Presented by Jocelyn Grunwell, MD
Critical to developing a highly successful pediatric sedation service is providing not only safe and effective care but to do so in an efficient manner as well. Dr. Jocelyn Grunwell, a pediatric critical care physician, led a provocative discussion on the Development of a Pediatric Assessment Tool for MRI. Discussion focused on the development of a rapid and simple screening questionnaire to determine score thresholds to predict children who should be referred to general anesthesia without over-referral. The tool consists of nine categories with a total of 42 questions. The goal of the tool is to increase the effectiveness of pre-screening in order to minimize same day cancellation rates which would in turn:
- Decrease patient backlog and MRI wait times
- Decrease ineffective use of scanner, physician and nursing time
- Decrease cost of lost school/work days
- Increase parental satisfaction
Dr. Grunwell concluded that the Pediatric Assessment Tool can reliably predict same day cancellation and failures but should not replace clinical judgement. There are opportunities for improvement for both inpatient and outpatient MRI departments that can be addressed by utilizing the screening tools in multiple areas including outpatient, emergency, inpatient and ICU departments. Prospective testing of a PSAT scoring threshold is needed to determine whether screening can decrease frequency of same day sedation cancellation rates.