The pediatric center of HM Hospitales in Barcelona adapts care, spaces, and communication to the needs of children and adolescents with autism, ADHD, or learning disorders. This more accessible and inclusive pediatric care model seeks to improve the experience of patients and their families during their stay in the hospital
Hospital HM Nens de Barcelona has launched a new care model to improve the care and well-being of children and adolescents with neurodivergent conditions, adapting the hospital experience to their needs. The initiative is being developed through a cross-cutting plan that covers care protocols, communication with these patients, the training of professionals, and support for families, as well as the progressive adaptation of the spaces.
The initiative stems from a reality that affects a significant part of the population. It is estimated that between 15% and 20% present a neurological development different from that considered statistically typical. The concept of neurodivergence encompasses differences in the way of processing information, perceiving the environment, learning, or experiencing thoughts and emotions, and includes conditions such as autism, ADHD, dyslexia, dyspraxia, or certain learning disorders.
These characteristics can make a visit to the hospital pose additional difficulties. Noise, intense lighting, waiting times, physical contact, being in an unfamiliar space, or not being able to anticipate what will happen during an examination or a test can increase the stress of some neurodivergent patients. In the Plan of Care for the Neurodivergent Patient of Hospital HM Nens, these particularities are taken into account to ensure that healthcare is more accessible for these children and adolescents and adapts to the individual needs of each one.
A model that involves the entire hospital
One of the main objectives of Hospital HM Nens is to promote early detection and diagnosis of neurodevelopmental disorders, with the aim of designing personalized intervention programs that take into account the strengths and needs of each patient.
But this new model concerns not only the services specialized in treating these patients, but also encompasses any care that a child or adolescent with neurodivergence who comes to the hospital may require. For this reason, protocols have been implemented to attend to them in outpatient clinics, emergency rooms, hospitalization, radiology, laboratory and even dentistry, in addition to providing specific training to all professionals at the center. It is also planned to expand the agreements that the hospital maintains with social entities, in order to coordinate the integrated care required by these patients and their families.
One of the most innovative measures is the Preferential Care Card, intended to identify neurodivergent patients who need adapted care. This tool makes it possible to reduce waiting times and facilitate access to calmer environments, whenever the care situation allows it, as well as to activate specific protocols and guarantee the accompaniment of the reference adult during care.
The model implemented at Hospital HM Nens also seeks to reduce the uncertainty that a medical visit can generate. For this reason, social stories and pictograms have been designed that explain in a visual and sequential way what will happen during a visit to emergency, a blood draw, a consultation or certain diagnostic tests. The plan foresees that these materials will be available both in the different spaces of the center and through the website, so that families can use them before coming to the center.
'Sensorially friendly' spaces
The adaptation also reaches the hospital’s architectural environment. The plan includes spaces that allow stimuli to be reduced such as noise, the intensity of the lighting, crowds or certain visual elements that can generate sensory overload. Likewise, more accessible signage is incorporated through visual elements and pictograms that make it easier to find one’s way around the hospital.
Among the measures is the Box of Calm in the emergency department, conceived as a quiet and safe environment for minors who need to reduce the level of stimulation during their care. This space, planned within the program although it is still not operational, will include adjustable lighting, materials to reduce noise, noise-canceling headphones, visual supports, and sensory and self-regulation materials. Although it is especially designed for neurodivergent patients, it may also be used by other minors who need it.
The adaptation of the hospital is not limited to services specifically linked to neurodevelopment, but rather accompanies the patient in all kinds of care situations. For example, with a quiet extraction box in the laboratory to perform blood draws, or with support materials in the different services of the center.
Observatory of Neurodivergence
This set of initiatives will turn Hospital HM Nens into a pediatric reference center in the care of neurodivergent patients in Catalonia. For this reason, in addition to the care aspect, an Observatory of Neurodivergence has been created to promote research on these conditions and disseminate the results of these new care models with the aim of being able to extend them to other hospitals.
The team driving the Plan for the Care of Neurodivergent Patients at Hospital HM Nens includes, among others, Dr. Miguel Ángel Hernández, neuro-pediatrician, Dra. Violeta Bittermann, pediatrician and head of Research at HM Hospitales Cataluña, Dra. Silvia Fernández, child psychologist, Dra. Fernanda Espinosa, child psychiatrist, and Montserrat Sagarra, social worker.
"This project represents a step forward in our care model and responds to the commitment of Hospital HM Nens to offer pediatric care increasingly adapted to the needs of each patient. Incorporating neurodivergence in a cross-cutting way throughout the hospital journey allows us to move toward more accessible and personalized care, improving the experience of children and adolescents and their families," emphasizes Dr. Marc Tarruella, medical director of the center.