Justin Sanders, (left), and Paul D. Franklin, CBET, of Riley Hospital for Children.

It is a sign of the times: From cell phones to portable DVD players, kids of all ages seem perennially attached to electronic devices. In most houses, in particular those with teens and tweens, it is unusual to not have some sort of digital gaming system demanding attention. It is far more normal to see one, or more, of the devices united with the family entertainment system.

Maintaining that sense of normalcy is the goal of the child life department at Riley Hospital for Children in Indianapolis. As a result of donations to the group, which focuses on minimizing the stress and anxiety children often feel when fighting an illness, it was recently possible for the hospital to provide readily available entertainment for its patients by way of dozens of Sony PlayStation 2 and Nintendo consoles.

Acquiring the game units, however, turned out to be just the beginning. As unfortunate as it may be, securing the game systems is a necessity in any high-traffic institution, and hospitals are no different, so simply plugging them into the patient rooms was not an option. Securing the valuable and in-demand machines became the first order of business.

This project fell to Paul D. Franklin, CBET, a biomedical technician II on the hospital’s clinical engineering team.

“I took it upon myself to see that it got done, because making sure the games are available is the important thing,” he says.

Guaranteeing Availability

The decision was made to make the majority of the systems mobile by securing them to a cart. Simply tethering them with cable was not an option because it would have impaired the functionality of the hardware.

“The boxes are really small, and you can’t just use a strap over the top of them, because the lid has to open to allow games to be inserted,” Franklin says. “The controller cables are attached to the front, and the power has to go in the back, so you can’t strap it that way, either.” He determined that the first step in modifying the game units was to disassemble the entire outer case, drilling out the existing bolt holes to a larger thread size, and then using the bottom of the game—still disassembled—to create a template.

“I can lay that template over anything, using it as a drill pattern,” Franklin says. “I then use Lexan to create a base to mount the game unit to.”

Lexan is a registered trademark for General Electric’s brand of highly durable polycarbonate resin thermoplastic. It provides a durable surface that can be easily mounted with security bolts to a cart, cabinet, or other stationary object.

Creating these unique mounting plates is done in collaboration with Tim Berglund, who designs and builds adaptive seating for children with disabilities as an engineer in the adaptive equipment department.

“The clinical engineering department does have a fabrication shop, but it’s located off campus, so it’s not directly accessible to them, and Paul knows that we do all kinds of things that are pretty much along the same lines of the work that is done in their fabrication shop, so he comes to us because we’re just a little bit more accessible,” he says. Berglund also tends to manual and power wheelchairs and special electronics. “I realize the biomeds can’t cover all the bases, so we just try to go in and help them whenever possible.”

Riley Hospital for Children provides entertainment for its patients with dozens of Sony PlayStation 2 and Nintendo consoles.

More Than Meets the Eye

Some of the game units are wall-mounted, which presents a certain set of challenges.

“It’s just not going into the room and hooking up the game,” says Randy Guenin, manager of clinical engineering at Riley Hospital for Children. “Paul has got to secure the cables and extend the lines so they can reach all the way to the patients’ beds, so everything is more difficult than what it would normally be.”

He also has to wait for the patients to be moved out of the room, either because they are discharged or to be transferred to another unit for testing or treatment. “As a result, a lot of times we stop what we’re doing to immediately respond and get that done because the patient went out for an x-ray or surgery,” Guenin explains.

Not working in a patient-occupied double room is a decision Franklin made to prevent a child from feeling he or she had been overlooked or excluded from the fun because his or her roommate received a game unit when he or she did not. This was particularly important when Franklin installed game systems in the hematology/oncology ward.

“All of the single rooms have one game, and the child life department also has carts they can move around for the rooms where there are two patients and one TV,” Franklin says. “I made a point during that whole project that I wouldn’t install one in a double room if there was a patient in there. I didn’t want to do it when one person was gone, because I didn’t want the other patient thinking, ‘Where’s mine?’ So I would have to get approval from the doctor or nurse to go in there when the patient was out of the room.”

In addition to the cart and room-based units, Franklin secured a Sony PlayStation 2 to a table in the waiting area in the hospital’s heart center. The room provides a comfortable place for patients to visit when they want a break from the confines of their rooms.

In addition to the Sony products, the hospital has several Fun Centers, designed and built in collaboration with Nintendo and the Starlight Starbright Children’s Foundation. These roll-around carts offer an LCD flat screen television, a Nintendo GameCube, and a DVD player, all of which are encased for security.

“I had to come up with a block that prevents anyone from removing the games, but that still allowed them to use both the DVD player and the GameCube,” Franklin says. Putting a plastic bar at the top of the container prevented the smaller Nintendo discs from being transferred to the larger, DVD-shaped slot and removed entirely.

Megan Schpok, child life specialist at Riley, and Paul Franklin, CBET, set up a patient room with the new Guitar Hero game.

One for All, All for One

“Securing them guarantees they will be there time after time for the patients who come in repeatedly or for lengthy stays, so those are very valuable,” says Mary Stogsdill, child life specialist in the hospital’s child life department. “We want to provide our patients with things that make their stay a little bit more comfortable— like having movies from home, and things that they watch or play—just to make them feel a little bit more relaxed and comfortable.”

Putting the donated systems, along with a number of VCR/DVD combination units, into rotation is more than just play for the kids in the Riley Cancer Center.

“Having those makes the hospital environment a little bit less scary for kids, a little bit more normal, because it is similar to what they’re used to,” Stogsdill says. “It also really and truly helps to reduce the stress and anxiety of our patients because they have those things available to them.”

Stogsdill first enlisted clinical engineering’s help because the department services a number of child life’s patient-use items, and
“they’re just the right people for the job,” she says. “The clinical engineering team is very important to us as child life specialists. I know that they do far greater things than what they do for us, in terms of maintaining medical equipment and the like, but just having someone who knows how to install a game system or install equipment that is essential to patient satisfaction is just invaluable.”

Numerous studies also indicate that having children engage in play and electronic games lessens fear and anxiety to a point that it actually makes procedures, such as surgeries, less traumatic for the patients. And it doesn’t take a study for techs to know that it is the little things that can make all the difference.

“The extra stuff we do with the games and TVs breaks up the monotony for the kids, who are stuck sitting there thinking about what’s wrong with them, thinking about how they’re sick and they’re scared, and video games are designed to put you in a different world for a minute,” Franklin says. “I took this job to be able to help people, and I enjoy seeing children smile, and this is just another way to do it.”

Recalling a story about a young child whose Tickle Me Elmo doll stopped working, Franklin recounts that crying, the child crawled over to him, and he quickly identified some dead batteries to be the culprit. “I picked up the doll, put a new battery in it, and pretended like we were doing a little surgery by putting the new batteries in,” he says. “Then I said, ‘OK, it’s time to wake up,’ and the Elmo sat up and the boy started laughing. That’s all it took to be part of making him happy.”

Most of the systems are mobile, which involves disassembling the outer case and drilling larger holes before securing them to a cart.

Help When It’s Needed

Part of Clarian Health, Riley Hospital for Children is one of the 15 largest children’s hospitals in the nation, caring for more than 57,000 patients per year. In addition to handling the bulk of the game-related maintenance, Franklin works alongside 10 other full-time techs, tending to 12,000 equipment items (not including any of the audiovisual equipment). Franklin is not the only one in the department to take projects outside the traditional job description.

“It’s always been like this in the clinical engineering department, because there are many projects that need to be done around the facility that don’t have an owner, and many times they fall to CE to complete,” Guenin says. “In Paul’s case, he’s been so good at that, now it’s not even a matter of can he do it, it’s a, ‘Hey, when can Paul do this?’ ”

Which is just how Franklin likes it. “My whole philosophy is, I’m trained as a biomed II, and they sent me to school on anesthesia machines and lasers and the traditional things, and I love that part of my job,” he says. “But too many times people get wrapped up in what we do and they lose track of why we do it. Then you end up with a ‘that’s not my job’ attitude—and I don’t want to be that way. I am here to support the hospital, and as long as the children are happy, I’ve done my job.”

Franklin’s reputation as someone who puts the time in to do it right—whatever the job is—has resulted in his being pulled into a number of nonconventional tasks. Another example of one such project was wrapped up recently for the child audiology department, which is housed adjacent to the clinical engineering shop.

Each therapy room is equipped with a one-way mirror, on the other side of which is an observation room from which parents, extended family members, therapists, students, and other involved individuals can watch a child’s therapy session. The rooms are equipped with speakers so people can hear, as well as see, what is happening in therapy.

“The speaker systems were no longer working in most of the rooms, and with confidentiality being very important to us, we wanted a system that would allow listening via headphones rather than a speaker and that would still accommodate multiple observers,” says Kelly Lormore, MS, CCC-A, clinical coordinator and audiologist for the Indiana University Cochlear implant program. Franklin evaluated the old system, determined the new equipment needs, and researched the pricing of different options.

“One of the headphone jacks he found was able to accommodate up to four people listening through headphones, with each listener having control over their own volume.” When the equipment arrived, Franklin created an installation plan that included how to secure all of the equipment and wiring.

“In talking with clinical engineering about the project, their understanding of the clinical relevance of the project was certainly important in their decision to support it,” Lormore says. “What we do in therapy has to be carried over at home, school, daycare; a crowded therapy room is counterproductive to getting most children to work in therapy. This system provided us the ability to keep children better on task with minimal distractions while still allowing for people to watch, learn, and feel connected to the child’s sessions so they can draw on those experiences when they do that therapy at home.”

Doing What It Takes

While his list of extracurricular duties grows, for Franklin it is bigger than any single project. “When I was 7 years old, I spent 8 days in the hospital by myself, so I know how you can be treated and I know how you should be treated, and that’s what I try to live by,” he says. “If you walk up to the rooms and watch the kids, you can see that their minds aren’t on their pain anymore. They’re focusing on trying to get another point or get to the next level in the game, and all of the sudden they’re oblivious to where they are after just a few minutes. They’re kids again.”


Dana Hinesly is a contributing writer for 24×7. For more information, contact .