TABLE 3.

Strategies used to optimize engagement

Theme	Exemplar quotes
Engage diverse patients	Aim for diversity in characteristics We believe in making sure that the most marginalized individuals have represented voices at the table…one of the things in terms of how we've been successful with being able to recruit these types of individuals is that we have a strategy around recruiting for diversity. So we specifically are looking for folks that represent the health disparities in our community and engage them (010 PE manager 100+) Employ various recruitment strategies to achieve diversity A lot of our recruiting often times is by word of mouth and we've tried newspaper ads, the last one we got through Facebook…you know it's those kinds of things; how do you reach the biggest population? (036 patient/family <100) Patient/family advisors were largely retired persons It tends to be the retired community that comes forward to be part of the patient and family advisory committee (027 PE manager <100) Because I’m retired I’m able to give the time to things (023 patient/family 100+)
Prioritize what benefits many	Chose projects that benefit the majority A lot of suggestions come to PFAC, but if they are more individualized, we try to triage that because it's not about one, it's about everybody. We try to talk about who is our catchment and who are we benefiting (002 patient/family <100) Used perspectives expressed by the majority And then when the structured reviews came back from patients and their families we had to set a priority, we're going to take everything that is said by more than you know ‘x’ percentage of patients and we're going to use that (012 clinician teaching) Blended approach of consultation then co‐design We were really trying to be driven by the data from our survey and post‐discharge phone calls, and then validating that with the experiences of our patient and family partners to dig a little bit deeper on some things that would have the biggest impact on improving our results (024 PE manager 100+)
Match patients to projects	Deploy those with PE experience/skill Sometimes we were selected because of other projects we had worked on. I mean they [PE managers/staff] have a good sense of our skills at this point. There's a large number of patient partners but there seems to be a group that does a lot of different kinds of projects and so they know who's got good analytical skills and good communication skills. So we were sought. We were recruited specifically (014 patient/family teaching) Match patient/ family experience or characteristics to PE project And basically what they ask for generally is people who have had a background as a patient in those areas. So for instance, when things come out in the neuro area or the cancer area I wouldn't apply because my background there as a patient just doesn't exist (039 patient/family teaching)
Train participants	Train patient/family for role of advisors They are trained during orientation and then have, with the interest in the program, a full day of training and then continued engagement throughout the program (037 clinician < 100) We usually have an education session for about a half an hour before we get into the meeting (036 patient/family < 100) Train health‐care workers on how to collaborate with patient/family advisors The staff and leaders received training on how to effectively engage with patient partners (029 patient/family 100+)
Ensure patient perspectives inform decisions	Include a critical volume of patient/family advisors About four years ago we established our first patient and family experience steering committee. The initial membership, the staff greatly out‐numbered the number of patient family partners. Over the last few years we've decreased the number of staff on the committee, increased the number of patient family partners on the committee (024 PE manager 100+) Quorum requires at least one patient/family advisor There's usually two of us [patient/family advisors on standing committees]. One of the requirements of the [Research Ethics Board] is that to have a proper quorum you need to have one patient/family advisor at the meeting (17 pat 100+) PFAC review of standing committee or project team work I would report back to the Patient and Family Council about what is going on in the General Medicine Quality Committee…and sometimes I’d be seeking out advice (007 patient/family teaching) Patient/family advisor feedback loop When we [patient/family advisors] made those suggestions, they were taken away and then at the next meeting they would hand the draft out and we'd go over it to see which of our suggestions had been included (035 patient/family <100) Somebody comes back to you and says, here's how your comments changed what we did. It's a very simple feedback loop but it's made a big difference (014 patient/family teaching) We're sending that out so that they [patient/family advisors] look at it and make sure that it reflects what they've said (040 clinician 100+) Philosophical commitment to respect/value patient perspective We've evolved and developed an understanding that any member around the table would have equal input or equal weighting to their opinions. So whether or not it was a frontline staff at the table or a patient and family advisor or the vice‐president or a physician (004 PE manager teaching) We come to the table with the philosophy that our family advisors are the experts (008 clinician teaching) Everybody had an equal say at that table and their comments were very well received so nobody was hesitant to speak up (023 patient/family 100+) The respect for patient/family advisors within the whole organization is very conducive to them [healthcare workers] listening to us and taking our advice (003 patient/family teaching) We've come to value that. They are like team members. It's built into the organization (020 PE manager 100+)
Staff champions	Skilled PE managers/staff They have really key skills around hearing, deep listening and reflective listening skills, and know the importance of being able to hear and integrate (028 PE manager teaching) Proactive standing committee/project team Chairs The chair of the working group made sure that all members are actively participating and that their voice is heard (038 corporate executive teaching)
Links with Board of Directors	Board member on PFAC Having a Board member sit on the PFAC, and bring those minutes to the Board [Quality] Committee and to the full Board ensures that if they need different equipment or whatever, that it's not just being minuted in a meeting and then never done (001 PE manager <100) Patients on Board/Board Committees We [patient/family advisors] also have voting rights on the Board committees (036 patient/family <100) Accountable to Board Being accountable to the Board…to report that there has been implementation and change (037 clinician <100)