Aims The Emergency Department (ED) can be extremely stressful for children with autism spectrum disorders (ASD). We aim to improve the standard of care provided to children with ASD and their families in the ED by introducing measures to reduce anxiety and stress, whilst educating staff and improving staff confidence in managing ASD patients.

Methods We assembled a multi-disciplinary team to brainstorm ideas that would improve patient care and decided to introduce a Patient Passport and electronic Communication Needs Alert. We distributed a questionnaire to parents and staff over a 6 week period to explore staff confidence in looking after children with ASD and parent satisfaction with current/previous care experiences. We also explored whether staff and parents would support our proposed interventions, and asked for suggestions of other potential ideas to improve care.

Results We surveyed 25 Paediatric ED staff and 9 parents who presented with their children during the 6 week period.

Staff

• 84% had no specific training in managing ASD patients

• 76% felt they would benefit from additional teaching

• Only 32% felt ‘very confident’ or ‘quite confident’ in managing ASD patients

• 72% felt a Patient Passport would be useful

• 64% felt an electronic Communication Alert would be useful

Parents

• 89% would want to use a Patient Passport

• 89% want to be asked at triage about their child’s communications needs

• Only 22% have been asked about their child’s communications needs on every occasion they have attended ED

Other suggestions included sensory toys, ear defenders and communication aids.

Conclusions

• On average at least 1 patient with ASD attends ED per week, so interventions are likely to be worthwhile

• Staff would benefit from additional training in autism management

• Staff and families strongly support introducing both a Patient Passport and Communication Alert

ConclusionsNext steps:

• Roll out Passport and Communication Alert for use in paediatric ED

• Liaise with Community Paediatric teams to distribute Passport further

• Teaching for staff on managing ASD patients

• (P)s inviting parents to highlight their child’s communication needs at triage

• Seek hospital charity funding for sensory equipment to use in ED such as ear defenders, PECS cards and social stories.