Dr Siow Yew Nam, and Dr Serene Lim from KK Paeds Anaesthesia talk about this important milestone in paediatric pain.
In April 2022, KK Women's and Children's Hospital obtained Childkind certification, becoming only the 12th children's hospital in the world to be certified, joining a network of hospitals that include Boston Children’s Hospital and Sickkids Hospital.
This also mark the first time that a children institution outside of North America is accorded the certification, bearing testimony to KK's institution wide commitment to provide excellent pain management to patients.
Pain management is an important determinant of the overall patient experience. Effective pain management requires a system wide commitment in multiple areas, and this is especially true for paediatric patients, where even pain from simple procedures such as intravenous cannulation and injections can have an outsized impact on a child's experience.
"The ChildKind initiative was conceived by the Special Interest Group on Pain in Childhood of the International Association for the Study of Pain to reduce pain in children by formally recognizing healthcare facilities that have made an institutional commitment to providing pain relief. If a hospital can provide evidence that it has made such a commitment and has in place policies, protocols, quality audits, and ongoing educational activities that address pain, it can apply for certification as “A ChildKind Hospital”. -Childkind International
Formed in 2008, Childkind international has now certified the following children's hospitals :
Advocate Children’s Hospital, Oak Lawn, IL
Alberta Children’s Hospital, Calgary, Alberta, CA
Ann & Robert H. Lurie Children’s Hospital, Chicago, IL
Boston Children’s Hospital, Boston, MA
Children’s Minnesota, Minneapolis & St. Paul, MN
Connecticut Children’s Medical Center, Hartford, CT
Hospital for Sick Children (SickKids), Toronto, Ontario, CA
KK Women’s and Children’s Hospital, Singapore
Northwestern Medicine Central DuPage Hospital, Winfield, IL
Rainbow Babies and Children’s Hospital, Cleveland, OH
Seattle Children’s Hospital, Seattle, WA
UCSF Benioff Children’s Hospital, San Francisco, CA
Childkind assesses each insitution based on it's commitment in 5 areas as defined by it's Five Principles:
PRINCIPLE 1
An institutional commitment to pain prevention, assessment, and treatment.
PRINCIPLE 2
Ongoing education programs and awareness initiatives on pain for staff, trainees, patients and any of their caregivers.
PRINCIPLE 3
Use of evidence-informed, developmentally appropriate processes for assessment of acute and chronic pain.
PRINCIPLE 4
Specific evidence informed protocols for pain prevention and treatment including pharmacological, psychological, and physical methods.
PRINCIPLE 5
Regular institutional self-monitoring within the framework of continuous quality improvement.
The certification exercise was coordinated through the Paediatric Pain Committee, a multi-disciplinary workgroup established in 2014 by the Department of Paediatric Anaesthesia, chaired by Dr Siow Yew Nam. For this certification, Dr Serene Lim was the Chief Liaison Officer for communications and programme development. The certification occured from Feb 28 to March 2, 2022.
The three Childkind auditors were all distinguished, dedicated and passionate advocates for paediatric pain:
Professor Stevens is the Chair of the Certification Committee for ChildKind International, She is a Professor Emeritus at the Lawrence S. Bloomberg Faculty of Nursing and Faculties of Medicine and Dentistry at the University of Toronto, Associate Chief of Nursing Research, and Senior Scientist in the Child Health Evaluative Sciences program at The Hospital for Sick Children (SickKids).
Professor Allen Finley is a pediatric anesthesiologist who has worked for over 30 years in pain research and management. He is Professor of Anesthesia, Pain Management, & Perioperative Medicine at Dalhousie University, and also Professor of Psychology & Neuroscience.
Professor Gary A. Walco is Professor of Anesthesiology and Pain Medicine (adjunct Pediatrics and Psychiatry) at the University of Washington School of Medicine and the Director of Pain Medicine at Seattle Children’s Hospital. He was the founder of the American Pain Society’s first special interest group, focusing on Pain in Infants, Children, and Adolescents, and was the 2003 recipient of the Jeffrey Lawson Award for Advocacy in Children’s Pain Relief as well as the 2019 Distinguished Service Award.
The Childkind auditors were very impressed with the institution wide commitment to pain management, from senior leaders to frontline healthcare providers. They also commented that the team were highly organised, and praised the holistic and compassionate approaches to some very challenging paediatric pain issues faced by patients.
They also commended the Pain Committee's framework for paediatric pain management, which was conceptualised with, at it's centre, a heart signifying compassion, a child and parent. The three main pain experiences are surgical, non-surgical, and procedural pain, and these are supported by 8 co-dependent components.
Figure 1
Pain management has always been an area of intense focus in the department, and this certification is an important milestone in the department's (and KKH's) 25 year developmental journey. (See Figure 2). The system has taken many years to build, achieved through close collaborations with other pain champions in the hospital, from allied health partners to nurses, from the neonatal Intensive care units to the children's emergency department.
Our work is still in progress with more analgesic gaps to fill. Nevertheless, our official "ChildKind status " gives us immense satisfaction, pride and inspires a renewed, passionate committment towards better pain care for all Paediatric patients.
Figure 2
To find out more about Childkind, vist it's website at https://childkindinternational.org
