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Pediatric Update


Pediatric Update

Summer 2007

New Mattel Children’s Hospital Provides Healing Environment

New Mattel Children’s Hospital Provides Healing Environment

Ronald Reagan UCLA Medical Center—slated to open next year—will replace the current structure that was built in 1951. The new hospital will combine the operations of Ronald Reagan UCLA Medical Center, Stewart and Lynda Resnick Neuropsychiatric Hospital UCLA and Mattel Children’s Hospital UCLA. A separate entrance to the Mattel Children’s Hospital UCLA will serve pediatric patients and their families.

Hospitals can be a frightening, foreign place for sick children and their families, all of whom are already under a great deal of stress. Through a thoughtfully planned, childfriendly layout, the Mattel Children’s Hospital UCLA—housed on two floors of the new Ronald Reagan UCLA Medical Center—aims to make a hospital stay as comfortable as possible for families. Together, architects C.C. Pei and I.M. Pei and hospital leaders embraced the idea of natural light as a source of healing. The hospital’s sweeping design and huge windows allow light to pour in from all directions. Edward R.B. McCabe, M.D., Ph.D., physician-in-chief of Mattel Children’s Hospital UCLA, wanted to be sure that the space inside wouldn’t feel too expansive and intimidating to children. To achieve this balance, the corridors are divided into three separate pods, keeping each child’s “home base” environment on a more human scale.

Nearly every patient room is large and private, and includes a foldout bed for parents. Private rooms also provide a quiet place for physicians to confer with parents and children. When necessary, conference rooms throughout the floor give parents, family members and physicians a place to talk without disturbances. “By giving parents space for their belongings and a tranquil place to be with their children, we hope to help reduce the stress of a very trying time so they can turn their attention to supporting their child,” says Judith Brill, M.D., director of pediatric critical care at UCLA.

Each patient room can quickly double as a procedure room. Some operative procedures—such as dressing changes, inserting a central line or ultrasoundguided diagnostics—can be performed at the bedside, reducing the stress of a trip to the operating room. When children are able to get up and move around, ageappropriate playrooms provide a welcome distraction. Just inside each playroom, a “white-coat hook” provides a place where physicians must leave their most recognizable article of clothing.

“Children need a space where they are safe from the poking and prodding of doctors,” Dr. McCabe explains. “When we visit a patient in a playroom, we come as their friend, not their doctor.”

The grand outdoor terrace adjacent to the playrooms sets Mattel Children’s Hospital UCLA apart from the rest of the building. Electrical outlets on the terrace allow children tethered to monitors the ability to enjoy the outdoors. “We have the best real estate in the building,” Dr. McCabe notes. “We are so happy to dedicate this bright space with panoramic views to the children so they can play outside, blow bubbles or just relax in the fresh air.”

Families will be greeted in the bright, colorful lobby by a “welcome wall”— a 60-foot-long display of small and large video screens, the contents of which can be refreshed frequently. Screens will display slideshow images from special events hosted by Mattel Children’s Hospital UCLA. But two of these video screens will truly give life to the building. With the theme “What’s your story?” these videos will feature vignettes of patients and their families. For example, one 16-year-old girl recently made a video about her life and her experience fighting Hodgkin’s Lymphoma. Patients and families will be encouraged to contribute pieces—whether they are still photographs or longer videos—to help share their experiences. The welcome wall also will present messages from doctors and other staff to help put children at ease.

Other surprises await young patients as well. A center pillar in the lobby houses tiny cameras at varying heights; when children look into the cameras, their picture will appear up on the wall. An image of a butterfly flies around the walls, on the floor and all around the room, inviting children to chase it.

Care for critically ill newborns in the Neonatal Intensive Care Unit (NICU) will be comprehensive, efficient and family-centered in the new hospital. With more space for each baby and controlled ambient light and sound, the NICU setting will allow care providers to meet each baby’s medical and developmental needs. “Care providers in the NICU work in partnership with parents toward meeting the specialized needs of ill babies to ultimately help place them back in their nurseries at home, where they belong,” says Sherin Devaskar, M.D., director of the Division of Neonatology and Developmental Biology at UCLA.

Adjacent to the NICU, a parent lounge allows parents the space to hold or breastfeed their baby, when appropriate. When a baby’s condition improves, parents can stay with their child around the clock.

Mattel Children’s Hospital UCLA is one of very few hospitals that have the specialized capabilities of a children’s hospital and high-risk obstetrics under one roof. As such, the NICU staff is able to provide immediate-response teams for resuscitations or other complications during childbirth. Specialists from the NICU staff work hand-in-hand with obstetrics and gynecology to conduct testing on high-risk fetuses and monitor a mother before, during and after birth. The NICU specialists advocate for the baby and discuss the management plan and outcome of a high-risk fetus with the parents. The NICU follow-up clinic, recognized as a California Center of Excellence, monitors children for two years after discharge from the NICU.

The hospital’s warm, nurturing physical environment sets the stage for the Child Life Program. A pioneer program when it began more than 30 years ago, the Child Life Program attends to the social, emotional and developmental needs of each child and his or her family in a culturally sensitive manner. “When children are sick, it affects entire families,” explains Amy Bullock, MSEd, CCLS, director of Child Life/Child Development Services. “Our goal is to put everybody at ease by preparing children for medical procedures and helping children and families cope with the challenges of illness.”

Child life specialists prepare children for difficult medical procedures such as spinal taps, bone marrow aspiration and surgery using age-appropriate techniques. For example, a young child may want to know what the OR or the surgeon will look like, whereas an older child might be worried about how much pain to expect after a procedure. Child life specialists present the information honestly and with concrete examples. Children can try on a mask and gown and lie down on a hospital gurney. Or, child life specialists may review an upcoming procedure using a medical kit as well as books, dolls and other props, giving children a sense of control.

Before and during surgery, child life specialists spend time with family members and the child. “We are part of the child’s support team,” Bullock says. “By supporting the ‘whole child’ we can help them cope with life-changing events, helping to reduce future maladaptive behavior.”

When procedures are finished, therapeutic play and educational programs enable children to develop positive coping skills during their recovery. “Children need to feel connected, especially when they are hospitalized,” says Hilary Gan, M.A., a child life specialist. “Online journaling or social groups for older children and games and playtime for younger ones help children express themselves and cope with feelings of isolation and the realities of their disease.”

Moving forward, the Child Life Program hopes to expand beyond the walls of the Mattel Children’s Hospital UCLA. “Our goal is to train hospital staff to interact in a developmentally appropriate way with every child who comes through UCLA’s doors—including siblings of hospitalized children and children of hospitalized adults,” Bullock says. “These children can be overwhelmed by the experience and may need to reach out to someone to help them work through their feelings.”

With an average caseload of 15 children, child life specialists rely heavily on their 100 strong, dedicated volunteer base. People from all walks of life, including community members, UCLA students and athletes—fill the corridors on a daily basis. Volunteers help coordinate arts and crafts or other projects as well as special events. Former Dodger manager Tommy Lasorda, one of many celebrities who have lent their time to the children, made a guest appearance as Santa Claus. But it is perhaps the smaller gestures, such as playing a video game, reading a story or simply sitting quietly by a sick child’s bedside, that is the heart and soul of the volunteer program.

After hospitalization, child life specialists may remain as a resource for families as they reintegrate their child or their family back into work, school and community.

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