We have the money, now what?
Expanding Child Life Services to
New Departments
Presented by:
Michelle Pennington, BS, CCLS
and
Karen Frame, BA, CCLS
Presentation Goals
Attendees will have an understanding of how to:
 Identify the needs and set goals for a new
program.
 Introduce and implement program with support
of the interdisciplinary team.
 Continuously evaluate efficacy of the program
and make appropriate adjustments.
Needs Assessment
Figure 1.1 Relating Needs to Discrepancies between What Is
(Current Results) and What Should Be (Desired Results)
A tool for making better
decisions
Need (gap)
 organizational leaders use
needs assessments to define
those areas where
performance can be
improved in the near term
and long term.
Process to achieve desired result
Current result

Desired result
Source: Based on Kaufman, Oakley-Brown, Watkins, and Leigh (2003)
and Watkins (2007).
Identifying the Needs for a
New Program
“ The goal for child life programming should contribute to the
advancing the clinical excellence and quality of services offered to and
for pediatric patients and their families across the healthcare system”
 Concentrations of the most challenging procedures and age groups
 Relative severity of illness/ patient time spent in healthcare
 Degree to which illness/treatment is unexpected or unfamiliar
leading to likeliness of being overwhelmed to traumatized by
experience
 Identifying families who will be most helped by new coverage
 Family centered approach
 Inpatient vs. outpatient services
 Sibling support
Cost Benefit Analysis
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List expected benefits of the program
Translate benefits into monetary value
List savings benefits (cost avoidance) of the program
List return on investments
List total cost of running program over a period of time
 Formula for cost/ benefit ratio:
Discount cost avoidance savings+ discounted return on investments
initial investment + operating costs
* If ratio is greater that 1, this demonstrates the benefits exceed the cost
Example CBA Worksheet
Cost Avoidance
Family cost avoidance savings:
20 beds = 1500 admissions = 500 surgeries
1% children will suffer long term = 5 children
Cost of therapy = $500 each; for 5 children = $2,500
Hospital cost avoidance savings:
Because of cooperation, the equivalent of 1 FTE saved =
20,000
2,500 + 20,000 = 22,500 -10% discount = $20,250 (CA)
Example CBA Worksheet 2
Return on Investment
Family return on investment:
Without prep., 2 of the 5 children will be impaired
Potential lifetime income of each is $500,000
Both will lose 25% of earning power
$500,000 x 2 = $1,000,000 – 25% = $250,000 lost
Hospital return on investment:
Good will and publicity of program hospital gains $2,000 in 1 yr
$ 250,000 + 2,000 = $252,000 – 10% discount = $226,800 (ROI)
$20,250 + $226,800 = $247,050 total
Example CBA Worksheet 3
Initial Investment
Initial Investment:
Furniture and equipment 1st year = $1,500
Operating costs salary, fringe, supplies etc. $24,500
$ 1,500 + 23,000 = $24,500
$ 247, 050 = greater than 10 = ratio benefit/ cost
$ 24,500
1
 10:1 is value of the investment
Setting Goals for a
New Program
 Look at the Mission Statement, Visions, Values and
operation principles of the organization.
 Look at the policies, procedures and program
guidelines.
 Look at the needs of the program.
 Be sure that all of the above align, then set the goals
accordingly.
Introducing a New Program to
the Interdisciplinary team
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Ground rounds
Psychosocial rounds
Informational letter to physicians
Staff meetings
Journal club
Bulletin boards
E-learning modules
Getting Everyone on Board
Child Life Team
Management
Interdisciplinary Team
Meeting with fellow
child life specialists to
garner support and
ideas for future growth
should begin with
presenting the idea at a
department meeting in
the very beginning.
Presenting the plan for a
new program to
management at a
steering committee
meeting!
Be sure to include all of
the costs and benefits,
including patient
satisfaction.
Staff meetings and
interdisciplinary rounds
are two good times to
present the plan. Include
Fellow Child Life Team
the ways that the new
program will assist the
interdisciplinary team in
caring for patients and
provide support for
families
Closing the Sale to Management
 Proposal for services to new area
 Operations report including all costs and benefits
 Evidence based practice statements supporting the
new program
 Patient and family satisfaction reports from other
facilities
 Interdisciplinary staff support
Proposal for Child Life Services in
Perioperative Services
Hours:
Pre-surgery
tour:
M-F 6:30-3:00pm
Weekly on Wednesday
from 3:30-4:30
Wednesday 8:00-4:30 tour
3:30-4:30
Day-of Surgery
Preparation
The Child Life Specialist will
help with surgery
preparation utilizing
education and medical play
materials allowing for
mastery of equipment and
expression of feelings
regarding procedure.
Procedural
support:
Induction
support
Diversion
activities
Iv starts
Procedural support and
distraction
Provide daily activities for
play for each age group
See and touch medical
items such as an anesthesia
mask, a syringe and an IV
bag to help alleviate fears
on surgery day.
Medication administration
Coaching deep breathing
and comforting presence
Maintain art and craft
materials
Engage in an age
appropriate discussion of
what will happen before,
during, and after surgery.
Vital signs
Get age-appropriate
answers to his/her
questions and clear up
misconceptions.
Separating from parents
Become familiar with the
hospital/surgery
environment.
Meet with patients during
PACE visit to introduce
services
Offer diversion during
recovery process
Garnering Support from the
Interdisciplinary Team
 Working with the interdisciplinary team building
support and trust is essential
 Showing the team that what you do is important and
helps the patients as well as fellow employees
 Being there consistently
 Working hand in hand with others in the department
or unit
 Being part of the team
Working Out the Kinks within the
Child Life Department
 Discussions at staff meetings
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Responsibilities
Coverage
Hours
Working within the department framework
Advertising the New Services
to the Community
 Website:
 http://wolfsonchildrens.org/your-visit/pops/Pages/tours.aspx
* Printed materials:
* Physician offices
* Hospital magazine or communication
* E-mail notice to employees
* Public Relations:
* Media coverage
* News releases
Michelle Pennington, BS, CCLS
Child Life Specialist
Family Support Services
800 Prudential Drive
Jacksonville, Florida 32207
Phone: 904.202.8548
Fax: 904.202.8187
wolfsonchildrens.org
Thursday, April 23, 2014
Dr. Loveless,
This letter is to inform you of a new “POPS” (pre-operative preparation session) surgical tour being offered
at Wolfson Children’s Hospital for pediatric patients ages 3-18 and their parents. This session will allow
patients to tour the pre/post surgical areas and have a hands-on medical play session to help them
understand what they will experience on the day of surgery. The tour will be scheduled on an individual
patient basis provided by a Certified Child Life Specialist, and will enhance the pediatric patients experience
allowing them to better cope with a surgical experience. Parents or staff members should call 904-202-8247
to schedule a tour. If you have any questions or would like more information, please feel free to contact me
at any time.
Sincerely,
Michelle Pennington BS, CCLS
Certified Child Life Specialist
904-202-8247
Building the Program
 Apply for grants
 Fundraising opportunities ie: movie sale, bake sale,
toy drive
 Donations from stores and community groups
 Addressing health needs through collaborative
agencies ex. Safekids coalition
Working with the Community
Volunteers
•
•
•
•
Kitted caps
Cloth dolls
Blankets
Providing normalization for
patients
• Helping with special events
Community Groups
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Renovation donations
Activities/ parties
Celebrity room visits
Supply donation
Evaluating the Program
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Patient surveys
Anecdotal reports
Staff opinion
Statistical Data
Patient behavior ratings scales
Quarterly Operations report
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Child Life Budget
Staffing
New Resources
Child life hospital wide
Committees
Goals
Plan of action
Challenges
 Getting the staff on board
 Nursing
 Physicians
 Ancillary departments
• Adequate coverage (spread too thin)
• Maintaining boundaries
• Family centered care
Success Stories
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DRMC one-person program
PICU/ Progressive Care
CVICU
Peri-anesthesia
Possible Growth and Community
Coverage
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Adult patients
Advocacy
Hospice
Peds Care
Discussion
Questions?
and
Comments!
Contact Information

Michelle Pennington, BS, CCLS
Perioperative Services
Child Life Specialist
Wolfson Children’s Hospital
office: 904-202-8247
michelle.pennington@bmcjax.com

Karen Frame, BA, CCLS
Intensive Care
Child Life Specialist
Wolfson Children’s Hospital
office: 904-202-8548
karen.frame@bmcjax.com
References:
Kaufman, R., H. Oakley-Brown, R. Watkins, and D. Leigh. 2003. Strategic
Planning for Success: Aligning People, Performance, and Payoffs. San Francisco:
Jossey-Bass.
Thompson, R. (2009). The handbook of child life a guide for pediatric
psychosocial care. Springfield, Ill.: Charles C. Thomas.
Thompson, R., & Stanford, G. (1981). Child Life in Hospitals Theory and Practice.
Springfield: Charles C Thomas Publisher.
Watkins, R., & Meiers, M. (2012). A guide to assessing needs essential tools for
collecting information, making decisions, and achieving development results.
Washington, D.C.: World Bank.