Sally Grady, RT, director of imaging services for Florida Hospital Celebration Health, in Celebration, Fla, watches a DVD describing the MRI experience with a young patient, as Buddy the Bear looks on.

Sally Grady, RT, director of imaging services for Florida Hospital Celebration Health, Celebration, Fla, still remembers the patient from Georgia who had a CT scan at the hospital’s imaging center after being brought to the emergency department while on vacation.

“Three hours later, I found her wandering back through. She had gone back to her hotel, and brought her family back with her camera because she said none of her friends would believe she had a CT scan in a castle,” Grady recalls.

Getting scanned in a castle is not unusual for the patients who come to the hospital’s CT and MRI center, Seaside Imaging. The center is decorated in a seaside theme, complete with lifeguard stations, cabanas, the sounds of seagulls, and the smell of coconut-scented sunblock.

Celebration Health is one of the campuses within the Florida Hospital group, an acute care system owned and operated by Adventist Health System. The 100-bed hospital is located in Disney’s planned community of Celebration.

Seaside Imaging is a reflection of Adventist Health System’s vision of providing “high touch care in a high tech environment.” Under that philosophy, Celebration Health’s administrators charged Grady—along with Ed Majors, now the executive director of imaging services, and Merle Peterson, now the director of imaging services at the Orlando campus—with creating an imaging center that did things “differently.”

“People come in with a lot of preconceived ideas about what the experience is going to be, and are very apprehensive before they even walk through the door,” Grady says.

The trio focused on creative ways to make the CT and MRI areas and equipment less intimidating for their patients. “Most of them have not had a good story told to them about what they’re going to experience during an MRI. Friends will tell them it’s like being in a tomb, it’s dark and tight, and all sorts of things,” Grady says. “We found that we had to sedate a fairly good percentage of patients, and that we were also having a lot of patients cancel because they couldn’t make it through the exam.”

The majority of patients seen at Seaside Imaging for MRI procedures are adults. While Celebration Health does a lot of CT scans on children because of the high tourist population in the area, the hospital does only a few pediatric MRI cases; most of those are handled at the health system’s main campus in Orlando.

A NEW LOOK

The first step in creating an imaging center that did things “differently” was the aesthetic change that would become Seaside Imaging. To create the beach environment, carpet was replaced with a boardwalk; the waiting area now includes a lifeguard chair and Adirondak chairs; and patients change their clothes in a cabana. There are no hospital gowns here; instead, patients wear T-shirts, surfer shorts, and flip-flops provided by the hospital. The pre-examination area is made up of four mini-holding rooms, two of which have Adirondak chaise lounges instead of stretchers.

The MRI machine is hidden within a fabricated sand castle, while the CT gantry is covered with an artificial coral reef. Various props, including fishing poles and murals, were added throughout.

And the hospital did not stop with the visual components. “I wanted to do similar to what Disney does; when you go to one of their theme parks, it affects all of your senses. I wanted to really affect what patients saw, what they felt, what they smelled, what they wore,” Grady says. “The whole idea was to really relax people. They hear the waves, people on the beach, a boat going by, a plane flying over. We have aromatherapy going, so it smells like the ocean in one section, while another section smells like coconut suntan oil.”

For those who drink barium for their CT scan, the hospital serves the concoction in turquoise cups that have the Seaside Imaging logo, and put little paper umbrellas in them.

It took about 10 months to complete the 2,400-square-foot project, which opened in October 2000. Eventually, the changes went beyond the CT and MRI areas: the imaging department’s mammography area is designed to look like an English tea garden, complete with a gazebo; the x-ray rooms within the emergency department are decorated with a manatee theme; and a second CT scanner near the emergency department is decorated with a dolphin theme.

The nuclear medicine area now comes with a movie theater set up in the waiting area, complete with theater-style reclining seats, a popcorn maker, and posters on the walls, after the hospital began showing movies to help pass the time for patients undergoing long procedures. “I never expected that a patient would not want to go home because they hadn’t finished the movie,” Grady says.

The seaside-type environment is so popular that it has been exported to Florida Hospital Kissimmee, which now has a freestanding MRI facility called Ocean View MRI. “Celebration was built so that if something worked here, we would want to take it to our other campuses,” Grady says.

PATIENT EDUCATION

The second part of the imaging center project was to create patient education tools for someone having an MRI.

Its first tool was the creation of a DVD, titled “The Bear Facts About MRI,” which teaches patients about the test using 3D computer-generated animation. The main characters are Buddy the Bear and his 11-year-old friend, Max, who loves riding skateboards.

The video is shown to all patients before they have an MRI. “There is another version of the video for adult patients, but every patient watches the pediatric one because they think it’s more fun,” Grady says. In the adult patient version, Buddy plays the role of the technologist.

After changing their clothes, patients are seated in the center’s education alcove, where a four-foot animatronic Buddy the Bear speaks to them, and triggers the 5-minute DVD to start. The DVD is packaged with an interactive CD-ROM that goes over the most frequently asked questions about MRI, including how long the scan takes.

The premise behind creating the DVD was to relax patients, especially children, and let them know what to expect from the test in order to decrease any anxiety.

“The Bear Facts About MRI” has been so successful that it spawned a separate entity called Bear Facts Entertainment, which focuses on producing health-related education for children, including more DVDs on such topics as CT scans and asthma.

Various Max and Buddy materials have also been created to be given to pediatric patients, including buttons, magnets, mouse pads, temporary tattoos, coloring books, caps, visors, T-shirts—all with Max and Buddy—as well as Buddy the Bear stuffed animals.

REAL RESULTS

Through Celebration Health’s efforts, the imaging center’s adult patient sedation rate dropped from 6% to 2%; and cancellations were cut by about 50%.

“There’s a certain age child with whom you’re always going to have to use general anesthesia or sedate,” Grady says. “But if you have a child who is 4 or 5, and you can avoid the sedation aspect, the parent can be in there with them, they know what to expect, and they’ve watched Buddy go through it and come out just fine, we think that would have tremendous benefit.”

The approximately 15 employees in the imaging department who work in Seaside Imaging also have benefited from the changes. Grady says before the changes, technologists could spend 30 to 40 minutes trying to coax a patient to take a test. “If the patient then can’t complete that exam, not only have we lost the patient and that revenue, the patient does not get the test that might give them the diagnosis they need,” she says. “Plus, if we don’t have to sedate people, our productivity goes up: I don’t need a nurse to monitor the patient; the patient doesn’t have to have someone come with them to drive them home. I’ve had several patients who have said they can have MR only with sedation, and we’ll tell them to come in and try [without] it first, and 99% of the time, they can get through it.”

Grady—who says there was fund-raising associated with the project but declined to comment on the cost—says the changes have also benefited the hospital in terms of the high competition it faces from freestanding imaging centers, and offers some advice to other hospitals considering doing the same.

“You can go all out, or you can do what you can,” Grady says. “You can spend a lot or you can spend a little, but you can still make changes that will make a difference for your patients.”

Danielle Cohen is associate editor of Decisions in Axis Imaging News.