Child-proofed and Kid-friendly

New emergency and trauma department is designed especially for children.

Children are not little adults, at least not at Arnold Palmer Hospital for Children, Orlando Regional Healthcare (Orlando, Fla.). Since 1989, Arnold Palmer Hospital has provided a broad range of services for children. And while the facility has always delivered the best of care, its physicians, staff and administration recognized that there was a better way to meet the needs of its younger patients.

One way to do so, they decided, was to build an emergency department specifically for kids. Traditionally, children in need of emergency care would receive it at nearby Orlando Regional Medical Center. “It wasn’t a great environment for children,” says Myra Hancock, chief operating officer at Arnold Palmer Hospital for Children.

In April 2005, the Arnold Palmer Hospital for Children began work on its $11 million emergency department, which would be built around the needs of children. Completed in January 2007, the 23,000-square foot, 33-bed addition includes a four-bed trauma unit, pediatric ICU, surgical suite and OR.

The project was funded through philanthropic support from Arnold Palmer and others, as well as funding from the Bert W. Martin Foundation, Champions for Children and the Greater Orlando Children’s Miracle Network. Construction of the Children’s Emergency Department and Trauma Center was completed in September 2006. Once the hospital’s staff was fully trained to work in the new department, it welcomed its first patients in January 2007.

“We trained the staff for at least a year before the pediatric emergency department opened,” says Hancock. Indeed, caring for sick and injured children can be very different from treating adults. “It’s very difficult to find people trained specifically in pediatric trauma and emergency,” says Hancock. “We began with the core staff from our downtown department who enjoyed working with children. As we hired new staff, they would join our downtown staff in training. As part of our training, we ran mock codes and sent them to conferences. But, the best preparation came once we got the new department up and running.

“Today, we have therapy specialists who provide play therapy and medical play, [which helps some patients avoid] pain medication,” she continues. “We also have a private family bereavement room, with chaplains and staff social workers trained specifically to work with children and their families. And, our lighting can be adjusted five different ways, because bright lights can be scary to children.” In addition, the facility provides a playroom, child-sized furniture, and DVD players and televisions in every room. “We even have child-sized stretchers,” she adds.

Bigger and better

In order for the new emergency department and trauma center to effectively service 16 counties in central Florida, new technology and equipment were in order. In addition to purchasing new stretchers and standard equipment, such as blood pressure monitors, a portion of the grant money funding the project was spent on a 64-slice CT scanner. “We now have [extensive radiology] diagnostic capability onsite,” says Hancock. “We also added bedside ultrasound and C-arms, which enable [our surgeons] to repair bone fractures at the patient’s bedside.” Wireless Internet service, which is accessible to physicians, staff, patients and their families, completes the high-tech hospital environment, she adds.

Since last August alone, the new facility has treated over 25,000 emergencies and 20 traumas, including near-fatal water accidents or drowning fatalities, gun shot wounds and motor vehicle accidents involving unrestrained children. “We also see children who are left in the backseat of the car in extremely hot weather,” says Hancock.

“We used to see 40 to 60 patients each day at the downtown [facility],” she continues. “Today, it is not uncommon to see between 125 and 150 patients each day.” But, thanks to upgrades at the hospital, this is very doable. A new helipad enables staff to move patients from the helicopter, down an elevator and into surgery, the neonatal unit, or anywhere else in the hospital, in just 90 seconds or less, she says.

Presently, Arnold Palmer Hospital for Children has no plans to further expand its facility. In fact, it still hasn’t opened one of its pods in the emergency department. “We set up the emergency department with three nursing stations, so we can open more or fewer areas, depending on our [needs],” she says. “And, we can gear up for the winter months, when we have more incoming patients.”

“However, we would like to open an observational center,” she adds. This would create additional space for less severely ill patients, who may be dehydrated or need IV antibiotics. “We want to [do what it takes to] always keep as many emergency beds open as possible.” For one of the best-planned facilities in central Florida, this should be no problem.

About Laura Thill

Laura Thill is a contributing editor for The Journal of Healthcare Contracting.

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