The history of Paediatric Services has been evolving over the last many decades in Windsor/Essex, the service being located at three different hospital facilities until a mandated site was recommended by a Steering Committee Report in a 1998 by the Health Services Restructuring Commission stating that all Women’s and Children’s Services was to be located at the Met Campus of Windsor Regional Hospital.
Once construction had been completed, expanding the square footage required to accommodate Paediatric Services, it relocated in 2005, opening a 33-bed inpatient unit and a vibrant outpatient unit. A wide variety of children with diagnoses ranging from medical, surgical, oncology to mental health issues are assessed and cared for with some of the most common diagnosis being neonatal jaundice, bronchiolitis, asthma and gastroenteritis. The multidisciplinary team of professionals including registered nurses, paediatricians and other specialists, social workers, respiratory therapists, physiotherapists, occupational therapists, child life specialists, other allied health professionals and dedicated volunteers, all providing a progressive treatment plan toward wellness.
Outpatient services make up more than 85 per cent of total paediatric volumes, focused on the day-to-day needs such as surgery, medical day care, oncology satellite unit, asthma, cystic fibrosis, hemophilia and metabolic clinics. Outpatient surgery is performed on children from newborns up to their eighteenth birthday. The most common surgeries are tonsillectomies, adenoidectomies, myringotomies, hernia repairs and dental surgery. A unique feature within the program is a visual concept known as Surgical Safari, a pre-op tour with the child and parents to help reduce the anxieties of having to undergo surgery.
When Paediatric Services re-located to Windsor Regional Hospital, a new progressive view of service had been planned which included the addition of Child Life Services, a team of specialists who assist to reduce stress and anxiety that is often associated with hospital visits. They provide music therapy, art therapy and therapeutic play opportunities to assist with preparation for procedures. Using cloth dolls, medical play kits and real medical equipment, children are able to play through their experiences, expressing emotions and relieving misconceptions. Through these avenues, children are provided with a sense of normalcy and control within an unfamiliar environment. Families support and participate as it helps with their level of anxiety as well.
In 2007, the service began functioning as a Clinical Teaching Unit (CTU), part of the Southwestern Ontario Medical Education Network (SWOMEN) which was an extension of the Schulich School of Medicine and Dentistry at the University of Western Ontario and now with a direct relationship with the Schulich School at the University of Windsor.
A realization evolved with children arriving at emergency departments that showed the hospital was not child friendly. Sick and frightened children endure the same long wait times and share crowded waiting rooms with sick adults. Embracing the Windsor Regional Hospital vision of Outstanding Care – No Exceptions, the team got to work to create a system where sick children can access specialized Paediatric care in a timely manner. The initiation of an Emergency Medical Paediatric Program (EMPP) is a first step towards meeting the goal. Children who present in the emergency department with respiratory or gastrointestinal problems, dehydration and/or fever are triaged as and sent directly from the ER to Paediatric Services. There, a Paediatrician assesses the child within 30 minutes of their arrival on the Paediatric Unit. Following assessment, the child is treated and released and/or admitted to Paediatric Short Stay Unit for observation or to the Paediatric inpatient unit for further treatment and investigations.
The EMPP operates Monday through Friday from 0900h to 1600h with a long term goal to offer the service to families on a 24/7 basis and to expand the scope to include children triaged as CTAS 2 with identified conditions. Through the trial, 348 children were seen through the program with up to 75 per cent of the children assessed, treated and discharged home within four hours. The remaining 25 per cent were admitted to Paediatric Short Stay or the Paediatric Inpatient unit for further treatment and observation.
As Windsor/Essex plans for a single site acute care hospital for the future, one of the objectives is to research and educate ourselves and the community about what Paediatric Services should consist of in the next decade and beyond to continue to serve children requiring hospital care.