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.