53 Pediatric Pain: A Network's Approach to Education

The Child Health Network for the Greater Toronto Area (CHN) is a partnership among 20 hospitals that provide maternal/newborn and paediatric services, and 10 Community Care Access Centres that manage home-based services.

Using pain management education, this article explores whether a network approach to education has merit and influences practice changes.

An Education Framework was developed to promote and support educational initiatives across the network. Pain management was identified as a hospital priority, whereby improvements were needed in clinicians' awareness, understanding and clinical practices about procedural, post-operative, peri-operative and traumatic pain in neonates, infants, children and youth. Best practice standards and education modules were developed on paediatric pain assessment and management, and a train-the-trainer approach was used for education.

CHN's paediatric pain management initiative had positive impacts. Changes in clinical practice were evident in 10 out of 12 hospitals. Eight hospitals instituted developmentally appropriate pain assessment tools for children, seven hospitals for youth, one hospital for neonates and one for infants. As a network, the CHN hospital collective worked collaboratively to develop best practice standards, and a methodological and comprehensive education approach. Resource constraints, lack of buy-in and competing priorities impacted on more wide-scale implementation of the pain management standards and best practices.

Networks can play an important role influencing change and promoting best practice standards. CHN's pain management initiative suggests that a network approach to education has definite merit and can influence changes in practice.