Production Tool Ref #73We often think of children as little adults – but, in so many ways, they are not. Nowhere is this more evident than in the emergency department of a hospital. While an emergency room is a scary place for adults, for children it can be absolutely terrifying. More so, how we deliver care to pediatric patients is different – different medicine dosages, different equipment, and a different style of communications.

That’s why we decided to design a new space within our current emergency room that considers the wellbeing of our youngest patients. Our pediatric ED opened in February 2016 and was immediately well received by our community. We have created a space that is friendly, comfortable, and as welcoming as possible for children and families.

Inside the Pediatric ED at the UVM Medical Center and Children’s Hospital

Creating a separate space was the first step in developing the new pediatric ED – from first arriving at the ED all the way through leaving it. A separate entrance was created so that children and families may immediately enter a space dedicated to them. Once inside, they will see that we have five beds available as well as one separate room set aside for procedures. The pediatric ED is open from 1 p.m. to 11 p.m., which is when we see the highest volume of patients. All children, teens, and young adults ages 0-21 are welcome. Pediatric patients are, of course, welcome in our general ED outside of these hours. If a child has a true emergency throughout Vermont, Upstate New York and outside Chittenden County, we always advise that the first stop for your child should be the nearest ED to your family from which a child may be transported safely to UVM if the necessity arises.

There is also a dedicated staff for the pediatric ED, including a dedicated nurse and technical assistant. Pediatric residents, family medicine residents, and a pediatric emergency medicine physician are also on shift during its hours of operation (1pm to 11pm). Emergency physicians trained in pediatrics also provide supervision in addition to the UVM Children’s Hospital both of whom support the pediatric ED 24/7 whether the pediatric ED is open or not.

We are proud and pleased that we have also designed a space that looks and feels friendly for children. Our Child Life team and our Patient and Family Advocacy advisors were instrumental in making this happen. The space includes pediatric equipment (sized for pediatric patients), pediatric-friendly pain scales, and lots of toys, games, and entertainment to provide comfort and distraction. The space is also kept quiet so as to alleviate stress and anxiety. The separation from the main emergency department helps make this possible.

Who Made It Happen?

A team from across the UVM Medical Center came together to make the pediatric ED a reality. That includes members from our ED team and from the UVM Children’s Hospital (both contributing physicians, nurses and staff), as well as our Patient and Family Advocacy advisors. Feedback from advisors offered real-life experience as most of the representatives have children with chronic illnesses who visit the ED. They participated in walk-throughs of the ED and waiting room and provided honest feedback for the planning and design process.

What is the Future of the Pediatric ED?

There is more to come! Private rooms are a goal for the future in addition to further equipment, and expanded staffing and hours. We also continue to add toys, interactive games, and design elements to make the space welcoming and comfortable.

We know that no one wants to visit a pediatric emergency department and, when they do, it should not be a scary experience. By rethinking and designing this space, we hope that we can reduce fears, lower stress, streamline the caregiver process, and improve children’s health outcomes in order to best serve the children and families in our community.

Katherine Nacca, MD, is Director of the UVMMC Pediatric Emergency Department, and Assistant Professor of Surgery and Pediatrics at the University of Vermont Medical Center College of Medicine.

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