tool for children with CI. occurred through a structured QI project that considered organizational priorities. clinical priorities, and developing champions with expertise in pain management at the unit level (Ellis et al.. 2007; Kavanagh et al.. 2007; Oakes et al. 2008: Paice el al.. 2006: Simons A. Macdonald. 2006) . This article will describe the QI project and process used to evaluate clinical utility of existing pain assessments tools for children with CI,. implementation of the chosen tool, and monitoring of the challenging process of creating a lasting change in practice.