Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care Susan B. Frampton, PhD, Planetree; Sara Guastello, Planetree; Libby Hoy, PFCCpartners; Mary Naylor, PhD, FAAN, RN, University of Pennsylvania School of Nursing; Sue Sheridan, MBA, MIM, DHL, Patient-Centered Outcomes Research Institute; Michelle Johnston-Fleece, MPH, National Academy of Medicine January 31, 2017 DISCUSSION PAPER Perspectives | Expert Voices in Health & Health Care ABSTRACT | Patient and family engaged care (PFEC) is care planned, delivered, managed, and continuously improved in active partnership with patients and their families (or care partners as defined by the patient) to ensure integra- tion of their health and health care goals, preferences, and values. It includes explicit and partnered determination of goals and care options, and it requires ongoing assessment of the care match with patient goals. This vision represents a shift in the traditional role patients and families have historically played in their own health care teams, as well as in ongoing quality improvement and care delivery efforts. PFEC also represents an important shift from focusing solely on care pro- cesses to aligning those processes to best address the health outcomes that matter to patients. In a culture of PFEC, patients are not merely subjects of their care; they are active participants whose voices are honored. Family and/or care partners are not kept an arm’s length away as spectators, but participate as integral members of their loved one’s care team. Individuals’ (and their families’) expertise about their bodies, lifestyles, and priorities is incorporated into care planning and their care experience is valued and incorporated into improvement efforts. A prevalent and persistent challenge to a system-wide transformation to PFEC is uncertainty about whether the resource investment required will lead to better results. There is also a lack of clarity about how, practi- cally speaking, to make it happen. To address these barriers, the National Academy of Medicine’s (NAM’s) Leadership Consortium for a Value & Science-Driven Health System convened a Scientific Advisory Panel (SAP) to compile and dissemi- nate important insights on culture change strategies. The SAP’s focus was on evidence-based strategies that facilitate patient and family engagement and are tied to research findings revealing improved patient care and outcomes. To achieve this goal, the SAP drew on both the scientific evidence and the lived experiences of patients, their care partners, practitioners, and lead- ers to develop a comprehensive framework that ex- plicitly identifies specific high-impact elements neces- sary to create and sustain a culture of PFEC. Research in support of the various elements of the model was then compiled into a selected bibliography. This paper introduces the framework and associated evidence, along with practical examples of elements of the mod- el applied in the “real world,” with the goal of support- ing action that will pave the way for PFEC to become the norm in health care.