Nicklaus Children’s Hospital is the top-ranked pediatric hospital in south Florida and home to the largest pediatric teaching program in the southeastern United States.
In a busy pediatric hospital on the cutting edge of innovation, clinicians and staff are always looking for ways to elevate care, improve the patient experience, and train effectively for high-stakes situations.
Virtual reality emerged as a flexible, scalable means to support clinical and operational goals across departments, from clinical care to staff training.
After introducing a pilot program using VR to reduce preoperative anxiety, Nicklaus Children’s expanded its program. With the help of ArborXR to power and scale its program, today it uses VR across 12 different hospital units.
Improving the Patient Experience With Immersive VR
When Nicklaus Children’s Hospital first began experimenting with VR in the clinical setting, staff in the fracture care clinic put a headset on an 8-year-old with a broken arm.
The staff set the bone, placed pins, and applied a cast using nothing but local anesthesia. The child, immersed in a VR adventure, never even cried.
It was a resounding success in the hospital’s first virtual reality use case: reducing patient anxiety. Studies have shown links between anxiety and increased sensitivity to pain, heightened need for anesthesia, and slower recovery times.
Nicklaus found that using immersive VR before an operation reduced anxiety by 60% among pediatric patients.
“It makes a difference for the staff, too,” observed Dr. Christina Potter, Manager of IT Digital Technology for the Nicklaus Children’s Health System. “There’s less resistance from the patient, which leads to less stress and overall smoother care.”
Soon, the VR program expanded to the behavioral health department. In traditional talk therapy, patients talk about experiences in the abstract. With the help of VR, the patient can have a real-time virtual experience in a safe environment, with their clinician by their side.
This ability to be “in the moment” helps behavioral health clinicians make more accurate assessments, and helps patients make faster progress.
If VR could help preoperative patients overcome anxiety, and could help behavioral health patients be in the moment, Nicklaus staff thought perhaps it could enhance end-of-life experiences, too.
In the hospital’s palliative care department, families preparing to say goodbye to their child can enjoy virtual experiences outside the confines of the hospital. These experiences offer opportunities for moments of joy and connection in the last days of life.
“No one wants to be in a hospital—especially not kids and their parents. VR offers a way to escape that environment. If our attention is focused on something fully immersive, it shifts perception, including pain perception.”
Dr. Christina Potter
Manager of IT Digital Technology | Nicklaus Children’s Health System
How VR Benefits Healthcare Staff
The virtual reality apps used for patients at Nicklaus include behavioral therapy scenarios, games, and distractions.
Seeing how much the program was helping patients, staff began asking for their own applications.
“Many of the new ideas have come directly from staff. I’ve been surprised by the variety of use cases they come to us with,” Dr. Potter said. “And the best part is, it works. VR has been effective in nearly every scenario we’ve tried.”
Today, Nicklaus staff have access to guided meditations and stress relief apps via VR. The hospital’s headsets are also used for immersive training.
Virtual reality learning is ideal for training in scenarios difficult or impossible to simulate safely in real life. Nicklaus staff train in VR for lifesaving procedures and to recognize signs of mental distress.
Psychiatry training teaches staff to recognize early warning signs of a mental health crisis. They also learn how to search patients for items that could be used for self-harm. These are critical skills that cannot be safely and ethically practiced in a real-world simulation.
VR Success in Unexpected Use Cases
Over four years, Nicklaus Children’s expanded its VR use from presurgical bays to 12 different hospital units.
Some applications have led to unexpected success. When VR was used to reduce the anxiety of patients before an operation, staff found parental anxiety also dropped—by as much as 70%.
For a parent, there are few experiences as frightening as seeing a child prepped for surgery. When the children are calm and happy, Dr. Potter said, the parents are also able to relax.
Nicklaus is also applying VR to help neurodivergent young adults gain more independence.
Nearly 20 young adults with autism have overcome their anxiety over getting behind the wheel and gotten driver’s licenses after completing the health system’s VR Drive driver’s education program.
From 6 Headsets to 37: Nicklaus Children’s Hospital’s VR Journey
Nicklaus Children’s Hospital began its virtual reality program in 2021. It formed a partnership with the Stanford Chariot Program at Lucile Packard Children’s Hospital, which had a well-established VR program, to learn the ropes.
Using what they learned, Nicklaus bought six Oculus Go headsets and six bed-mounted Nebula projectors. Dr. Potter was brought on to run the program.
As she tweaked the program to tailor it to Nicklaus, Dr. Potter quickly realized she couldn’t be everywhere at once. She launched an Innovation Ambassador Program, empowering hospital staffers passionate about VR to bring the technology to their departments.
In its first year, Dr. Potter was the only employee dedicated to the VR program full time, and she had three Ambassadors identifying use cases for the technology.
Within four years, the department had its own small corps of support technicians and 65 Ambassadors.
The fleet of six headsets has ballooned to 37. Within the first 10 months of 2024, Nicklaus’s VR program had logged more than 8,000 user sessions.
A reliable MDM is crucial to managing the fleet of headsets and the myriad content the hospital uses. ArborXR makes it possible for Dr. Potter’s staff to know at a glance where each headset is at any given time, whether it’s in use, and whether it’s charged.
“ArborXR has made tracking much easier. And its ability to manage and push content has been a game changer, especially with our wide variety of use cases.”
Dr. Christina Potter
Manager of IT Digital Technology | Nicklaus Children’s Health System
Analytics gathered by the MDM are vital to the program’s continued growth. Reliable data on content, devices, and user sessions makes the case for continued support from hospital leadership, donors, and sponsors.
Virtual Reality is Transforming Healthcare
In just four years, Nicklaus Children’s Hospital has expanded its VR program from six headsets in a single unit to 37 in a dozen departments.
From developing staff skills to empowering patients in therapy to helping frightened kids forget their pain for a while, VR has transformed the way the hospital approaches healthcare.
Dr. Potter said new use cases for VR are being proposed at the hospital all the time. As one of the nation’s premier pediatric teaching hospitals, Nicklaus is also exposing a new generation of clinicians to the possibilities of virtual reality in healthcare.
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