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In the bustling corridors of The Children’s Hospital at Westmead, a new initiative is quietly transforming the way children with severe behavioural disturbances receive medical care. 

The Quiet Pathway started as an idea in 2017 when discussions surrounding particularly challenging cases resulted in the discovery of an unnoticed direct entrance into the anaesthesia bay. This conversation sparked the concept of ‘patient-focused hospital admission�, revolutionising the induction of anaesthesia.

Now, the team have relaunched a newly designed procedural room, offering an even more seamless transition for children from the car, into the anaesthetic bay, while avoiding crowded waiting rooms, and the normal hustle and bustle of the hospital.

Led by the Department of Anaesthesia, The Quiet Pathway Program is a perioperative preparation program designed to provide tailored admission processes for children who require anaesthesia for medical procedures but face severe anxiety, autism, or behavioural and intellectual disabilities.

Twelve-year-old William, who lives with Down Syndrome and Autism, was the first patient to use the new pathway, his mum saying it transformed their hospital experience.

Due to his cognitive impairment, William experiences elevated levels of anxiety and hypersensitivity to touch and bright lights. Hospital visits often caused William heightened agitation, resulting in self-injurious behaviours and sometimes unintentional aggression towards others. 

“Visiting the hospital prior to the Quiet Pathway Program always caused me anxiety, even for a day visit,� William’s mum, Filomena, said.

“William would often start to show signs of distress and become aggressive when inside. Once he escalates, it is really challenging to soothe him because he cannot understand or process his emotions.�

“Being able to bypass the usual admissions process and avoid this distress for William was invaluable.�

Stephanie Crescini is the Quiet Pathway Coordinator. Her position, generously funded by donors of Sydney Children’s Hospitals Foundation, is essential in developing and implementing the care plan and pathway for children like William.

“The Quiet Pathway Program delivers a pathway that not only accommodates but prioritises the needs of children with high level needs and ensures we begin to empower them to continue accessing healthcare - sparking pivotal change for the future,� Stephanie said.

“It’s not just about looking after the child, we are supporting the whole family, making their journey through the healthcare system not only better but more inclusive for children with special needs,â€� Dr Jonathan De Lima, Senior Staff Specialist in Anaesthesia,  added.

The new Quiet Pathway room is fitted with recliners that resemble home furniture, dimmable LED lighting, soothing music, and discreetly hidden medical equipment to maintain a serene atmosphere. 

“The new Quiet Pathway procedural room allows us to make reasonable adjustments and modifications to our usual perioperative processes to cater for the child’s needs. It is designed to minimise sensory overload and provide a safe, calm, and controlled environment tailored to the needs of each patient,� Stephanie said.

By using the Pathway, William was able to undergo four different procedures from dental work through to a lumbar puncture, but more important than that, he was also able to be comforted by his mum and doting big brother, Cristian, while going under the anaesthetic.

“The care and attention we received from Dr De Lima, Stephanie and the Quiet Pathway Team were exceptional, they went above and beyond to ensure not only William’s comfort but also that of his older brother, Cristian, and myself,� Filomena said.

“Surgery, whether big or small, can cause anxiety, especially for children with disabilities who cannot communicate their feelings, so having a program like the Quiet Pathway to manage this is essential.�

Dr De Lima said the experience of families like William’s is what makes the Pathway so worthwhile.

“Being part of the Quiet Pathway team is incredibly rewarding and is a testament to the work of many dedicated individuals,� Dr De Lima said.

“It is incredibly fulfilling to see how our efforts provide healthcare services to the most vulnerable children and their families, like William’s.�

To show your support for programs like the Quiet Pathway, make a donation to .