Everything We Say & Do: What PFACs reveal about patient experience
Editor’s note: “Everything We Say and Do” is an informational series developed by the Society of Hospital Medicine’s Patient Experience Committee to provide readers with thoughtful and actionable tactics that have great potential to positively impact patients’ experience of care.
Patient and Family Advisory Councils (PFACs) provide a tool for understanding the patient perspective and are utilized nationwide. These councils, typically consisting of former and current patients and/or their family members, meet on a regular basis to advise provider communities on a wide range of care-related matters. At my institution, Beth Israel Deaconess Medical Center, our PFAC has weighed in on a wide range of issues, such as how to conduct effective nursing rounds and the best methods for supporting patients with disabilities.
Most recently, we have utilized an innovative approach to both understanding the patient experience and capitalizing on the expertise of our PFAC members. Modeled after a program developed at the Dartmouth-Hitchcock Medical Center, we have trained members of our PFAC to interview inpatients at the bedside about their experience. Time-sensitive information is immediately reported back to the nurse manager, who responds with real-time solutions. Oftentimes, problems can be easily resolved using the right communication, or just providing the “listening ear” of someone to whom the patient relates.
Dr. Amber Moore
In addition, the information is aggregated to provide us with a broad-based perspective of the patient experience at BIDMC. For example, we found that our patients often discuss issues with volunteers that they have not addressed with providers, suggesting they may at times feel more comfortable disclosing concerns to people outside of their medical team.
The Society of Hospital Medicine (SHM) also recognizes the central role of the patient’s voice in quality medical care. Through the work of its Patient Experience Committee, SHM has convened a nationwide “virtual” PFAC consisting of leaders of PFACs from medical facilities across the country. Members of the SHM PFAC share questions posed by SHM’s committees with their constituents, and the responses are reported back to the Patient Experience Committee.
What lessons have we learned from the SHM PFAC? Make no assumptions. While some of us have been patients ourselves and all of us interact with patients, our ability to understand the patient perspective is blurred by the lenses of medical training, system constraints, and the pressures of the challenging work that we do.
It is often impossible to predict the response when you question a patient about his or her experience. For example, the first question we asked SHM’s nationwide PFAC was: “What is one thing that a hospitalist could do to improve the patient experience?” The most common response we received was: “What is a hospitalist?” These responses suggest that we (hospitalists) need to redirect our efforts in a way that we had not anticipated, with a focus on clarifying who we are and what we do.
Other, more predictable themes emerged as well. Our patients want consistency and continuity throughout their hospitalization. They value a good bedside manner and want us to engage in sensitivity training. They ask us to work on minimizing errors and ensuring accountability both during hospitalization as well as pre- and post hospitalization.
Ultimately we hope that the SHM PFAC will be utilized by all of SHM’s committees, allowing for the patient experience to be a common thread woven through all SHM initiatives.
Amber Moore, MD, MPH, is a hospitalist at Beth Israel Deaconess Medical Center, and instructor of medicine, Harvard Medical School.
