The Implementation of an Extended Hours Child Life Therapy Service in a Paediatric Emergency Department

Child Life Therapists (CLT) are healthcare professionals who support children in hospital by engaging, educating and empowering them. With a high rate of procedures, the Emergency Department (ED) would seem an ideal site for CLT; however literature is limited regarding their utility. In 2024, the ED of The Royal Children's Hospital (RCH), Melbourne commenced an integrated, extended hours CLT service. This study outlines the patient demographics, support provided by CLT and presents feedback on the effectiveness of CLT from caregivers, children and clinicians.

A retrospective chart review in 2024 included all CLT referrals over 6 months, describing patient characteristics, CLT interventions and reported CLT effectiveness. Prospective surveys of a convenience sample of carers, children and clinicians determined the effect of CLT on the procedure, net promoter scores and satisfaction scores. Hospital ethics approval was obtained (Reference number: 3915).

CLT assisted 1130 patients. Median age was 5 years (IQR 3-8 years). Seventeen percent were neurodiverse or had developmental delays. Sixty-six percent were admitted to hospital. Two-thirds required support for procedures-mainly blood tests via venepuncture and finger pricks (64.4%). One hundred and eighty-five caregivers, 58 patients and 58 clinicians responded: feedback indicated that CLT eased procedures, reduced distress, worry and pain. Clinicians reported increased procedural speed and efficiency and reduced use of sedation and restraint.

Child Life Therapy enhances patient care whilst improving clinical workflow. Stakeholders indicate that CLT reduces distress, pain and worry for children and may reduce the need for sedation and restraint.