As a pediatric provider organization, Phoenix Children's Hospital's biggest problem is simply the fact that kids don't sit still for long, regardless of age.

THE PROBLEM

For instance, in imaging, it is really important for children to be calm and still, as any movement can lead to increased uptake of radiotracer. Increased muscle intake could lead staff to believe there's a problem where there's not – or could obscure an area of disease that staff needs to see.

"And it's not just the child who needs calming," said Dr. Dianna M.E. Bardo, vice chair of clinical development radiology at Phoenix Children's Hospital. "Parents also are on edge, and that stress can influence the patient."

PROPOSAL

To help with this problem, Phoenix Children's Hospital turned to Philips Ambient Experience.

Ambient Experience applies human-focused design to give patients of all ages and staff an engaging and pleasant experience, with the aim of improving the efficiency of diagnostic and therapeutic procedures and generating confidence in the services and reputation of the healthcare provider.

It works to achieve this through a combination of multimedia elements and video themes. Ambient Experience environments can be integrated with MRI, PET, CT, DXR and IGT rooms to promote positive distraction and active relaxation in patients, while also helping staff to work under less pressure and within schedules.

"The primary benefit offered by the Ambient Experience technology was that Phoenix Children's could diminish our use of anesthesia or sedation while still achieving precision in patient exams," Bardo explained. "We knew that children would be able to choose a cartoon or lighting sequence, providing the distraction they need along with an element of control. We knew this would greatly increase their comfort level."

Any time staff uses anesthesia or sedation on kids, there are some risks involved. By eliminating or minimizing those risks, staff are better able to deliver the highest quality care. This is especially important for chronically ill patients who receive scans frequently.

"Our anesthesiologists have shared that it creates a soothing, low-stress environment for patient and provider alike. This has been very helpful in putting kids to sleep."

Dr. Dianna M.E. Bardo, Phoenix Children's Hospital

During the exam, Philips Ambient Experience helps create and maintain the calm feeling kids need while helping calm parents, too, Bardo said. Not only does this improve patient families' experience, it allows staff to do their jobs more quickly and with a greater degree of precision, she added.

"Interestingly, our providers have reported the technology has a similar calming effect on them," she reported. "For example, our anesthesiologists have shared that it creates a soothing, low-stress environment for patient and provider alike. This has been very helpful in putting kids to sleep."

MEETING THE CHALLENGE

Staff needed to better understand the current patient experience and how the Ambient Experience might alter that, so they surveyed patients who had received care from Phoenix Children's for years and had undergone multiple PET scans.

"We also surveyed our staff to understand how the technology was affecting patient comfort and to get a clear sense of the operational implications – like increases in patient volume, decreased need for sedation, improved detection of small lesions and many others," Bardo said. 

"Once the technology was installed, the advantages were clear. The survey results were positive across the board. These testimonies helped our leadership team understand the value of the technology and prioritize its use in our hospital."

The Ambient Experience is primarily used by nurses and technologists. These are the people who know patients by name and know which kids (and parents) will benefit from the system.

"Our technology is all Philips," Bardo said. "The Ambient Experience is part of our uptake, and PET scan rooms and will soon be offered in our magnet room, where we are installing a new 3.0 T MRI scanner."

RESULTS

In patient family surveys, staff measured a number of things, including their comfort level, feeling of control, benefits of the new setting and interaction with staff.

"Our patient surveys included really positive responses like 'It's beautiful' and 'relaxing,' so we believe the Ambient Experience technology is improving patient care," Bardo related. "Our provider surveys examined the calming effect of Ambient Experience, as well as the operational benefits of the technology. All responses were very positive."

Other benefits Phoenix Children's Hospital has seen are a reduced need to rescan and reduced total scan time, which have improved throughput.

ADVICE FOR OTHERS

"Do anything you can to alleviate worry during the preparation and scanning processes," Bardo advised. "Adult patients worry because they know what's at stake and often fear the worst. Kids worry because everything is foreign, and they pick up on their parents' anxiety.

"In my work with an adult health system, we used this same technology and saw similar results," she continued. "Having a positive calming experience/distraction can greatly improve their state of mind and thereby improve the quality of the scan."

The importance of precision in these scans cannot be overstated, Bardo stated. In a PET scan, staff usually are looking for cancer. Any sort of movement can make a lesion look larger or make one think there's a problem when there isn't.

"This has an immediate and direct effect on treatment, since providers use the images to determine appropriate dosing for chemo and other therapies," she explained. 

"Obviously, you never want to give a child more chemo than needed. Not only does it make kids feel awful, but it often requires hospitalization, which takes a parent out of work and creates numerous other ripple effects. It's also very expensive."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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