PATCH Program at Children’s Hospital in Omaha
PATCH is an amazing program at Omaha Children’s Hospital and Medical Center for children with an Autism Spectrum Disorder (ASD). Think of it as a medical IEP. It lets the doctors, nurses, and other professionals know what negatively triggers your child.
PATCH stands for Patient Assistance Team at Children’s Hospital and Medical Center. Other hospitals throughout the country have similar programs with different names.
My Experience with PATCH
Through my son’s last few visits to our local children’s hospital, we experienced the medical version of an IEP, PATCH, Patient Assistance Team at Children’s Hospital & Medical Center.
Two of the visits were for planned surgeries, and one was an emergency room visit.
Prior to my son’s first scheduled surgery in March someone from the PATCH team called me to explain the program. After hearing more about it I figured why not. It would not hurt and just might be helpful.
We had a long phone conversation all about my son, how he reacts in medical situations and the best ways to help him cope with medical experiences. Not only was the program helpful . . . it one of the best ideas my children’s hospital, or any hospital for that matter should invest in.
Once my son’s PATCH was completed it was entered into his file. Any time a doctor, nurse 
or tech at the children’s hospital, their clinics or urgent care facilities pull up his file, they immediately see that he has a PATCH.
This allows them to read it first, before interacting with my son in order to be prepared to do everything they can to make the interaction more positive. They even had PATCH written in large letters on the door to his pre-op room so everyone knew to check it before entering.
PATCH (Patient Assistance Team at Children’s Hospital & Medical Center)
Examples From My Son’s PATCH
Here a few things that are included in my sons care plan (PATCH). Each plan is individualized with information taken from family before a visit or stay at the hospital.
- Come in quietly and speak in soft voices.
- Limit the amount of people entering the room at one time.
- Explain to him what they were doing, including where they were going to touch him for examination, even when using the stethoscope and taking his temperature.
- Follow specific instructions for how he handles anesthesia, like never using Versed because it makes him come out very agitated from anesthesia.
- He has a favorite blanket that soothes him and they know to make sure it is up against his cheek as he wakes up from anesthesia.
- Explain things to him at his developmental level instead of his chronological age. My son is 18, but he has the understanding of a 7 or 8 year old.
Results of Using the Medical Care Plan
The first two surgeries after implementing the PATCH program went so much more smoothly than in the past.
Our third medical adventure this year was a trip to the ER at the children’s hospital, but then we were transferred to a larger medical center. At the Emergency Room, his PATCH was utilized, but after transferring to the other hospital, I realized quickly how much I had gotten used to the luxury of a PATCH.
With the PATCH at Children’s Hospital in Omaha, I didn’t have to be ‘on guard’ at all times. Without the Autism Care Program, I always have to intercept people and explain his quirks and calm my son down when someone speaks in a loud voice or does things in a way that would causes him anxiety.
After being transferred to the bigger hospital I once again had to be ‘on guard.’
The biggest difference between our experience with the PATCH and at the hospital without the PATCH program was having to explain my son to every single person who came in the room.
At this larger university hospital, that included day and night nurses, his neurosurgeon, critical care doctors, critical care residents, neurosurgery residents, nurses’ aides, child life specialists, radiology techs, food service workers and on and on and on.
We were lucky and had great nurses in the ICU who worked well with my son. That experience could have been much smoother if his PATCH was universal and could transfer with is records to every medical center.
Nemours Children’s Hospital Autism Care Plan
Nemours Children’s Hospital has a similar program called REACH (Respecting Each Awesome Child Here).
A review of two years worth of electronic health records showed that the program significantly reduced the need for behavioral drugs and restraints in the ER.
Our program was designed to help prevent escalation of anxiety and agitation in children with ASD, therefore leading to the reduced use of sedatives and restraints,” said Cara Harwell, ARNP, CPNP, PMHS, lead researcher and a Nurse Practitioner at Nemours Children’s Hospital. “Sedative medications do have side effects, and if we can manage kids’ stress in other ways, we create a better experience for them and their families.”
The Future of Care Plans For Autistic Children
This program is only available at a few children’s hospitals around the country, but I hope it is the start of something that can be universally accepted at every hospital.
Autistic children need something that does not expire when they ‘graduate’ from a children’s hospital and are seen as adults.
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