Canada’s first kids-only ER at a general hospital
===================================================

* Lauren Vogel

A British Columbia hospital’s new emergency room includes a separate, kids-only department to make visits less chaotic for young patients and their families.

“With adult patients, you can have people with significant wounds waiting to be seen; they can be confused and agitated or coming in with police, so for us it was a priority to keep kids from witnessing that sort of stuff,” says Dr. Craig Murray, clinical director of emergency at Surrey Memorial Hospital.

The hospital’s 5500-square-foot pediatric emergency department is the largest of its kind in Canada and the first housed outside a children’s hospital. Opened Oct. 1, the department has its own entrance, walk-in and triage zone.

It’s a “drastic change” for children compared to the old emergency department, which offered little privacy because of overcrowding, says Lakh Bagri, interim executive director at the hospital. Originally built for 44 000 patient-visits a year, last year the department treated more than 100 000 people.

Roughly 18 000, or 20%, of those patients were children — a “critical mass” that Bagri says will continue to grow. “We felt we could provide better care by isolating our pediatric population in an area that’s built for them, and so the [new department’s] features are designed with kids and families in mind.”

Bagri adds that “streamlining our patients allowed us to really start specializing.” Part of that targeted care includes providing pediatric mental health services and a pediatric pharmacy to ensure appropriate dosing.

Murray says such specialization is only possible because the hospital created a unique space for young patients. “Given the reality of public health dollars, I think it would be a large challenge to get budget approval for some of these specialized things if you were just a regular emergency.”

The space features a large reception area with child-friendly furniture and an entertainment centre. “It’s very colourful, like being in a playground,” but also practical, says Bagri. “Patients can even draw on their bedside tables with markers — it just wipes off.”

Treatment rooms are larger to accommodate families and have walls, instead of curtains, for privacy. The rooms also have sinks to promote hand washing — a feature, along with three isolation rooms, designed to prevent the spread of disease to other children, visitors and staff.

The new department is staffed 24 hours a day by a pediatric team including emergency physicians, pediatric-trained emergency nurses, psychiatric nurses, child life specialists and a clinical nurse educator.

The opening of Surrey Memorial Hospital’s new general and pediatric emergency departments marks the completion of phase 1 of a $512-million redevelopment project.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/185/16/E748/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/185/16/E748/F1)

Surrey Memorial Hospital’s new pediatric emergency department is “very colourful, like being in a playground.”

Image courtesy of Fraser Health Authority