Determining Resource Requirements

This section covers the types of resources required to implement and operate a consumer engagement strategy. The specific resource needs will vary depending on the types of engagement strategies selected and the overall scale of the program. All engagement strategies require some degree of organizational-level support, staff time and financial investment. The Collaboration and Co-ownership strategies will require materials such as charters and onboarding manuals. It is also advisable to budget for supports such as travel reimbursement, on-site childcare, and/or stipends for participating patients and caregivers. Finally, tokens of gratitude such as certificates of appreciation and awards to recognize special efforts are inexpensive, yet invaluable to sustaining active participation in engagement efforts.

Key resource requirement considerations include

• NOTE FROM THE FIELD

  Children’s Mercy Kansas City hired the parents of two former patients to serve as members of their Patient and Family Engagement Team (PFE Team). The PFE team supports the hospital’s infusion of the patient and family voice within all levels of the organization. It is housed within the Improvement Center and is responsible for the oversight of all system-wide and department-specific Patient Family Advisory Councils (PFACs) and serves as the liaison between all the groups.

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  Staffing:Consumer engagement requires dedicated staff time to support the organization’s overall engagement effort as well as the individual engagement strategies. Organization-level staffing generally requires at least one FTE tasked with overseeing the implementation and operation of the overall engagement effort, as well as staff time to operate the specific engagement strategies. The exact staffing needs will be dictated by the type of engagement strategy selected and the scale of implementation. For example:
  • Co-Ownership: Co-ownership strategies include engaging consumers in strategic planning and governance roles. These efforts require a long-term commitment to the recruitment, training and support of consumers to enable their full and equal participation in strategic planning and governance activities such as membership on organizational boards. The staffing responsibilities include time dedicated to the onboarding, training, and ongoing development of the consumer or family members.
  • Collaboration: Patient and Family Advisory Councils (PFACs) are one of the most common examples of a collaboration-based engagement strategy. PFAC staffing roles often include participant recruitment and onboarding; assisting the PFAC with the development of charters and standard operating procedures; managing meeting logistics such as scheduling, reserving space and ordering food; facilitating meetings or training a PFAC member in facilitation techniques; compiling PFAC feedback to be applied within the health care organization; updating PFAC members on the impacts of PFAC recommendations; and managing any reimbursements, stipends or other supports available to participants. Developing an effective PFAC is a long-term engagement strategy and require the allocation of consistent and reliable staffing over a sustained period.
  • Consultation: Common consultation-based engagement approaches include surveys, interviews and focus groups. Staffing requirements to carry out surveys can vary depending on survey design. Telephonic and in-person surveys require staff time to administer, while online, email and traditional mail surveys typically do not, although response rates may be lower with these modes of contact. All surveys require staff time to analyze and interpret the results. An additional staffing consideration is whether to use a standard pre-designed survey or create a custom survey to meet the organization’s needs. A custom survey will require staff time to design, field test, and validate prior to broad administration. Staffing responsibilities for interviews, listening sessions, and focus groups typically include developing interview or discussion guides; recruiting participants; scheduling and facilitating interviews/listening sessions/focus group meetings; analyzing the feedback provided; and developing summary reports with recommendations.
  • Communication: Common communication-based engagement approaches include newsletters, email notifications and health fairs. These approaches are often familiar to health organizations, which typically already have dedicated marketing, communications and/or health education staff to lead such efforts. Cultural competency and language considerations are important factors for all communication strategies. This presents an opportunity for organizations to use Collaboration-based strategies to engage patients, community members and frontline staff members in the review of materials to improve cultural competency and ensure that materials accurately convey information to the intended audience for English and non-English speakers, alike.
• Outreach, Onboarding and Meeting Strategies: Organizations should budget for the design and printing of outreach, onboarding and meeting materials. Organizations should also anticipate dedicating staff time to building relationships with community partners and working with those partners to conduct outreach to underrepresented or hard-to-reach populations. Onboarding also requires training for staff as well as consumers and families. In addition to creating new materials, organizations can also leverage existing patient-facing strategies to conduct outreach and recruitment efforts. Organizations can also modify existing onboarding materials to be suitable for consumer and community member onboarding. Specific meeting materials such as charters, agendas, and reports are generally guided by participants.

• NOTE FROM THE FIELD

  HRHCare spends approximately $300,000 per year on its patient engagement strategies. This includes direct costs (e.g., gift cards, travel and transportation) and allocations of time from a mix of senior level leadership and project managers and clinic staff. Additional costs include $15,000 per year for Planetree membership and a $20,000 fee for certification.

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  Refreshments: Organizations should budget for food and refreshments at in-person engagement activities. This can range from simple snacks to full meals depending on the meeting time and duration. Ideally, organizations should seek out healthy and culturally inclusive options. Organizations experienced in implementing engagement strategies commonly highlight the importance of food as a critical component of engagement meetings. Providing food is one mechanism for showing appreciation to participants and encouraging longer-term relationship building between participants.
• Supporting Participation: Implementing and sustaining engagement strategies requires regular ongoing participation from consumers, their family members, and the broader community. Successfully maintaining participation from a diverse and representative cross section of the community requires that organizations invest in resources that minimize barriers to participation. Common budget items that support participation include travel and parking reimbursement, child/elder care during meeting times, interpreters and offering stipends or honoraria to participants.
• Recognizing and Honoring Participants: Recognizing the efforts that consumers and staff members have made toward the engagement strategy is a critical component of successful implementation. Recognition can come in a range of forms including low-cost but meaningful certificates of appreciation and awards to recognize special efforts, and moderate-to-higher cost events to celebrate the team such as holiday parties or special ceremonies to recognize the completion of a specific project.

Resources

1. Foundational Materials
   • Institute for Patient and Family Centered Care: A patient and Family Advisory Council Workplan-Getting Started
   • Institute for Patient and Family Centered Care: Creating Advisory Councils
   • AHRQ: Working with Patients and Families as Advisors Implementation Handbook
2. Participant Supports
   • Institute for Patient and Family Centered Care: Patient and Family Leaders in Paid Positions - Common Challenges and Effective Solutions
   • Patient-Centered Outcomes Research Institute: Guide to Financial Compensation for Patients
   • Patient Experience Journal: Patient Partner Compensation in Research and Healthcare Perspective Article