Effectively engaging consumers requires creating a structure and environment that recognizes all stakeholders as equal. Onboarding and involving consumers in multi-stakeholder efforts is, in a way, about onboarding and involving everyone. Decision-making and accountability should be transparent and equitable, and meeting procedures should acknowledge all voices as important. Meeting ground rules are a useful tool, and referring to all participants (whether consumer, physician, or other) by first name can help create a more comfortable environment and level playing field.
It is important to include multiple consumer representatives—not just a single voice. Given existing power dynamics and the challenge of some stakeholders accepting consumer perspectives as equal, the number of consumers engaged can make a difference. At minimum, include more than one consumer member on a given planning body. Preferably, strive for proportional representation (e.g., if there are three employer representatives, include three patient or consumer representatives).
Walk the walk: make consumer involvement a requirement, and own its implementation. Buy-in from senior leaders is critical, and explicit requirements provide reinforcement. AF4Q’s mandate that Alliances engage consumers helped launch some Alliances’ work. Governance bodies can build consumer membership into their bylaws, and regional collaboratives can mandate consumer engagement in PCMH pilot practices. The AF4Q NPO had originally outsourced consumer engagement functions, but later learned consumers did not feel fully integrated. Based on that feedback, the NPO modified its approach, bringing more consumer engagement functions in-house.