Project Abstract

Although children are one of the most fragile segments of the population, and the experience with the hospital is per se a delicate moment, currently pediatric patients do not used to have the chance to express their voice about the hospital care received.

The VoiCEs project aims to strength the children involvement in the evaluation and improvement of care quality in children’s hospitals, taking into account their opinions in modulating child-friendly care for inpatient services. In particular, the project will include the design, implementation, and evaluation of a children Patient-Reported Experience Measures (PREMs) Observatory on hospitalization.


Children are one of the most fragile segments of the population and they might be disadvantaged in expressing their opinions, experiences or preferences. As stated by the Manual for Human Rights Education with Young People, “the child has the right to express freely views on all matters affecting him/her, and the child’s views should be given due weight”.
Great efforts have been done in Europe to strengthen “the right of the child to be heard” (Committee on the Rights of the Child, 2009: General comment No.12).

Needs assessment

Since hospitalization represents a very delicate moment, it is especially important to focus on health-related vulnerable children and adolescents. This project focuses on raising children’s and adolescents’ voices on their experience with hospital care.
There are several experimental or cross-sectional studies aimed at investigating children’s perceptions during hospitalization (Runeson et al 2002; Coyne 2006; Pelander et al 2010; Lambert et al 2013).


The target group of this project is represented by all pediatric patients (0-17 years old) who receive hospital care in the 4 hospitals involved in the project. Although children are one of the most fragile segments of the population and the hospitalization experience can per se make them more vulnerable, usually hospitalized children do not have a chance to express an opinion about the care they received. Conversely, practitioners should make decisions considering children’s preferences and opinions.


The aim of the project is to design and implement a system ensuring that hospitalized children can continuously be involved and heard. This would help to identify which aspects of care in children’s hospitals should be improved from their point of view.
The long-term objective is to make inpatient care more child-friendly in children’s hospitals by taking into account the children’s reported experience.

Results and Impact

The project will contribute to enhance the participation of children in the evaluation and improvement of healthcare quality during hospitalization. This will be done with PREMs implementation in 4 children’s hospitals and with the planning of quality improvement activities.
At the local level one of the expected results is the increased awareness among hospital staff, as well as external stakeholders, of the relevance of listening to the voices of children as patients. This makes it possible to ensure a high-quality healthcare service and a better experience during hospitalization.


  • Bastemeijer CM, Boosman H,… & Hazelzet JA (2019). Patient experiences: a systematic review of quality improvement interventions in a hospital setting. Patient related outcome measures, 10, 157-69.
  • Coyne I (2006). Children’s experiences of hospitalization. Journal of child health care, 10(4), 326-36.
  • Corazza I, Gilmore KJ, Bonciani M, & De Rosis S (2019, September). Building big data from experience: a new model for prems collection and utilisation. In BMC Israel Journal of Health Policy Research. 8(1).
  • De Rosis S, Cerasuolo D, Nuti S (2020). Using patient-reported measures to drive change in healthcare: the experience of the digital, continuous and systematic PREMs Observatory in Italy. BMC Health Services Research.
  • Karisalmi N, Kaipio J, Lahdenne P (2018). Improving patient experience in a Children’s hospital: New digital services for children and their families. Stud Health Technol Inform 2018; 247:935-9.
  • Latour JM, Duivenvoorden HJ, .. & Hazelzet JA & EMPATHIC Study Group (2013). The shortened EMpowerment of PArents in THe Intensive Care 30 questionnaire adequately measured parent satisfaction in pediatric intensive care units. Journal of clinical epidemiology, 66(9), 1045-1050.
  • Latour JM, van Goudoever JB,… & Hazelzet JA (2011). Construction and psychometric testing of the EMPATHIC questionnaire measuring parent satisfaction in the pediatric intensive care unit. Intensive care medicine, 37(2), 310-8.
  • Pelander T, & Leino-Kilpi H (2010). Children’s best and worst experiences during hospitalisation. Scandinavian Journal of Caring Sciences, 24(4), 726-33.
  • Runeson I, Hallström I,… & Hermerén G (2002). Children’s needs during hospitalization: An observational study of hospitalized boys. International journal of nursing practice, 8(3), 158-66.
  • UN Committee on the Rights of the Child (2009). General comment No.12: The right of the child to be heard. CRC/C/GC/12
  • WHO Regional Office for Europe (2015). Hospital care for children: quality assessment and improvement tool
  • WHO Regional Office for Europe (2017). Children’s rights in hospital – Rapid-assessment checklists

Let’s keep in touch

The VoiCEs Project is co-funded by the European Union’s Rights, Equality and Citizenship Programme (2014-2020) (REC-RCHI-PROF-AG-2020

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