IMAGING CHILDREN IN ADULT HOSPITALS: IMPROVING QUALITY, SHARING PRACTICE
3RD JUNE 2014 AT THE UCH EDUCATION CENTRE LONDON
A very full programme of speakers presented to a packed audience during this lively and thought provoking day. Sandie Mathers, Honorary Research Fellow, Institute of Health and Welfare Research, Robert Gordon University, Aberdeen chaired the day and set the scene by presenting a brief resume of the findings of the original research project Survey of Imaging Services for Children 2007/2008: Evidence for Change and the resulting recommendations.
Christina Freeman, Professional Officer, The Society and College of Radiographers gave the view of the professional body, including its role in the setting of standards for the profession. Several guidance and policy documents on the topic of improving the quality of imaging services of children particularly in adult hospitals have been published and the webpage has been developed to include advice and resources.
Jeremy Weldon and Bindiya Vekaria from North West London Hospitals NHS Trust presented a study conducted between two institutions which gave a snapshot of Imaging of Children in the Adult-Led Services Environment. The issues generated from the responses included the significance of the roles of the lead paediatric radiographer and the health play specialist.
The Problems in Practice were discussed by Jonathan Grant and Lauren Morgan from Countess of Chester Hospital NHS Foundation Trust. The Lead Paediatric Radiographer in a busy district general hospital can be an extremely challenging role but also a rewarding one which can really help the service user of a district general hospital by driving up quality.
Gail Woodhouse, Senior Clinical Officer, Public Health England reminded participants that optimisation is key when imaging children in an adult hospital. Her talk explored the challenges presented when optimising paediatric medical exposures in a general hospital setting. Radiographers are the acknowledged radiation protection experts within healthcare and need to take every possible step to minimise radiation doses.
Maryann Hardy, Professor of Radiography & Imaging Practice Research, University of Bradford told the participants that children account for an estimated 20% of imaging examinations. Many published papers and authors have stated that imaging children requires a unique set of skills and knowledge as children are “not little adults”. However, radiographers working with children also need to have a good understanding of anatomical growth and development to improve image acquisition techniques and appreciate the distinctive radiographic appearances associated with juvenile anatomy. Maryann’s presentation included case studies demonstrated how knowledge of development during childhood can prevent the misapplication of image acquisition techniques and quality assessment criteria and the misinterpretation of normal developmental variations.
The presentation prepared by Donna J Dimond, Senior Lecturer in Diagnostic Imaging, University of the West of England examined the difficulties faced by those radiographers attempting to provide a high standard of imaging and treatment to children being examined in adult departments.
Donna discussed key factors that affect the radiographer’s task and made suggestions as to how improvements can be made at both a local and national level.
After lunch, members of the Association of Paediatric Radiographers, Jo French, Paediatric Radiographer Practitioner, West Suffolk Hospital and Jennifer McKinstry, Superintendent Radiographer, Royal Belfast Hospital for Sick Children gave their expert views. Jenny works in a specialised paediatric unit and Jo in a general department. Jenny described the origins, objectives and the work of the Association of Paediatric Radiographers and Jo discussed the ways in which those working in a general department can ensure that children receive the same high standard of imaging
Promoting the Importance of Child Development and Collaborative Links with Health Play Specialists presented by Alison Tonkin and Claire Weldon from Stanmore College explained that understanding the progressive nature of developmental stages that children and young people pass through forms a vital role in education. Alison and Clare explored how developmental information and factors relating to how children and young people develop would be useful for radiographers. This includes having an awareness that children and young people may show signs of regression when faced with stressful experiences and the consequences of illness or injury which may impact on the success (or otherwise) of the imaging procedure. There are many ways of improving the imaging experience for children, young people and the practitioner, and this presentation explored how collaborative links with health play specialists can help.
Good Practice Stories from the MRI Department and Nuclear Medicine at UCH were described by Felicity Lacchin, Advanced MRI Radiographer, Rayjanah Allie, Deputy Superintendent, Nuclear Medicine and Laura Walter, Senior Play Specialist. The participants heard what a difference had been made to the quality of services by having the input of a health play specialist. Imaging paediatric patients in an MRI department can be quite a challenge, especially in an adult hospital. As the demand for the MRI services increased the paediatric MRI service had to evolve. New streamlined paediatric pathways were created, including a new play specialist service, and development of parent/carer information to enhance children’s and young people’s understanding of hospital treatments and procedures and reduce anxiety throughout their healthcare experience. The role of a health play specialist in nuclear medicine and the impact it can have on patient experience and throughout a busy department was described. The use of health play specialist for both SPECT/CT and PET/ CT procedures in the nuclear medicine department has led to dramatic improvement and change in practice since they started out one year ago.
Amy Low, NHS Highland and John Temple, NHS Tayside described The Paediatric Imaging Tayside Study Sessions (PITSS) Team at NHS Tayside explained how prior to PITSS, Ninewells Hospital had implemented a quality improvement programme for neonatal radiography in NICU which showed marked improvements in examination quality. PITSS formed in 2011. The team decided to do something to improve the quality of paediatric imaging in adult radiology departments across NHS Tayside. Study events with paediatric specialist speakers were chosen to maximise distribution of information across Tayside and beyond. Four study events have now been held and the team were awarded the Scottish & UK SoR Team of the Year Awards in 2013. The message was summed up by one word – “inspiration”: Experts: continue to inspire and Audiences: be inspired and act on your inspiration
At the end of the day a panel discussion answered questions from participants considered how good practice could be shared. Post-conference feedback was very positive and everyone agreed that the speakers had given excellent presentations that challenged and informed in equal measures. Huge thanks to all involved with this important study day. The speakers are going to share their expertise so watch out for articles in Synergy News and Imaging and Therapy Practice