A turnkey resilience program for pediatric surgical patients ages 2–12 — proven to reduce postoperative behavioral symptoms and improve family satisfaction scores.
A child’s psychological wellbeing is not secondary to their physical safety — it is inseparable from it. What happens to a child’s mind in the operating room follows them home.
— Dr. Michael Huot, MD • Executive Medical Director of Quality & Safety, Monument Health • Anesthesiologist
Approximately 50% of pediatric surgical patients exhibit negative behavioral symptoms two weeks after surgery — including nightmares, separation anxiety, and eating problems. These aren’t just clinical concerns. They show up directly in your family satisfaction scores, your HCAHPS data, and your reputation for pediatric care.
The root cause is well-documented: children arrive at surgery psychologically unprepared. Existing protocols focus on physical readiness. Teddy Knights closes the emotional gap — using an evidence-based storybook and plush companion to build coping skills before the child ever reaches the pre-op bay.
The long-term stakes are higher than most realize. Research shows that traumatic perioperative experiences can chronically activate the stress-response system in children, increasing the risk of long-term health consequences. [4,5,6] The landmark ACE (Adverse Childhood Experiences) Study found that early stress events have measurable effects on adult health outcomes decades later — from behavioral challenges to cardiovascular disease. Even small, targeted resilience interventions during childhood have been shown to produce meaningful long-term benefits. [7] A frightening hospital visit is not simply forgotten.
[4] Fang Y, et al. Stressful life events and behavioral problems in children 0–7 years. Int J Environ Res Public Health. 2022. | [5] Felitti VJ, et al. Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998. | [6] Shonkoff JP, et al. Lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012. | [7] Cicchetti D, Rogosch FA. Adaptive coping under conditions of extreme stress. New Dir Child Adolesc Dev. 2009.
Created by anesthesiologist Dr. Michael Huot and child psychiatrist Dr. Mark Garry, in partnership with Toby Brusseau, Co-Founder of Teddy Knights, and best-selling author Jörg Ihle — every element of this program is clinically grounded and operationally simple to deploy.
Pediatric anxiety isn’t just a compassion issue — it’s an operational one. When children arrive calmer and more prepared, the ripple effects touch every layer of your hospital’s performance. Here’s what the evidence tells us changes.
Family satisfaction is directly tied to how a child experiences surgery emotionally. Prepared children are calmer at induction, recover with fewer behavioral issues, and leave with parents who feel the hospital went above and beyond — all of which feeds directly into experience survey scores.
Highly anxious children require more time and intervention at anesthesia induction. Teddy Knights’ breathing exercise is specifically designed to facilitate mask induction — meaning calmer kids move through induction faster, keeping your OR schedule on track and reducing costly delays.
Managing a distressed, uncooperative child at induction is one of the most emotionally draining moments in pediatric nursing. When children arrive calm and prepared, staff spend less energy on de-escalation — reducing burnout, improving morale, and protecting one of your most expensive assets: your people.
There is a deeper effect too: when staff see their institution going above and beyond for children — providing tools that set every child up for success — it reinforces that they work somewhere that shares their values. Mission alignment is a proven driver of engagement, retention, and discretionary effort. Teddy Knights gives your team something meaningful to be part of.
Managing a distressed, uncooperative child at induction is one of the most emotionally taxing moments in pediatric nursing. When children arrive with coping tools already in place, staff spend less energy on de-escalation and more on the care they were trained to deliver. Teams report less emotional exhaustion and greater job satisfaction when pediatric experiences go smoothly.
Parental anxiety directly amplifies child anxiety — it’s well-documented in the literature. When families receive the Teddy Knights book two weeks before surgery, parents arrive calmer too. That means smoother check-ins, faster consent processes, and pre-op bays that move more efficiently. Less time managing distressed parents means more time for clinical care. [1]
[1] Kain ZN, Mayes LC, O'Connor TZ, Cicchetti DV. Preoperative anxiety in children: predictors and outcomes. Arch Pediatr Adolesc Med. 1996;150(12):1238–1245.
Pediatric surgical families choose hospitals. A documented, evidence-based emotional care program is a meaningful differentiator in a competitive market — particularly for health systems competing on pediatric service line growth. Teddy Knights gives your marketing team a story, and your clinical team a protocol, that sets your program apart.
Post-op behavioral distress — nightmares, separation anxiety, eating problems — drives follow-up calls, unplanned visits, and parental dissatisfaction that lingers long after discharge. Reducing these downstream symptoms doesn’t just improve outcomes. It reduces the administrative and clinical burden of post-surgical follow-up and complaint management.
Teddy Knights integrates into your existing pre-op workflow with no additional staff training and no meaningful time burden. Here’s how it runs.
Two weeks pre-op, families receive the Teddy Knights storybook during your scheduling call. Parents are guided to read it daily. The book introduces breathing exercises and coping strategies — so the child arrives on surgery day already practiced and prepared.
Your pre-op nurses spend 15–30 minutes with each patient. Teddy Knights gives them a simple, playful script to reinforce one coping technique from the book. The anesthesia team uses the breathing exercise at induction — calming the child while simultaneously facilitating mask placement.
Families receive follow-up surveys at 2 weeks, 6 months, and 1 year. You get ongoing data on behavioral symptom reduction and family satisfaction — real numbers that document program impact and feed your quality reporting.
When children arrive prepared — with breathing skills, a brave mindset, and a Teddy Knight by their side — they leave the hospital differently. Not just recovered, but resilient.
That family walking out smiling? That’s your experience score. That’s your referral. That’s your reputation for pediatric care done right.
Every kit includes the hardcover storybook and your child’s chosen knight — packed in the iconic castle gift box. Bruno or Polly: both are brave, both are clinically designed to help. [9,10]
Bold, brave, and always ready for adventure. Includes “Teddy Knights in Giant Trouble” hardcover + Bruno plush in the castle gift box.
Wise, warm, and fearless. Includes “Teddy Knights in Giant Trouble” hardcover + Polly plush in the castle gift box.
Can’t choose? Get both. Perfect for siblings or kids who want their whole squad. Includes “Teddy Knights in Giant Trouble” hardcover + Bruno + Polly plush.
Teddy Knights is built on a robust body of peer-reviewed research. Every element — from the storybook structure to the breathing technique to the plush companion — is grounded in clinical evidence.
The storybook incorporates CBT principles — teaching children to reframe fear, regulate breathing, and build positive coping patterns through age-appropriate adventure.
The breathing exercise serves a dual clinical purpose: calming the child while facilitating mask induction — a direct operational benefit designed by a 15-year pediatric anesthesiologist.
Strong evidence supports plush companions as transitional objects that reduce pain, anxiety, and stress in pediatric patients during medical procedures. Bruno and Polly aren’t just characters — they are clinically grounded comfort companions.
[9] Anderoğlu & Çağlar. BMC Pediatrics. 2025 | [10] Abdul Rashid et al. BMJ Open. 2021
Parental anxiety directly amplifies child anxiety. Preparing families two weeks out reduces parent distress at check-in — improving throughput and staff experience alike.
Surveys at 2 weeks, 6 months, and 1 year track reductions in nightmares, separation anxiety, and eating problems — giving your quality team real data to report on.
Launched in Rapid City, the program is designed for multi-site expansion — with standardized materials, staff guides, and outcome tracking built in from day one.
Built by two physicians who saw the gap firsthand, and two storytellers who knew exactly how to fill it. Teddy Knights brings together clinical credibility and creative excellence in one deployable program.
Best-selling author Jörg crafted the storybook at the heart of the program — weaving evidence-based coping skills into an adventure children genuinely love to read again and again.
Producer and creative director, Toby built the Teddy Knights world from the ground up — ensuring every element of the program is as engaging for kids as it is clinically effective.
With nearly 15 years as a pediatric anesthesiologist, Dr. Huot designed the clinical framework — including the induction breathing technique that makes this program uniquely effective in the OR.
Dr. Garry provided the child psychiatry expertise to validate the program’s approach against best practices in pediatric mental health and cognitive behavioral therapy.
What begins as a surgical prep tool has the potential to reshape how entire communities relate to medical care — and to stress itself.
Medical anxiety is often learned — children absorb fear from parents who absorbed it from their own parents. When a child learns coping skills before surgery, those skills don’t disappear afterward. They carry them into the next difficult moment, and the next. Families that go through Teddy Knights together often report the techniques showing up at the dinner table, at the dentist, at school.
Research shows that traumatic childhood medical experiences can chronically activate the stress-response system, contributing to long-term health disparities. [4,5] In underserved communities where children may face more medical encounters with less preparation, resilience tools like Teddy Knights have an outsized impact — reducing the accumulated burden of medical trauma before it compounds.
Deep belly breathing, bilateral stimulation, and positive self-talk are not surgical tools. They are life tools. A child who learns to use their breath to calm their nervous system before anesthesia is the same child who can use it before a test, before a difficult conversation, before life’s inevitable hard moments. The literature consistently shows that coping skills learned early can strengthen emotional resilience well beyond the immediate context. [2,3]
[2] West N, et al. Reducing preoperative anxiety with Child Life preparation. Paediatr Anaesth. 2020. | [3] Pastwa-Wojciechowska B, et al. Resilience and coping in difficult social situations. Curr Issues Personal Psychol. 2021. | [4] Felitti VJ, et al. ACE Study. Am J Prev Med. 1998. | [5] Shonkoff JP, et al. Pediatrics. 2012.
Every child deserves a brave companion — no matter the procedure. Procedure-specific kits are in development for the most common pediatric encounters.
Interested in a specific procedure? Contact us — hospital partnerships help shape what we build next.
Whether you’re looking to pilot Teddy Knights at one facility or deploy across a health system, we’d love to talk. Leave your email and we’ll be in touch with partnership details, pricing, and outcome data.
Parents looking to purchase a kit? Shop here.