Closing the Safety Gap: Improving Children’s Pain Management Across Canada

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Submitted by Solutions for Kids in Pain

Safer care doesn’t happen by chance. The Canadian Patient Safety Week 2025 theme, All Voices for Safer Care, reminds us that building safer healthcare systems isn’t the responsibility of one person or one role — it’s something we create together.   

Throughout this blog series, we’re sharing the stories of champions for safer care from across Canada who are helping redefine what safer care looks like in their communities and settings: from point of care to leadership, from lived experience to learning systems.   

Their insights show how building safer systems, supporting all roles, and listening with curiosity are essential steps toward safer, more equitable care for everyone.   

At the heart of safer care is the belief that everyone deserves to be heard and supported — especially children. When children visit the hospital, families trust that they will receive the best available care that treats their child’s illness and manages their pain. But too often, children’s pain is missed or minimized, presenting a safety gap that comes with serious, lasting consequences. 

Children in Canadian hospitals undergo an average of six painful procedures per day. For babies in neonatal intensive care, that number increases to fourteen.

Research shows that two-thirds of these procedures are performed without any pain management. On top of that, one in four children who have major surgery develop chronic pain. When children’s pain is ignored, it represents a silent safety failure that can follow them into adulthood. Poorly managed pain can delay healing, increase sensitivity, affect neurodevelopment, and lead to avoidance of healthcare later in life. It is also linked to depression, anxiety, suicidality, and harmful substance use.

These preventable outcomes reveal a broader, systemic issue in pediatric care. When pain is inadequately treated, children experience measurable and preventable harm and that constitutes a patient safety incident.

Recognizing children’s pain as a patient safety incident

A patient safety incident occurs when care is provided or omitted in a way that could lead to, or has already caused, unnecessary harm. Examples include not using topical analgesics before a vaccination or IV insertion or delaying pain relief after major surgery.

Canada now has a guideline to recognize unmanaged pediatric pain as equally critical to patient safety.

Leading the way: Canada’s Pediatric Pain Management Health Standard

Pediatric pain management is essential to every child health encounter and key to delivering safe, high-quality, person-centered care. The release of the Pediatric Pain Management health standard (CAN/HSO 13200:2023) in April 2023 marked a significant milestone in Canadian healthcare.  

Developed by Solutions for Kids in Pain (SKIP) in collaboration with the Health Standards Organization (HSO), this standard is the first of its kind globally. As a National Standard of Canada, it guides the delivery of quality, equitable pain care for children in all Canadian hospital settings, from children’s hospitals to rehabilitation and community hospitals. It applies across all areas of care, including inpatient, outpatient, diagnostic and emergency services. The standard emphasizes equity as part of quality care, including anti-racist, anti-oppression and trauma-informed approaches. Importantly, it also outlines criteria to classify under- and untreated pain in children as a patient safety incident.

Since its release, uptake has been strong. As of Sept 16th, 2025, it has been downloaded more than 2,900 times across 78 countries, with over 1,600 downloads from Canada alone, having been accessed in every province and two territories. This broad national and international interest signals a shared recognition that pediatric pain management is not only a clinical priority but a matter of health equity and patient safety. The standard directly responds to Health Canada’s 2021 ‘Action Plan for Pain in Canada’, which called for consistent access to timely, evidence-based and person-centred pain care for all people in Canada. By setting a national benchmark, the standard aims to close gaps in care and ensure that all children, regardless of where they live or receive treatment, have access to the best possible pain care.

Solutions for Kids in Pain (SKIP): Accelerating change through collaboration

Solutions for Kids in Pain (SKIP) is a national knowledge mobilization network dedicated to improving children’s pain management. SKIP brings together patients, families, health professionals and decision-makers to drive change through coordination and collaboration.

SKIP has led a series of engagement and implementation activities involving more than one hundred families, health professionals and leaders from across the country. Their insights are helping shape an implementation roadmap that aims to bring high-quality pain management to children everywhere by equipping hospitals and communities with the tools they need.

This work includes developing a highly requested Implementation Guide and other tailored resources that help hospitals assess current practices and plan for improvement. SKIP is also fostering a coordinated, community-driven approach by sharing hospital success stories, centring patient and family experiences and supporting training through early adopters.

Fueling a culture shift toward safer care

Partnerships are a cornerstone of SKIP’s approach. Working in lockstep with its national network, patient and family partners, and organizations such as the Health Standards Organization, Accreditation Canada, and Children's Healthcare Canada, SKIP aims to fuel a broader culture shift that makes pediatric pain management synonymous with patient safety.

Everyone has a role to play in closing the safety gap for kids in pain. Whether you work in a hospital, care for a child living with pain, or shape healthcare policy, you can help raise awareness about this critical issue and the evidence-based tools available to improve care.

Visit kidsinpain.ca to learn more about the Pediatric Pain Management Health Standard and discover resources to help your team take action. 

Together, we can make safer care for children a shared reality — one where every child’s voice, experience and comfort truly matter.