Is your Patient and Family Advisory Council a checked box or a meaningful vehicle for collaboration with patients and families?
With the implementation of CMS’ Comprehensive Primary Care Plus (CPC+) initiative, practices are required to convene a Patient and Family Advisory Council (PFAC) as part of patient and caregiver engagement. Many health systems are struggling to manage these groups successfully. Practices should ask themselves one question: Is your PFAC a checked box or a meaningful vehicle for collaboration with patients and families?
Previously, I wrote about the lessons I learned in launching a PFAC.
As we are wrapping up our third year at one practice and have successfully launched two additional PFACs at community partner sites, I have continued to gain a better understanding of strategies for successful sustainability.
Here are 5 ways to promote a PFAC that will prosper:
1. Less is not always more: More meetings mean more engaged advisors
The requirements for CPC+ are minimal concerning PFACs. According to current guidelines, PFACs must meet a minimum of one to four times each year.
The idea that having fewer meetings is easier does make sense; however, I would argue this is not the case. Our PFACs meet monthly throughout the year with a 3-month break in the summer. This cycle is critical to our success. If you only meet once or twice a year, it will be difficult to work as a team for meaningful change. Monthly meetings help build a sense of community and provide a safe environment for your advisors to give you honest feedback.
In addition, regular meetings build momentum. Our advisors know that every month we will meet on the same day at the same time (e.g., the second Wednesday of the month at 5:00 pm), so they can plan to be there. Each month, we quickly review highlights of the prior meeting and pick right up where we left off, increasing our efficiency and value as a group.
2. Double is no trouble: Recruit twice as many advisors as you want at your meetings.
Our average meeting attendance is roughly 50 percent of our membership. For our practices, the composition of our PFAC includes patients and family members, staff, resident physicians, and attending physicians. Our first year, we had a council membership of 20 advisors, but our average attendance was a group of 12, with four patient advisors on average. We have made an effort to recruit a broader base of patient and family advisors, so our meetings will be better attended, include ample patient voice, and encourage deeper discussion. In our third year, we have 25 advisors and an average of 14 attendees per meeting with a patient representation of eight. If you put in the work to recruit a larger council, it will pay dividends down the road.
3. Encourage buy-in, don’t settle for less: Leadership should be present at every meeting.
Strategic partnerships benefit ALL parties involved. Our partnership brings together key stakeholders to collaborate for meaningful change. If decision makers are present and engaged at each meeting, your practice can increase relevance and work to fill gaps identified by patients; physicians and staff members gain critical awareness of new perspectives of the care they provide; and patients and family members discover practice logistics, limitations, and areas of expertise.
Last year, our team identified the medication refill process as a quality improvement project. We developed a process map to illustrate the steps of a ‘simple’ refill. Providers learned about the frustration patients face when they miss a day of medications because of delays in pharmacy refills. Patients were surprised at the complexity of the process. They came away with an understanding of how urgent issues are triaged to providers and take precedent. They also appreciated the checks and balances that are in place to ensure correct dose, drug interactions, and appropriateness of medicine. As a result of our process improvement, we streamlined the necessary steps to complete a refill and now medication refills are finalized in roughly half the time.
4. Say what? Teach your advisors how to communicate.
It is important to set your advisors up for success by giving them the tools they need to thrive. We need to understand what our advisors are saying before we can work toward a common goal. These are the key communication concepts we teach our advisors.
Emphasize core concepts: The more specific your words are, the more profoundly others will understand you. We teach our advisors the framework: What? So what? Now what? This helps them to communicate the issue, its impact, and their proposed solution based on their experiences.
Diversity expands our possibilities: We learn more from differences of opinion than from validation. We intentionally seek a diverse PFAC in age, race, and experiences. We agree to disagree and respect the opinions of others.
Don’t avoid conflict: Seek to communicate and appreciate differences. When practices ask for feedback, it’s helpful to hear the good, the bad, and the ugly. We strive to create a safe place for challenges to be discussed.
Listen to and learn from others: Communication isn’t just spoken words; it is the silence between words. Be mindful of reading body language, as well as spoken language. Spend time as a PFAC facilitator thinking about your members and how they communicate.
5. Facilitate rather than dictate: Make time for patient topics and concerns.
Effective leaders understand that building a powerful team includes sharing power with your teammates. A slide at the end of your meeting that says “Questions?” is not enough to let your advisors know you value their voice and concerns. At every meeting, we plan a dedicated time for our advisors to share their concerns, ideas, or ask questions. “Patient and Family Priorities” is a recurring agenda item. Our patients and family members know this is a time for them to lead discussion and they come prepared. Establish your ground rules and expectations first, then encourage your patients and family members to come ready to share. These discussions provide important insight that otherwise may have gone unnoticed.
One of my favorite quotes is an African proverb, “If you want to go fast, go alone; if you want to go far, go together.” Here’s wishing you a long and healthy partnership!
Keesha Goodnow is the coordinator for the Patient and Family Advisory Council at The Christ Hospital Family Medicine Center and a member of the patient experience team at The Christ Hospital. She collaborates on a PFAC refresh initiative to help their 36 practices implement proven strategies for successful outcomes. She is also program manager for the University of Cincinnati College of Medicine, Department of Family and Community Medicine, supporting faculty physicians as they equip family medicine residents and geriatric fellows to lead and inspire healthcare transformation in their future practices.