The Setting PFAC Recruitment Goals worksheet is designed to help the PFAC team consider aspects of PFAC representativeness and develop data-informed goals to improve the extent to which PFAs represent the full range of patients and families served by the hospital.

Hospitals may have different goals for PFAC representation based on patient population and gaps in health equity and outcomes. Identifying goals to improve PFA representativeness requires examining data and meeting with the PFAC team and others to understand gaps and priorities.

Aspects of representativeness that may be important to consider to ensure that PFAs represent the full range of patients and families served include:

• race
• ethnicity
• age
• gender identity
• sexual orientation
• health and disability status
• diagnosis or condition
• socioeconomic status
• language spoken
• family composition (e.g., single parents, foster parents, legal guardians)
• geographic location within the hospital’s catchment area
• immigration status
• religion
• health insurance type

Understanding patient population characteristics

Data collected by hospitals can help the PFAC team understand the current patient population and avoid incorrect or incomplete assumptions about who is underrepresented on the PFAC. To understand the current patient population, look for data about:

• Patient demographics. Most hospitals collect information about patient demographics, including age, race, ethnicity, language, disabilities, sexual orientation, gender identity, insurance type, and residence zip code. Potential data sources include administrative enrollment and billing records, medical records, and health surveys.
• Inequities in patient outcomes and experiences. When stratified by segments of the patient population, hospital-level data about clinical outcomes, patient safety, and patient experiences of care can help identify priority populations based on risk for adverse outcomes.
• Hospital service area (HSA) characteristics. Data about people living within the HSA—i.e., the people likely to use some or all of the hospital’s services—can help understand the demographics, health status, and needs of the broader community.

Suggestions for accessing data about the hospital’s patient population include:

• Contact various departments or offices within the hospital to learn what data they collect and report. Offices that may have relevant data include:
  • Community Relations
  • Community Health
  • Health Equity
  • Population Health
  • Data Management
  • Patient Experience
  • Quality Improvement
  • Patient Safety
  • Health Services Research
  • Marketing and Communications
  • Business Development
• Review the community health needs assessment (CHNA). Not-for-profit hospitals are required to conduct a CHNA every three years. The CHNA includes a written report with data about health needs within particular communities and populations.
• Explore publicly-available databases with information about social determinants of health. Databases with local demographic and health data can highlight factors that affect people living within the HSA. Examples include:
  • City Health Dashboard: Data about health outcomes, social and economic factors, health behavior, physical environment, and clinical care for 900 cities across the United States.
  • County Health Rankings and Roadmaps: Health snapshots showing county-level health data, changes over time, and areas of strength and opportunity for health improvement.

Data about patients and the local community is an important foundation for understanding the extent to which PFAs represent the range of patients and families served by the hospital. However, there are aspects of representation that may not be reflected in available data. Talk with staff—particularly those in departments that address community health, patient experience, and health equity—to understand their perspectives about patient and family voices that may be underrepresented on the PFAC.

Understanding PFA characteristics

To help identify gaps in PFA representativeness, examine the current makeup of the PFAC compared to information about the hospital’s service area and patient population. It is important to avoid making assumptions about how PFAs identify.

• Some hospitals collect demographic information about PFAs as part of the recruitment and onboarding process. If PFAs are classified as volunteers, the hospital’s volunteer department may also be a source of information.
• Selected demographic data about PFAs may also be available from the Electronic Medical Record (EMR). For example, EMR reports may provide information about zip codes, race, preferred language, and ages of children.

If the hospital does not have demographic data about current PFAs, this may be an opportunity to develop plans for collecting this information moving forward. If plans involve collecting potentially sensitive demographic data, it may be helpful to work with the hospital’s research, legal, and compliance teams. Some hospitals collect demographic data from PFAs as part of the post-onboarding process. Others conduct a yearly PFA experience survey that includes demographic information. The PFAC Survey included in this Toolkit contains demographic questions as an optional section.

For more information about one hospital’s efforts to assess the demographic characteristics of PFAs across their 19 PFACs and compare them to the population of patients served, see this article from Children’s Mercy Hospital of Kansas City: Demographic Characteristics Among Members of Patient Family Advisory Councils at a Pediatric Health System.