At Texas Children’s Hospital, we understand that fear, anxiety and stress are common among young patients undergoing surgery and other medical procedures. And while our care teams do their absolute best to make patients comfortable and put them at ease, certain procedures — including simple needle sticks — can be painful and even traumatic for some patients.

Childhood Anxiety Reduction Through Innovation and Technology

In 2018, Texas Children’s launched CHARIOT (Childhood Anxiety Reduction Through Innovation and Technology), a program of the Department of Anesthesiology, Perioperative and Pain Medicine. CHARIOT was developed and first deployed by Stanford Children’s Health, and as a Stanford partner, Texas Children’s became the second hospital in the U.S. to implement the program.

The CHARIOT team helps patients cope by capturing their imaginations and drawing attention away from stressful situations. They do this in several ways, including using technology similar to smartphones and tablets that most children enjoy, and many are already familiar with, such as:

Video projection (BERT)

CHARIOT Program Feature 3


BERT (Bedside Entertainment and Relaxation Theater) is a mobile projector that can be projected onto any flat surface, like a wall or ceiling, or onto a large screen that attaches to the foot of the hospital bed, enabling patients to watch movies or play games even while being wheeled into surgery or procedure suites. The screens are larger than a phone or tablet, allowing for deeper immersion and distraction. 

CHARIOT Program Feature 1


Virtual reality (VR) goggles

VR goggles, the most immersive technology used by the CHARIOT team, take patients out of the hospital environment and immerses them in interactive games, scenes and scenarios.

For many patients, these distraction techniques help manage pain and anxiety associated with hospitalization, surgery and other medical procedures. They can help by:

  • Minimizing the patient’s perception of wait times
  • Reducing fear of parental separation
  • Decreasing the need for sedation and pain medication
  • Improving patients’ overall experience
  • Increasing the success of future medical encounters

The CHARIOT program off­ers a team-focused, multidisciplinary approach to care, with teams from the departments of Child Life, Anesthesiology, Surgery and Nursing working together to engage patients and improve the overall patient and family experience.

While immersive technology is helpful for a great many patients, it does not replace the care, comfort and communication provided by medical professionals and families or caregivers. Each patient is unique, with varying ages, maturity levels and medical needs. Our goal is to develop a rapport with each child and family to discover which tools and techniques are best for them.

Immersive technology is still a developing field. Texas Children’s CHARIOT team is committed to ongoing research to advance the use of these and other technologies to improve care for our patients.