In January 2024, Ranken Jordan Pediatric Bridge Hospital in St. Louis, a 60-bed children’s rehabilitation hospital, began hiring patient play advocates to incorporate play into children’s recovery.
By November 2024, Ranken had launched a research department to study the incorporation of play into recovery and whether getting children out of their hospital rooms can improve health outcomes. So far, the research appears promising.
“If you are playing, you are getting better, you are healing, you are getting stronger, socializing, re-engaging with your community,” Nick Holekamp, MD, Ranken Jordan’s chief health transformation officer, said on Becker’s “Pediatric Leadership Podcast.” “If not, you’re not able to do those things optimally.”
Dr. Holekamp shared the goals of the research department and what other hospitals can learn from Ranken Jordan’s strategies.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What are the goals of Ranken Jordan’s research department?
Dr. Nick Holekamp: The first major goal was to assess our own environment, because obviously that’s one of the things we have in our control — the environment in which children are unfortunately stuck for medical reasons. And when we looked, nobody had ever assessed the environment in terms of where kids are, who they’re with, what they’re doing, what impact that was having on their recovery. That was the starting point: How are we doing on helping enhance their environment to give them those developmental opportunities alongside the intensive medical support that they’re getting to recover from whatever insult, prematurity or a terrible accident?
We’ve made a lot of enhancements to our care environment as a result of that. We’re remeasuring that, and along the way we’ve then taken the next step to try and assess what impact does improving a child’s environment have on their outcomes. And what outcomes are we interested in? How well they’re healing. How well small children are developing.
Small children stuck in hospitals for extended periods have a very high incidence of severe developmental delay. Might we have an impact on that? That’s our real focus at the moment, and probably for a number of years to come. [We ask,] can we improve the course of what is commonly not a great track record on developmental outcomes for high-medical-needs kids stuck in hospitals for extended periods?
Q: What can other hospitals learn from Ranken Jordan?
NH: [Applying Ranken Jordan’s approach is] really hard to do upstream in the acute care environment, but here are a few things you can do. You can take notice, instead of ignoring, that child sitting in bed by themselves doing nothing but staring at a screen and say, “we need to do better,” and encourage your colleagues and administrators to find ways — instead of excuses — for leaving kids in beds too long. And then little things: getting a mat in the room or outside the room, and getting kids up and out of bed.
Getting kids with other kids is really hard because there’s such a high bar for infection prevention purposes, and we have to go to extra lengths to overcome that concern. I will tell you that it’s not only possible, we do it really well and don’t increase a child’s risk of infection. So, more generally, test and sort of push on the conventional hospital norms that require kids to be stuck in their room. They’re not all as valid and well-seated in science as you might have been taught.
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