The Kids Pain Collaborative: A Hybrid Type 3 Implementation Effectiveness Study Transforming Paediatric Pain Care in...

Area of Science:

• Implementation Science
• Pediatric Emergency Medicine
• Healthcare Improvement

Background:

• Optimizing pain management in pediatric emergency departments is crucial.
• Existing pain care processes often require enhancement for better patient outcomes.
• Participatory implementation strategies can drive significant improvements.

Purpose of the Study:

• To evaluate a participatory, action-oriented implementation study using the Promoting Action on Research Implementation in Health Services (PARIHS) framework.
• To optimize pain care processes in a tertiary pediatric emergency department.
• To assess the impact of the Kids Pain Collaborative (KPC) on pain management.

Main Methods:

• Hybrid type 3 implementation effectiveness design.
• Collaborative appraisal of context and culture informed two action cycles: nurse-initiated analgesia and family involvement.
• Interrupted time series analysis and emotional touchpoint interviews evaluated implementation impact.

Main Results:

• Sustained improvements in nurse-initiated analgesia and pain assessment rates.
• Shift towards person-centred family involvement in pain care.
• Development of frontline staff leadership for sustained innovation in pain management.

Conclusions:

• The Kids Pain Collaborative fostered a practitioner-led coalition for change in pain care.
• Key principles included collaborative engagement, enabling context, safe reflection spaces, and sustainable practice change.
• A multi-level facilitation model, supported by an embedded researcher, drove sustained improvements.