New ED a significant advance in care of paediatric patients in Mid West
Single treatment rooms, better isolation facilities and a more child-friendly environment are among the improvements paediatric patients and their families can expect when the new Emergency Department opens at University Hospital Limerick on May 29th.
There were 64,443 attendances at the ED in 2016 – making it the busiest such facility in the country – of which just over 16,000 were paediatric patients (under 16s).
The new department will be laid out in pods with separate areas for major injuries, minor injuries, resuscitation and diagnostics - and including a dedicated space for paediatric patients with separate triage, waiting and treatment areas. Where the paediatric area in the current ED has six treatment bays, there will be eight single rooms for paediatric patients in the new department.
Dr John Twomey, Consultant Paediatrician, Specialist Interest in Ambulatory Paediatrics, UHL, said clinicians working with children were looking forward to the opening of the new ED.
“Much work has gone into improving unscheduled paediatric care in recent years and that must be acknowledged. When I first arrived, children and adults were seen in the same area which meant that children arriving in the middle of the night might have been exposed to distressing scenes of adult emergency care which was inappropriate. In March of 2014, we were able to introduce audiovisual separation within the ED to prevent parents and children being exposed to that. That was a great advance but what we will shortly have is a step above again
“We are excited at the prospect of having single rooms for assessment of patients. Over 80% of our clientele presenting in the ED will have an infectious component to their illness and if we have the means of isolating them on presentation, we can minimise cross-infection and the problems associated with that,” said Dr Twomey.
“The majority of our clientele are under 2 and it can be distressing for parents as well as toddlers to arrive in an emergency department in the middle of the night. If we can make the place seem a little less intimidating that will certainly benefit in the treatment and recovery of the child and the experience of the family. The new ED will help in this regard also with bright colours, tastefully and appropriately decorated for children and, from what I understand, even a fish tank!”
Access to advanced diagnostics is available within the ED, meaning children will not have to move to other parts of the hospital for x-ray or CT. And there will also be facilities for bereaved families, including two family rooms and a viewing room with access to a courtyard.
“It is rare but unfortunately there will continue to be cases where children are brought in severely injured or ill and will either die in transit or shortly after arrival. The most caring and empathic way to manage parents in that situation is to provide them with separate room for them to grieve appropriately, to spend time alone with their loved ones and to provide them with whatever pastoral care they require,” said Dr Twomey.
Along with this new infrastructural development, and in line with the National Clinical Programme Emergency Medicine Model of Care, the Paediatric ED needs increased numbers of paediatric emergency consultants/senior clinical decision makers and children’s nurses delivering front line emergency services.
“While the new ED represents a significant advance for paediatric patients and their families, the evolution of unscheduled paediatric care in the Mid-West must not stop there,” Dr Twomey said. “Unscheduled care means patients presenting acutely unwell and may be provided in a number of ways – through ED or GP Rapid Access Clinic. In order to improve access, additional investment is needed in the development of ambulatory care from an infrastructural and personnel point-of-view. Such developments could significantly reduce the number of paediatric patients presenting to the ED,” said Dr Twomey.
Developing such facilities was part of the long-term vision of the Department of Paediatrics in UHL, supported by the CEO, Executive and Board and in line with the National Clinical Programme in Paediatrics Model of Care.
“Additional objectives include the development of UHL as a regional centre providing paediatric surgery with appropriate anaesthetic support, further augmentation of paediatric services in UHL, the development of regional subspecialisation including adolescent care, securing resources for Health & Social Care Professionals to deliver the Model of Care, i.e. Psychology, SLT, etc, the expansion of the nursing role and the trilocation of Paediatric, Neonatal and Maternity services on a single site at UHL,” Dr Twomey said.