As part of the reflection process, PFAC leaders should seek feedback about progress, ideas for improvement, and future directions. Reflection and planning should be a collaborative process with the PFAC team, PFAs, community members, staff, and leadership.

One approach is to establish an annual PFAC goal-setting meeting. Prior to this meeting, it may be helpful to complete the PFAC Assessment again to identify how responses have changed over the past year and identify new areas of opportunity. During the goal-setting meeting:

• Review the PFAC Action Plan and discuss progress on goals and action steps over the past year.
• Discuss lessons learned along with facilitators of and barriers to progress.
• Set new goals, or revise existing goals based on progress.
• Update or create a new PFAC Action Plan to capture the next iteration of PFAC goals.

Systems change helps create long-term progress by focusing on sustainable initiatives rather than short-term or one-time activities. As the organization's PFAC work evolves, look for opportunities to solidify systems that support successful initiatives, continuity, sustainability, and ongoing relationships with communities. Systems help implement and promote collective participation rather than having one person or a small group drive the work.

Example: Training Future Community Leaders

A children's hospital has worked to develop sustained relationships and build capacity in the community by participating in a community-based project that trains 10th and 11th-grade students to become community leaders. The project is a collaborative effort between community leaders, the Office of Community Affairs, and the PFAC leadership team. Program participation is open to all 10th and 11th-grade students in the community and several members of the hospital's youth leadership advisory council have participated in the training program. The hospital views the program as an important opportunity to remain active in community initiatives and extend their efforts and contributions beyond the hospital walls.

Example: Collecting Information about PFAC Demographics

To identify and address gaps in PFA representativeness, one hospital conducts a demographic assessment process. Upon joining the PFAC and completing the onboarding process, all PFAs are asked to complete a demographic survey, which has been developed in conjunction with researchers and the hospital’s legal and compliance department. The hospital compares specific demographics (e.g., race/ethnicity/country of origin, location of residence, and primary language) against patient and family population demographics to ensure alliance with the communities served. Survey results help the team identify gaps in representativeness and set priorities for recruitment and engagement efforts. Previous findings have prompted conversations with leadership about the use of available resources to reach underrepresented populations.