Hospital Patient and Family Advisory Councils: A Mixed-Methods Study

Hospital Patient and Family Advisory Councils (PFACs) are a key strategy in advancing patient-centeredness, heralded by the Institute of Medicine as a goal to improve healthcare quality. Although PFACs have been around since the early 1980s, they exist in only 54% of U.S. hospitals. This three-article mixed-methods dissertation reveals new empirical and primary research about PFAC characteristics, answering the question of what factors contribute to an effective PFAC. The three articles cover (1) a literature review of 143 articles about hospital PFACs around the world, which has been published by the Journal of Patient Experience, (2) a qualitative study of 20 interviews with U.S. hospitals about their PFAC qualities and practices, which has been conditionally accepted by the Journal of Patient Experience pending revisions, and (3) a quantitative, validated survey of 60 questions with 203 respondents working in U.S. hospitals. The scoping review highlighted a dearth of evidence proving the value of PFACs, with scant data on project metrics and outcomes, despite endorsements from major institutions. The exploratory qualitative study, grounded in partnership theory, uncovered the need for broad organizational commitment, systematic evaluation to ensure sustainability, and the need for training employees who work with PFACs. Building on the literature and the qualitative studies, the quantitative research aimed to identify the key predictors of PFAC effectiveness in a 60-question survey answered by 203 people who worked in U.S. hospitals. The results revealed that leadership support was significantly associated with increased meeting content, stronger measurement practices, and more frequent decision making and involvement with policies and procedures. PFACs, focused on conditions or patient types rather than general PFACs, scored higher on multiple factors, including meeting content, measurement practices, level of engagement, and coaching and training members. This groundbreaking study provides evidence-based research to guide hospital leaders in launching a PFAC or strengthening an existing one.