Student Renaissance School of Medicine at Stony Brook University Port Jefferson, New York, United States
Background: Child Life Services (CLS) is a growing specialized field dedicated to addressing the social, emotional, and educational needs of pediatric patients and their families. Studies have demonstrated CLS to have a significant positive impact on patient experiences and outcomes, including providing non-pharmacologic pain management, decreasing procedural times, and reducing anesthesia usage. However, CLS remain underutilized. Objective: To assess healthcare professionals’ knowledge of the scope of CLS practice and identify barriers to utilization at an academic children’s hospital Design/Methods: A cross-sectional survey was conducted among healthcare professionals in inpatient and emergency department settings. Respondents were categorized based on training, years of experience, frequency of interaction with CLS, and proximity to CLS offices. The survey assessed Respondents’ ability to correctly identify 26 specific CLS tasks and apply their knowledge through case scenarios. Chi-square analysis was performed using IBM® SPSS® Statistics. Qualitative content analysis of open-ended questions was used to identify additional barriers to CLS utilization. Results: Respondents (N=72) were physician-trained (49%), nursing-trained (44%) or other staff (7%) with an overall 27% response rate. Respondents tended to correctly identify patient-care and support system-related CLS tasks, but many were unable to identify education and professional responsibility-related tasks (Table 1). Those with >6 years of experience outperformed those with less at identifying education tasks like “pre-admission orientation visits” (81% vs 42%, χ2=9.1, p=0.01), while physicians outperformed nursing in identifying education tasks like “familiarize the child with new surroundings on admission” (91% vs 63%, χ2=7.0, p=0.03). Proximity to CLS offices had no impact on task identification across all categories. Increasing frequency of CLS interaction was associated with increasingly accurate identification of CLS specific roles, and with conflation of nursing and CLS tasks (Table 2). Self-reported barriers to CLS utilization included time sensitivity and/or CLS availability.
Conclusion(s): CLS adds significant value for hospitals, patients, and families. While CLS have a large scope of clearly defined roles, misconceptions about their scope of practice are likely contributing to their underutilization. In addition to augmenting CLS staffing and availability, addressing this gap in understanding may help facilitate more optimal integration into the multi-disciplinary healthcare team.
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