Creating a Patient and Family Advisory Council:
A Toolkit for Pediatric Practices

Step One: Assess Practice Readiness

In This Section:

Is Your Practice Ready for a PFAC?
Creating a PFAC Launch Team
Clarifying PFAC Structure
Clarifying PFAC Purpose
Creating PFAC Bylaws
PFAC Launch Checklist

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A Patient and Family Advisory Council (PFAC) can provide a critical feedback loop that enables practices to enhance service and improve quality. Best practices in patient and family involvement show that engaging patients and their families in meaningful ways improves services, makes service delivery more responsive to the needs of families, and ultimately saves resources. Strong family involvement can lead to better service delivery and improved health outcomes.

A thriving PFAC requires some planning and effort to get it off the ground, even before a single member is recruited. Every high-functioning, engaged PFAC needs to receive support and resources from practice leadership and staff early to ensure its success.

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Is Your Practice Ready for a PFAC?

Your practice may be considering creating a PFAC for a number of reasons. You may feel that a PFAC is an effective way to listen to your patients and families talk about their experience with your practice. You may also be in the process of transforming your practice into a medical home using guidelines or tools like NCQA Medical Home Standards or the Center for Medical Home Improvement’s Medical Home Index. Both require or encourage that practices demonstrate continuous quality improvement initiatives and patients and families are part of this process.

Regardless of why your practice is considering a PFAC, creating one requires the commitment of resources from your practice, leadership and staff. You will benefit from assessing your readiness in order to determine what resources your practice possesses and what it lacks.

We welcome you to explore the ideas and resources contained in this toolkit and wish you good luck in creating your own PFAC.

Leadership Readiness Assessment 

Use this self assessment as the basis for a conversation among leadership to determine your practice’s level of readiness for launching a PFAC. Consider to what degree the statements on the assessment are true for your practice.

Staff Readiness Assessment

Most staff and providers are both excited and nervous about the idea of asking patients and families for direct feedback about their experience. Setting aside time at a staff meeting to discuss a possible PFAC early in the process is critical to future engagement.

Some staff resistance may be due to a lack of information about what PFACs do. This video from MaineGeneral’s PFAC may be helpful to show staff to give them a general vision of how patients and families are getting involved at other organizations.

Ultimately, acknowledging and assuaging concerns is critical to meaningful family-professional partnership. This self assessment contains some questions that can facilitate an open, honest conversation.

This video, from MaineGeneral’s PFAC, may be helpful to show staff to give them a general vision of how patients and families are getting involved in PFAC's at other organizations.

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Creating a PFAC Launch Team

Once your practice has determined that it is ready to support a PFAC, a team can be convened to manage the launch. One practical way to do this is to create a small PFAC launch team which includes practice members who have the authority to commit resources and the time available to do the necessary work to get the PFAC off the ground. This often means including someone in a leadership role as well as someone with administrative expertise.

Authentic patient and family engagement means including them not only in the evaluation of your practice, but also in the planning and implementation of the PFAC launch itself. The earlier the patient and family voice is included in the process, the more authentic your PFAC will be.

Creating a PFAC launch team that includes leadership, staff and a family member is one way you can ensure that both adequate resources and a genuine patient and family perspective are present right from the start.

Here are some possible roles and responsibilities for a PFAC launch team.

PFAC Champion

A leader of the practice who values family-professional partnerships.

PFAC Liaison

A staff member of the practice who values family-professional partnerships.

PFAC Launch Partner(s)

One or more patients or family members who have some family leadership or advocacy experience and value family-professional partnerships.

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Clarifying the Structure of Your PFAC

There is no single model for a successful PFAC. They vary in the formality of their structure and size, as well as in their frequency of meetings. Some PFACs are highly structured, with bylaws, officers, term limits, applications and a formal interview process. Others are much less structured, functioning more as a series of stand-alone focus groups open to any patient and family member who wants to attend. However, a focus group, while helpful, is not a substitute for the establishment of a PFAC. It is possible to start with a less formal group and let it organically evolve. Our goal with this toolkit is to urge practices to move toward full patient and family engagement and quality improvement strategies.

As your practice assesses which PFAC structure is right for you, here are a few considerations:

Informal, Focus Group-Style PFAC Structure



Traditional, Formal PFAC Structure



Transitional Informal-to-Formal PFAC Structure



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Clarifying the Purpose of Your PFAC

The PFAC purpose and structure that is right for your practice will be based on your practice’s resources and needs as well as the needs of your patients and families. The PFAC champion is likely in the best position to ensure that the PFAC aligns with the practice’s goals and vision. He/she may also be able to best assess the practice capacity and guide the process for determining your PFAC structure. Other members of the PFAC launch team and the practice can also be asked for feedback and ideas.

This worksheet contains some questions to help you identify your PFAC’s purpose and determine the right PFAC for your practice. Let the answers to these questions be your primary guide when creating a purpose statement for you PFAC. A few examples from established PFACs are available below for reference.

Purpose Statement: The Massachusetts General Hospital for Children’s Family Advisory Council (MCHC PFAC)
The Massachusetts General Hospital for Children’s Family Advisory Council is dedicated to fostering the partnership of parents, children and professionals working together to ensure a climate of responsiveness to the needs of children and their families in all areas of care delivery within Massachusetts General Hospital. The council’s goals are to align with the broader Mass General/MGHC goal of enhancing patient-physician communication by fostering family-centered communication and promoting the principles of patient- and family-centered care:

· Dignity and Respect: Honoring patient and family perspectives, choices, knowledge, values, beliefs and cultural backgrounds.
· Information Sharing: Communicating and sharing complete, unbiased, accurate and timely information with patients and families so they can effectively participate in care and decision-making.
· Participation: Encouraging and supporting patient and family participation in care and decision-making at the level they choose.
· Collaboration: Partnering with patients and families in the delivery of care; policy and program development and evaluation; healthcare facility design; and, professional education.

Purpose Statement: BJC HealthCare Patient and Family Advisory Council
To serve as a formal mechanism for involving patients, family and staff as partners for policy and program decision making in healthcare settings.

Purpose Statement: The Missouri Baptist Medical Center Patient and Family Advisory Council
The Missouri Baptist Medical Center Patient and Family Advisory Council will be a partner with the Missouri Baptist Cancer Center team, involved in decision making and committed to creating an environment of safety, dignity, respect and honesty to assure the very best for patients and families.

This worksheet contains some additional questions you should be prepared to answer before you begin reaching out to patients/families.

• For practices that have decided to launch a less formal PFAC, skip ahead to Step 2 of the PFAC Toolkit.

• For practices which have decided to launch their PFACs through a more formal structure — including bylaws and an application process — please continue to the end of Step 1.

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Creating PFAC Bylaws

Most PFACs working at the hospital level require bylaws as a way of establishing transparent guidelines, procedures and expectations. On the practice level, it can be useful to create bylaws as a way of clarifying and communicating expectations to patients and families who are thinking about becoming members. If your PFAC is essentially organized as a series of open-invitation focus groups, you may not need them at first, or at all.

If you do decide to create bylaws, here are some helpful guidelines.

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PFAC Launch Checklist

Use this PFAC Launch Checklist from the BJC Health Care Patient and Family Advisory Council: Getting Started Toolkit as a template to create your own project plan. [source]


Devote an all-staff meeting to discussing development of a Patient and Family Advisory Council using the resources and tools mentioned above.

Possible Agenda:
1. Explain the benefits. What can a PFAC help us achieve that we can’t do without them?
2. Share this video from MaineGeneral’s PFAC and/or show web reports of other organizations to help staff understand what a PFAC does.
3. Encourage an open, honest conversation on concerns using the Staff Readiness Assessment.
4. Discuss the PFAC’s purpose and structure using the worksheets in Clarifying the Purpose of Your PFAC. Acknowledge that concerns may not have been entirely addressed, but ask staff to answer these questions above as if they were.
5. Circle back to unresolved concerns. Now that you have some clarity on the purpose and structure of your PFAC, have some of these concerns been resolved?
6. Solicit or introduce PFAC launch team members and describe what they will do.

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