From the hospital’s point of view, the use of general anaesthetic for MRI scans adds an additional challenge, as general anaesthetics are costly and often result in a long wait time for patients due to limited bed capacity. Prior to this project launching at NUH, the Paediatric MRI scanned around 2,200 patients a year, or roughly 6 a day.
Then, play specialist expert Jamie-Lee Phillipson asked “is there an alternative to automatically sending a child under general anaesthetic?” This question changed everything, setting off the team on a journey to transform the experience of Paediatric MRI.
The Play Specialist MRI Pathway project was born, to reduce the number of children and young people needing general anaesthetic for a non-invasive MRI scan.
The project was delivered through the WAVE team, which works with various departments around the NUH Trust for 17 weeks at a time, to recommend and deliver quality improvement projects.
By introducing play therapists to support patients prior to an MRI scan, the project aimed to make it a more positive experience for the patient and to reduce the backlog of patients waiting for scans.
Play specialists use a variety of tools to help children prepare for and deal with being in hospital. This might include toys, books, videos and even needle work if cannulation is required. For children requiring a scan, play specialists help create a more positive experience and helps equip children with the skills needed to understand and cope with the procedure. The pre-operative approach can be tailored to the individual, and is adaptable for different age groups.
After all – one thing children know is how to play!
The project received a grant of £55,000 from Nottingham Hospitals Charity, which was used to recruit play specialists specifically to support the Paediatric MRI. A 12-month pilot was approved, and the play specialists worked closely with the Radiology department to trial scans with play therapist input.
Since the start of the project, the play specialist team has supported 757 patients over the age of 5 years old who are undergoing an MRI scans. For these patients, they have avoided admission for general anaesthetic and therefore the project has freed up beds that can be used for other surgical and day care activities at Nottingham Children’s Hospital.
The Play Specialist MRI Pathway project has had a significant positive impact on patient care. Patients no longer have to automatically undergo a general anaesthetic for a non-invasive MRI scan, making it a much easier, calmer experience for many patients and their families.
Tom and Sophie Derry are parents of Odette, who has had in the region of 15-20 MRIs during her admissions at QMC. The family praised the play specialist role, saying:
“We found the play specialist role to be particularly useful in the earlier admissions, at that point as a parent I was fairly overwhelmed with everything going on, as you’re moving through an emotional and unfamiliar process. The play specialists were an additional advocate for the well-being of our daughter, and were able to provide comfort, help Odette to focus on something fun and lighten the stress, and for that we are very grateful.”
The MRI backlog has been reduced too, from 804 patients at the end of December 2021 to just 268 patients, decreasing the wait for a scan by 19 weeks. Behind the scenes, the cost of providing an MRI under general anaesthetic is approximately £925, whereas the cost of MRI with non- general anaesthetic is around £178, making it a much more cost-effective option and freeing up budget to be used elsewhere within the hospital.
The project has been a real multidisciplinary effort, with the support of Radiographers, admin staff, and all the others who have taken on additional workload to bring the pilot to success.
The Play Specialist MRI pathway project is a great example of the significant impact that a small change can make in improving patient care, and could only happen thanks to the generosity of our donors at Nottingham Hospitals Charity.
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