It is clear that despite the dramatic increase in knowledge regarding pain management in the past 25 years, a significant number of children in healthcare settings continue to experience pain that could be prevented or reduced by the uniform application of currently available information. Although many techniques have been attempted to improve pain management, research suggests that any intervention will have limited success unless it is perceived as representing a core institutional value, similar to confidentiality and safety. 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 designation as “A ChildKind Hospital”. This designation, endorsed by ten international organizations, is testimony to the fact that the hospital has made the comfort of those for whom it provides care, a foundational value. This approach has been applied to the promotion of breast feeding through the hugely successful Baby Friendly Initiative, a joint WHO/UNICEF project which has been, at least in part responsible for an enormous increase in breast feeding in the developed and developing world. To date, four institutions (Boston Children’s Hospital, Connecticut Children’s Medical Center, Seattle Children’s Hospital, and the Hospital for Sick Children) have been designated as ChildKind facilities. In addition to formally recognizing institutions, ChildKind will maintain a website that offers evidence-informed policies, protocols, and educational materials so that lack of access to up-to-date information will not preclude the provision of appropriate pain relief. The lure of a prestigious internationally recognized designation that attests to their ongoing commitment to providing a uniform approach to pain relief should provide an incentive for institutions to overcome whatever barriers they are encountering in providing pain relief for all children. By formalizing their approaches to pain management, they will foster our goal of pain prevention and relief, for all children, regardless of their site of care. A child’s comfort should be considered a cornerstone of the compassionate medical care.
