Trabajo En Equipo

Pediatr Radiol DOI 10.1007/s00247-012-2520-1

COMMENTARY

Teamwork among pediatric anesthesia and radiology providers at a large tertiary-care children’s hospital: past, present and future
Mohamed Mahmoud & Blaise Jones & Daniel J. Podberesky

Received: 11 June 2012 / Revised: 20 August 2012 / Accepted: 23 August 2012 # Springer-Verlag 2012

Introduction Cooperation and coordinationbetween anesthesia and radiology providers is required to create and maintain a safe, productive and efficient environment in a pediatric radiology department. We describe the important components of a proficient model for collaboration with anesthesia-radiology staff including radiologists, anesthesiologists, nurses and MR imaging technologists at our institution and how policies and procedures haveevolved to efficiently deliver safe patient care in a high-volume pediatric radiology department.

departments has historically been performed under supervision of pediatric radiologists [2, 3], but the number of complicated cases requiring anesthesia rather than sedation has steadily increased during the last 10 years, prompting a switch from radiologist-led sedation practices to anesthesialedsedation/anesthesia practices. In this commentary we discuss the strategies we have employed to address these changes and the impact they have had on our ability to deliver high-quality care.

Setting Background Today’s practice of medicine is increasingly complex, with highly technical, system-based, multidisciplinary teams caring for very sick patients. Recent advances in technology and theimportant role of MR diagnosis in the management of childhood diseases have increased the need for sedation and anesthesia [1]. Procedural sedation in radiology Cincinnati Children’s Hospital Medical Center (CCHMC) is a large, urban pediatric academic medical center and serves as a primary referral center for an eight-county area in southwestern Ohio, northern Kentucky and southeastern Indiana. In2011, we performed more than 14,000 diagnostic MR imaging procedures, of which 2,318 required general anesthesia (GA) and 1,238 required sedation performed by anesthesia providers. The MR imaging section at our main hospital consists of four MR imaging suites, an induction room and an eight-bed recovery room. The enterprise is supported by booking clerks, reception staff, MR imaging technologists,nurses, anesthesia providers, a patient family advocate, patient care assistants, child life specialists, radiology fellows and staff radiologists.

M. Mahmoud (*) Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 2001, Cincinnati, OH 45229, USA e-mail: mohamed.mahmoud@cchmc.org M. Mahmoud Department of Pediatrics, Cincinnati Children’s HospitalMedical Center, Cincinnati, OH, USA B. Jones : D. J. Podberesky Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Leadership vision and strategy Our institution has a wide organizational structure for promotion and implementation of quality improvement initiatives termed Clinical Systems Improvement, which provides the infrastructure and ensures thatimprovement efforts throughout the hospital are aligned with the priority areas

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identified by hospital leadership. These priorities include patient safety, improving patient flow across the system, value initiatives, and patient- and family-centeredness throughout the organization. These priorities are reflected in the goals that have been defined by the anesthesia radiologyleadership at our institution, a group that includes medical, nursing, safety, quality, finance and business leaders. The overall goals defined by our leadership are as follows: (1) ensure patient safety and optimal patient outcome, (2) provide high-quality imaging studies required for accurate interpretation and subsequent medical decisionmaking, (3) maximize the efficiency in the radiology...