Heather Real, one of the consultants on the Urgent Care Consultants team, attended the Third Annual Society for Pediatric Urgent Care Conference held October 5-8 at Seattle Children’s Hospital. During a packed three days at the conference, Heather gleaned a profusion of expert information regarding the pediatric urgent care industry. She was excited to share her findings with UCC’s clients, so she put together her top three takeaways from her three days in Seattle.
“One of the things that was discussed more than I expected was the consumer approach to medicine, especially when it comes to the urgent care setting,” said Real.
The consumer-based approach is what the proprietor model of urgent care is built on, and according to Real, pediatric urgent care is no different. With mom being a savvy consumer, she is applying her value-based approach to how she makes medical decisions for herself and her family.
During the Pediatric Urgent Care Conference, the conversation focused on how consumers expect health care services to be just as responsive and accessible as other industries, such as banking and online shopping. Consumers expect affordability and convenience. And with the increased prevalence of high deductible insurance plans, patients are warier of costs. In the past, patients weren’t as judicious when an office visit was required because insurance covered the bulk of the cost. Now that responsibility falls primarily on patients’ shoulders.
“Patients are becoming cost-conscious consumers who seek low-acuity care in the same way one might seek a mechanic,” said Real. “If the need is episodic and urgent, the patient needs to feel they are getting quality care at a reasonable rate.”
One particularly hot topic at the conference was pain management in the pediatric urgent care setting.
“A lot of research has been done lately around a child’s experience with pain in a medical setting and how that affects how they approach medicine later in life, particularly as it relates to potentially painful procedures,” said Real.
Rather than previously used methods, such as restraining children, conference attendees learned how techniques used by child life specialists in the hospital setting can be applied in the urgent care setting to ease patient anxieties. Those techniques involved distraction and updated language and medical devices that decrease children’s distress when undergoing procedures, such as laceration repairs, IV placement, blood draws, foreign body removals, intramuscular injections and more.
For example, active distraction techniques include tablet games, “I SPY” books, bubbles and meditation, while passive distraction techniques include movies, singing, reading a book or spinning toys.
One of the medical devices Real learned about was the J-Tip, a needle-free device that can be used to inject lidocaine. “They call it a space ship because it makes a ‘wooshing’ noise as the medication is deployed and may startle a young patient if they are not properly prepared,” said Real. “The device drives the medicine below the surface of the skin and blocks the nerves to numb the skin. No pain and no needles. You can even have the child touch the tip to show them there’s no needle, and then ‘1-2-3 blast off!’ Just a blast of air and a little fluid and it doesn’t hurt.”
According to Real, many states are moving toward having some regulations with sedation, requiring urgent cares to be licensed, certified or fall under the regulations of an outpatient surgical center. For urgent care centers located in states with these kinds of regulations, sedation may not be a reasonable option, so these kinds of techniques will become a necessity.
For everyone else, these techniques are great to know to if you want to offer your patients the best experience possible.
There is a common misconception that urgent care centers that cater to kids are out to steal patients from pediatric practices, when the reality is that urgent care is well-positioned to augment the medical services in a community. Conference attendees discussed how to approach local pediatricians to introduce the concept of pediatric urgent care as an alternative to the emergency department, not an alternative to the pediatrician.
“This is especially important to communicate to local pediatricians if you have overlapping hours,” said Real. “The pediatrician could think the urgent care will not treat the patient appropriately or even think the urgent care will try to take over the primary care of that patient, but the urgent care center is better suited to see the child who has the episodic and urgent medical need and needs to see a provider right away. Pediatric urgent cares can take unnecessary visits off pediatrician’s schedules so they can handle wellness visits and manage their chronically ill patients within their normal office hours.”
Real says the key is for urgent care providers to emphasize that they will always refer the kids back to their pediatricians for follow-up care.
“Kids can decline fast, so they shouldn’t have to wait to get in to see their pediatrician or be diverted to the ED for non-emergent needs,” said Real.