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Why are children still crying? Going beyond "evidence" in guideline development to improve pain care for children:
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada Centre for Effective Practice, Toronto, ON, Canada.
Insights
Implementing knowledge translation strategies in guideline development improves the uptake of clinical practice guidelines for pediatric procedural pain management. This approach ensures evidence-based care for children, enhancing quality across healthcare systems.
Area of Science:
- Health Services Research
- Implementation Science
- Pediatric Pain Management
Background:
- Suboptimal quality of care stems from the gap between research evidence and clinical practice.
- Clinical practice guidelines (CPGs) aim to bridge this gap, but adoption challenges persist, particularly in pediatric procedural pain management.
- The Help ELiminate Pain in KIDS (HELPinKIDS) initiative addresses these challenges in childhood vaccination pain management.
Purpose of the Study:
- To review the HELPinKIDS team's approach to integrating knowledge translation (KT) strategies into CPG development.
- To facilitate greater uptake of CPGs for childhood vaccination pain management.
- To highlight the importance of implementation considerations in guideline creation.
Main Methods:
- Review of the HELPinKIDS guideline development process, focusing on stakeholder partnerships, rigor, implementation issues, and editorial independence.
- Utilization of a KT map to identify target audiences, key messages, tools, and dissemination strategies.
- Presentation of examples of individual and systems-level impacts from KT activities.
Main Results:
- The HELPinKIDS approach incorporated KT strategies throughout the guideline development lifecycle.
- A KT map guided the communication, dissemination, and implementation of the CPG.
- Demonstrated impact on both individual patient care and healthcare systems.
Conclusions:
- Integrating KT strategies and implementation considerations into CPG development is crucial for enhancing evidence-based practice adoption.
- The HELPinKIDS model provides a framework for developing and implementing guidelines effectively in pediatric pain management.
- Successful KT activities can lead to measurable improvements in healthcare quality at multiple levels.
Abstract:
The failure to translate research evidence into day-to-day clinical practices is identified as a significant reason for suboptimal quality care across the health system, including procedural pain management in children. Clinical practice guidelines (CPGs) have been developed to assist in this process by synthesizing and interpreting research evidence for end users. Numerous CPGs have been developed for procedural pain management in children, yet gaps persist in the adoption of best practices. This article reviews the experience and approach of 1 guideline development group, the Help ELiminate Pain in KIDS Team (HELPinKIDS), in incorporating implementation considerations and knowledge translation (KT) strategies within the process of guideline development for the HELPinKIDS CPG about childhood vaccination pain management to facilitate greater uptake of the CPG. Specific areas that will be addressed include partnerships with stakeholders, rigor of guideline development, issues of implementation, and editorial independence. The work of HELPinKIDS was guided by a KT map, which identified, at a high level, the target audiences, key messages, tools, and strategies that could be used to communicate, disseminate, and implement the CPG into diverse settings. Examples of impact at both the individual and systems levels from HELPinKIDS KT activities are also presented.
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