Description

The Parent Voice Note (PVN) is an innovative practice designed to ensure that parents’ perspectives, priorities, and words are represented within their child’s care plan and electronic health record (EHR).

The PVN is completed during intake conversations and includes parent-identified goals, priorities, supports, strengths, and opportunities. Once recorded in the EHR, it is visible to the entire care team, helping ensure that every provider understands and honors the parent’s perspective in ongoing care and decision-making. This innovation advances family-centered care by institutionalizing parent voice within clinical documentation—moving from provider-driven assessment to shared understanding.

Need / Problem Statement

Before this innovation, there were no formal structures in place to assess or record parent priorities and strengths in a consistent and visible way within the EHR.

This lack of structure meant that while providers collected clinical data, the family’s voice and lived experience were often missing from the care plan. The PVN addresses this by elevating the parent’s perspective to the same level of visibility as clinical observations. This change supports improved communication, more relevant goal-setting, and better alignment between families and providers, especially in complex cases requiring coordination across multiple disciplines.  

Process

The PVN was designed by building on the Medical-Financial Partnership (MFP) team’s experience with family intake processes.

Design began with input from parents and parent leaders, who identified the most meaningful questions and content areas for inclusion—such as what supports they already rely on and what goals they prioritize for their child’s health and development. The design team included pediatric clinicians, social workers, and family partners, who collectively shaped a template to fit within the EHR workflow. The process emphasized simplicity and clarity to make it both sustainable for staff and authentic to the parent’s voice.  

Partnership

Family and parent input were central to this innovation.

Through listening sessions and co-design discussions, parents helped identify key strengths, priorities, and areas of opportunity that should be reflected in the PVN. Parent leaders also advised on language tone, ensuring it felt affirming and nonjudgmental. This collaborative approach strengthened parent-provider trust and modeled partnership in action—parents were not simply consulted but co-authors of the process.  

Implementation

The design-to-launch process took approximately one to six months, reflecting a rapid cycle of development and refinement. Steps included:

• Discussion and feedback with parent leaders and clinical team members
• Iterative development of the PVN template for intake documentation
• Team-wide socialization to ensure buy-in across clinical and social work staff
• Full implementation within the EHR once the template was finalized

While staff initially expressed concern about the added time during intake, the team found that the PVN ultimately saved time later by improving care coordination and clarifying family priorities.

Changes & Outcomes

Since implementing the PVN, providers and social workers report improved alignment and coordination around family goals, including:  

• Increased awareness of what parents identify as their most pressing needs, which helps the care team focus interventions and resources more effectively

• Stronger relationships and trust between families and providers–One clinician noted, “Having the parent’s words in their own voice changes how we see the care plan—it reminds us who we’re working for.”

• Parent perspectives made visible to all team members—the PVN reinforces a culture of respect and shared purpose

Measurement for Success

The team tracks implementation and success through both quantitative and qualitative methods, including:  

• EHR documentation tracking to monitor completion and visibility of PVNs

• Staff interviews and focus groups to assess usability and impact on workflow

• Parent and clinician listening sessions to gather direct feedback on value and relevance

Payment & Funding

• Funding type:The PVN initiative was funded through philanthropic support, including support from the Pediatrics Supporting Parents coalition of funders during the PSP Implementation years.
• Anticipated gains:This innovation contributes significant human and relational value by deepening trust, enhancing coordination, and supporting family engagement across the care continuum.

To learn more about this innovation please email Drs. Monique Holguin ([email protected]) and Adam Schickedanz ([email protected]), Co-Directors of the Medical-Financial Partnership and PSP’s Los Angeles Proof Point Community.