Novant emergency room drill helps move hospital toward ‘kid qualified’ care

Published 12:00 am Wednesday, June 27, 2018

SALISBURY — A 5-year-old boy arrives by ambulance at Novant Health Rowan Medical Center’s emergency department with complaints of a 102-degree fever, a rash, and shortness of breath.

A team of nurses and a doctor dive right in to get to the bottom of what led to his illness.

The scenario was only a mock drill Tuesday, but the emergency department sees about 16 to 18 pediatric patients a day. Many of them arrive with similar symptoms.

The hospital is working to become a “kid-qualified emergency department” through VEPeds, a program of Valley Emergency Physicians Healthcare. Tuesday’s drill was part of that process.

Valley Emergency Physicians partners with hospitals around the country to provide clinical staffing and management training and services.

“The program was implemented to provide a comprehensive structure for pediatric care,” said Dr. John Bream, director of the emergency department at Novant.

The program is intended to address deficiencies in children’s emergency care. In addition to the mock drill, a review of the hospital’s capabilities provides a summary of recommendations.

The emergency department has 12 months to implement the recommendations. At that time, it will be provided a scorecard to determine if it meets qualifications to achieve “kid qualified” status.

Nationwide, children account for 25 percent of emergency room visits.

Statistics show that the younger the patient, the more likely he or she is to receive inadequate pain control, an inadequate physical evaluation, or early diagnosis.

“The care is the same. We’ve been offering pediatric care,” said April Gaither, a nurse manager.

“Practice makes perfect,” Bream said. “You have to be ready to intervene. The best way to be ready is to continue to prepare for it.”

The doctor and nurses who participated in the drill are actually some of the most experienced emergency room staff. The idea is that they would be the people to help educate those who are least experienced, Gaither explained.

The drill was facilitated by Dr. Annalise Sorrentino, a pediatric emergency medicine physician with Children’s of Alabama hospital in Birmingham, Alabama. She is also a professor at the University of Alabama.

Sorrentino a Rowan County Emergency Services Battalion Chief Bradley Dean programmed a pediatric mannequin used in the drill.

The doctor and nurses could ask questions, including what a red spot on the mannequin’s leg meant and whether the “patient” came into the hospital with a fever. The spot in this scenario meant the patient had a rash.

The hospital staff provided care as they normally would if the patient were a real 5-year-old boy. At the end of the drill, they received a critique from Sorrentino and discussed what they believed they did right and what they believed could be improved.

“I think you guys did a great job. Great teamwork,” Sorrentino told the group during the debriefing.

The preparation for the drill began in November 2016 with a pre-assessment. The staff identified what improvements were needed.

Novant Rowan President Dari Caldwell said the hospital already does its own internal review after a patient has a medical emergency that requires a team to rush in to provide care.

“It’s a continuous learning process. You are always learning,” Caldwell said.

The hospital tries to provide a child-friendly environment in the children’s waiting room area of the emergency department that is separate from the adult waiting room. Children will be able to wait with their parents in that space.

Three patient rooms are dedicated to children and have pediatric equipment, as well as colorful murals on the walls.

The Novant Health Rowan Medical Center Foundation provided money for six Kindle Fire tablets that will be given to children to use while they wait to be seen in the emergency department.

Contact reporter Shavonne Walker at 704-797-4253.