WELCOME TO ETCH!

1. WELCOME TO ETCH!

2. Instructions for completion of module Welcome to ETCH Service Excellence Family-Centered Care Child Life No Information Patient Patient Safety Goals Restraints Isolation/Infection Control Pain Management Child Abuse Death & Dying Emergency Codes Pneumatic Tube System Dress Code Parking and Other Info Forms to Complete This module contains:

3. Carefully read through the entire module. When you have completed the module, download the Completion Form and the Information Security Compliance Statement Form. Sign these two forms and turn in to your instructor. IMPORTANT! These forms, along with your Centralized Student Orientation transcript and immunization record, MUST be in the ETCH Education office PRIOR to your clinical rotation! Instructions for Completing the ETCH Module

4. Our Philosophy Because Children are Special…

5. Our Mission… • Delivery of Care to patients between the ages of birth to 21 years, in the East Tennessee and surrounding region • Education of patients, families, the community, students in medical disciplines, ETCH employees and healthcare providers in the CRPC area • Research through participation in the BENCH networking program • Community Involvement

6. ETCH History • Opened in 1937 and located on Laurel Ave. • Originally called Knox County Crippled Children’s Hospital

7. ETCH History • Moved to 21st and Clinch in 1970 • 2018 Clinch Ave P.O. Box 15010 • Much expansion since then

8. ETCH 2007 …155 bed facility with multiple pediatric subspecialties

9. East Tennessee Children’s Hospital offers many services such as… • Child Life • Pastoral Care • Social Work • Specialty Outpatient Clinics • Home Health Services • Rehabilitation Services • Clinical Nurse Specialists in the areas of Surgery, Critical Care, Hematology/Oncology, and Pulmonary Care • Nutrition Services • Healthy Kids Program • Ronald McDonald House

10. Service Excellence… Our Responsibility. Our Commitment. Children’s Hospital

11. People don’t carehow much we knowuntil they know how much we care.

12. Service Excellence VisionTo be the kind of organization wherechildren and familieswant to come for care,physicians want to practice,andemployees want to work.

13. Service Excellence…Our Responsibility. Our Commitment.Statement of PurposeWe strive to give extraordinary care and service to our patients, their families, members of the Children’s Hospital family, and the communities we serve.

14. Our Philosophy of Service Excellence*We take pride in our professions and feel personal ownership and responsibility for achieving Children’s Hospital mission.*We seek opportunities to be friendly and to help patients, families, and coworkers.*We are always courteous and respectful.*We show care and compassion by acknowledging people’s feelings.*We demonstrate respect for privacy and confidentiality in all we do.*We never tire of explaining what to expect, what we are doing, and why.*We try to understand how our work affects others and look for ways to help each other.*We respect diversity among our patients, families, co-workers and community.

15. SHARE: Service Excellence in Action • S SENSE people’s needs before they ask. • H HELP each other our through teamwork. • A ACT with empathy and compassion. • R RESPECT the dignity and privacy of others. • E EXPLAIN what is happening.

16. Customer Satisfaction: A fool’s gold?What is fool’s gold? Something that looks more valuable than it really is. Let’s compare the difference between customer “satisfaction” and “loyalty.”The customer satisfaction formula:Doing it right the first time+effective complaint handlingThe customer loyalty formula:Doing more than is expected+Doing more than the situation warrants

17. Does customer satisfaction = customer loyalty?On a five-point scale, people who mark a 4 (satisfied), compared to those who mark a 5 (very satisfied) are 5 times more likely to defect to the competition.Satisfaction is based much on convenience, while loyal customers will often drive longer to seek out your services because of the way they are treated and the service they receive. Loyal customers will tell others about how good you are---they have a story to tell.What separates the excellent from the best?Nothing---They do the same things especially more consistently and under pressure over time.

18. The secret of excellence is consistency and the enemy of excellence is too much variation.Organizations with a reputation for world-class service simply know how to attract and keep individuals who will deliver the same courteous, compassionate care, day in and day out, regardless of the circumstances.

19. ATTITUDE: The one thing I have control over • An attitude is my frame of mind when I approach a situation. I choose my attitude in every situation. • Stimulus--------*Interpretation----------Response *All emotional growth in life occurs in the interpretation phase. Learn to ask: What would cause me to act like that? Asking this simple question when we are faced with difficult people can help us maintain tolerance and even compassion for our patients, families, and co-workers.

20. Non-Verbal Communication • 93% of what we communicate in attitude is non-verbal. • 7% In words • 38% By tone of voice • 55% By body language • And it’s done in the first few seconds. Even in job interviews by a professional, the decision is essentially made in 20 seconds!

21. Never get tired of explaining! • 75% of all medical malpractice lawsuits could have been prevented by explaining things better. • One of the most common complaints patients and their families have is that things were not better explained. • The highest ranked quality desired in choosing a doctor is the doctor’s willingness to listen and explain in words I can understand.

22. AttitudeThe longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness, or skill. It will make or break a company… a church… a home. The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change our past… we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you… we are in charge of our attitudes.Charles Swindoll

23. Child/Family Centered Care Children’s Hospital Knoxville, TN

24. Definition of Child/Family Centered CareChild/Family Centered Care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. It redefines the relationshipsbetween and among consumers and health providers.

25. *Child/Family Centered practitioners recognize the vital role that families play in ensuring the health and well-being of infants, children, adolescents, and family members of all ages. They acknowledge that emotional, social, and developmental support are integral components of health care. They promote the health and well-being of individuals and families and restore dignity and control to them.

26. *Child/Family centered care is an approach to health care that shapes policies, programs, facility design, and staff day-to day interactions. It leads to better health outcomes, and wiser allocation of resources, and greater patient and family satisfaction.

27. Child/Family Centered Care is the Right Way to Treat People…*Leadership*Human Resources*Architecture and Design*Family participation in care*Communicating with families*Family to family support and networking*Linking families with community resources*Educating Child/Family Centered professional collaboration in policy and program development

28. In Child/Family Centered Care:*People are treated with dignity and respect*Health care providers communicate and share complete and unbiased information with patients and families that are affirming and useful*Individuals and families build on their strengths by participating in experiences that enhance control and independence*Collaboration among patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care

29. In a Hospital that Practices Child/Family Centered Care, Administrative, Clinical, and Support Staff:*Recognize the family is the constant in the child’s life*Facilitate collaboration between families and professionals*Honor the racial, ethnic, cultural, and socio-economic diversity of family*Recognize family strengths and respect various methods of coping*Share complete and unbiased information with parents*Encourage and facilitate family to family networking*Understand and incorporate developmental needs*Design accessible health care delivery systems

30. Core Concepts • Strengths • Collaboration • Partnership • Information Sharing • +Support • Flexibility • Empowerment

31. C/FCC in Action • Inclusion of parents on Steering Committee • Increased MD involvement • Parent Advisor Programs • Resident Education • Website Changes • Chronic Care Parent Notebook • NICU Journal • Questions for My Doctor • Family presence during procedures and codes • Kangaroo Care in the NICU

32. C/FCC in Action, continued • Orientation / Inservices / Courses—Inclusion of Family Centered Care Concepts • Disaster Planning • Review of Parent Materials • Family Resource Center • Welcome Guide for Families • Inclusion of Parent Advisors on Hospital Committees

33. Benefits of Child/Family Centered Care • Improves medical and developmental outcomes • Leads to health care that is more responsive to patient and family-identified needs and priorities • Reduces health care costs • Enhances patient/family/staff satisfaction

34. Age-Specific Interventions Age-Specific Interventions are the skills you use to give care that meets each patient’s unique needs.

35. Every patient is an individual with his or her own... • likes and dislikes • feelings • limitations and abilities • experiences

36. Everyone grows and develops in a similar way or stages that are related to their ageBUTat their own pace.

37. Strategies to Enhance Coping: • Newborns: Pacifier, Blanket, Soothing sounds, Touch, Music • Toddlers: Pacifier, Blanket, Favorite toy, Holding a hand, Party Blowers, Blowing bubbles, Pop-up books, Toys, Mobiles, Pre-Post Procedural play, Play Dough • Preschoolers: Party Blowers, Blowing bubbles, Counting, Pop-up Books, Holding a hand, Manipulative toys, Computer games, Listening to music, Singing songs, Pre-Post Procedural Play, Play Dough • School Age: Deep breathing exercises, Music, Hand-held games, Computer games, Imagery/fantasy, Pretending to be in a favorite place or doing a favorite thing, Pre-Post Procedural play, Squeezing Nerf balls • Adolescents: Deep breathing exercises, Music (head sets are popular), Computer games, Imagery/fantasy, Imagine a favorite activity, Squeezing a Nerf ball, Hand-held games

38. Child Life Specialists-What do they do? • Child Life Specialists are individuals who have a degree in a type of early childhood education or development. • They may sit for a national certification exam after obtaining a certain number of clinical hours on the job. • They have many roles, and this may vary institution to institution.

39. The Role of the Child Life Specialists At ETCH • Provide therapeutic play for stressed, anxious patients. • Provide play opportunities and other experiences which foster continued growth and development and prevent adverse reactions. • Provide developmentally appropriate education and preparation to patients for upcoming procedures. Help patients express their feelings and cope with stress in ways that enhance their sense of mastery and self-esteem.

40. The Role of the Child Life Specialists At ETCH • Teach patients appropriate coping techniques – relaxation, deep breathing, etc… • Provide distraction for patients during procedures in the clinical setting and other procedural areas in the hospital. • Initiate medical play with patients to encourage the expression of fears and misconceptions. • Incorporate place to encourage positive interactions with taking medicine and other behaviors to be in compliance with their treatment plan.

41. The Role of the Child Life Specialists At ETCH • Provide planning/scheduling to help with patient behavior modification. • Serve as a resource to all departments relating to development and psychosocial issues and provide ways by which these needs can be met. • Provide a means by which the hospital staff can make meaningful observations of patients in normal play and educational situations to better assess the patient’s progress and needs.

42. The Role of the Child Life Specialists At ETCH • Orient new Child Life students and volunteers to the appropriate departments. • Organize volunteers to provide the following services: • Requested toys and supplies • Visits to the playroom and teen room (inpatient) • Play at the bedside

43. Child Life Staff… • During your rotation, notice the Child Life staff and how they interact with your patients! • Child Life Specialists provide an invaluable service to our patients and families here at ETCH!

44. No Information Procedure East Tennessee Children’s Hospital

45. What is the purpose of “No Information”? • This procedure provides guidelines for addressing a “No Information” status on a patient and outlines steps to initiate, authorize, notify personnel, and flag pertinent records. • The procedure defines a “No Information” patient as one who is not acknowledged as being in the institution. • The procedure provides a basis for all staff that may have contact with the patient. Everything is done on a need to know basis.

46. Who can initiate (ask for) “No Information” status?

47. Nursing Coordinators Nurse Managers Nursing Directors Social Work Security Who has theauthority to authorize (give the OK)?

48. Flagging the medical record… • Meditech - admitting flags the patient as confidential by preceding the patient’s name with a “c” (e.g. cSmith, John). This patient’s medical record is tracked by Information Systems. All staff DO have computer access to confidential patients, but volunteers do not. • Medical Record – chart is flagged with the name “Cody Seagreen”

49. Flagging the medical record… • Patient assignment board – room number will list the name “Cody Seagreen” • Label – tag with “Cody Seagreen” • Patient door sign – “Cody” • Surgery Schedule– actual patient name will be listed • Patient census – actual name will print if run by authorized personnel • Over-the-bed card – actual patient name listed (keep door closed, call child by REAL name)

50. Responding to requests for information… • Respond to ALL requests for information with the following: “We have no information on a patient by that name.” • Community relations will respond to all media requests for information.