Focus on Pediatrics

Family-friendly facilities ease the stress of care

Have play areas for children and trained staff

A hospital stay can be very stressful for children and their families. However, there are many ways pediatric facilities ease stress that other health care institutions can model when serving a pediatric population.

The environment plays a key role, but hospitals don’t have to have cartoon characters on the wall to be more inviting to children. Painting walls in pleasing colors and having things for children to do while they wait will help ease stress, says Chris Brown, MS, CCLS, director of child life and education at The Children’s Hospital of Philadelphia.

Kiosks in waiting areas offer interactive learning experiences at The Children’s Hospital of Philadelphia. At one kiosk, children can see what physician’s see when they look at people’s eyes, ears, nose, and throat. At another exhibit, children can put their arm in a blood pressure cuff and push a button to see what it feels like when it squeezes their arm.

While the exhibits are fun and help kids pass the time as they wait for their visit at the emergency department or primary care, they also are teaching tools. "It helps children process some of their fears and concerns about coming to the doctor," says Brown.

Having equipment and furnishings that are appropriate for children of different ages also is important when serving a pediatric population, says Brown. Pediatric hospitals not only have playrooms but also treatment rooms designed for children.

If parents have difficulty finding the clinic or day surgery area, their anxiety increases, and that often transfers to the child. Therefore, signage should be clear and people should be available to help with directions, says Sheila Palm, MA, CCLS, director of child life at Children’s Hospitals and Clinics Minneapolis and St. Paul (MN).

It’s also important for staff to be friendly and engaging, introducing themselves to both the child and parents or caregiver. Staff needs to know the developmental differences in how children perceive their health care experience, says Palm. "We want health care providers to understand how the concerns of a 5-year-old are different from a 12-year-old," she says.

One way to address the concerns of each age group is to offer tours of surgical areas for families before the actual day of surgery. That’s why Children’s Hospitals and Clinics schedules weekly tours of the operating room for younger children educating them on what they might expect the day of surgery. A tour for adolescents is scheduled once a month. 

Also, the health care system has virtual tours of the surgical areas on its web site and coloring books that take children through the process. Parents can use the coloring books to review the experience with the child at home so that he or she is better prepared.

Staff also use relaxation techniques in treatment rooms to help ease stress, says Palm. For example, to help children regulate their breathing, they may have them blow bubbles or a feather on the end of a string.

Distraction is another technique that can be used to reduce stress. To take children’s minds off a medical procedure, a child life specialist, nurse, or parent might read a book or talk to the child about a favorite activity.

It’s important to partner with parents and family members because they are the constant in a child’s life and the experts. "It’s about communication, giving information in a way that families can understand, as well as hearing their needs and expectations, says Brown.

To help meet the needs of families who have a child in the hospital, The Children’s Hospital of Philadelphia has sleep space for parents in many of the rooms on units as well as at the 3,500-square-foot Family Resource Center.

The center, which is open 24 hours a day, has a large living room area where parents can come to relax as well. Attached to the resource center is a family library that not only has books and information but computers and other business machines so that families can stay connected to friends and relatives during their child’s hospital stay. It also provides an opportunity for parents to keep abreast of their business obligations. Inside the family library is a children’s library.

A third component of the Family Resource Center is a learning center where family members are taught the care techniques that they will need when their child is released from the hospital. The environment in which they learn is designed to be similar to a home setting.

To make sure the staff at The Children’s Hospital of Philadelphia understand the needs of families with ill children, several people who have a chronically ill child are on staff. These people sit on committees to help develop programs and policy and sponsor coffee hours for families, which provide parents and caregivers a time to interact with those who already have been through the experience.

Sources

For more information about creating a child-centered environment to reduce the stress of a hospital stay, contact:

  • Chris Brown, MS, CCLS, Director of Child Life and Education, The Children’s Hospital of Philadelphia, 34th St. and Civic Center Blvd., Philadelphia, PA 19104. Telephone: (215) 590-2001. E-mail: brownc@email.chop.edu.
  • Sheila Palm, MA, CCLS, Director of Child Life, Children’s Hospitals and Clinics Minneapolis and St. Paul, 2525 Chicago Ave. S., Minneapolis, MN 55404. E-mail: Sheila.Palm@childrenshc.org. For more information about preparing a child for a hospital stay or procedure in order to reduce stress, contact: