Christine Cho, MD, MPH, clinical director of the Division of Pediatric Emergency Medicine, examines a young patient.
New signs and fresh arrows painted on the sidewalks of Parnassus Avenue mark the important opening of a new, child-friendly, Pediatric Emergency Department (ED) at UCSF Benioff Children’s Hospital, on UCSF’s Parnassus campus.
In late April, a new, eight-bed pediatric ED opened its doors — most of which are covered in dinosaur wall stickers or painted with under the sea vignettes — to the San Francisco community, to help fill the need for child-focused emergency services.
Prior to its opening, pediatric patients with emergency health problems were seen by pediatric or emergency medicine providers in the main ED. The whitewashed rooms with adult-sized equipment made for a setting that was often stressful for children, who are often terrified at the prospect of being in the emergency room in the first place.
For walk-in pediatric patients and their parents, the new entrance, check-in and triage are separate from the main ED; the Pediatric ED entrance is just around the corner from the gift shop on the first floor of Moffitt Hospital.
It is located in a former Adult Prepare space, which was used for adult anesthesia pre-operation. The space also houses the lower acuity Pediatric ED beds, as well as the Pediatric Urgent Care facility and a family-friendly waiting area with toys and games.
Because the Urgent Care unit is located within the same space as the Pediatric ED, patients who arrive at check-in can be quickly triaged and screened for the appropriate level of care. The four higher-acuity Pediatric ED beds are located just across the hall and adjacent to the main ED, but are outfitted with equipment designed for children and their unique needs — as well as the stickers, Disney DVDs and painted walls that make it a more welcoming setting for kids.
To staff the new department, UCSF has brought on two new physicians who are board-certified in Pediatric Emergency Medicine, in addition to two who were already on the faculty. Residents from both the Emergency Medicine and Pediatrics programs rotate through the Pediatric ED as part of their training at the academic medical center.
Child Life Specialists from UCSF Benioff Children’s Hospital are also available in the Pediatric ED to ensure that each child’s developmental and emotional needs are met during their stay. They are able to offer support, answer questions and prepare children and their families before and during medical procedures, in addition to providing other helpful services.
The nursing and support staff specialize in pediatrics as well, making the entire experience child-centered.
The main difference between being seen in the pediatric Urgent Care room versus the Pediatric ED is the acuity level of the patient’s illness or injury, so having a dedicated Pediatric ED allows UCSF to provide child-centered care to children presenting with more serious symptoms.
Christine Cho, MD, MPH, who is trained in Pediatric Emergency Medicine and has overseen much of the new Pediatric ED project, says that “cohorting patients in one service allows for expertise to be further developed and enhanced” pediatric emergency nursing, child-life services, physician coverage. In this way, the new Pediatric ED benefits both UCSF patients and learners alike.
Since its opening in late April, it's been providing care 24 hours a day, 7 days a week. Evelyn Porter, MS, MD, says that use of the new Pediatric ED “ebbs and flows,” with some shifts bustling and others quieter.
This new Pediatric ED on the Parnassus campus also foreshadows what’s to come at UCSF’s Mission Bay campus, where the new medical center to serve women, children and cancer patients, is set to open in February 2015. The Mission Bay medical center will include a Pediatric ED as well, with 19 beds (two of which will be in resuscitation rooms) and a dedicated procedural room.
Once the Mission Bay medical center is up and running, the dedicated Pediatric ED at Parnassus will close and the main ED at Parnassus will again see pediatric patients as needed. Until then, the new Pediatric ED at the Parnassus campus is UCSF’s primary location for specialized pediatric emergency care.
Theresa Poulos is a third-year medical student and executive editor of Synapse, which previously ran this story.