Building, Evolving, & Elevating PFACs: 8 Lessons Learned on My Journey from Advisor to PFAC Leader

By Vicki Mascareño Nelson

My journey to becoming a Patient Experience Partner at the University of Vermont Medical Center (UVM) has been years in the making. It began in 2018 when I became a Patient/Family Advisor on the UVM Children’s Hospital PFAC. My daughter’s experience of living with chronic illnesses led me to want to improve the phlebotomy experience of pediatric patients.

Anyone with a child with chronic illness knows that the anticipatory anxiety of blood draws is exhausting. Over several years, a group of Advisors, including me, partnered on the design of a new phlebotomy lab. The changes included a pediatric waiting room, adding a child life specialist to the lab, and the creation of poke plans to be included in the pediatric patient health record. As an Advisor, I saw firsthand the impact of PFACs on the patient experience. It is what kept me at the table for so many years.

After two decades as a school counselor, I transitioned in 2020 to take on the leadership of the Patient and Family-Centered Care (PFCC) Program at UVM Children’s Hospital. Changing careers felt big, but with encouragement and soul searching, I joined the Patient Experience Department. Drawing on my skills from public education and my experience as a former Patient/Family Advisor, I brought a unique intersection of perspectives to the PFCC Program, enriching it with fresh insights and approaches. In addition, my other role as a school district DEI coach gave me the insight into removing barriers and centering equity in the program. My initial goals were revamping the Advisor application process and creating specialized PFACs.

My role expanded to encompass oversight of the PFCC Program for the UVM Children’s Hospital and UVM Medical Center. After two years in this capacity, I’d like to share some key lessons learned and provide a pathway for others to explore. Below is my Road Map to Advisor Engagement, a collection of strategies designed to evolve and elevate your Patient Family Advisory Council.

1. Curiosity Cul-de-Sac: Get curious, especially if you have been in your role for a while. I asked so many questions! For example:

• Why do we ask this question on the application?
• Why is the application housed there?
• How can we keep Advisors more informed?
• How can we push more information out to leadership?
• How can we offer stipends for Advisors (especially co-chairs)?

If your Advisor program or PFACs have stalled or remained unchanged since 2020, consider conducting a re-envisioning audit with a group of Advisors. Do not be afraid to delegate! Advisors are not employees by any means; however, with the right structures, you can keep more of them engaged by offering them opportunities to lead various initiatives.

2. Partnership Park: Collaboration is key. Early on, I realized I needed to extend my ‘roads’ further into the organization. I knew that to grow the PFACs and create a transformational model, I would need engaged partners to row in the same direction. Some strong connections I built were with Language Access Services, Social Work, and our Immigrant Health Coordinator. They have been key partners in creating the Multilingual PFAC.
3. Recruitment Road: Reevaluate the recruitment and retention process. Since I joined the team not long after the COVID-19 lockdown, I needed to re-evaluate. The Advisor lists did not reflect active engagement. It took several months to fully identify which Advisors were still engaged. After identifying the gaps, I was able to recruit with more intention and partner with different departments and community organizations to engage new Advisors and patient populations. I often refer to this as a “PFAC garden,” where we all must plant seeds to grow the program and include a variety of plants and flowers.
4. Empowerment Alley: Foster an environment where Advisors feel heard, valued, and impactful. Reflecting on my time as an Advisor, I remember how important it was to know that my voice mattered and that my contributions made a difference. Patients and caregivers quickly recognize when interactions lack genuine connection, so I prioritized creating systems that keep Advisors informed, engaged, and actively involved. Now, as a positional partner to the PFAC co-chairs, my focus is on empowering them to lead with authenticity, encouraging them to develop and share ideas while providing support that strengthens their leadership without overshadowing it.
5. Transformation Checkpoint: Consistently assess and measure the function of the PFAC to ensure impact is transformational, not transactional. How do we determine if we’re truly making a difference? How do we measure this? What are the most effective methods for gathering feedback from Advisors and ensuring they are genuine partners? This is the heart of the work. My perspective as a former Advisor informs every aspect of what we do. Our PFACs must operate with clear purpose and maintain a bi-directional flow of communication, ensuring meaningful collaboration and impact.
6. Accountability Avenue: Continually search for opportunities to further PFAC integration. I learned quickly that quality and patient experience data are imperative to healthcare. Our team focuses on the objective, key, and results (OKRs) that feed into our strategic plans. We continue to evaluate the structure of our PFACs, so they are integrated into our larger system and continue to impact patient care positively and effectively.
7. Leadership Lane: Strengthen and diversify PFAC leadership. In 2025, we will be creating an overarching steering committee comprised of the PFAC co-chairs and organizational leadership. As we continue to focus on creating specialized PFACs, diversifying our Advisor team, and elevating PFAC partnerships, we needed to restructure to create a new unified group that provides direction and support. In addition, over the last year, PFAC support from C-Suite leadership has increased. This is due to organizational restructuring, which has been incredibly valuable!
8. Celebration Station: Celebrate and honor Advisor’s contributions. Advisors give so much time, energy, and commitment. They also share stories of care that can come from traumatic experiences. We had a celebration that included all Advisors, leaders, and other partners and collaborators. We ate incredible food and then had an hour celebration where Advisors and partners shared stories of impact. We also honored the UVMCH and UVMMC employee ‘gardeners’ who helped cultivate the program (we gave them flower seeds) and are committed to supporting our PFACs. The room was full of love, joy, laughter, inspiration and, in many ways, healing and hope. The President of our Health Network joined for the first time and saw firsthand the full force of our partnerships and the value of our Advisors celebrating and cultivating together!

By continuously reflecting on these eight lessons learned and integrating the feedback and experiences of our Advisors, we can build PFACs that drive meaningful change. Transformation is not a one-time achievement but an ongoing commitment to partnership, purpose, and progress. Together, we can ensure that every interaction, decision, and outcome reflects the authentic voices of those we serve. This is how we move from intention to true impact.

*This blog was reviewed and improved by UVMMC & UVMCH Patient Family Advisors.

About the Author
Vicki Mascareño Nelson
Patient Experience Partner | Patient Family Advisor Program
University of Vermont Medical Center and the University of Vermont Children’s Hospital. 

Service to others has been a core value for Vicki ever since she was a young girl growing up. Realizing she could use her voice and experiences to positively impact the lives of others, she has applied these ideals in both her professional and volunteer careers. Vicki’s volunteer involvement has included hospice, shelters for families experiencing homelessness, animal rescue, Fresh Air Fund, and being a Patient Family Advisor at the University of Vermont Children’s Hospital. After twenty years as a school counselor, she transitioned to healthcare where she now coordinates the Patient Family – Centered Care Program. Vicki enjoys spending time with her rescued animals affectionately known as the “fur circus.” While her family loves snow and cold weather in Vermont, she would prefer to sit by the fire and read a book with a furry friend in her lap.