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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Family Centered Care.

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Strategy. Consumer Participation in healthcare Governance

Approach. Engage with parents on clinic or hospital healthcare governance to improve systems of care.

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Overview. healthcare entities are often governed by boards that are charged with setting the organization’s strategic direction; board decisions help determine organizational policy, shape patient services, and ultimately, affect patient outcomes. Governing boards are generally comprised of a variety of stakeholders and can include consumer representatives, who are usually patients of the organization. Consumers may also be integrated into other governance activities, participate in projects to develop and disseminate consumer-friendly health and comparative quality information, or take part in healthcare system redesign efforts.[1] Patient advisory councils. (PACs), also known as patient and family advisory councils. (PFACs), made up of patients, family members, healthcare providers, and administrative staff can carry out these governance activities as well, in settings including hospitals, primary care practices, and community health centers.[2, 3] Consumer roles may be long-term commitments such as reviewing current services or potential change initiatives, or short-term engagements to provide feedback or preferences on discrete questions.[4]

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Policy. This strategy helps to promote decisions, laws, and regulations that promote public health practices and interventions.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of clinics or hospitals partnered with Title V that establish consumer participation mechanisms (e.g., patient advisory councils, board positions) for parents in healthcare governance. (Shows the adoption and scale of the approach) Number of parents recruited and trained by Title V to serve as consumer representatives in clinic or hospital healthcare governance roles. (Indicates the capacity and readiness of the parent workforce to engage in the approach)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of parent consumer representatives who receive comprehensive orientation, training, and ongoing support from Title V to effectively participate in healthcare governance roles. (Shows the quality and preparedness of the parent workforce to contribute to governance process) Percent of healthcare governance meetings or initiatives led by Title V that provide meaningful opportunities for parent consumer representatives to share their perspectives, priorities, and recommendations. (Indicates the authenticity and influence of parent participation in governance decision-making)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of best practices, tools, and resources created and disseminated by Title V to guide clinics and hospitals in successfully integrating parent consumer representatives into governance structures and process. (Shows the knowledge generation and sharing efforts to facilitate widespread adoption of the approach) Number of partnerships and collaborations led by Title V between clinics, hospitals, patient support organizations, and community groups to support and sustain parent engagement in healthcare governance. (Indicates the level of multi-partner commitment and coordination to advance the approach) Number of parent consumer representatives trained by Title V who transition into other leadership roles (e.g., patient supporters, community organizers, policy advisors) to champion patient-centered care beyond their governance experiences. (Shows the approach's ripple effect on building a pipeline of parent leaders and change agents) Number of clinics, hospitals, and health systems partnered with Title V that report cost savings, efficiency gains, and improved resource allocation as a result of aligning governance decisions with patient and family priorities identified through parent consumer representation. (Indicates the approach's impact on driving value-based, patient-centered care transformation)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of best practices, tools, and resources created and disseminated by Title V to guide clinics and hospitals in successfully integrating parent consumer representatives into governance structures and process. (Shows the knowledge generation and sharing efforts to facilitate widespread adoption of the approach) Percent of partnerships and collaborations led by Title V between clinics, hospitals, patient support organizations, and community groups to support and sustain parent engagement in healthcare governance. (Indicates the level of multi-partner commitment and coordination to advance the approach) Percent of parent consumer representatives trained by Title V who transition into other leadership roles (e.g., patient supporters, community organizers, policy advisors) to champion patient-centered care beyond their governance experiences. (Shows the approach's ripple effect on building a pipeline of parent leaders and change agents) Percent of clinics, hospitals, and health systems partnered with Title V that report cost savings, efficiency gains, and improved resource allocation as a result of aligning governance decisions with patient and family priorities identified through parent consumer representation. (Indicates the approach's impact on driving value-based, patient-centered care transformation)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Mende 2013 - Mende S, Roseman D. The Aligning Forces for Quality experience: Lessons on getting consumers involved in health care improvements. Health Affairs. 2013;32(6):1092-1100.

2 Sharma 2016 - Sharma AE, Willard-Grace R, Willis A, et al. “How can we talk about patient-centered care without patients at the table?” Lessons learned from patient advisory councils. Journal of the American Board of Family Medicine. 2016;29(6):775-784.

3 Peikes 2016 - Peikes D, O’Malley AS, Wilson C, et al. Early experiences engaging patients through patient and family advisory councils. Journal of Ambulatory Care Management. 2016;39(4):316-324.

4 Crawford 2003 - Crawford M, Rutter D, Thelwall S. User involvement in change management: A review of the literature. National Institute for Health Research, National Health Service (NHS). 2003:1-205.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.