Small gestures in pediatric oncology can have a big impact
A little bit goes a long way, especially when concerning children suffering from chronic disease.
Children’s hospitals are designed to remove some of the fear and anxiety experienced by pediatric patients but efforts are largely informal: encouraging parents to bring toys, playing music for the children or painting equipment in bright colors. However, radiation therapists Natasha McMaster and Jennifer DeGiobbi from the Nova Scotia Cancer Center want to integrate these gestures into EMR and pediatric oncology workflow, making the hospital, well, more hospitable.
While the Nova Scotia Cancer Center has been using a portable DVD player and a “treasure chest”—where children pick a toy after treatment—the impetus for EMR integration was a slightly-more time consuming support method: customized radiation therapy masks.
Depending on where they are receiving radiation, a mask may be used to immobilize the patient, ensuring the dose is delivered as planned. Certain areas of the body are very sensitive to radiation and the masks ensure that the patient is in the exact same position for every treatment.
Children are asked about favorite things, characters and colors, and the therapists will decorate the thermoplastic mask with medical physicist-approved tissue paper and acrylic paint. This work is done on their time and dollar—but the therapists don’t mind.
“Seeing the reaction from the patient is enough,” said McMaster. “I think giving the patient a little bit of control over something eases the stress of the treatment, especially when things have been out of their control for a while.”
Pediatric patients are more compliant, parents and caregivers are less stressed, and some children are even excited for daily treatment, according to McMaster. Right now the masks are created on an ad hoc basis, but the therapists are working with software developers to creates prompts in their EMR system that will facilitate the process.
“If we can have a task pop up, we don’t have to go down to the therapists to see if it’s ready, an automatic alert can notify us that a mask has been requested or is complete,” said McMaster. “A standard process can ensure requests for masks don’t get sprung on us.”
Additionally, including mask preferences and status with a patient’s chart allows caregivers to double-check the information.
“For instance, we had a Pokémon mask and we wanted to make sure we had the right one, so we took a picture down to the patient to confirm,” said McMaster.
The next step is a pilot study to quantitatively measure the effects the masks have on patient anxiety. The study will record how patients are feeling about their treatment before the masks are fitted, and before and after the treatment itself. McMaster expects to find a decrease in stress and anxiety, not just from the masks but from all of the “little things” provided to their pediatric patients.
“You step out of your comfort zone sometimes, but anything you can think of to give the patient a better experience is worth it,” said McMaster.
View a poster created by McMaster and DeGiobbi for more information about their efforts.