The introduction of 'open' visiting and family involvement in the care of hospitalized children created a revolution in the care of children in hospitals. This historical study utilized the situation at the Hospital for Sick Children, Toronto (HSC), as a case study illustrating change. Although psychological research provided a strong rationale for including families in the care of hospitalized children, change occurred slowly. In this regard, HSC was typical of many children's hospitals. However, there seemed to be a significant failure to learn from innovations elsewhere. Paediatric nurses, in particular, were slow to encourage family visiting and participation in care.