On April 20, 2023, Health Standards Organization (HSO) and Solutions for Kids in Pain (SKIP) hosted a virtual town hall that brought together more than 200 attendees, including health care providers, patient and family partners, health system leaders, and researchers, to learn about Canada’s first national Pediatric Pain Management standard.
Canada is a world leader in producing new knowledge about children’s pain. Still, it is often overlooked, and children continue to experience preventable and untreated pain in day-to-day care. Closing this knowledge-to-practice gap and prioritizing pediatric pain management at an organizational level can improve the quality and equity of pain services available to children and their families.
Dr. Katie Birnie, and a panel of people with lived experience, health system leaders, and experts in pediatric pain management, brought their diverse perspectives to the forefront, discussing how this evidence-based standard aims to ensure that all children and families have access to quality, equitable pain management.
Dr. Katie Birnie revealed, “All children experience acute pain, and one in five children will experience chronic pain lasting months to years before reaching adulthood. Children with pain can have both short- and long-term negative consequences. Children with chronic pain are at increased risk of experiencing mental health issues, substance use, and socioeconomic disparities into adulthood. That’s where this standard comes in.”
The standard recommends 34 criteria for health care organizations and teams to ensure every child receives quality, equitable pain management. These include regular comprehensive assessments of pain to guide treatments and to prioritize a child’s self-reported pain experience. It also focuses on how Canadian organizational leaders and health teams should address preventable, untreated, and unmanaged pain as a patient safety incident.
“The part that hits home for me is: believe kids. Believe them when they are in pain and when their behaviour shows they are in pain. When there is an institutional and professional understanding of the importance of better pediatric pain management, the only way forward is to implement that with, and not for, children and families,” expressed Isabel Jordan, who has lived experience as an individual and parent.
The standard highlights the importance of recognizing pain management as a fundamental human right, in alignment with Jordan’s Principle. It is a need also addressed in the United Nations Convention on the Rights of the Child, underlining that children have their own voice, agency, and right to participate in decisions that affect them, separate from those of their family.
Rounding out the panel were Julia Hanigsberg, President and CEO at Holland Bloorview Kids Rehabilitation Hospital and Dr. Régis Vaillancourt, Vice President of Pharmacy Affairs at BCE Pharma, who discussed the clinical urgency of this standard, including what it means for organizational leaders and health teams.
“Appropriate pain management, in the way this standard makes possible, is more urgent and more important than it has ever been. Adopting a national standard like this will ensure the equity of experience for every child or family that comes through your doors. Another especially important thing about the standard is it is multimodal and multidisciplinary. Pain is the shared domain of every discipline and direct care provider; this standard applies to everyone,” said Hanigsberg. That’s why the new standard recommends children’s hospitals use a multimodal approach to manage acute and chronic pain, including physical, psychosocial, and pharmacological strategies.
“This standard is about taking care of patients, having families at the centre of decision making and being involved in their care. It is one of the most important aspects of care. The standard recommends how organizations can structure their programs, key elements to provide optimal patient care through a quality improvement approach for pain,” said Dr. Régis Vaillancourt, who worked in a children’s hospital and saw firsthand the impact of pain and chronic pain on patients.
One thing is clear, now is the time to prioritize children’s pain and ensure they are receiving access to evidence-informed practices for quality, equitable pain management – a sentiment echoed by the panelists during the discussion.
When looking to the future, it was highlighted that the recommendations laid out in the new standard are optional for implementation. Still, the goal would be for this standard to become integral to pain management services offered across all hospitals in Canada.
HSO would like to thank our partner, Solutions for Kids in Pain (SKIP) and the panel for a thought-provoking conversation on pediatric pain management. Access a copy of the standard at no fee here to continue this conversation and to mobilize efforts towards improving children’s pediatric pain management to build healthier communities.
Watch the full recording of the panel discussion here.