In response to the increasing recognition of the negative effects of chronic pain for children with cerebral palsy, the Evidence to Care team at Holland Bloorview created an evidence based resource called the 'Chronic Pain Assessment Toolbox for Children with Disabilities.' This Toolbox was created for clinicians with the objective of standardizing assessment processes to promote earlier identification and more appropriate management of chronic pain for children with cerebral palsy. Work by Stevens (2015) indicates that Toolkits that are used to 'educate and/or facilitate behaviour change' show promise as a practical method for moving high quality research evidence into practice.

The Toolbox was co-created with a multidisciplinary team including an occupational therapist, physiotherapist, nurse practitioner, psychologist, patient safety manager, physicians, and youth and family leaders. This is the first Toolbox available that addresses chronic pain assessment for children with disabilities using rigorous research methods to develop, implement and evaluate the product and usage in clinic.

The Toolbox consists of pain assessment recommendations; cerebral palsy specific clinical practice points; 15 pediatric chronic pain assessment tools; and an implementation supports manual. It has been implemented and evaluated in 8 outpatient clinics at Holland Bloorview using a multi-pronged knowledge translation approach including:
– Champions (clinical, management & parent)
– Clinical education
– Tailoring Toolbox to individual clinic needs
– Weekly huddles (brief in-clinic meetings)
– Centralized documentation screen
– Audit & feedback

As a result, more children with cerebral palsy have received standardized pain assessments using validated tools, with this information captured in a centralized documentation screen. Clinicians reported an increased focus on chronic pain as a priority issue and clients/families indicated they were better able to identify and discuss pain with their clinical team.

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Title: Evidence to Care Lead

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