Specialist Anne O’Gorman enters the clinic room and gently approaches the family. She’s taking it all in. Is the parent anxious? How is the child interacting with his surroundings? As she listens and observes, she reaches into her pocket – not for a medical instrument, but for a deck of cards. She is a child life specialist at Shriners Children’s New England. While playing might be part of the job, she in fact has an essential role, right alongside the physicians, nurses and parents.
“I’ve taught myself two card tricks to make patients laugh,” said O’Gorman. “Humor is a great coping tool.”
She’s one of many child life specialists, recreation therapists and care managers responsible for Shriners Children’s signature approach to care, which is affectionately known as wrap-around care. This child and family-centered focus supports social and emotional needs and enhances physical healing. Wrap-around care, which is sometimes explained as a concern for the overall well-being of our patients, is so successful it has become central to the system’s identity.
A hallmark of care
Shriners Children’s provides superb medical care, but staff members also take pride in looking at additional ways they can enrich kids’ lives and help them on their journey through life.
Larissa Sims, a child life specialist for 29 years at Shriners Children’s Spokane, explains that child life specialists look at the child’s many needs related to their care.
“When children are treated at Shriners Children’s, we don’t just look at them in a medical or clinical way,” said Sims. “Wrap-around care originates from our mission: It’s who we are and what we all do.”
The wrap-around care approach helps the system stand apart from other healthcare models.
“Shriners Children’s approach to most things, recreation therapy included, is unique from other systems,” said Laura Hollingshead, who has led recreation therapy at the Salt Lake City location for 22 years. “The focus on patients’ needs is exceptional. It’s what makes us special. We feel different because we are different, and I love it.”
It’s always been this way
It should come as no surprise that Shriners International – a fraternity founded on the principles of fun, fellowship and philanthropy – established a healthcare system known for its kindness and compassion. It was not enough to get children walking again after treatment for polio, unless they also walked away with some of their most cherished, lifelong memories.
Examples of infusing medical care with loving attention go back to Shriners Children’s earliest days. In 1922, when the first hospital opened in Shreveport, Louisiana, the sound of children’s laughter echoed throughout the halls. The hospital was known for its child-focused activities, such as a classroom to help children keep up with their studies, and Boy Scouts and Camp Fire Girls programs, to teach life skills and encourage a sense of adventure.
In the early years, most patients stayed for a year or more at the Chicago Shriners hospital, established in 1926. The hospital sought to create a family atmosphere. Between treatments, the distractions from healing were plentiful.
The Daughters of the Nile, a women’s organization allied with the Shriners fraternity that founded the healthcare system, arranged parties for the children. The annual Christmas play not only afforded a festive opportunity for singing and acting, but it was also the only time boys and girls came together for socializing. Necessity led to more enrichment opportunities. It was difficult to retain a gardener during this time, so flowerbeds gave way to a vegetable garden, planted and tended by the patients, who quite literally enjoyed the fruits of their labor during evening meals.
In the 1930s, weekly movies became popular, and a patient’s note from the 1960s in the Chicago hospital archives detailing Saturday nights as movie and candy night proves this tradition had staying power. To this day, Chicago patients enjoy movie night, only now they can stream movies in their own rooms.
The power of listening
Wrap-around care starts with listening.
“Listening is number one,” O’Gorman said. “In child life, we do an assessment, just as the doctor does. We assess the patient on their likes and dislikes, watch how the child interacts with others in play, notice what they are touching or not touching, and gauge whether they look scared or happy.”
Listening is how our Salt Lake City location’s staff identifies and meets unique needs. A simple question, “What are you going to be for Halloween?” led to staff in the wheelchair seating and mobility department creating a wheelchair costume clinic. Good listening also sparked Salt Lake City’s special needs car seat clinic, when families mentioned how uncomfortable their child was in their vehicle without proper seating.
When O’Gorman heard that a patient’s hospital stay would prevent her from attending her high school prom, she sprang into action transforming the teen’s room into a Starry, Starry Night-themed prom. The dance was complete with her prom date, friends, family and school principals in attendance, and formal attire, of course.
Play with purpose
Incorporating recreation and play into the medical setting helps kids cope and grow through their experiences at the hospital.
However, Sims in Spokane is quick to point out that it is not all fun and games. “There’s a purpose behind activities and treatments that are individualized for each patient and family.”
She runs the hospital’s FutureFest Transition Group that helps teens tackle some of the challenges of moving into adulthood. She also leads Teen Group where teens with similar conditions get together weekly to discuss issues they’re facing.
Beyond facility walls
Shriners Children’s signature wrap-around care has always extended beyond the walls of its physical buildings. Camp Achieve, for example, is a Twin Cities camp that helps patients with limb differences conquer their fears. Kids can rock climb, ride horseback, swim, ski and much more.
“We believe that challenges are what makes life interesting and overcoming them is what makes life meaningful,” said Maureen Johnston, recreation therapist. “The weeklong program gives campers a chance to push the limits of their physical and mental capabilities and reach new heights of excellence.”
“In the past 20 years, I can say with certainty that we have witnessed a growth in confidence and self-esteem in the children who have attended our camps,” said Johnston. “The increase in independence and leadership qualities that have emerged in these kids is truly astounding.”
Predicting the future
Wrap-around care has changed since the early days.
“On the surface, recreation therapy at Shriners looks nothing like what it did when I first started,” said Hollingshead.
Nearly her entire focus was on the inpatients and, in most cases, their parents who were staying with them. Her focus has changed to an outpatient program, but her approach is the same.
“The patients still are my number one focus,” said Hollingshead. “Providing them a safe place to grow, to work on goals and create relationships is and will always be there.”
And the need is growing. “Our role has expanded so much that it’s difficult to be available for every patient who may need us, but we make sure each area has special toys to hand out when we can’t be there,” said O’Gorman. “I see such a difference in patient experiences when we get to be involved.”
While healthcare will inevitably keep changing, there is one constant: Our skilled specialists will know what to do.
“Thankfully a skillset in every recreation therapist’s toolbox is the ability to adapt,” said Hollingshead. Perhaps this was never tested as much as it was in 2020, during the onset of the COVID-19 pandemic.
“We’re involved in all areas of the hospital now,” said O’Gorman. “I get called into the outpatient department for blood draws, Botox, removal of casts and rehabilitation. These are things we are already doing, and I see us doing more.”
Pair that spirit of versatility and adaptability with a 100-year legacy of care, and you have a prescription for success for centuries to come.