Children centered care status after implementation: What happens when the spotlight and hype are turned off?

A Children Centered Care (CCC) MRI environment was developed, including animated figures, an interactive app, a children's lounge with a toy scanner, and was facilitated by specially trained pediatric radiographers. The aim was to evaluate the CCC MRI concept for children aged 4-10 years, 6 years after the concept's initial implementation.

This retrospective implementation study was conducted in the Department of Radiology at the Lillebelt University Hospital, DK. Data on examination date, sex, age, sedation, type of MRI examination, reason if not successful, and duration were collected. Furthermore, data were collected on whether radiographers who entered the MRI team had received communication training or any refresher training.

Over 1 year, 636 children were deemed eligible for MRI without sedation. Exclusions were made for incomplete examinations, follow-up scans, scaphoid, or the use of GA. A total of 436 children were included (48% females, 52% males; median age was 7.5 years). Thirty-three children required a repeat MRI scan for various reasons (7.6%). Only five children (1.1%) needed GA and this resulted in a success rate of 98.9%.

To the authors' knowledge, there are currently only a few studies that have evaluated an intervention after implementation. Other studies have included, e.g., educational animated videos, animal intervention (therapy dog), and a mock scanner. All with positive results, which indicates that it is very important to invest time and resources to limit the use of expensive and potentially risky GA in children undergoing MRI.

The children's dedicated lounge and app appear to be very important. We found that only a small number of children needed GA, and that a non-sedated MRI protocol is still highly successful six years after implementation.

Magnetic resonance imaging, often called an MRI scan, uses magnets to take pictures inside the body and can be stressful for young children. This study reviewed the use of a child-friendly MRI space with toys, an app, and trained staff for children aged 4 to 10 years. This study found that nearly all children finished their scan without needing general anesthesia, which is medicine that puts a person into deep sleep. This matters because reducing the need for anesthesia can lower risk, stress, and cost while improving care for children and families.