A team of clinicians at Royal North Shore Hospital (RNSH) Emergency Department (ED) is using a digital interactive playground to help children feel more comfortable during a visit to hospital.
Play is a fundamental component of paediatric care. Clinicians use play to engage children, support understanding of clinical interventions, and reduce anxiety during their ED journey. At the RNSH ED, operational and environmental change over recent years have influenced how care is delivered within the paediatric space.
While infection prevention requirements affected the availability of traditional play resources during the COVID-19 pandemic, broader changes in workflow and environment also had an impact. Communal items were removed in line with safety standards, limiting previously common distraction techniques such as bubbles.
These constraints made it increasingly difficult to deliver engaging, developmentally appropriate play experiences within the department. Feedback from staff, patients and families highlighted a gap in play opportunities. It became evident that we were not fully meeting the needs of paediatric patients and their families, nor maximising the role of play in fostering therapeutic relationships.
Providing play in a complex healthcare climate
The ‘Bright lights for kids’ initiative introduces an interactive digital playground designed to meet contemporary healthcare requirements. Using projection technology, dynamic images are displayed onto the floor, enabling paediatric patients to actively engage in play while in the ED.
This innovation also supports clinical assessment. Observing children interacting with the floor allows clinicians to assess movement and mobility in a natural, low-pressure way. For example, evaluating gait in a child presenting with a limp.
The system is ceiling-mounted in the paediatric ED, with software offering a diverse range of interactive visuals from animated marine life to immersive landscapes. These features create an engaging, sensory-rich environment that can help reduce stress and improve the overall patient experience. The displays has been particularly beneficial for neurodiverse children, offering a non-intrusive and visually engaging form of interaction.
Motion-sensing technology ensures the system activates only when in use or can run continuously, integrating seamlessly into the clinical setting. In addition, we have expanded the physical environment, introducing a digital ceiling displaying in the procedure room shortly after initial installation, and a newly developed floor-based play space within the triage waiting area in 2025. This enhanced playground provides families with a dedicated, welcoming space while waiting and whilst undergoing procedures, further supporting engagement and comfort.
A successful pitch
The project was presented to the Northern Sydney Local Health District innovation program in 2022, where it received the People’s Choice award, securing funding for implementation. We partnered with a Melbourne-based company experienced in installing large digital projections.
The projector was installed in the ceiling and enclosed with a clear Perspex cover. It is energy-efficient, automatically powering down when not in use, and the projected images respond interactively to patient movement.
Installation was completed within a single day midweek to minimise disruption to clinical operations. At the time of implementation, this project represented a first within NSW, delivering a meaningful, child-centred play solution aligned with infection prevention and control principles.
Patient Experience Officers continue to collect feedback through regular rounding and surveys, with overwhelmingly positive responses indicating strong positive engagement.
We acknowledge the ongoing leadership and support of the Northern Sydney Local Health District and RNSH senior executive team for supporting and fostering innovation.
References
- Gjærde LK, Hybschmann J, Dybdal D,et al, Play interventions for paediatric patients in hospital: a scoping review, BMJ Open 2021;11:e051957. doi: 10.1136/bmjopen-2021-051957
- Salmela, M., Salanterä, S., Aronen, E.T., 2010. Journal of Advanced Nursing 66.
