follow the core tenets of the chronic care model and the PCMH model than clinics where providers alone chose the priorities.”
Other experts say PACs are an effective method for ensuring patient-centered care.
“How can we talk about patient-centered care without having patients at the table?” said an interview respondent in a study published in the Journal of the American Board of Family Medicine.
PAC efforts are often also effective, the AAFP researchers said.
“PACs have led to meaningful changes, including improved patient education materials, better wheelchair access for patients, clearer clinic signs, and more amenities for pediatric patients,” the researchers explained.
As more healthcare organizations embrace patient-centered care, it will be critical that they consult with patients and form PACs to determine which of their efforts genuinely serve patients.
What do PACs do?
As noted above, patients participating in a PAC advise hospital officials about general patient and family member needs and provide feedback for current patient engagement strategies. This advice can include everything from hospital layout navigation to better care coordination to easier facility access for low-mobility patients.
At Northwestern University’s Robert H. Lurie Comprehensive Cancer Center, the PAC includes patients, caregivers, and providers, and aims to improve cancer care for all diagnoses. The PAC specifically works to improve care coordination, patient-provider communication, and patient/family advocacy through patient testimony.
The PAC at Johns Hopkins Medicine has similar goals. The patient advisory council aims to improve patient-centeredness across all aspects of family care, and presents ideas to improve standards of care.
At many hospitals, PACs produce actionable results. At Nemours Children’s Health, for example, the PAC offered feedback that helped influence the construction and furnishings of its newest facility.
“The parents came in and tested all of the furniture that they might be sleeping on in the rooms. They provided input into what we actually purchased,” said Nemours’ CIO Bernie Rice in a past interview with PatientEngagementHIT.com.
“The children came in as well and helped pick colors and room layouts as far as if the counter was too high. They were very valuable and heavily influenced our construction and design to make sure it was a very family- and patient-friendly environment.”
It is also important to note what PACs do not do. At San Francisco General Hospital, the PAC established a list of actions they are not allowed to perform:
- Mandate Policy
- Authorize programs or procedures
- Advocate for special groups
- Provide financial aid
Ultimately, the PAC serves a purely advisory role and cannot enact actual hospital policy. Many other PACs follow a similar strategy.
How do you create an effective patient advisory board?
When building a patient advisory council, leaders must ensure they have the right mix of patients, caregivers, and providers to create an open and productive atmosphere.
According to the AAFP article, that means recruiting a diverse patient population who can speak to multiple kinds of patient needs. Leadership can accomplish this by “casting a wide net,” and asking clinicians to nominate patient members, putting up flyers within the facility, and disseminating marketing materials via the patient portal or email.
PAC leaders should look for patients who are comfortable speaking in front of a crowd, present effective and thoughtful arguments, and are good listeners.
In the JABFM study, PAC leaders stated that creating group chemistry is key.
“The thing that is most important is not what [patients] think so much as how they express it,” one clinician interviewer said to the researchers. “It is really critical that they are not combative, that they are able to represent a number of voices and to listen to a number of voices and that they can be representative of people who are unlike themselves.”
After creating the PAC, the group should create a mission statement to clearly articulate its patient-centered goals. PAC members should also continue their healthcare education by attending topical seminars.
What constitutes a successful PAC meeting?
As with any multi-stakeholder meeting, PAC meetings require an organized structure. Meeting agendas are key to ensuring PAC meetings accomplish its goals.
The AAFP researchers explained that meetings typically have two main agenda items.
“The first allows PAC members to discuss their experiences with care at the clinic and brainstorm ways to address those issues through quality improvement projects,” the AAFP researchers said. “The second agenda item features clinic staff and guests presenting projects or ideas to the PAC members for feedback.”
In most PACs, members elect a meeting facilitator to ensure the group adheres to the agenda.
According to the JABFM article, PAC meetings also need to be inclusive spaces where patients feel free expressing their opinions about various hospital operations.
“Facilitators were responsible for providing a safe space for all members to be involved, including reigning in members who had more dominant communication styles that could overpower meetings,” the JABFM researchers reported.
PACs should meet as often as members feel necessary. While some PACs, like the one at San Francisco General Hospital, meet three times per year, others choose to meet more frequently.
According to the AAFP experts, meetings should be long enough to facilitate detailed discussion, approximately 90 minutes to two hours. PACs should meet often enough to ensure continuity in agendas.
With these goals and guidelines in mind, healthcare organizations should be able to enact their own successful patient advisory councils. Additionally, healthcare organizations should be mindful of their own unique goals and shape their PAC requirements from there.
Ultimately, taking patient advice into account should drive more patient-centered care and an overall better patient experience.
“At our practices, those who have worked with PACs can attest to the power of this level of patient collaboration. As clinics evolve from places of health care into patient-centered medical homes, PACs uniquely provide meaningful patient engagement in the life and services of the clinic,” the AAFP researchers said.
“With the support of motivated leadership and with a proper foundation, any clinic can start a PAC and experience an enhanced level of patient partnership.”