Christine Forman didn’t expect to fall in love with the Patient and Family Advisory Council (PFAC). As director of patient experience and person-centered care at Vassar Brothers Medical Center in Poughkeepsie, she began attending monthly meetings nearly four years ago out of obligation. It was a sharp pivot from her high-speed days as an emergency department nurse. The meetings weren’t fast-paced. They weren’t clinical. They were raw.
A small group of former patients, family caregivers, community volunteers, and hospital staff gathered around a long table and combed through patient education pamphlets, follow-up instructions, and discharge procedures. They asked tough questions, shared painful stories, and proposed changes on everything from signage to how it feels to sit in the waiting room.
Stepping into her new role meant slowing down and inviting criticism. And Forman kept showing up. Month after month, she sat alongside PFAC co-chair Tiffany DeLaCruz and listened. Over time, something shifted. After 17 years in nearly every corner of Vassar—from transporting patients to providing bedside nursing—the PFAC became “my favorite meeting of the month,” she says. “When community members see their ideas come to life, it’s incredibly powerful. There’s no better feeling than being truly seen and heard.”
PFACs like Vassar’s have expanded across the region through systems including Nuvance Health, a network of seven community hospitals and over 1,000 outpatient facilities in the Hudson Valley and western Connecticut. Though they often operate quietly, PFACs are reshaping how hospitals relate to the people they serve, offering something radical in their simplicity: people talking to people. In an era of public distrust in institutions, they function as small engines of participatory governance within complex and often opaque healthcare systems.
Anatomy of a PFAC
The PFAC model emerged in the late 20th century as part of the patient-centered care movement. Organizations like the Institute for Patient and Family-Centered Care, founded in 1992, challenged the top-down structure of modern medicine, advocating for care delivered with patients, not to or for them.
PFACs were a practical response to this philosophical shift—ongoing, structured forums to improve care quality, communication, and policy. Unlike one-off surveys or complaint forms, PFACs are a two-way conversation. Participants co-develop solutions, review hospital materials, and raise concerns that might otherwise go unheard, which helps demystify and democratize healthcare systems. “There’s no substitute for hearing directly from those who have walked through our doors,” Forman says.
Collaborative Healthcare Governance
At Vassar Brothers Medical Center—a 349-bed regional hospital serving the Mid-Hudson Valley since 1887—PFAC meetings are held online, with occasional in-person gatherings for special projects or celebrations. Topics range from refining Vassar’s anesthesia education booklet to evaluating “Code Help” awareness materials, and assessing communication clarity in follow-up appointment instructions—elements that may seem procedural, but deeply affect how safe, informed, and supported patients and families feel. “Psychological safety is just as important as physical,” Forman says.
Vassar’s “Code Help” initiative, developed with PFAC input, “empowers family members to request immediate assistance if a loved one’s condition suddenly declines,” Forman says. This program places patients and families at the heart of rapid response. The PFAC “stamp of approval” now appears on the program’s materials.
Similar councils have taken root across the Hudson Valley. Westchester Medical Center (WMC), which oversees Kingston Hospital and Mid-Hudson Regional Hospital in Poughkeepsie, runs PFACs focused on improving patient flow and interdepartmental communication. New York-Presbyterian Hospital’s PFACs across Westchester County extend the model to a larger urban context and address cultural competency and accessibility.
Though each council reflects its community, they’re united by a shared structure and purpose. “PFACs are a form of shared governance that fosters transparency and open dialogue,” Forman says. “Everyone involved shares a common goal: to make things better than they were yesterday.”
The Power and Limits of Listening
Still, PFACs aren’t a panacea. Attendance fluctuates. Strong voices may dominate the conversation while others hesitate. Hospital’s regulatory, financial, and logistical frameworks can delay or limit reforms. And despite efforts to diversify councils, gaps in representation persist, particularly among non-English speakers, undocumented residents, and other marginalized groups. But by offering “a real seat at the table,” Forman says PFACs foster incremental but meaningful change.
One poignant example is the Sanderson family, who came to Forman with a formal grievance a few years ago. Instead of closing off, she invited them into the PFAC. Their ongoing involvement, she says, has provided valuable perspective and helped transform conflict into collaboration.
By involving patients and families through PFACs, hospitals demonstrate accountability during a time of political polarization, misinformation, and institutional skepticism. Healthcare, especially, has faced challenges with trust, exacerbated by the pandemic and longstanding disparities in access and outcomes. “PFACs are uniquely positioned to bridge the trust gap,” Forman says. “They do something rare in healthcare: invite the public to help shape the system from the inside out. The result is more human-centered care built on collaboration rather than compliance.”
PFACs prove that participation matters, that voices can be heard, and that institutions can change when they listen. For Forman, this work is personal. “I believe we can make a difference,” she says. “The journey is not easy, but growth happens in the grit. PFAC is that moment of growth every month, and I’ll keep showing up.”
This article appears in August 2025.
