Importance of Preparation: A Partnership Between Child Life and Radiology to Reduce Sedation, Increase Safety and Improve Patient Experience

Purpose: In 2019, leaders from Radiology identified a need to reduce the number of patients receiving general anesthesia for MRI scans to improve patient safety. In reviewing the US News and World Report methodology for ranking hospitals, one best practice that is noted is “having patients undergoing imaging studies (e.g., MRI, CT, or VCUG scans) be provided access to a certified child life specialist (A10.5).” Radiology partnered with child life at this institution to create a program designed to provide child life interventions before MRI scans.

Methods/Materials: Interventions include child life facilitated outreach to caregivers for patients 12 and under scheduled for their first non-sedate MRI. Additionally, patients can be referred to the program by ordering providers or schedulers based on complexity of the MRI (e.g., fMRI), developmental delays, or previous traumatic medical experiences. This program started with one child life specialist (CLS) providing outreach and support in an outpatient facility within the institution that provided both general anesthesia and non-sedate MRI scans. The CLS began programmatic planning, partnering with radiology to further educate medical staff, and developing a phone screening process to ensure patients are scheduled appropriately. Caregivers of patients within the program received developmentally appropriate preparation through email and phone consultation that encouraged caregivers to have patients practice staying still at home. The phone consultation also allowed the CLS to further assess and answer questions.

Results: This outpatient facility quickly progressed to providing only non-sedate MRI scans due to the program's success. Not only did the program increase patient safety, but it also provided an opportunity to see more patients and save on anesthesia costs. This program has reduced the percentage of patients receiving general anesthesia at this institution for MRI scans from 48% in 2019 to 25% in 2022.

Conclusions: With the continual collaboration of radiology and child life, this institution strives to further reduce the use of general anesthesia for all imaging studies and procedures through the expansion to 8 CLSs and one program coordinator.