One of the burdens joys of being a child life specialist is that you get REALLY good at explaining what you do and why you do it. It’s incredibly common for us to be recognized in the hospital as “the girl with the iPad” or “you’re the fun one!”

Sometimes getting recognized like this can feel like it diminishes our role, but I like to go back to the fact that if staff sees me this way – parents and kids do, too… and isn’t that the whole point? To be a safe, fun, calming presence in the hospital?

Now, as “fun” as we may be, the truth is that Child Life Specialists improve healthcare efficiency and operations in ways that affect the bottom line as well as patient experience. This means we help hospitals save money. This means having a skilled, passionate, and efficient child life team can save your organization money while improving your patient satisfaction scores.

So how does Child Life really improve major hospital Key Performance Indicators (KPI)?

According to the Association for Child Life Professional’s Value Proposition statement,

???? “CCLSs are a low-cost yet high-yield investment in the direct and downstream success of healthcare institutions”

as discerned by the American Academy of Pediatrics, The Beryl Institute, The Canadian Paediatric Society, the Society of Critical Care Medicine,4 the Walt Disney Company, and over forty years of clinical research.

You may be wondering what KPI’s for hospitals actually are and how child life specialists improve them, so I’ve compiled some real-life examples for you:

Average Hospital Stay

• An 8yo patient is status post ruptured lap appendectomy and is scared to move after surgery. All clinical indicators and pain management is taken care of, but the patient needs to pass stool prior to discharge. However, due to the patient’s developmentally appropriate fear of pain, she is afraid to move. Child life is consulted to help the patient identify the source of fear and provide interventions accordingly to get the patient out of bed. The patient is up and moving in a designed therapeutic activity that has her getting to the playroom. The discharge passes stool and is discharged prior to 1:00 PM. Without child life intervention, this patient would have stayed over an additional night.

Medical Equipment Utilization

• One of the reasons IVs are hard to place in children is because children move and wiggle during procedures. This example shows you two ways that child life saves on adding unnecessary medical equipment:
  • The nurse at the bedside is starting an IV with a lab draw on a 2yo patient in the emergency room. This nurse brings all necessary equipment for the procedure. The child life specialist is also present and knows that toddlers can associate the combination of unknown objects, people and discomfort with pain. The child life specialist brings in a diaper or sock to wrap around the child’s IV site after the procedure to keep the IV out of sight for the toddler, thus keeping the toddler from trying to grab it and having to start a new IV.
  • The child life specialist has also brought distraction items to provide the toddler with an alternative focus and has implemented a comfort hold with the caregiver to keep the patient safe and still. With this positioning and distraction, the nurse only needs one attempt for a successful procedure.

Average Patient Wait Time

• Child Life Specialists are acutely aware of wait times and their impact on a patient and family’s ability to cope in the healthcare setting. For this reason, the child life team communicates regularly with other child life specialists in departments throughout the facility to help cases move as efficiently as possible. This is done through: developmental assessment hand-offs, transitional coping plans to reduce delays due to non-adherence or anxiety, and communicating families needs and desires.

Patient Drug Cost Per Stay

• Child Life Specialists help reduce the need for analgesics in certain situations by offering educational tools and psychosocial support. These interventions save the hospital and family money by reducing the need for anesthesia and more invasive interventions.
• Child Life Specialists have a connection with families and an understanding of the patient’s development. This relationship leads to insight regarding how a child takes medicine. For example, the doctor discusses prescribing a pill medication for the patient, but child life knows that the patient has a history of not being able to swallow pills. Child life informs the physician of this prior to the prescription being written, thus saving the costly error of two medications being ordered and filled prior to discharge.

Bed or Room Turnover

• When the emergency waiting room is filled, child life specialists are integral team members that do what they can for productivity on the unit. For this reason, although out of their job description, they are often changing linens, wiping rooms, and escorting families to help with room turnover.

P.S. My newsletter offers more tips like these “How does Child Life improve Hospital KPI’s” PDFS, parent, professional and diagnosis-specific resources, and podcast episodes from parents sharing their own personal experience of having a child with a diagnosis.

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References

1. American Academy of Pediatrics. (2014). Child life services. Pediatrics, 133(5), e1471-e1478.
2. The Beryl Institute. (2018). What patient experience can learn from child life professionals. Retrieved from: https://www.theberylinstitute.org/store/ViewProduct.aspx?id=11084124.
3. Canadian Paediatric Society. (2019). Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures: Position statement. Retrieved from https://www.cps.ca/en/documents/position/managing-pain-and-distress
4. Frankel, L. R., Hsu, B. S., Yeh, T. S., Simone, S., Agus, M. S., Arca, M. J., … Gayle, M. O. (2019). Criteria for critical care infants and children: PICU admission, discharge, and triage practice statement and levels of care guidance. Pediatric Critical Care Medicine, 20(9), 847-887.
5. The Walt Disney Company. (2018, March 7). The Walt Disney Company commits more than $100 Million to bring comfort to children and their families in hospitals. Retrieved from:https://www.thewaltdisneycompany.com/walt-disney-company-commits-100-million-bring-comfortchildren-families-hospitals-2/