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After Hours Convenient Care: COVID Update

St. Louis Children’s After Hours offers convenient medical care for children’s illnesses and injuries when their pediatrician’s office is closed. During the COVID-19 pandemic, After Hours has made changes to their processes and services to ensure the safety of patients, families and staff while still delivering kid-focused care.

Learn more from Beth Schickler about the changes made and how they are working with pediatricians to care for their patients.
After Hours Convenient Care: COVID Update
Featured Speaker:
Elizabeth (Beth) Schickler, MSN, RN
Elizabeth (Beth) Schickler, MSN, RN is the manager of St. Louis Children’s Hospital After Hours.

Introduction: Another episode of Radio Rounds, the podcast interview series presented by St. Louis Children's Hospital covering pediatric topics of interest to doctors and healthcare professionals. Here's Melanie Cole.

Melanie Cole: St. Louis Children's After Hours offers convenient medical care for children's illnesses and injuries when their pediatrician's office is closed. During the COVID-19 pandemic, After Hours has made changes to their processes and services to ensure the safety of patients, families, and staff, while still delivering kid focused care. You're listening to Radio Rounds. The podcast series from Washington University Pediatric Specialists at St. Louis Children's Hospital. I'm Melanie Cole and today we're discussing the After Hours convenient care we're giving a COVID update. Joining me is Beth Schickler. She's the Manager of the St. Louis Children's Hospital After Hours Convenient Care, Beth, it's such a pleasure to have you back on with us today. Tell us about the After Hours Convenient Care through St. Louis Children's Hospital. What services do you provide? Tell us a little bit about it?

Beth Schickler: Thanks Melanie, for having us on. So After Hours Convenient Care is staffed by advanced practice registered nurses, and we provide acute illness and injury visits for kids up to the age of 22. The services we provide are point of care testing. So that includes rapid strep test, urine analysis, urine HCG, influenza, RSV, mono glucose, and stool guaiac testing. Additionally, we have radiology services as well. If physicians are concerned, their child has a injury that needs to be x-rays. We are able to do X rays up the clavicles to the fingers, pelvis to the toes, foreign body series as well. Additionally, we're now offering two view chest and two view abdomen images as well, which is new for us in the last two months or so. So if we see an injury that needs to be splinted, we can splint those on sites. Additionally, we offer removal of foreign body. So ears, nose, the superficial skin foreign body. We have tissue adhesive, Fluorescein eye exams, and we're now working on offering sutures as well.

Host: Wow. What a very comprehensive after hours care. So tell us a little bit about what's changed or what's happened with the pandemic. Were you always offering all of these services? What's changed?

Beth Schickler: Yeah, so we have been offering the services, definitely. And I think lots of the changes that we have made are changes other physician's offices have had to make as well. Some of the changes we've made have started by prescreening patients and families upon arrival at the door and closing the waiting room. This quickly evolved to over the phone preregistration and families using their car as a waiting room. So we call the waiting when the waiting room is clear and there's a room available for them. This has helped smooth out our families coming to the clinic, decrease their time interacting with our front desk team, gets them to a private room pretty quickly as well, has also decreased their overall time spent in that clinic. In addition to preregistration changes, we've had some environmental changes as well, which I think most offices are doing as well. We ask that there's one parent with one child. This is to keep the number of people low in the clinic to keep everyone safe. If a child has additional special needs, families just need to let us know that and we can accommodate those additional needs. Anyone over the age of two, we asked to wear a mask. If they don't have one, we provide one for them. Additionally, we ensure that no families are passing each other in the hall. We like to make sure that the waiting room and front desk are clear and wiped down before we bring in the next family.

Host: What about same day reservations?

Beth Schickler: Yeah, that's a great question. So our phone lines are open to start the preregistration process starting at 3:00 PM, Monday through Friday and 10:00 AM on Saturday and Sunday. So this essentially holds the family's place in line. Once they arrive, they call us and let us know that they're there. Then we let them know when the child's room is ready. And if we're ready for them in the waiting room, we're not taking appointments at this point. We're just really having families call so we can do the prescreening and get them registered.

Host: So, you said you're not taking appointments, so families do not make appointments. They can still walk in. Explain that a little bit.

Beth Schickler: Yeah, definitely. So families can still walk in. We know that injuries happen and they may not have time to call and do the preregistration process, so they can definitely still walk up and still do the preregistration process. If we're ready for them, we will bring them in right away. If not, we just have them use their cars, a waiting room. In the meantime, while we're getting the clinic cleaned and ready for their visit.

Host: Thank you for clarifying that, Beth. So what should a family do if they think their child may have COVID?

Beth Schickler: First and foremost, we really want families to be in contact with their child's primary care provider or pediatrician. We encourage, and we ask them, did you call and speak with your physician. And what direction did they ask you to do next? In order to come to the clinic, we do have them call ahead and do the prescreening process. If there's a high risk for exposure, we make sure that those families are brought directly to a room. They don't stop in the waiting room. They don't stop at the front desk. All of their registration happens in the room with the door closed. And then as far as our team members, we try to really control the amount of team members that are going into the room in and out of those rooms.

Host: While you were telling us about all the services you offer, you didn't mention COVID testing. Do you do that?

Beth Schickler: Yes. So we do perform COVID testing. We have the same set of criteria that is available through Washington University. We screen patients according to that, we just want to make sure that we're testing appropriately. Additionally, we are looking into offering rapid COVID testing in our clinic. We don't have that right now, but as soon as we do, we will share that with everyone.

Host: So, if a pediatrician's patient visits after hours, how do you communicate back with the pediatricians? What do you tell them about their patient coming in and any results? What's the communication like?

Beth Schickler: That's a great question. That is one of our central tenants. When we started was to be able to have a close loop communication with our pediatricians and advanced practice providers as well. So after the visit is complete, we send a full note back to the provider to letting them know lab tests that were performed. Any medications that were dispensed. Additionally, for kids who have a radiology or labs that were sent away, once those final reports are available, we also send those to the provider as well. And we're following up with the families to make sure that they are aware of those final results. Additionally, if we have a kid who's in the clinic and we think that the provider needs to be aware of them, situational awareness, or we would like them to see them the next day, we will call them in the moment to let them know that we have concerns. We'd like them to see them. We also notify the providers through their exchange of any transfers from our facility to a higher level of care. So if we think they need to go to the emergency room or we're admitting them directly from our clinic to an inpatient floor, we do call and let those providers know.

Host: So, wrap it up for us Beth, what would you like other providers to take from this podcast about the After Hours Convenient Care through St. Louis Children's Hospital and what they should be telling their patients about the services you offer and the best times to visit After Hours Convenience Care?

Beth Schickler: I think one of our central tenants is that we're here for their patients when their office is closed. So we are open Monday through Friday from 5:00 PM to 11:00 PM, Saturday and Sunday from noon to midnight. And we do have select holiday hours as well. So we're really working in partnership with the pediatrician's offices to be able to provide pediatric specific care to kids. Providers have additional questions or concerns. They're always welcome to reach us through the Children's Direct. Additionally can call our back line in the office. Families can reach us through StLouischildren' That will give you a little bit of information about the clinic, times that we're open, the preregistration process and services we offer.

Host: Thank you so much, Beth. It's really great information and really important, especially at this time to hear about the services that are available after hours and people can learn more about the After Hours Convenient Care by visiting StLouischildren' or to speak with a pediatric specialist at St. Louis Children's, Please call the children's direct physician access line at 1-900-678- Help. That concludes this episode of Radio Rounds. The podcast series from Washington University Pediatric Specialists at St. Louis Children's Hospital. Please remember to subscribe, rate, and review this podcast and all the other St. Louis Children's Hospital podcasts. I'm Melanie Cole.