Patient and Family Engagement 

What is Patient and Family Engagement (PFE)?

The Centers for Medicare and Medicaid Services (CMS) defines PFE as:

"persons, families, their representatives, and health professionals (clinicians, staff, and leaders), working in active partnership at various levels -direct/point of care, organizational design, policy, and procedure; organizational governance; and community/policy making-across the health care system and in collaboration with communities to improve health, health care, and health equity."

Improving PFE practices and integrating patient- and family-centered care is an area of increasing importance for hospitals. Improving PFE means that patients and families become partners and allies in efforts to improve quality and safety, including helping to identify potential safety issues and reduce or eliminate preventable safety events. Meaningful PFE enables hospitals to incorporate what matters most to patients and families and greatly improves the ability to achieve long-term improvements in quality and safety. Not only is engaging patients and families and providing patient- and family-centered care the right thing to do, but also the many individual benefits of patient and family engagement work together to contribute to improved hospital performance.

Building patient and family engagement into your hospital's current policies and practices can help:

  • Contributes to better clinical outcomes
  • Reduces institutional and individual costs of care
  • Increases adherence to recommended treatment regimens, which can lead to fewer complications and re-hospitalizations
  • Improves patient satisfaction with care coordination and other patient experience measures
  • that impact the hospital's reimbursement rates from Medicare and other payers
  • Enables compliance with patient engagement requirements included in HITEC meaningful use and patient-centered medical home payment models

What is a Patient and Family Advisor?

Patient and family advisors are individuals, or family members of individuals, who have received care at a hospital and volunteer to offer input and feedback regarding hospital and health system policies, programs, or practices affecting the care and services provided.

Patient and family advisors provide a voice that represents all patients and families of patients who receive care at a hospital.

Patients and family advisors:

  • Offer insights on what we do well and where changes may be needed
  • Help make improvements based on patient- and family-identified needs rather than our own professional assumptions.
  • Bring a fresh perspective and help us come up with solutions that clinicians and staff may not have considered.

A patient and family advisor is someone who:

  • Wants to help improve the quality of a hospital's care for all patients and family members
  • Gives feedback to the hospital based on his or her own experiences as a patient or family member
  • Helps plan changes to improve how patients are cared for
  • Works with the hospital for either short- or long-term commitments, depending on the project
  • Volunteers his or her time typically (usually at least 1 hour and not more than 4 hours per month)

What is a Patient and Family Advisory Council (PFAC)?

The PFAC is a formal group of patient and family advisors that meets regularly for active collaboration on policy and program decisions. The purpose of a PFAC is to integrate the patient and family perspective into the work and operation of the hospital. A PFAC is not a support group or grievance committee. It also is not a group that is convened to provide approval for programs, processes, policies, or materials that have already been developed. To be effective, a PFAC should be involved in the development, planning, implementation, and evaluation of programs, policies, and initiatives, with the ability to offer input that is received and acted upon in meaningful ways. While hospitals may structure PFACs according to their individual needs, typical PFAC operating guidelines include the following:

Membership. Patients and families who participate as PFAC members are individuals with health care experiences in the specific hospital for which they are serving as advisors. PFAC membership may also include hospital leaders, clinicians, and staff, but at least 50% of the members should be patients and family members.

Size. PFACs vary in size, but typically consist of between 12 and 25 members. PFACs that are too small may find it difficult to accomplish goals, or face sustainability challenges due to membership attrition. When PFACs are too large, it can be challenging to manage and come to consensus.

Diversity. PFAC members should have diverse health care experiences and reflect the types of patient and family populations and communities that the hospital serves. Particular attention should be paid to recruiting members of vulnerable populations to serve on the PFAC.

Mission. The PFAC should have a clear mission statement to guide and focus the work of the PFAC. Mission statements typically indicate the council's purpose, outline major goals, and identify the key stakeholders.

Charter. Effective PFACs also establish a charter to guide how the PFAC functions. The charter typically addresses topics such as membership eligibility and terms, meeting schedules, and roles and responsibilities. The PFAC should have a designated patient chair or co-chairs with responsibility for ensuring that the PFAC has active participation from all members, is functioning effectively, and that the activities and outcomes of the PFAC are communicated outward.

Meetings. Effective PFACs convene regularly to ensure consistent partnership and collaboration. The frequency of meetings may vary depending on the needs and activities of the hospital. However, PFACs should, at a minimum, meet quarterly. Communication in between meetings helps ensure that members remain active and engaged in the work.

Projects and work. PFACs can participate in a variety of projects, but the purpose and value of their work should be clearly specified. Why is the hospital seeking their input? How will their work be incorporated into the activity at hand? Specific activities may include providing feedback and advice for changes to hospital policies, care practices, and materials; helping create materials and strategies for improving health care quality and safety for all patients; providing input in the hiring of physician and senior leadership candidates; or helping hospital staff carry out changes to improve hospital safety and quality. It is important for hospitals to truly listen to input, incorporate the work of the PFAC in meaningful ways, and report back to the PFAC members on the outcomes of their work.

Materials adapted from Agency for Healthcare Research and Quality's (AHRQ)
Guide to Patient and Family Engagement in Hospital Quality and Safety, and CMS'
Partnership for Patients Strategic Vision Roadmap for Person and Family Engagement

List of hospitals with Patient Family Advisory Councils

(See Excel Spreadsheet: GROUP\HEN\Focus Areas\PFE\MTC HIIN Webpage Info)

Learning Collaborative

PFE strategies are a major priority of FHA's Mission to Care initiative. By engaging in active partnerships with patients and their families, hospitals have the opportunity to make great strides towards improving health care experiences, care delivery, and outcomes.

To support hospitals in navigating this space, the FHA Mission to Care Hospital Improvement Innovation Network has launched the PFE Learning Collaborative. The goal of the Collaborative is to provide HIIN hospitals with the opportunity to explore PFE strategies. The intent is to leverage existing resources and tools to accelerate the adoption of patient- and family-centered care practices through education and collaboration. Supported by national and statewide experts, the Collaborative focuses on key PFE concepts and practices, including strategies for establishing or expanding a Patient and Family Advisory Council (PFAC) and improving the patient experience. Three tracks are available:

Track 1: Developing and/or Enhancing a PFAC
Track 2: PFAC Sustainability and Expansion
Track 3: Faculty/Mentoring Opportunities

There are two exciting opportunities available to hospitals. The first option is to participate with no formal commitment, which will provide access to monthly webinars, an in-person workshop, newsletters, templates and tools to aid in the journey to meaningfully engage patient and families. To select this option, hospitals only need to submit the Team Member Registration to be given access to a member only site filled with an abundance of PFE resources. The second option is to submit a Statement of Interest, which will indicate that the hospital is interested in formally joining, would like to receive access to all of the PFE Learning Collaborative resources mentioned above, as well as receive additional technical support from FHA and Collaborative staff through periodic coaching calls.


Embed the PFE video here??

Patient and Family Engagement Summit (July 21, 2017)

(See Word Document -Agenda w/ Links to Slides: GROUP\HEN\Focus Areas\PFE\MTC HIIN Webpage Info)