Kids Care - A Model to Build Trusting Relationships

baby oliver and his mom Oliver with his mother, Shannon Matthew and Shannon sing the praises of the care their 1-year-old son, Oliver, received at Children’s Hospital, except for one brief moment. The relief of a quick diagnosis in the Emergency Department turned into momentary panic when the doctor began an appropriate, effective — yet to Matthew totally bizarre — treatment to slow Oliver’s racing heart.

The doctor came in with a bag of ice and pressed it against Oliver’s face. "I was about ready to grab the doctor to make him stop," Matthew recalls. "Oliver was screaming, ‘No, no, no.’ I was going crazy."

The doctor had skipped an important step in the KIDS CARE model (see below) of family-centered care: The E, which stands for "Explain what you are going to do before you do it."

"If someone had just taken a minute to prepare us, it would have been OK," Matthew says. "But no one did."

Clinicians did a much better job of hitting all the points of KIDS CARE throughout the rest of Oliver’s three-week stay, during which cardiologists were able to control his supraventricular tachycardia, or SVT, a cardiac condition characterized by a racing heart beat caused by electrical misfiring in the heart.

KIDS CARE model

Here’s what you can expect your child’s care team to do while your child is hospitalized at CHOP:

  • Knock on the door before entering your room.
  • Introduce herself or himself and determine who is at the bedside (relationship to the patient) and how you want to be addressed.
  • Discuss plan of care and incorporate your input.
  • Scrub their hands. Hand hygiene is essential to reduce hospital-acquired infections.
  • Check your child’s ID band and tell you why this is important.
  • Assess your child’s pain level on the appropriate scales, and partner with you on the plan to reduce any pain.
  • Return to the room in a timely manner and reinforce their availability to your family, if you should need them or have questions.
  • Explain what they are going to do before to doing it and ensure you, and your child if appropriate, understand.

It wasn’t until Oliver was back home being a normal toddler, thanks to five doses of heart medication a day, and Matthew had joined the Family Advisory Council, that he learned about the KIDS CARE model. In 2011, nursing leadership revived the acronym, originally created in 2002, and updated a couple of the letters’ meanings to reinforce patient safety while still maintaining its purpose of building trusting, respectful relationships between families and care providers.

"The actions described in KIDS CARE are what our nurses already do, but KIDS CARE helps them deliberately communicate so everyone is on the same page," says Joanna Horst, MSN, RNC, NEA-BC, nurse manager in the Garbose Family Special Delivery Unit.

"The deliberate nature of communicating what we are doing allows parents to be involved and informed, and to intervene or ask questions, if needed," says Ana Figueroa Altmann, MSN, RN, nurse manager for the Medical Hospitalist Team unit. "A parent may not know all of the safety measures we take to ensure the quality and safe care of their child. So, when a nurse states, ‘I’m going to check Ben’s ID band now to make sure it matches this ordered medicine,’ it educates parents."

To make it a true partnership with patients and families, KIDS CARE  information is now part of the Welcome Packet and nurses review it with family members within 48 hours of admission.

 "We definitely felt like we were a part of Oliver’s care team," says Matthew. "I remember every time there was a nursing shift change, the out-going nurse would introduce us to the next shift nurse. I could see them checking Oliver’s ID band, even in the middle of the night, before they gave him his meds."

He also remembers one night, when overnight nurse Jackie Brown, RN, BSN, after taking Oliver’s vital signs, stayed and sang softly to him until he fell back to sleep. "You see all the accolades about CHOP being the number one Children’s Hospital," Matthew says, "but the tenderness our nurse showed that night is the reason CHOP is number one for us."