Increasing the Utilization of Moderate Sedation Services for Pediatric Imaging.

Area of Science:

• Pediatric Radiology
• Quality Improvement in Healthcare
• Sedation Management

Background:

• Motion-free imaging in children is challenging, often necessitating general anesthesia.
• A moderate sedation program existed but had low utilization despite patient eligibility.
• Barriers included unclear criteria, inconsistent screening, and poor provider visibility.

Purpose of the Study:

• To improve the utilization of a moderate sedation program for pediatric imaging.
• To address key drivers of low utilization through a multidisciplinary quality improvement approach.
• To increase the number of weekly imaging examinations performed under moderate sedation.

Main Methods:

• A multidisciplinary team utilized an A3 approach within a 5-month quality improvement course.
• Developed clear eligibility criteria and standard work for registered nurses (RNs) and technologists.
• Implemented modality-specific forecasting for patient rerouting and electronic health record changes for automated routing.

Main Results:

• Weekly scheduled moderate sedation imaging examinations increased from a mean of 1.2 to 6.1.
• The achieved rate exceeded the SMART goal of five examinations per week.
• The initiative successfully increased access to moderate sedation for pediatric imaging.

Conclusions:

• A multifaceted quality improvement approach can significantly enhance moderate sedation program utilization in pediatric imaging.
• Addressing process deficiencies and engaging multidisciplinary teams are crucial for success.
• This model can be adapted for workflow changes in settings with organizational resistance.