Changing hospital environments Are children falling through the gaps

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• Changing hospital environments Are children
  falling through the gaps?
• A/Prof David Bennett
• National President, AWCH

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Why are children important?

• Vital for the future strength and success of
  society
• Not just small adults differing needs at each
  developmental stage
• Competing with needs of adults likely to be
  overlooked
• Cannot speak for themselves need advocates

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Why are adolescents important?

• Adolescent health problems
• result in great personal, social and monetary
  costs (costly now)
• are mostly psychosocial and preventable
• contribute to the leading causes of adult
  morbidity and mortality (costly later)

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Children in hospital

• gt 0.5 million admissions for 0 14 years 1.5
  million patient days per annum
• In 15 24 years age group, 15 per cent of all
  occasions of service are in Emergency Departments

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Best practice in paediatric health care

1998
1974
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New Zealand Handbook

Children and young people receiving health and
disability support services are vulnerable, and
their wellbeing must be safeguarded. Nick
Baker, President Paediatric Society of New
Zealand, 2004
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Why conduct research? Who benefits?

• Saves lives Patients
• Decreases harm Practitioners
• Builds consensus Managers
• Monitors progress Policy makers
• ARACY - Research provides evidence that informs
  policy and practice

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The Psychosocial Care of Children and Their
Families in Hospital AWCH 2005 National Survey
Report Recommendations
Funded by NSW Health
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Launched on 15th August 2005
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National survey 2004

• Project Officer, Research Internship Program,
  University of Western Sydney
• Questionnaire sent to 465 Australian Hospitals
  caring for Paediatric patients
• Of 239 respondents, 42 excluded as unsuitable
• Study represents an analysis of responses from
  197 hospitals across Australia

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Stating the obvious?

• There have been many improvements (since AWCHs
  previous survey in 1992), but there is still a
  long way to go.
• Prof Kim Oates, President, CHA (Preface)

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National trends - 1992 to 2004

• A decrease by 30 per cent in the number of
  special units exclusively for child patients
• More co-location of children and adults

In this snapshot, things are slipping backwards
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Children Separate From Adults
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Areas with no improvements

• Of registered nurses working permanently in
  paediatric areas
• only 23 have appropriate postgraduate training
• Only 1 in 3 hospitals have
• preadmission programs
• availability of play staff
• arrangements for children whose parents are
  unable to visit
• Written info for parents infrequent and rarely in
  other languages

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Recommendations galore

• Paediatric adolescent facilities, accommodation
  for families
• Preparation for admission, tests and procedures
• Childcare visiting parental participation in
  care
• Schooling, play and recreation
• Staffing and qualifications, cultural sensitivity
• Evaluation and planning

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Stating the obvious!

• It would be difficult to argue with any of the
  recommendationswe should be providing these
  fairly basic psychosocial supports for children
  and their families far more widely than at
  present.
• Prof Kim Oates, President, CHA (Preface)

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What can AWCH do now?

• Tell me and Ill forget show me and I may not
  remember involve me and Ill understand
• Change for the better will occur only through
  local understanding, support, involvement, action
  and pressure for change. This depends upon
  people, leadership and support from the very top
  of organisations.
• Aynsley Green, National Childrens Director for
  Children, UK

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Opportunities for action at the hospital level

• Promote practical guidelines and strategies for
  hospitals to improve psychosocial care
• Provide education support and evaluation support
  to hospitals
• Work in partnership with hospitals providing
  links to support organisations

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Soliciting the views of young people
Young Peoples Panel at 2005 AWCH Conference,
Healthy Solutions for Children and Young People
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Opportunities for action at the national level

• Advocate for incorporating psychosocial issues as
  part of hospital accreditation
• Develop national standards and guidance for the
  appropriate care of children and young people in
  all health settings

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AWCHs vision

• An Australian culture where our Nations
  children young people are respected and
  cherished

www.awch.org.au
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