Benefit of an Interdisciplinary Pediatric Sedation Team With a Clinical Pharmacist on Outpatient Appointment Duration...

There is difficulty completing outpatient procedures in children with complex developmental and behavioral diagnoses. These visits may require increased personnel and incur delays.

We sought to evaluate if an interdisciplinary team of providers, nurses, and a clinical pharmacist dedicated to advanced preparation (e.g., discussing patient, reviewing concerns with procedure completion, understanding medication needs) and the development of a pre-appointment plan can streamline outpatient visits.

Pediatric patients with complex behavioral disorders requiring a procedure at an outpatient visit were evaluated retrospectively using pre- and post-implementation data. Outcomes assessed were duration of outpatient appointment and procedural sedation times, procedure success, and description of pharmacist interventions as part of the team. Data are reported descriptively.

Thirty-five patients were included: 17 pre- and 18 post-implementation of the team. Median appointment and sedation times were reduced in the post- compared to the pre-implementation group, 133 min (IQR 98-178) vs. 173 min (IQR 153-190) (p = 0.08) and 40 min (IQR 30-54) vs. 75 min (IQR 45-100) (p = 0.02), respectively. There was no difference in procedure success, and 15 pharmacist interventions were made in six patients in the post-implementation group related to drug-drug interactions, premedication selection, and dose recommendations.

An interdisciplinary sedation team focused on pre-appointment planning for complex pediatric behavioral patients requiring a procedure in the outpatient setting was associated with reduced appointment and sedation times, a clinically and statistically significant finding, respectively. Future studies should focus on resource utilization and patient and caregiver satisfaction.