Introducing St. Louis Children’s Hospital After Hours – providing medical care for illnesses and injuries by specially-trained pediatric providers. When most pediatrician offices are closed, After Hours offers a kid-focused and lower cost alternative to ERs and urgent care centers.
Listen in as Beth Schickler talks about how our newest offsite facility provides quality after-hours care with seamless follow up with the patient's primary care provider.
Selected Podcast
St. Louis Children’s Hospital After Hours Clinic
Featured Speaker:
Elizabeth Schickler, MSN, RN
Elizabeth (Beth) Schickler, MSN, RN is the manager of St. Louis Children’s Hospital After Hours. Transcription:
St. Louis Children’s Hospital After Hours Clinic
Melanie Cole (Host): When most pediatrician offices are closed, St Louis Children’s Hospital After Hours can provide medical care for illnesses and injuries by specially pediatric providers as a kid-focused and lower-cost alternative to ERs and urgent care centers. Speaking with us today is Beth Schickler. She’s the lead pediatric nurse practitioner for the newest off-site location for St. Louis Children’s Hospital, called After Hours. Welcome to the show, Beth. So, let’s just start with the difference between a convenient care, an urgent care, and an ER visit. What does this mean for the physician’s patients?
Elizabeth (Beth) Schickler, MSN, RN, CPNP (Guest): So, for our St. Louis Children’s Hospital Convenient Care, we are an extension of the pediatrician’s office. So, anything that you would be sending to us, would be kids that you would generally see in your office. Lower acuity and the things that you would be sending to the emergency room would be kids that have an obvious broken bone, have color changes, or have chronic illnesses that are followed by our pediatric specialists.
Melanie: So, the importance of pediatric-focused care is really what this is all about. Tell us about that.
Elizabeth: The care of a pediatric child is unique. Our kids are not small adults; so, our care is tailored specifically to our pediatric patients. More specifically, a kid with a urinary tract infection, the care and treatment of that child is absolutely different than care and treatment of an adult patient, and that’s what our focus is.
Melanie: So, tell us a little bit about the facility itself. Give us the location and the amenities. Tell us about St. Louis Children’s Hospital After Hours.
Elizabeth: So, we are conveniently located on Tesson Ferry Road and 270 in our Dierbergs Shopping Plaza. Our address is 12436 Tesson Ferry Road. We are directly across from St. Anthony’s Medical Center. We are an extension of St. Louis Children’s Hospital so when you walk into our Convenient Care, what you are going to be walking into, is an outpatient office of St. Louis Children’s Hospital. So, it has the same feel and atmosphere as the hospital itself and as our specialty care center in West County. So, we have five exam rooms, which are all pediatric specific, colors and amenities, equipment that is all pediatric specific as well.
Melanie: So, what do you feel that this type of facility addresses in the community and really how did it get started? What was the idea behind it?
Elizabeth: So, our idea was to provide a high-quality, low-cost, pediatric-specific healthcare in our South County region. We identified that this was an area that needed pediatric-specific care, and it was an area that we needed to have a footprint in as well. Our goal, as well, was to enhance our pediatric partnership to be an extension of pediatric practices and further provide seamless follow up with our physician partners. That was our central tenet in providing care in this area. So, when families come to our Pediatric After Hours, they will have one bill. So, this is different than our hospital-based billing, where they have a bill for the facility and a bill for the providers. Their families are going to see one bill, which we feel like is a convenience for them as well. It’s also billed at a lower rate. It is an outpatient hospital. So, they have their pediatric provider, their office visit copayment that is due at the time of service. Their coinsurance and deductibles will still apply.
Melanie: How is the facility staffed?
Elizabeth: So, our facility is staffed by pediatric providers. So, we have four pediatric nurse practitioners. We have two pediatric nurses, who came from our emergency room and two pediatric radiology technicians as well.
Melanie: And tell us about your process for maintaining continuity of care and the streamlined communication with and to the pediatricians. How do you communicate back to the physician, and if it’s an off hour are they on call? How does that work?
Elizabeth: So, we will be going live on our Epic medical system. The hospital is going wide as well with Epic, and so we will have that ability to, if a child sees a provider outside of our medical practice or even our facility, BJC, we’ll have the ability to pull those records then as well. We also encourage our pediatricians if they have a child they would like us to evaluate, to give us a call and let us know, hey, I’m sending this child to you, and we can call them back at their preference or send them a fax of information that we had their diagnosis and their treatment plan as well. We really encourage our pediatric partners to give us a call for feedback and if they would like us to see their child as well.
Melanie: And what will you treat there?
Elizabeth: So, we have point of care testing. So, our rapid strep, rapid influenza, rapid mono, RSV, and urinalysis. We have the ability to send out labs and cultures back to St. Louis Children’s Hospital. We also have clean film radiology services, which have our primary interpretation by our Washington University pediatric radiologist. Our physician partners can also send in children for lab testing. If it’s a kid they see in the office and they think, oh, they need a CBC, it’s later in the afternoon, and the family wants to do it close to home, we’re a collection site as well. So, we’ll be able to do that with our pediatric equipment and supplies. With our radiology films, physicians can also send in patients for plain-film radiology. We’re an area where kids are playing late into the afternoon and evening, family calls and says, I think they twisted their ankle or broke their ankle, we can take a film for them and let the pediatricians know what the result of that film is. If we need to see their child for splinting, then we can also splint as well for that film. We also provide suturing and then we have first dose of medications, emergency medication. If a kid comes in with a laceration and they need a tetanus booster, we’ll be able to provide that as well.
Melanie: So, reiterate the hours for us, Beth, and anything else you’d like a referring physician to know about St. Louis Children’s Hospital After Hours clinic.
Elizabeth: Absolutely, so, we’re open seven days a week until midnight, Monday through Friday we start at 5 pm going to midnight. Saturday and Sunday starting at noon going to midnight as well. For our holiday hours that are coming up, we’re open from 5 pm to midnight. The only day we’re closed throughout the entire year is Christmas Day. We also want our pediatricians to know that if a child needs a higher level of care, is not turning around after an asthma treatment, we have our St. Louis Children’s Hospital Transport Team and our Mehlville Fire EMS, who are helping to transport our kids back down to St. Louis Children’s Hospital, kind of keeping our children in our St. Louis Children’s Hospital family.
Melanie: And then what can a physician expect from your team after referral in so far as communication with that referring physician and your team approach.
Elizabeth: So, we have a small team of our pediatric providers. We plan to after each child has a visit looping the pediatrician back in based on their preference, whether it’s a fax to their office, a phone call, or having the record available in our Epic system for them to review the chart. If they have questions or concerns, we want them to call us back. Any lab in radiology, if they have pending labs, pending cultures; we’re going to be following those, and we’ll call them back with the results. So, our small team is dedicated and all hands-on-deck model. We want our pediatric partners to let us provide quality care. That’s the same thing they provide in their pediatrician’s office as well, in our After Hours location.
Melanie: Thank you so much, Beth, for being with us today. A physician can refer a patient by calling Children's Direct Physician Access Line at 1-800-678-HELP. That's 1-800-678-4357. You're listening to Radio Rounds with St. Louis Children's Hospital. For more information on St. Louis Children's Hospital After Hours, please visit stlouishildrens.org/afterhours. That’s stlouischildrens.org/afterhours, and for general resources available at St. Louis Children’s Hospital, you can go to stlouischildrens.org. This is Melanie Cole. Thanks for listening.
St. Louis Children’s Hospital After Hours Clinic
Melanie Cole (Host): When most pediatrician offices are closed, St Louis Children’s Hospital After Hours can provide medical care for illnesses and injuries by specially pediatric providers as a kid-focused and lower-cost alternative to ERs and urgent care centers. Speaking with us today is Beth Schickler. She’s the lead pediatric nurse practitioner for the newest off-site location for St. Louis Children’s Hospital, called After Hours. Welcome to the show, Beth. So, let’s just start with the difference between a convenient care, an urgent care, and an ER visit. What does this mean for the physician’s patients?
Elizabeth (Beth) Schickler, MSN, RN, CPNP (Guest): So, for our St. Louis Children’s Hospital Convenient Care, we are an extension of the pediatrician’s office. So, anything that you would be sending to us, would be kids that you would generally see in your office. Lower acuity and the things that you would be sending to the emergency room would be kids that have an obvious broken bone, have color changes, or have chronic illnesses that are followed by our pediatric specialists.
Melanie: So, the importance of pediatric-focused care is really what this is all about. Tell us about that.
Elizabeth: The care of a pediatric child is unique. Our kids are not small adults; so, our care is tailored specifically to our pediatric patients. More specifically, a kid with a urinary tract infection, the care and treatment of that child is absolutely different than care and treatment of an adult patient, and that’s what our focus is.
Melanie: So, tell us a little bit about the facility itself. Give us the location and the amenities. Tell us about St. Louis Children’s Hospital After Hours.
Elizabeth: So, we are conveniently located on Tesson Ferry Road and 270 in our Dierbergs Shopping Plaza. Our address is 12436 Tesson Ferry Road. We are directly across from St. Anthony’s Medical Center. We are an extension of St. Louis Children’s Hospital so when you walk into our Convenient Care, what you are going to be walking into, is an outpatient office of St. Louis Children’s Hospital. So, it has the same feel and atmosphere as the hospital itself and as our specialty care center in West County. So, we have five exam rooms, which are all pediatric specific, colors and amenities, equipment that is all pediatric specific as well.
Melanie: So, what do you feel that this type of facility addresses in the community and really how did it get started? What was the idea behind it?
Elizabeth: So, our idea was to provide a high-quality, low-cost, pediatric-specific healthcare in our South County region. We identified that this was an area that needed pediatric-specific care, and it was an area that we needed to have a footprint in as well. Our goal, as well, was to enhance our pediatric partnership to be an extension of pediatric practices and further provide seamless follow up with our physician partners. That was our central tenet in providing care in this area. So, when families come to our Pediatric After Hours, they will have one bill. So, this is different than our hospital-based billing, where they have a bill for the facility and a bill for the providers. Their families are going to see one bill, which we feel like is a convenience for them as well. It’s also billed at a lower rate. It is an outpatient hospital. So, they have their pediatric provider, their office visit copayment that is due at the time of service. Their coinsurance and deductibles will still apply.
Melanie: How is the facility staffed?
Elizabeth: So, our facility is staffed by pediatric providers. So, we have four pediatric nurse practitioners. We have two pediatric nurses, who came from our emergency room and two pediatric radiology technicians as well.
Melanie: And tell us about your process for maintaining continuity of care and the streamlined communication with and to the pediatricians. How do you communicate back to the physician, and if it’s an off hour are they on call? How does that work?
Elizabeth: So, we will be going live on our Epic medical system. The hospital is going wide as well with Epic, and so we will have that ability to, if a child sees a provider outside of our medical practice or even our facility, BJC, we’ll have the ability to pull those records then as well. We also encourage our pediatricians if they have a child they would like us to evaluate, to give us a call and let us know, hey, I’m sending this child to you, and we can call them back at their preference or send them a fax of information that we had their diagnosis and their treatment plan as well. We really encourage our pediatric partners to give us a call for feedback and if they would like us to see their child as well.
Melanie: And what will you treat there?
Elizabeth: So, we have point of care testing. So, our rapid strep, rapid influenza, rapid mono, RSV, and urinalysis. We have the ability to send out labs and cultures back to St. Louis Children’s Hospital. We also have clean film radiology services, which have our primary interpretation by our Washington University pediatric radiologist. Our physician partners can also send in children for lab testing. If it’s a kid they see in the office and they think, oh, they need a CBC, it’s later in the afternoon, and the family wants to do it close to home, we’re a collection site as well. So, we’ll be able to do that with our pediatric equipment and supplies. With our radiology films, physicians can also send in patients for plain-film radiology. We’re an area where kids are playing late into the afternoon and evening, family calls and says, I think they twisted their ankle or broke their ankle, we can take a film for them and let the pediatricians know what the result of that film is. If we need to see their child for splinting, then we can also splint as well for that film. We also provide suturing and then we have first dose of medications, emergency medication. If a kid comes in with a laceration and they need a tetanus booster, we’ll be able to provide that as well.
Melanie: So, reiterate the hours for us, Beth, and anything else you’d like a referring physician to know about St. Louis Children’s Hospital After Hours clinic.
Elizabeth: Absolutely, so, we’re open seven days a week until midnight, Monday through Friday we start at 5 pm going to midnight. Saturday and Sunday starting at noon going to midnight as well. For our holiday hours that are coming up, we’re open from 5 pm to midnight. The only day we’re closed throughout the entire year is Christmas Day. We also want our pediatricians to know that if a child needs a higher level of care, is not turning around after an asthma treatment, we have our St. Louis Children’s Hospital Transport Team and our Mehlville Fire EMS, who are helping to transport our kids back down to St. Louis Children’s Hospital, kind of keeping our children in our St. Louis Children’s Hospital family.
Melanie: And then what can a physician expect from your team after referral in so far as communication with that referring physician and your team approach.
Elizabeth: So, we have a small team of our pediatric providers. We plan to after each child has a visit looping the pediatrician back in based on their preference, whether it’s a fax to their office, a phone call, or having the record available in our Epic system for them to review the chart. If they have questions or concerns, we want them to call us back. Any lab in radiology, if they have pending labs, pending cultures; we’re going to be following those, and we’ll call them back with the results. So, our small team is dedicated and all hands-on-deck model. We want our pediatric partners to let us provide quality care. That’s the same thing they provide in their pediatrician’s office as well, in our After Hours location.
Melanie: Thank you so much, Beth, for being with us today. A physician can refer a patient by calling Children's Direct Physician Access Line at 1-800-678-HELP. That's 1-800-678-4357. You're listening to Radio Rounds with St. Louis Children's Hospital. For more information on St. Louis Children's Hospital After Hours, please visit stlouishildrens.org/afterhours. That’s stlouischildrens.org/afterhours, and for general resources available at St. Louis Children’s Hospital, you can go to stlouischildrens.org. This is Melanie Cole. Thanks for listening.