"How Can We Talk about Patient-centered Care without Patients at the Table?" Lessons Learned from Patient Advisory Councils

Abstract

Context and Objective:Patient advisory councils (PACs) are a strategy for primary care clinics to engage patients in practice improvement. However, there is scant research on how PACs function. This study aimed to understand how PACs are organized and identify common challenges and perceived benefits of high-functioning PACs.Setting and Population: Key informants identified 8 primary care clinics in California with highfunctioning PACs. Leaders from each of the 8 clinics nominated 1 clinic staff member and 1 PAC patient member to be interviewed.Study Design: Semistructured, one-on-one interviews were conducted at each clinic site or by phone. Interviews were dual-coded using modified grounded theory. Common themes were identified that would be pertinent to the development of future best practices for running PACs.Results: Common characteristics of high-functioning PACs included careful attention to participant recruitment, facilitation strategies guiding diverse personalities toward a common purpose, and assigning accountability for practice improvement projects. Interviewees identified a variety of positive outcomes that ranged from tangible improvements to the waiting area to a more patient-centered staff culture.

Implementation of Patient and Family Advisory Councils in Primary Care Practices in a Large, Integrated Health System

“…The role of patient engagement in healthcare is well recognized. 1 While some guidelines exist for development of patient councils, 2 and characteristics of high functioning patient advisory councils have been identified around representative patient sample recruitment, facilitation, accountability, and supportive culture, 3 implementation of patient and family engagement is not well standardized. There has been interest in patient engagement in healthcare research, 4,5 but there remains a need to describe the process of patient and family involvement in primary care practice including recruitment, goals and expectations, and outcomes of the engagement process.…”

Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?

“…QI implementation studies also recognize the key role of HCO managers in setting QI goals [47], centralizing QI goals and tasks as a core function of the governance structure [48], and supporting QI initiatives via adequate resource allocation [49][50][51][52]. These key practices were used by top and midlevel managers to support PP implementation and its sustainability over time.…”

Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?

“…QI implementation studies also recognize the key role of HCO managers in setting QI goals [47], centralizing QI goals and tasks as a core function of the governance structure [43], and supporting QI initiatives via adequate resource allocation [48][49][50][51]. These key practices were used by top and midlevel managers to support PP implementation and its sustainability over time.…”