Ⅰ. Introduction
Patient-centered care has become prevalent in healthcare systems as part
of a broader global movement over the past two decades (Dukhanin et al.,
2019). Patient engagement entails the active collaboration between
patients, families, caregivers, and healthcare professionals to enhance
healthcare delivery at individual, organizational, and policy levels
(Sharma et al., 2018). Since the growing consensus is that patient
participation is foundational to improving patient experience and
clinical outcomes (Herrin et al., 2015; Jarrar et al., 2019), healthcare
organizations strive to integrate patient inputs and resources into
their management to enhance patient-centered care delivery (Forward &
Sieck, 2022; Snow, 2022). Given the prominence of patient and
family-centered care, they have been empowered to play more active,
informed, and influential roles in healthcare service provision (Carman
et al., 2013).
One primary form of collective patient engagement in an organization is
the Patient and Family Advisory Councils (PFACs). Through healthcare
reform and programs, PFACs have been established in the hospitals.
Federally Qualified Health Centers (FQHCs), Accountable Care
Organizations (ACOs), and Medicare’s Comprehensive Primary Care Plus
(CPC+) require the establishment of PFACs as a prerequisite for
participation (Sharma et al., 2018; Dukhanin et al., 2019). Furthermore,
in 2008, Massachusetts enacted a mandate requiring that every hospital
institute PFACs and disclose their operational activities. PFAC is
widely defined as “a group of patients, families, caregivers, and other
consumers and citizens, and health professionals working in active
partnership at various levels across the health care system, such as
direct care, organizational design and governance, and policymaking”
(Carman et al., 2013, p. 224). PFAC advisors share their perspectives
and provide inputs on hospital policies and programs; serve as a
resource to providers and promote relationships between staff, patients,
and family members (Forward & Sieck, 2022).
In this regard, PFACs have contributed a variety of inputs and resources
to hospitals, equipping them with strategic assets and thus enabling
them to attain organizational sustainability. However, there has been
limited attention to the relationship between the role of PFACs as
strategic resources and hospital performance in two aspects. First, the
Resource-Based View (RBV) or extended Social Resource-Based View (SRBV)
focuses on both tangible and intangible resources, including financial
and physical resources, human capital, organizational culture,
reputation, inter-organizational relationship, social and natural
capabilities (Barney, 1991; Kraatz et al., 2001; Short et al., 2002;
Upadhyay et al., 2020; Lee et al., 2023). Despite its applicability
within the healthcare domain, a lack of empirical evidence has been
explored (Koisol et al., 2023). Moreover, they did not shed light on how
a PFAC can provide unique resources and improve organizational
performance through the comprehensive lens of the SRBV framework.
On the other hand, the previous literature on PFACs has acknowledged the
positive impact of PFACs on hospital performance. However, empirical
evidence remained unclear despite their conceptual recognition of PFACs’
role. One study criticized that while participants felt heard and
valued, their impacts on outcomes were limited (Fredriksson & Modigh,
2021). In addition, most studies tend to focus on qualitative and
descriptive approaches, using systematic reviews or case studies (Peikes
et al., 2016; Sharma et al., 2017; Oldfield et al., 2018; Taff et al.,
2018; Fredriksson & Modigh, 2021).
To fill this gap, this study examines the role of PFACs as strategic
resources on hospital performance, applying the comprehensive framework
of the Social Resource-Based View. Integrating the Social Resource-Based
View with patient engagement, this study analyzes the relationship
between financial, physical, human, and social resources, alongside
patient engagement resources (PFACs), and their impact on hospital
quality of care and patient satisfaction.