A Formalized Pathway to Sustained Quality Improvement in Pediatric Pain Care: A ChildKind International Certification...

Untreated pediatric pain is associated with serious immediate and long-term negative consequences, yet a significant evidence-to-practice gap persists. To formally bridge this gap, the Stollery Children's Hospital (SCH), a tertiary care center in Canada, pursued ChildKind International (CKI) certification, a globally recognized standard for excellence in pediatric pain care.

To describe the CKI certification process at SCH, highlighting strategies for institutional culture change and key implementation barriers, facilitators, and lessons learned in order to inform other institutions undertaking similar quality improvement initiatives.

The SCH CKI journey spanned nearly six years, beginning with a comprehensive environmental scan and gap analysis informed by patient, family, and healthcare provider perspectives. Strategies included intentional team composition, integrating patient partners, securing institutional funding, and aligning CKI principles with the hospital's strategic priorities. Implementation focused on all five CKI principles, including creating a "Pain Dashboard" for continuous post-certification self-monitoring and developing site-specific, evidence-informed pain resource documents.

Despite challenges, including a multi-year funding hold due to the COVID-19 pandemic, the SCH achieved CKI certification in January 2025. Key successes included hospital-wide engagement of clinical and non-clinical staff, integration of specialized pain roles into existing positions to support sustainability, and establishing local governance for ongoing quality improvement.

The CKI certification process provides a formalized, multi-faceted pathway for sustained quality improvement in pediatric pain care. Success relies on robust interest-holder engagement, dedicated resources, and integrating the CKI principles into the permanent institutional culture and governance structure.