PAEDIATRIC MRI PROJECT THAMES VALLEY AND WESSEX ODN Issue 2. This project aims to: Improve access and availability of paediatric MRI

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1 July 2 PAEDIATRIC MRI PROJECT THAMES VALLEY AND WESSEX ODN Paediatric MRI Project Thames Valley and Wessex ODN IN THIS ISSUE October 2016 Welcome By Nadine Duffin Welcome to the second newsletter for the Thames Valley and Wessex Paediatric MRI project. It has been a busy few months here at paediatric MRI HQ. I have been to meet people who are equally passionate about improving access to paediatric MRI, who are willing to share what they are good at and to learn from others to improve the experience for patients The clinician s survey and the Paediatric MRI Stars and Wishes surveys have closed. The information from the surveys, process mapping and meeting with key stakeholders have identified key themes which are being adopted. A trip to the Royal College of Radiologists allowed me to meet trail blazers and innovators in providing radiology services in keeping with the NHS Five Year Forward Plan. Some of these ideas could be replicated within the TV& W region to improve the paediatric MRI service provision. All in all it s been a busy time! This project aims to: Improve access and availability of paediatric MRI Establish a clinical network for paediatric MRI for TV&W Share best practice across the region Develop common standards and protocols Improve and standardise patient pathways Provided a pull shared imaging viewing platform across the region Paediatric MRI Project Map Map of the geographical area the project covers Clinicians MRI Access Survey Results from the Clinician s Survey on Access to Paediatric MRI Paediatric MRI Study Day Book your place today 18 th Nov 2016 MRI Working Group Updated MRI Working group list MRI Stars and Wishes An early review of the results. Coming up next month Page 2 Page 2 Page 3 Page 4 Page 3 A look into what is planned for month 2 of the paediatric MRI Project. Page 4

2 2 Paediatric MRI Project Coverage This map shows the geographical area the Thames Valley and Wessex Paediatric MRI Project covers. MRI Access Survey Results Access to non-sedated, non-ga MRI was acceptable across the Thames Valley and Wessex region except at the tertiary referral hospitals. Half of the respondents found access to MRI under sedation and MRI under GA adequate or better. A large percentage of hospitals do not have access to MRI under sedation, with other clinicians struggling to access MRI under sedation due to the ad-hoc nature of the service. This was often deemed to be due to the perceived safety issues regarding sedation for MRI scans. Access to MRI under GA is variable across the region with 30% of respondents finding the service good or excellent and 42% finding the GA MRI service poor or unsatisfactory. Particular problems related to accessing an urgent MRI scan. Transfer of imaging studies was generally problematic, sometimes causing delays to patient care. This was further compounded as the report of the scan was not transferred alongside the images, therefore requiring the clinician to request the radiologists at their hospital to report the imaging as well. There appears to be a lack of knowledge, on what MRI services are available at hospitals by clinicians undertaking outreach clinics. Action Plan Undertake process mapping at a hospitals with an excellent and poor access to MRI, to identify variations in patient pathway (completed). Review the safety profile of sedation under MRI, to identify if the concerns are warranted and to allow a decision to be made regarding the use of sedation for MRI scans Set up formal image transfer process that includes the local report being transferred with the images. Please contact the Paediatric MRI Project manager if you wish to have a copy of the complete report on the Clinician s access to paediatric MRI Survey. CONTACT DETAILS Nadine Duffin Paediatric MRI Project Manager Thames Valley and Wessex ODN M: E: Nadine.duffin@ouh.nhs.uk

3 3 MRI Study Day Book Your Place Today! Places are going fast for The Thames Valley and Wessex Paediatric MRI Multi-professional Study Day so book your place today. This event is designed to share best practice in paediatric MRI. It is aimed at Radiologists, Radiographers, Play Specialists, Paediatric Clinicians, trainees, Anaesthetists and Nursing staff. The event is open to all, not just staff in the Thames Valley and Wessex Region. If you would like to attend or want further information, please

4 4 MRI Working Group Since the last newsletter the working group has grown, with a good response from the Thames Valley. We have a large working group due to the diverse areas this project covers. Members of the Working Group Thames Valley Jane Andrews, MRI Lead - Oxford Mr Amedeo Calisto, Consultant Paediatric Neurosurgeon Oxford Dr Subhashis Chakraborty, Consultant Paediatric radiologists - OUH Dr Sumit Das, Consultant Paediatric Anaesthetist Oxford Dr Marc Davison, Consultant Paediatric Anaesthetist Stoke Mandeville Dr Lucy Grain Consultant Pediatrician- Great Western Hospital Dr Kieran Hogarth, Consultant Radiologist Royal Berkshire Hospital Dr Tony McShane, Consultant Paediatric Neurologist - Oxford Mr Shailendra Magdum, Consultant Paediatric Neurosurgeon - Oxford Dr Indranil Misra, Consultant Pediatrician Milton Keynes Mr Colin Nnadi, Consultant Spinal Surgeon Oxford Wessex Mo Ahmed, MRI Radiographer- Southampton Dr Mark Alderton, Consultant Paediatrician - Southampton Judith Bennett, Paediatric Clinical Matron - Hampshire Hospitals Ashlyne Buchan, MR Radiographer Isle of Wight Julie Fairbank, Lead Health Play Specialist- Hampshire Hospitals Dr Hazel Griffith, Consultant Paediatric Radiologist Basingstoke Dr Joseph Jacoby, Consultant Paediatric Radiologist Poole Dr William King, Consultant Radiologist Isle of Wight Helen Peel, Lead for MRI Dorset County Hospital. Dr Matt Taylor, Consultant Paediatric Radiologist Portsmouth Dr William Ward, Consultant Pediatrician Dorset County Hospital Dr Stephen Warriner, Consultant Paediatrician - Portsmouth Dr Vollmer, Honoury Consultant in Paediatric Neurology University of Southampton. MRI Stars and Wishes Here are a few more of the stars and wishes for the paediatric MRI Service. See what you said section (page 4) for how we plan to tackle some of these wishes The Stars Radiology team always helpful when we discuss case with them. Helpful and will do the utmost to accommodate Excellent quality of reports and availability of radiologists (general paed and paed neuro - radiologists) to discuss reports The Wishes Set up a service to aim at reducing need for GA in children under age 7 or with behavioural problems (i.e. specific play therapy etc etc). MRI with sedation list nurse led with Anaesthetist overseeing it. The organisation of getting patients a scan date and liasing with the family

5 5 You said. We are doing Nurse led MRI with sedation list We are developing evidence based guidelines for sedation for radiological examinations and reviewing the safety profile of MRI under sedation. Set up a specific service aiming to reduce the need for GA MRI i.e specific play therapy etc. We are developing a pre-screening proforma for paediatric MRI to highlight the children who would benefit from play therapy and develop formal pathways for access to a play specialist. Capacity for more GA list to reduce routine OP MRI Better communication between radiology and clinicians regarding scan dates, DNA s and cancellations. We are reviewing the booking process of paediatric MRI scans and the notification process from the radiology information system to the electronic referral system (ordercomms). Easier access for urgent MRI scans under GA We aim to reduce the need for MRI under GA in patients to reduce routine OP waiting times rather than increase capacity as GA MRI is scan time intensive. We are reviewing the access for urgent MRI scans including under GA and we are looking at the feasibility of utilising capacity at other hospitals. Coming up next November o Analysis of the paediatric MRI workload activity for Oxford and Southampton including mapping of regional referrals. o Thames Valley and Wessex Paediatric MRI Multi-professional Study Day o December Review safety profile of MRI under sedation and development of evidence based guidelines if appropriate. o Service Specification for Paediatric Imaging Network to go to working group for review. o Develop proforma for the prescreening of paediatric patients to help the decision making process regarding the need for GA / play specialists input. January o Workshop to develop standardised patient pathways and scan protocols for the top 15 clinical indications for MRI. o Meeting of IT and PACS teams to discuss shared imaging platforms across the region. o Test the pre-screening proforma in one hospital.