Client and Family-Centred Care (CFCC) helps VHA Home HealthCare (VHA) deliver home care to families based on what is most important to them. At VHA, CCFC is well formed through internal education developed with the support of best practice guidelines and delivered to point-of-care staff. Despite these efforts, there is limited evidence to show that clients were engaged in content development or if this education aligns with what is important to clients and families in this unique care setting.

Results show that there is some alignment between the perspectives of clients and families and the organization’s educational content, however many gaps lie. Through participant photographs, we come to understand their perspectives using the phrase, the little things. Parents of children with complex medical needs shared that it is the little things that make the biggest impact during care.

To address this gap, this study worked with parents of children with complex medical needs (CCMN) receiving services from VHA to develop a deep understanding of their perceptions and experiences of CFCC through the approach of PhotoVoice. Clients have expressed that they are discouraged by paperwork and experience survey fatigue. PhotoVoice is an ideal approach to bring forward authentic expression and depth of the lived experience of CFCC due to its flexibility. Participants are given cameras which allows them to visually represent a subject or concept promoting an effective means of sharing expertise and knowledge. The emergent themes identified from photograph and interview data will be used to examine if underlying constructs of CFCC education are in alignment with parents’ perspectives and practice improvements can be made within the organization. To ensure that the study was designed in a way that was attuned to the needs of clients and families as well as represented the working principles of CFCC, a client partner joined the research team and the study was co-designed together.

We recommend that:

• the visual stories generated from this study are included into the present CFCC curriculum at VHA Home HealthCare
• the process of education development at VHA move towards a co-design model where clients and families work collaboratively with the organization to develop content that prioritizes the client’s voice in education provided to point-of-care staff