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Kosair Children’s Hospital, University of Louisville Pediatrics Announce Innovative ‘No Hit Zone’ Policy, Program

LOUISVILLE, KY. (Nov. 12, 2012): Kosair Children’s Hospital and University of Louisville Department of Pediatrics officials today announced an innovative new “No Hit Zone” policy and program to help maintain a calm, safe and caring patient care environment for children, patients, families, staff and guests. With this morning’s announcement, Kosair Children’s Hospital, Kosair Children’s Medical Center – Brownsboro and the University of Louisville Physicians – Pediatrics primary care offices become No Hit Zones. Kosair Children’s Hospital is now one of only about 30 children’s hospitals nationwide to implement the No Hit Zone program.

The No Hit Zone announcement was made this morning in a celebration in a packed lobby at Kosair Children’s Hospital in downtown Louisville. The No Hit Zone designation means that, in these patient care settings, the organizations maintain and enforce an environment in which:

  • No adult shall hit another adult;
  • No adult shall hit a child;
  • No child shall hit an adult;
  • And no child shall hit another child.

The effort to research, develop and implement the No Hit Zone policy and program has been led by Erin Frazier, M.D., FAAP, associate professor of pediatrics at the UofL Children & Youth Project, and the Kosair Children’s Hospital Child Abuse Task Force, which Dr. Frazier chairs. This has included researching No Hit Zone programs at several children’s hospitals, customizing the program to meet the two organizations’ needs and philosophies in Louisville, and developing the associated educational and training efforts.

“Many health care workers in pediatric settings have encountered situations in which parents or adults have become angry, raised their voices, or hit a child or another adult in their presence without clear guidelines for them of what to do to intervene,” Dr. Frazier said. “Our goal for this initiative has been to help equip health care workers with some tools to use during these encounters and to help reduce the frequency of disruptive behaviors in our patient care settings; maintain a calm, safe and caring environment for patients, families, staff and guests; and elevate our overall standard of care,” Dr. Frazier concluded.

“Kosair Children’s Hospital’s goal of becoming a top 20 children’s hospital goes beyond having the top pediatric specialists, the best technology and facilities, and leading-edge pediatric research,” said Thomas D. Kmetz, division president, women’s & children’s services and president, Kosair Children’s Hospital. “It means establishing a solid reputation as having one of the highest quality and safest pediatric hospitals in the country. And to do that, we must maintain an environment that is conducive to providing the highest quality patient care possible. That is what the No Hit Zone is all about.”

In recent weeks, the two organizations have been training staff at Kosair Children’s Hospital, Kosair Children’s Medical Center – Brownsboro and the UofL Physicians – Pediatrics pediatric primary care offices about how to intervene when difficult situations occur in patient care settings, including scripting for different scenarios that may arise involving disruptive or potentially disruptive behavior, according to Dr. Frazier. She said the No Hit Zone policy states that when hitting or other disruptive behavior is observed in Kosair Children’s Hospital or other patient care settings, it is everyone’s responsibility to interrupt the behavior as well as communicate the No Hit Zone policy.

“Some key hospital staff members who are then available to help with the situation include social workers, chaplains, child life staff and security,” Dr. Frazier said. “Our general guidelines encourage our staff members to be nonjudgmental; to model effective interventions, such as distractions, when appropriate; to try to have conversations with parents and other caregivers out of earshot of others, including the children, so the parents aren’t embarrassed into being confrontational; and to thank parents for respecting our policies.”

The Kosair Children’s Hospital/Norton Healthcare and UofL organizations plan to expand the No Hit Zone policy and training to all pediatric facilities and to evaluate potentially expanding it to other facilities as well. To review a new brochure about the No Hit Zone, click here.

About Kosair Children’s Hospital
Licensed for 263 beds and recognized as one of the top children’s hospitals in America, Kosair Children’s Hospital is located in the downtown Louisville Medical Center. It is the region’s only full-service, free-standing pediatric hospital, and the only hospital in Kentucky offering a pediatric trauma center. Kosair Children’s provides a complete range of services for children, including pediatric intensive care and one of the nation’s largest intensive care nurseries for newborns.

Kosair Children’s Hospital serves as the pediatric teaching facility for the University of Louisville School of Medicine and is supported by the Children’s Hospital Foundation. As part of its commitment to teaching and research, the hospital offers special programs for cancer; heart, lung, kidney and infectious diseases; respiratory ailments; neurology and neurosurgery; general pediatric surgery; orthopaedics; diabetes; psychiatry; plastic surgery; and infant/pediatric heart, kidney and bone marrow transplants. The hospital operates the area’s only self-contained pediatric burn unit. Because of the hospital’s special mission, all care is provided by professionals specially skilled in the care of children.

Kosair Children’s Hospital received the prestigious Magnet designation for excellence in nursing care from the American Nurses Credentialing Center in 2007. Kosair Children’s is one of the top children’s hospitals in the United States as ranked in U.S. News Media Group’s 2009, 2010 and 2011 editions of America’s Best Children’s Hospitals. More information is available at

About Kosair Children’s Medical Center – Brownsboro
Kosair Children’s Medical Center – Brownsboro opened in May 2010 and is part of Kosair Children’s Hospital. Located adjacent to Norton Brownsboro Hospital in northeastern Jefferson County, Kosair Children’s Medical Center – Brownsboro is the only pediatric outpatient center of its type in Kentucky. The medical center features 365-days-a-year pediatric emergency services; a full complement of pediatric diagnostic imaging services, including MRI, CT, X-ray, fluoroscopy and ultrasound; cardiology services; a full-service laboratory; and a wide range of pediatric outpatient surgery services, including ENT, orthopaedics, eye, urinary, dental, nutritional services and general surgeries. The medical center’s layout, processes and amenities were designed to ease children’s and families’ anxiety about medical experiences and to make the facility a friendly and inviting place for children, teens, young adults and their families. More information about Kosair Children’s Medical Center – Brownsboro is available at

About University of Louisville Physicians – Pediatrics
University of Louisville Physicians – Pediatrics is part of the largest, multispecialty physician practice in the Louisville region, UofL Physicians. All University of Louisville School of Medicine faculty, these 170 pediatric specialists care for patients in their offices and at Kosair Children’s Hospital, conduct research and train the next generation of pediatricians. For more information, go to

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