"The concept of engaging patients and families wasn’t new to CapitalCare. During its previous work in a PCMH project, the medical group had used survey data to shape some aspects of the medical home. While the information was generally useful, practices participating in the CMS Comprehensive Primary Care (CPC) Initiative agreed the surveys only skimmed the surface of patient engagement needs. The practices collectively decided the PFAC approach would provide up-close and actionable feedback that was specific to their sites, staff and workflow. Additionally, the council approach could foster an ongoing conversation about patient care as the practice continued its path toward comprehensive primary care.

Physicians at each practice drew up a list of candidates who would be willing and appropriate to invite to the PFAC. Qualifying criteria were that participants would be a mix of new and long-standing patients and family members. Some long-standing patients were also the parents of pediatric patients, which provided a multi-generational perspective to the care experience.

Council sizes range from six to 12 participants. During each site’s weekly CPC meeting, PFACs are a standing agenda item for ongoing planning for the quarterly meetings. This timing ensures all team members are aware of the process and can contribute as well as make decisions as needed. This lessens the burden on individual members and spreads the work over several weeks.

CapitalCare site managers have been directing the meetings, borrowing guidelines the group has used with support groups for patients with diabetes. Their tasks include timekeeping, explaining the privacy of health information and defining the topics that pertain directly to the practice site. This helps the discussion stay on track and generates feedback that is pertinent to the site. Meetings generally last one to two hours. Physicians drop in at the start of meetings to thank participants and to encourage them to provide frank input. Knowing that their presence can be distracting or intimidating, physicians then leave to allow the site managers to run the rest of the meeting.

To date, PFAC feedback has influenced changes ranging from all staff wearing name tags to new walk-in hours for same-day visits. Comments garnered from the patient portal roll-out led to provision of one-on-one tutoring on how to use the new features.

“The PFAC has given us specific ideas of how to improve our care,"" said Carol Braungart, FNP-BC. “Our patients provide us with their perceptions and ideas of what they want from their health care provider, enabling us to move health care to a higher level.”

“Of all our CPC work, the value from the outcomes with the PFACs is obvious,” said Brittany Bardin, MBAH, clinical quality analyst. “We can plainly see how we directly and indirectly affect patients and what specifically we do that meets our patients' needs.""

“We’ve been working so long at putting the patient at the center,” said Kathleen Mattice, BSN, RN, PCMH-CCE, director of clinical services for CapitalCare Medical Group, “but we’ve been doing it around them through processes and outcomes. The councils are our way of saying ‘You are our partner. We want to hear the good and the bad.’”

Information obtained from "CPC Practice Spotlight, April 2014""