Autism-Friendly Emergency Department Improves Patient Satisfaction

Posted on Tue, Nov 03, 2015
Autism-Friendly Emergency Department Improves Patient Satisfaction

By Fareed Nabiel Fareed, MD, FACEP
Patients with autism react and communicate differently, requiring a specialized approach to create a safe and supportive environment – especially in emergency situations.
Recognizing this, in April 2014, we worked with EmCare Partners Group to develop a program to provide an “autism-friendly” experience in the emergency department (ED) at HealthAlliance of the Hudson Valley’s Broadway Campus (HAHV).
The program uses iPads with autism-specific apps that help our staff communicate with patients with autism and verbally impaired patients. The devices help medical providers learn the reason the patient has arrived for care; the patient’s pain and discomfort level; and his or her communication preferences. It also enables our staff to better explain what the patient can expect during his or her visit to alleviate fear and confusion. Sensory boxes provide objects with a variety of textures to enable autistic patients to self-soothe and better deal with stress.
The program also involved comprehensive education regarding special considerations in the care of ED patients with autism for our staff and pre-hospital personnel.
The hospital’s administration embraced this initiative whole-heartedly, and it’s great to see how this effort is truly improving the care experience. We’ve seen a significant increase in patient satisfaction scores, especially in 2015. We attribute it to a greater emphasis on the patient experience and customer service, of which the autism-friendly ED initiative is a part.
Meghan Goodnow, lead clinical technician in HealthAlliance’s ED, said the education and tools provided through the new program enabled her to quickly assess and calm an agitated patient – and provide peace of mind to his parents.
“A young boy with autism was yelling and crying very loudly when he came into the ED with burns on his fingers. I brought the iPad over to him, and we sat together and quickly navigated through the screens,” explained Goodnow. “He was much happier communicating using the iPad, and I could see the look of relief on his parents’ faces as the child relaxed and found a way to explain his pain.”
Goodnow also offered the boy the opportunity to select an item from the sensory box. Noting that he chose a squishy item, she made his ice packs “extra squishy” so they were more appealing to the young patient.
“When they were leaving, the patient’s mother said that she was very impressed with our staff’s patience and understanding toward their son. She said she was thankful to have a group of people willing to take the time to make her son feel special and to attempt to understand and communicate with him. She was planning to tell other local parents about our new service,” said Goodnow.
A young, non-verbal patient also found comfort by using a toy from the sensory box.
“The young man’s caregiver said that he probably wouldn’t be able to use the iPad but that the patient liked toys that made noise,” explained Pamela Ausanio, RN. “I offered him a pinwheel that moved and made a sound at the same time. The patient blew on the pinwheel during the evaluation, distracting him and easing the stress that can be associated with a physical exam. The young man’s caregiver was impressed with our attentiveness to his client’s disability. As the community becomes more aware of our services for people with Autism Spectrum Disorder, I think we’ll see an increase in visits from patients with autism.”
As clinicians and leaders, it’s important to recognize how our patient populations are changing – and evolve to meet those changes. I’m proud of what we’ve accomplished and I look forward to seeing the program expand.

Fareed N. Fareed, MD, FACEP, Medical Director of the Emergency Department at HealthAlliance of the Hudson Valley. Dr. Fareed graduated magna cum laude from Harvard University with a bachelor's degree in biochemical sciences. He obtained his medical degree at Columbia University College of Physicians and Surgeons. He completed an emergency medicine residency program at New York University/Bellevue Hospital Center. He was director of Columbia University's research associates program at NewYork-Presbyterian Hospital, was a faculty member for NewYork-Presbyterian Hospital's emergency medicine residency program, and was assistant professor at Columbia University. Dr. Fareed is a diplomate of the American Board of Emergency Medicine and a fellow of the American College of Emergency Physicians.

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