This webinar was presented on March 12, 2015 by Barbara Lewis. It looks at the prevalence and roles that Patient & Family Advisory Councils (PFACs) are playing in U.S. hospitals today, and builds a business case for their implementation:

1. Patient & Family Advisory Councils (PFACs):
the Business Case for Starting a PFAC &
PFAC Survey Results
Barbara Lewis, MBA
March 12, 2015
1

2. Barbara Lewis, MBA
• Act 1 – Journalist: national publications WSJ to
Ladies Home Journal > Modern Healthcare & BMJ
• Act 2 - Founder - marketing company for professional service
firms
– MBA from UCLA Anderson School of Management where
I lecture
• Act 3 - Founder – Joan’s Family Bill of Rights 2012
• Co-chair of The Beryl Institute’s Global Patient & Family
Advisory Council
• Member of the Kaiser Permanente Regional Member
Advisory Council
• P/T Managing Editor of DocCom – on-line interactive
communication skills learning platform for clinicians and
students (DocCom.org) > Beryl Grant (HCAHPS)
• DocCom free trial subscription – send me an email 2

3. Agenda
• Background
• Survey Results
• PFAC Impact
Examples
• Oops…We Forgot to
Ask Patients
• Recommendations.
3

4. I’m on a Mission
4
Keynoter called for
patients on
committees
State mandate CEO wants to
start a PFAC
Audible groans
from audience
Lip service only Needs a business case
Prove that PFACs save hospitals money!

5. Patient & Family Advisory Council
(PFAC) Description
• 5 to 20 members represent the hospital
population
• Meet periodically – once a month for 1 to 3 hours
• Snacks and drinks provided
• Perhaps stipend for parking, mileage, babysitting
• Tackle issues members identify or hospital
requests feedback.
5

6. Background
• PFACs started in the 1980s
• Pediatric hospitals were some of the first
• In Massachusetts, PFACs are
mandated, also in Canada & England
6
Any others? Please let me know.

7. How Many Hospitals
Don’t have a PFAC?
60%
40%
No PFAC
PFAC
7
~5,000 hospitals in the U.S.

8. Consumer Research
8

9. 2 Surveys
• March 2014
– Supported by the Beryl Institute
(TheBerlyiInstitute.org)
– 60 participants
– 17 questions
• November 2014
– Supported by Partnership for Patients
(JoansFamilyBillOfRights.com)
– 209 participants
– 22 questions 9

10. In what areas does the PFAC contribute?
93%
81%
78% 76% 74%
57%
52% 52% 50%
40% 40% 40%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
10

11. What committees/improvement
teams/boards are patients & family
members on?
11
57%
48%
38%
24% 23%
19%
16% 14%
11%
14%
0%
10%
20%
30%
40%
50%
60%

12. Do PFAC projects have metrics to gauge
success?
57%
26%
5%
12%
0%
10%
20%
30%
40%
50%
60%
Sometimes Never Always Don't Know
Let me know if your PFAC measures results. 12

13. If you have a PFAC or are planning
one, do you have a budget?
13
42%
58%
0%
10%
20%
30%
40%
50%
60%
70%
Yes No

14. What’s the Cost?
• Most PFACs have little budget
– Staff devotes some hours
– Food and drinks
14

15. How many full-time employees are
engaged in staffing your PFAC?
15
No FTEs - the
PFAC is staffed
by volunteers,
14%
Less than one FTE,
24%
1 to 2 FTEs, 29%
More than 2 FTEs,
15%
Not Applicable,
19%

16. Do you track return on investment
related to your PFAC?
16
Yes, 9%
No, 53%
Don't know,
16%
Not
Applicable,
22%

17. PFAC at Work
Problem:
Medication
errors in
neuroscience
unit
Solution:
Patient
explanations
&
descriptions
Benefit:
62% less
errors
17

18. PFAC at Work
Problem:
Readmission
Rate
Solution:
2 council
members
visit home
Benefit:
Rate dropped
to 8% from
15% saving
$000s
18

19. Vanderbilt University Medical Center
• Needed new chairs
• Picked out chairs, but the PFAC nixed
• Saved $540,000 when PFAC members
recommended against chair purchase.
19

20. • Patients frustrated over recurring problems
with billing practices
• 2 letters to better explain fees & discount for
prompt payment
• Result: prompt payments increased by 6 fold
– Boosted the net present value of the collections
– Decreased collection costs.
20

21. Oops…We forgot to Ask Patients!
• Welcome Packets – cannot use them
• 10-story inpatient tower
– Designed Surgical Waiting Room
• No windows
• Long narrow room
• 4 TVs
– Redesign
• Modular seating
• Windows and “amazing” murals
• Tables and chairs
• Lockers
• Hundreds of electrical outlets
• Vending machines
• Play area for children
21

22. Mission
• PFAC in every hospital
• Metrics with every project
100%
22

23. If you do not have a PFAC, select the
reason that best describes why
23
43% 43%
29% 29%
14% 14%
29%
14%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Staff to
implement
Time
limitation
Competing
initiatives
Not a
designated
priority in
our
strategic
plan
Little
knowledge
about PFACs
Money Don't know Other

24. If you discontinued your PFAC, select
the reason that best describes why
• Change in leadership
• Couldn't find patients to participate
24

25. If you cannot find patients, please
explain your the challenges
• Finding patients with specific conditions
• Finding diverse patients
• Lack of time commitment
• Health issues of prospective members
• Finding younger people, especially parents
with young children
• Lack of patients’ confidence in public
interaction, presentation skills
• Rural location
25
Who has virtual PFACs?
Please let me know.

26. Finding Patients to Participate
1. Community groups
2. Written comments in survey
3. Patients and family members who have complimented
and complained to the hospital and staff
4. Recommendations from staff, ombudsmen, etc.
5. Newsletter articles requesting volunteers
6. Website page that invites visitors to apply
7. Pamphlets in waiting areas
8. Posters in the cafeteria
9. Messages in pharmacy bags
10.Local TV Public Service Announcements (PSAs). 26

27. Top 10 Recommendations
(Have a PFAC)
1. Use metrics before & after
2. Track all projects & results
3. Report on results and distribute to leadership
4. Implement all projects with a process
5. Reboot if PFAC is struggling
6. Train PFAC members on committee participation, story telling,etc.
7. Involve patient & family members on all hospital committees
8. Survey leadership on PFAC’s impact
9. Spread the word about the availability of PFAC for research
10.Treat PFACs as valuable consumer research tools.
27

28. Success Steps to Launch PFAC
1. Conduct feasibility assessment - In your opinion…
2. Formally solicit support from leadership
3. Identify a high level champion
4. Identify PFAC area - e.g. general, pediatric, etc.
5. Develop a budget
6. Establish a time-line
7. Decide on the PFAC size
8. Analyze the hospital’s demographics
9. Identify the ideal candidate qualities
10.Create plan to identify candidates
11.Create the application process
12.Develop the application.
28

29. Success Steps to Staff Council
1. Identify potential candidates to mirror
demographics
2. Invite candidates to apply
3. Request applications from candidates
4. Interview the candidates
5. Select the candidates to attend first meeting
6. Identify staff liaison
7. Conduct the first meeting
8. Train the candidates in PFAC dynamics
9. Invite applicants to become members
10.Provide hospital training and education
11.Provide medical tests.
29

30. Success Steps for Sustainability
1. Create the Vision, Mission and Norms and Charter
2. Select the Chair or Co-Chairs
3. Identify projects
4. Establish metrics
5. Institutionalize projects
6. Monitor success
7. Report results
8. Solicit involvement from hospital staff
9. Publicize results
10.Bring members onto all hospital committees
11.Allow PFAC to run on its own.
30

31. What Hospitals Say about PFACs
• “Mutually Beneficial Partnership”
• “We don’t do anything without
consulting our PFAC”
• “PFACs are partners in everything
that we do”
• “How can a hospital NOT have a
PFAC?”
31

32. PFACs…
• …save hospitals money
• …improve safety
• …enhance the patient experience
That’s the Business Case!
32

33. Starting and Sustaining PFACs:
from Leadership Assessment to Success Metrics
I. Introduction
II. The PFAC Start-up
A. Leadership Support
B. Making the Business Case for a PFAC
C. Forgetting to Ask the PFAC
D. Identifying Barriers
E. Finding a Champion
F. Identifying the Staff Liaison
G. Developing the Budget
H. Compensating the Members
I. Creating the Timeline
III. Council Members
A. Deciding on the Size
B. Analyzing the Demographics
C. Identifying the Ideal Candidate Qualities
D. Creating the Job Description
E. Deciding on Parameters
F. Finding Candidates
G. Using an Application Process
H. Interviewing the Candidates
I. Interviewing Departing Members
IV. The First Meeting
A. Training the Candidates
B. Creating the Charter
C. Selecting the Chair or Co-Chairs
V. Projects
A. Establishing Metrics
1. Survey Results
2. Sample Metrics
B. Identifying Projects
C. Operationalizing Projects
D. Monitoring Success
E. Reporting Results
VI. Mature PFACs
VII. Institution Support
A. Publicizing Results
B. Asking Patients to Join Committees
VIII. Black Belt in PFACs
IX. Resources
Wiki-type document to add info, comment, etc.
33

34. Doctella Patient Engagement Solution
Doctella is looking for partners to help get its tools into the hands of patients.
We are offering a free 6 month pilot to the first 3 PFACs that express interest.
Doctella is a mobile health company that partners with health care providers to create more
meaningful interactions between patients and their doctors. We work with health experts to
develop lists of questions specific to each surgery and procedure so that patients can use these
to ask the important questions and get answers at each point along their care journey.
Doctella also offers the “Patient Passport” – a guide to make conversations easier in hospitals.
The Passport allows patients to prepare in advance their history, any needs or concerns they
have, and preferences for treatment and care. Read about the Patient Passport in the Wall Street
Journal.
In addition to the pre-prepared list of questions, you can add your own questions in Doctella. You
can also write notes to yourself, set reminders and appointments that are synced to your calendar,
record audio conversations, and review lists of “things to do” after each step of your care journey.
Doctella makes it easy to share these functions with your family, friends, and health care team.
If interested in exploring a pilot, please email rachel@doctella.com
34

35. Barbara Lewis, MBA
BarbaraLewis@JoansFamilyBillofRights.com
www.JoansFamilyBillofRights.com
818.784.9888
Google Drive Doc as a Resource & for Comments
Starting and Sustaining Patient & Family Advisory Councils:
From Leadership Assessment to Success Metrics
http://joansfamilybillofrights.com/pfacs-from-starting-up-to-sustaining/
Click on the link on the page
© 2015 Joan’s Family Bill of Rights