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A senior leader's guide to form and run effective patient and family advisory boards.

Patient and family advisory boards can provide valuable feedback on care processes, discharge instructions, and even facility design. But senior leaders shouldn't view these boards as "window dressing," says Patricia Sodomka, senior vice president of patient family centered care at MCG Health Inc., a two-hospital, 632-licensed-bed system in Augusta GA. They require real work to be effective. It's about viewing patients and families as valued partners that the health system can't live without, she says. Here are four tips on getting started.

1. Assessing: St. Joseph Hospital, a 525-licensed-bed community hospital in Orange, CA, conducted a staff attitude assessment about having patients and families on committees (Visit www.familycenteredcare.org for more information on assessment tools). "People were afraid," says Mary Ann Vincent, RN, vice president of quality and performance improvement. "The staff was nervous about data and being around family members and answering questions." Those fears evaporated once patients started to participate and staff members realized "they weren't here to complain about what we are doing," she says. The senior leaders' role is to set the expectation, remove barriers, and hold people accountable, says Sodomka. "To me it is a very organic process … You start to build the culture somewhere in the organization that makes sense."

2. Recruiting: St. Joseph created its patient and family advisory board three years ago. The hospital recruited its first three members from a focus group it convened composed of 40 family members of people who had died in the hospital. Today, the board has seven members. "It is hard to build the program," says Vincent.

For example, St. Joseph put information about the advisor program in its hospital magazine, complete with contact information for those interested in participating, but it never received a call. The hospital has had success finding new family members through patient complaints, says Vincent.

MCG Health established its first advisory council roughly 15 years ago. To date, it has four major institutional councils and 250 active family or patient advisors. "The recruiting is done throughout the whole medical center," says Sodomka. Any staff member or physician can help recruit a patient advisor, but every candidate goes through a central office for screening, orientation, and training.

3. Screening: Risk managers should be involved to conduct criminal background checks and ensure that potential recruits aren't involved in pending litigation. Advisors will also need to sign confidentiality agreements. Hospitals should look for people who are representative of the patient population, have good communication skills, and are comfortable working in a group setting. People need to participate, but they also can't dominate the conversation, only offer praise, or only complain.

4. Training: Everyone needs training. Staff members should be taught how to work with family members. If advisors are invited to a meeting, someone should be there to greet them, says Sodomka. Advisors at St. Vincent's are paired with a staff mentor who sits next to them during meetings, explains acronyms, and offers support. It's essential that patient and family members understand their role in the partnership. "If they have a personal agenda, you have to get above that and be there to help make it better."

Carrie Vaughan

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