Description

This innovation centers on patient and family–centered care, bringing family perspectives directly into the planning, delivery, and evaluation of healthcare.

Pediatrics Northwest and WCAAP are intentionally reimagining the pediatric medical home as a system co-designed with those it serves. Their model is built on perspective-taking, curiosity, and self-reflection, inviting families to help shape the culture and practices of care teams. The result is a deeply relational approach to pediatric primary care that elevates trust, empathy, and partnership as drivers of quality and safety.

Need / Problem Statement

Primary caregivers are the most important advocates for their children, yet systemic racism, bias, and structural barriers often limit their ability to partner effectively with healthcare systems.

The practice recognized that caregiver engagement is not just an enhancement but essential to children’s well-being and healthcare quality. Families’ lived experiences of care also directly influence safety, trust, and adherence. The innovation was designed to strengthen trustworthiness at Pediatrics Northwest and address long-standing systemic inequities by embedding family partnership throughout the organization.

Process

The design process began with an organizational readiness assessment using the Family Engagement in Systems Assessment Tool (FESAT) developed by Family Voices.

The framework guided four core commitments: embedding family engagement as a core value, building trust through transparency, recognizing why representation matters, and documenting how engagement changes organizational practice. Leaders, clinicians, and family partners collaboratively assessed readiness, identified barriers, and created structures for sustained partnership. This deliberate groundwork ensured family engagement would be authentic, meaningful, and sustainable.

Partnership

Families were not asked to provide input after the fact; instead, they co-designed from the outset.

Parent leader Shayla Collins emerged as a pivotal partner—serving on the Care Transformation Committee, the Pierce First Year Families PPC leadership committee, and WCAAP’s Early Childhood Committee. Her collaboration expanded statewide networks, informed learning retreats, and inspired others through lunch-and-learns and mindfulness sessions. Family and parent partners have since been integrated into governance structures, with compensation and clear roles, ensuring shared ownership of decision-making and policy development.

Implementation

The innovation moved from design to implementation within six months.

Initial skepticism from providers—concerns about time and workflow—was met with intentional, relationship-based learning opportunities. Family leaders hosted lunch-and-learns that reframed engagement as reciprocal and emphasized provider self-care and wellness.  
Implementation steps included:  

• Embedding family representatives in governance and quality committees  
• Hosting quarterly Family Night Dinners to collect family input  
• Co-designing perinatal mood disorder screening workflows for both parents and caregivers  
• Revising missed-appointment policies and communication strategies  
• Expanding mindfulness and relational health learning offerings through WCAAP  

Changes & Outcomes

The shift toward authentic family partnership has yielded powerful results, including:

• Improved trust and communication between families and pediatricians
• Increased preventive care engagement and vaccination rates
• Decreased emergency department visits and missed appointments
• Improved parental and child mental health, provider morale, and staff retention
• Reshaped clinic policies to better align with family needs (e.g., flexible scheduling, communication access)
• Strengthened connections between health systems and local communities
• Families report feeling heard, respected, and valued as partners rather than passive recipients of care. (One recurring internal phrase, “Less telling, more listening,” captures the transformation.)

Measurement for Success

The practice documented qualitative data through stories, dialogue reflections, and family feedback loops to track progress over time. Success was also measured using:

• FESAT and Institute for Patient- and Family-Centered Care (IPFCC) tools
• Family surveys from Family Night events
• Tracking of family participation in committees and events
• Clinic-level metrics: missed appointments, staff turnover, and patient satisfaction

Payment & Funding

• Funding type: The initiative was funded through philanthropic support, which allowed for family partner compensation, training, and dedicated staff time.
• Anticipated gains: Stronger family trust, higher engagement in preventive care, reduced turnover and training costs, and measurable gains in community connection and family well-being.

Resources

• Washington Chapter of the American Academy of Pediatrics (WCAAP), Generate and Teach Health Equity Routinely
• WCAAP Equitable Care Webinar: Rebuilding Trust in Medicine Through Courageous

To learn more about this innovation please email Rachel Lettieri, Director of Care Transformation at Pediatrics Northwest: [email protected].