Reproducible evidence review
Search lanes, grey-literature sources, eligibility rules, bias controls, screening, evidence-strength appraisal, extraction, version control, and an ongoing PubMed/My NCBI/Outlook/Zotero surveillance workflow.
Applied Practice Experience • practical use • competency proof
Two practical deliverables built for health-system use.
The APE is organized around the two approved products: an environmental scan with annotated bibliography, and a practical PFAC leadership toolkit. Supporting analysis, benchmark pages, data structures, and surveillance workflows strengthen those products but do not create extra deliverables.
Evidence foundation
Environmental scan and annotated bibliography.
Evidence-to-action matrix
Every key source is separated by evidence type, limitation, supported claim, leadership action, anticipated patient benefit, and measurement connection.
Open matrixUpper Valley service-area re-analysis
Town-level age, disability, poverty, population, and access data from the 2025 CHNA are re-analyzed and interpreted for PFAC representation and implementation planning.
Open local analysisAMA 11 bibliography
Peer-reviewed research, federal guidance, implementation resources, public benchmark sources, and lived-experience sources are kept in distinct evidence layers.
Open bibliographyPractical leadership tools
PFAC leadership toolkit.
PFAC current-state assessment
Review executive sponsorship, authority, committee interfaces, advisor readiness and onboarding, agenda pipeline, decision rights, measurement, and report-back.
Closed-loop action tracker
Capture what patients and families raised, leadership disposition, accountable owner, due date, implementation status, evidence of change, and report-back.
Representation and access check
Identify who is represented, who is missing, and barriers related to recruitment, language, disability, geography, compensation, technology, or scheduling.
PFAC measurement plan
Separate structure, process, implementation, experience, and outcome measures and connect the workstream to appropriate PREM, PROM, Press Ganey, access, safety, or project-specific signals without unsupported attribution.
Domain 5 traceability
Map CMS Patient Safety Structural Measure, Domain 5: Patient and Family Engagement requirements and guidance to local evidence, accountable roles, gaps, and actions.
Upper Valley access implementation case
Populate the toolkit with current local access, navigation, rurality, and representation signals so leaders can see how the method works before host validation.
Open implementation casePractice-derived requirements
The toolkit responds to needs identified through fellowship and preceptor work.
Make the product deployable.
Stakeholder discussions repeatedly returned to senior leadership buy-in and the question of what would be genuinely useful and practical for leaders to deploy in a health system.
Prepare both sides of the partnership.
Project notes identified orientation for patient and family advisors, orientation for health-system leaders, training, mentoring or shadowing, role clarity, and system language as implementation needs. A reviewed Dartmouth Health onboarding job aid now provides documented local process evidence for part of that infrastructure.
Connect engagement to the existing experience system.
The APE developed in a care-experience environment using patient-reported experience and outcome measures and Press Ganey measures. The toolkit therefore measures PFAC contribution alongside workstream-specific experience, access, safety, or outcome data rather than treating PFAC activity as an outcome itself.
Close the loop and adapt.
The operating model reflects the Learning Health System context in which the APE began: evidence informs decisions, patient and family input enters action, implementation is measured, results are reported back, and the next cycle adapts based on what was learned.
Competency traceability
What artifact demonstrates each selected competency.
| Competency | Applied demonstration | Primary artifact | Evidence state |
|---|---|---|---|
| CEPH 4: Interpret results of data analysis for public health research, policy, or practice | Re-analyze municipality-level 2025 CHNA population, poverty, disability, and age data; calculate population shares above service-area averages; interpret access and navigation survey signals for PFAC design and leadership action. | Applied Analysis and reproducible CSV | Demonstrated. Data source, calculation rule, results, limitations, and practice interpretation are visible. |
| CEPH 7: Assess population needs, assets, and capacities that affect communities’ health | Define the 72,736-person, 19-municipality Upper Valley service area and assess age, disability, poverty, rural/isolation, access, navigation, and participation context that should shape PFAC representation and operating design. | Applied Analysis plus Representation and Access Check | Demonstrated. Local population context is documented and translated into engagement requirements. |
| CEPH 16: Apply leadership and/or management principles to address a relevant issue | Define sponsorship, governance, ownership, escalation, decision rights, measurement, and follow-through, then populate those elements for an Upper Valley access/navigation use case. | Leadership Toolkit and Implementation Case | Demonstrated. Toolkit structure and applied case both show management action. |
| CEPH 21: Integrate perspectives from other sectors and/or professions to promote and advance population health | Integrate patient/family experience, health-system leadership, safety, quality improvement, co-production, implementation science, public-health evidence, CHNA community input, and host-site stakeholder requirements. | Environmental Scan and Leadership Toolkit | Demonstrated. Multiple evidence and professional perspectives are visibly integrated. |
| Dartmouth Program-Specific Competency 4 | Compare approaches to engaging target populations in decision-making, design, governance, and service delivery, including differences in quality, safety, equity, and value implications. | Comparative Toolkit Scan and DH Benchmark | Demonstrated. Common comparison dimensions are explicit. |
Leadership standard
Useful on the day it is opened.
A health-system leader should be able to use this product to identify the current state, see what evidence supports each design choice, understand the local population context, identify gaps, assign ownership, choose measures, and leave with a documented next action.