How PACs Are Improving Patient-Centered Care

How PACs Are Improving Patient-Centered Care


Health care organizations in 2017 are on a constant quest to improve the patient experience and provide patient-centered care. Now, a new study has found that patient advisory councils (PACs) are an effective strategy to engage patients in improving health care organizations.

PACs are advisory groups comprised of patients, family members, and caregivers who meet regularly with doctors and hospital or practice staff about patient experience and possible areas for improvement. The success of a PAC is determined by many factors. Here’s a look at a few in particular, as well as strategies to achieve positive outcomes in your own practice.

The history of PACs

PACs have been around for at least a decade in hospital settings. The Beryl Institute, an organization dedicated to improving the patient experience, published a toolkit for getting started with a Patient and Family Advisory Council, based on years of research and trials in several hospitals beginning in 2007. However, little research has been done on how PACs function, according to the authors of a recent study published in the Journal of the American Board of Family Medicine (JABFM), which examined high-functioning PACs within primary care clinics. The researchers identified four fundamental qualities that contribute to a successful PAC.

1. The first step is recruiting participants.

Ideally, these are patients with good communication skills. “The thing that is most important is not what they think so much as how they express it,” reported “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.”

Patients who have registered complaints make ideal PAC participants.

Where to find patients with something to say who are willing to volunteer their time? Start by reaching out to patients who have made complaints, suggested Joanne Muzzey, RN, MHA, director of patient advocacy at Elmhurst Hospital in Chicago, to

“When we started our council, we looked back at a database of patient complaints … and selected about 20 or 30 that we knew would have some valuable feedback,” she said. They also identified patients who had had frequent experiences on specific units. Elmhurst invited about 40 patients to an informational session on the advisory committee, after which 20 people expressed interest in participating.

For more on this topic, see Do You Know Your Patient Satisfaction Score? How Surveys Can Help.

2. A strong leader is the second fundamental element for success.

At all primary care clinics that participated in the JABFM study, the PACs nominated a leader to facilitate productive meetings. “Facilitators are specifically in charge of nurturing PAC projects, getting patient member feedback, translating patient experiences into projects, and identifying projects that may not be feasible,” explained

Start with a tangible project so that the PAC can see the results of their feedback.

Projects with tangible outcomes can help promote engagement and enthusiasm, especially among a new advisory group, Muzzey told, because participants can see that their feedback has had an effect. Elmhurst’s PAC played a key role in designing a new hospital campus, providing feedback “on everything from furniture to room service menus to beds,” she said.

3. A third key factor for effective PACs is assigning accountability.

The PACs in the JABFM study all agreed on the need to communicate expectations and accountability for practice improvement projects—but they could not agree on who should be in charge of this.

More patients thought clinicians should take the lead, possibly because they were perceived as having more influence within the health care organization or because doctors are more familiar with practice culture.

However, several clinician PAC members and even some patients in the study thought patients should be the ones to take on a greater role in communicating expectations and accountability, stated “According to these respondents, when patients are not engaged in or passionate about different initiatives, the council cannot carry out projects properly.”

4. Lastly, spreading awareness makes all the difference.

Sharing the findings from your PAC meetings with the rest of the practice greatly improves provider buy-in and participation, the study found.

“Just like everything, you have to have that senior leadership support,” Muzzey told At Elmhurst, she provides monthly reports from the PAC meetings to hospital executives. She also recommends inviting leaders such as managers and department directors to attend meetings when possible so they can share and receive direct feedback from members.

Ongoing patient input is essential to achieving a culture of patient engagement.

While metrics to assess PACs’ success still need to be developed, evidence from organizations that have implemented them shows their potential. “At sites that have invested in PACs, ongoing patient input was seen by staff as an essential component of achieving a culture of patient engagement,” the researchers concluded.

For a comprehensive guide to establishing a PAC in your practice, download The Beryl Institute’s toolkit. And for more articles like this, check out the Patient Engagement section of our blog archives.

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