Getting Imaging into Focus

Joe Cantlupe, for HealthLeaders Media , December 28, 2011
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Success key No. 4: Reducing anxiety
Patients’ anxiety—adults or children—is one of the biggest problems for physicians and nurses involved with MRI exams. It is estimated that up to 10% of all proposed exams with traditional MRI systems are abandoned because of patient fears.

The 557-staffed-bed Northeast Georgia Medical Center offers a spa-like atmosphere to help patients relax, says Debra Duke, director of imaging services for the facility.  

 The rooms allow each patient to adjust the atmosphere to a particular scenery and lighting during exams at the imaging center in Braselton, GA. The hospital provides wireless Internet service at all of its sites, a refreshment bar, and coffee. There is also a women’s waiting area and a mammography suite with lighted scenery panels and amenities provided, such as warmed robes.

St. Joseph’s concentrates on children, giving parents a series of video segments about what to expect in the radiology department. “We strongly believe that lower anxiety levels in our pediatric patients helps engender cooperation in obtaining the best images the first time around—which eliminates the need for repeat images and additional radiation,” Hart says. “Parents have told us how helpful the videos have been in calming their children as well as preparing the parents for how we acquire images.”  

One of the more unusual techniques has been created by the 100-staffed-bed Medical Center of the Rockies in Loveland, CO, which uses a hypnosis system aimed at decreasing the need to sedate patients during MRI exams for overall comfort and improved clinical experience, says Holly Knaub, BAS, RT(R), radiology supervisor for the hospital.

While hypnosis has not been used often in hospitals, it has been accepted for healthcare, according to the National Institutes of Health. The director of the National Center for Complementary and Alternative Medicine testified before a Senate committee in 2000 that “mind-body modalities” were being studied, including hypnosis.Three years ago, an NIH study found that women who used self-hypnosis during a breast biopsy experienced relief and reduced pain compared to patients undergoing standard care. A number of hospitals have been involved in hypnotherapy programs, Knaub says.

“There are many patients anxious about having their MRI exam because of claustrophobia or a bad experience, and the hypnosis helps them,” Knaub says. She cites several bad experiences of patients: One patient refused to use the MRI, saying, “That is too much like a coffin. I’m not going in there.” Another patient crawled out of the MRI bore as a technologist was setting up the scan and was knocking on the door to get out, Knaub says. And there were other patients “who did not know they were claustrophobic before they got in to the MRI, and they flipped out.”

Knaub says the hospital employs a hypnotherapist as a consultant to carry out the process. For each patient who requests and has the therapy, it has resulted in a calming experience that continues through the MRI exam, she says.

“We wanted to make the patient experience the best it could be in a medical facility,” Knaub says. “We want to provide an atmosphere that people would want to come to.”

Knaub says the hospital system alerted primary care and hospital physicians about the hypnosis program. “The referring physicians brought up the program as an option when patients said they were apprehensive about an MRI,” she says.

Once a patient sought a hypnosis session, the consultant hypnotherapist would have a one-hour meeting with the patient and provide a relaxation CD about the process for the patient to review. Later in the week, when a patient is hypnotized and undergoes an MRI, the process usually takes an hour, she says.
Using a hypnotherapist reduces the need for a sedative, she says, which reduces overall cost. “Too often, an automatic response from a physician is ‘Let’s give [the patient] a pill to sedate them’,” Knaub says.

Patients who need medication to take an MRI prompt nurses to spend more time on each case, sometimes a few additional hours, to help ease their anxiety and recover from the drugs, she says. After the hypnosis, “which basically amounts to being a little nap, they get off the scanner table and go off to do their day-to-day business,” Knaub says.

The hospital received a $7,500 grant to pay for a hypnotherapist part-time for more than 30 patients. The hospital pays the hypnotherapist about $150 each session, Knaub says.

The community is slowly becoming attracted to it, she says. “We are in a conservative area, but patients who have gone through it have loved it.” Knaub hopes to continue the program next year.

This article appears in the December 2011 issue of HealthLeaders magazine.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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