Radiology: Anesthesia slows pediatric MRI patient flow, raises costs
Visit durations are significantly longer for anesthetized and sedated pediatric patients undergoing MRI, and hospital costs are higher, according to a study published in the July edition of Radiology.
“The inability of young children to remain motionless for extended periods of time often necessitates the use of sedation or anesthesia during pediatric MR exams…the growing use of MRI has maintained a substantial need for sedation and anesthesia; however, the effect of sedation and anesthesia on patient flow within diagnostic imaging departments remains largely unexplored,” noted Sonya A. Vanderby, PhD, of the department of mechanical and industrial engineering at the University of Toronto, and colleagues.
The authors conducted the study to determine total visit duration differences, investigate variations in visit stage durations according to patient type and estimate visit costs on the basis of human resource and medication use.
The researchers recruited 237 pediatric participants from the MRI clinic at the Hospital for Sick Children in Toronto for the patient flow study that tracked patients’ progress through each stage of the clinic process. Information collected included demographics, visit processes and medications administered, and each participant was classified as awake, sedated or anesthetized.
Of the 237 participants, complete data sets were obtained for 148 awake, 28 sedated and 27 anesthetized participants. Vanderby and colleagues observed 12 stage sequences among patient visits, with each sequence differing according to patient category.
Compared to the three hour and 38 minute average sedated patient visit and the four hour and seven minute anesthetized patient visit, an awake patient experienced an average visit length of two hours and 21 minutes. Visit costs were higher for sedated and anesthetized patients, on average 3.24 and 9.56 times higher, respectively, than those for awake patients, the researchers added.
While the costs incurred for anesthetized patients were 2.95 times higher than those for sedated patients, sedated and anesthetized visit durations did not differ significantly, said Vanderby and colleagues.
Noting that although this finding may be attributable to the small patient cohort observed, the research has led to appointment and scheduling procedure changes within the facility, with further improvements anticipated, said Vanderby.
“To accommodate anesthesiologist availability, rather than scheduling patients who require anesthesia sequentially, awake patients are now scheduled between anesthetized patients, and appointments are staggered between MR imaging suites to improve use of nursing staff and the induction room,” she offered.
“By revealing the cost and resource implications of sedation and anesthesia treatments, this approach can aid hospital and clinician decision making,” the study concluded.
“The inability of young children to remain motionless for extended periods of time often necessitates the use of sedation or anesthesia during pediatric MR exams…the growing use of MRI has maintained a substantial need for sedation and anesthesia; however, the effect of sedation and anesthesia on patient flow within diagnostic imaging departments remains largely unexplored,” noted Sonya A. Vanderby, PhD, of the department of mechanical and industrial engineering at the University of Toronto, and colleagues.
The authors conducted the study to determine total visit duration differences, investigate variations in visit stage durations according to patient type and estimate visit costs on the basis of human resource and medication use.
The researchers recruited 237 pediatric participants from the MRI clinic at the Hospital for Sick Children in Toronto for the patient flow study that tracked patients’ progress through each stage of the clinic process. Information collected included demographics, visit processes and medications administered, and each participant was classified as awake, sedated or anesthetized.
Of the 237 participants, complete data sets were obtained for 148 awake, 28 sedated and 27 anesthetized participants. Vanderby and colleagues observed 12 stage sequences among patient visits, with each sequence differing according to patient category.
Compared to the three hour and 38 minute average sedated patient visit and the four hour and seven minute anesthetized patient visit, an awake patient experienced an average visit length of two hours and 21 minutes. Visit costs were higher for sedated and anesthetized patients, on average 3.24 and 9.56 times higher, respectively, than those for awake patients, the researchers added.
While the costs incurred for anesthetized patients were 2.95 times higher than those for sedated patients, sedated and anesthetized visit durations did not differ significantly, said Vanderby and colleagues.
Noting that although this finding may be attributable to the small patient cohort observed, the research has led to appointment and scheduling procedure changes within the facility, with further improvements anticipated, said Vanderby.
“To accommodate anesthesiologist availability, rather than scheduling patients who require anesthesia sequentially, awake patients are now scheduled between anesthetized patients, and appointments are staggered between MR imaging suites to improve use of nursing staff and the induction room,” she offered.
“By revealing the cost and resource implications of sedation and anesthesia treatments, this approach can aid hospital and clinician decision making,” the study concluded.