There is no place like Ranken Jordan Pediatric Bridge Hospital! We practice a revolutionary model of healthcare called Care Beyond the Bedside®, focused on getting patients up and out of their beds to engage in playful therapy.
The Pioneers behind OZ
What is OZ?
OZ (Optimization Zone) is a play-based learning program for our 0–5-year-old patients. This one-of-a-kind initiative aims to reduce the adverse developmental impacts that accompany long-term hospitalization. Ranken Jordan staff recognize that we are charged with caring for many young patients during a critically important window of early childhood development growth, a time when children are developing foundational skills for all future learning. This responsibility, along with our mission to get patients up and out of bed as much as possible, drove the creation of OZ. The OZ team includes: an OZ coordinator, Child Life Specialists, Psychologists, Physical, Speech, and Occupational Therapy Professionals, Therapy Technicians, Nurses, Respiratory Therapists and volunteers. This team works in consultation with our medical and infection prevention teams to meet patients’ health needs. This program is an essential part of our Care Beyond the Bedside® philosophy because it is focused on getting patients up and out of their beds to engage with each other.
Medical studies, such as a Chicago study of children with tracheostomies and ventilators recently discharged home, find that nearly 80% of these patients perform below the 5th percentile in developmental activities and mobility. “Giving these patients more exposure to developmental opportunities like the OZ program will help close the gap,” Dr. Wallace says.
OZ was created by the Committee to Assure Neuro-Developmental Optimization (CAN-DO). This committee was developed to formalize, enhance, and establish neurodevelopmental evaluation and programming for the 0-5-year-old inpatient population. CAN-DO believes that inpatients will benefit from a more robust outcome-driven approach to combating the negative effects of prolonged hospitalization on typical child development. Goals of CAN-DO include standardizing screening and assessment, incorporating therapeutic goals across disciplines into daily routines, and developing educational programming for patients, caregivers, and staff.
In May 2021, CAN-DO embarked on a time motion study. The goal of this study was to analyze what patients in this age range were doing during waking hours. This study showed that on average these patients spent 1 hour and 45 minutes a day out of their rooms. Compared to most hospitals, this amount of time spent out of their rooms is great, but for the Ranken Jordan CAN-DO team, it was not enough. A second time motion study was conducted in May 2022, three months after the initial start of OZ. The results showed that with OZ, patients in this age range now spend an average of 3 hours a day out of their rooms, a 84% improvement.
OZ Effect: Initial Goals
OZ has had a tremendous positive impact on our inpatient population of ages 0-5 years old. After just 10 months after the launch of OZ, positive results are evident. The effects of OZ have reached beyond the initial goals. Staff have reported improvement in social skills, communication skills, emotional development, and patients’ sleep, not to mention, expedited progress in meeting physical therapy goals, improvement in chronic respiratory conditions, and much more. Patients’ families also report positive impacts as OZ provides caregivers with the opportunity to play with their children and become comfortable helping them engage in typical childhood development activities.
These goals were the guiding principles for the creation of OZ. We wanted to prevent the delays
and disabilities that occur in patients due to long-term hospitalization.
Sneak-peak into OZ: Development Groups
Developmentally age 2 and above, attend 4 days a week, high-functioning patients, ever changing and ever evolving
Preschool
Developmentally age 6 months old to 2 years old, attend 2 days a week, emerging social interactions, starting to reach milestones such as crawling, sitting, and walking
Early Explorers
Developmentally age 6 months old and below, attend 2 days a week, goal is tolerating life, lower stimulation group, traumatic brain injury patients
Care & Comfort
Another important component of the OZ program is the iCare app, frequently used in childcare centers. This app allows the team to communicate with caregivers by providing developmental updates and sending pictures of children throughout the day. Chief Medical Officer, Dr. Holekamp believes the OZ program combined with the iCare app allows caregivers to see their children in a more typical early childhood setting helping them build confidence in caring for them.
“Many caregivers can’t be with their children at Ranken Jordan every day,” he explains. “My hope with iCare is that these caregivers can feel more connected to their children and learn what they can do to help them progress developmentally. They’ll also be more comfortable and better prepared when it’s finally time to take them home.”
Vision of OZ
One patient from the Care & Comfort group was sitting in the group. This group had a rainbow parachute draped over barriers, like a rainbow cave. One caregiver came in to see her son smiling. She immediately burst into tears of happiness at the sight of her son’s first smile since his injury.
Two patients that developed a sibling like relationship from being here participated in OZ together. One day while one of patients was playing on the light table, the other patient snuck up behind him and scared him with a Minnie Mouse doll. This resulted in a chance to work on conflict resolution, which is what children at this age should be learning.
One patient who was anxious and nervous to be around other children was in OZ one day. Every adult in OZ tried to engage with him but he was not interested. Another patient in OZ went up to him and used sign language to say, “You, me, snowman. Come on.” He followed her. She was the one who got him to play. While playing with the cardboard snowman, this patient reached some of his therapy goals outside of his therapy sessions.
Beyond the current OZ initiative, we look forward to exploring the future of OZ and its potential to touch more lives, both at Ranken Jordan and as a model used by other institutions to support the developmental needs of children in the hospital.
For even more information about OZ and how OZ has been shared
in the community, check out these additional resources:
