PFACs: Where’s the Money? The Financial Impact on Hospitals June 27, 2014 Barbara Lewis, MBA

Introduction Patients and Family Advisory Councils (PFACs) started in the 1990s 2,000+ hospitals have launched a PFAC Some states, such as Massachusetts, PFACs are mandated (Florida & New Hampshire?)

How Many Hospitals Don’t have a PFAC?

Survey March 2014 60 survey participants 17 questions Supported by The Beryl Institute

If you are a patient or family member on a PFAC, how would you describe the PFAC voice? 34% 41% 25% 0% Totals 32 100% 41% said that PFAC voice is oftentimes heard with PFAC suggestions adopted 34% said that PFAC was an integral part of the hospital 25% said voice is only occasionally heard with suggestions & sometimes adopted

How many PFAC members are on the Council How many PFAC members are on the Council? (If you are affiliated with more than 1 PFAC, then please average the number.) 30% of PFACs have 11 to 15 members 23% of PFACs have 5 to 10 members 22% of PFACs have 15 to 20 members

How satisfied are you with the PFAC with which you are involved? 58% are extremely satisfied with the PFAC 32% are only somewhat satisfied 5% are rarely satisfied or thinking of quitting  

In what areas does the PFAC contribute? (Please check all that apply.) Communication 93% Quality 81% Signage 78 % Safety 76 % Clinical areas 74 % Orientation 57 %

Do you benchmark each PFAC project Do you benchmark each PFAC project? (measure where you are before the project starts) 60% sometimes benchmark each PFAC project 18% never do 8% always measure the status before the project starts

Do you measure the success of each PFAC project at some time after the project has been implemented? 48% sometimes measure the success 23% never measure the success of projects 13% always evaluate the progress of PFAC projects

PFAC Examples of Financial Impact on Hospitals

Barriers to Research “No financial component should be included in the value of PFACs” PFAC is like consumer research

“We would never do anything without asking the members “We would never do anything without asking the members.” 400 patients in > 35 PACs 100s of projects Few metrics

Daryl Bell – Professional Practice Leader Spiritual Care Issue – Chairs for patients undergoing chemotherapy Staff picked chairs thinking they would be the very best for patients “Patients picked a far cheaper version… the patients were coming with the actual experience of chemo in mind and knew what they wanted and needed.”

Pat Stahl - PFAC staff liaison and manager of volunteer programs and services One of the first hospitals to start a PFAC “PFACs have had enormous impact” PFAC suggested that afternoon food carts wasted a lot of food and suggested options that decreased the amount of waste.

Other suggestions Lisa Morrise Intake forms in Spanish – no need for 1-on-1 translator Inventory control system for clothing handed out to families Double bunkers get personal DVD player (about $75 each) > etiquette guidelines for how to share the TV Keep food in the refrigerators – no vouchers.

Best ROI: Patients frustrated over recurring problems with billing practices 2 letters to better explain fees & discount for prompt payment Result: prompt payments increased by 6 fold Boosted the net present value of the collections Decreased collection costs

It’s Not Just the Money Safety – Better Outcomes In-Kind Donations Kaiser – patient input reduced falls Vidant – significant reduction in serious safety events & hospital acquired infections In-Kind Donations Children’s Hospital of the King’s Daughters – photography, printing, project design

Top 10 Recommendations We never do anything without asking the Council Use metrics before & after Track all projects & results Report on results and distribute to leadership Implement all projects with a process Reboot if PFAC is struggling Train PFAC members on committee participation Involve patient & family members on all hospital committees Survey leadership on PFAC’s impact Spread the word about the availability of PFAC for research Treat PFACs as valuable consumer research tools We never do anything without asking the Council

Conclusion Thriving PFACs are an integral part of the hospital where projects are benchmarked when ideas are suggested and then implemented with a process or procedure, after which success is measured. Daryl Bell asked, “How can we possibly be making the best decisions if the people, who have actually had the hospital experience, aren’t at the table?” Pat Stahl added, “How can a hospital NOT have a PFAC?”

Joan’s Family Bill of Rights Barbara Lewis, MBA BarbaraLewis@JoansFamilyBillofRights.com www.JoansFamilyBillofRights.com 818.784.9888 Services Presentations | Communication | Research The Mission Continues What’s your PFAC doing? What metrics do you use? Why doesn’t your hospital have a PFAC? Please let me know.