Where personal efforts like deep breathing, meditation, and positive visualization leave off, manufacturers of patient-comfort accessories take over. Studies show that anxiety on the part of patients can prompt them to cancel medical imaging exams. Today, providers can reduce cancellations—and calm uneasy patients—with innovative products designed to provide comfort and ensure better testing experiences and quicker diagnoses.

The ancients understood that remedies for calming were as important as those that were curative. Egyptian physicians often used incantations and magical ingredients as part of their treatment to soothe the soul as well as the body. The ancient Greeks prepared patients for medical treatment with sea baths and specific herbs designed to comfort the person. And many cultures throughout the ages have integrated music with medicine to relax the anxious patient.

In short, everything old is new again. Although patient-comfort accessories may seem of secondary importance in radiological care, recent studies and evidence have shown that comfort accessories may provide far more significant health benefits than one might imagine.

Several developments in the field have led to significant changes in medical imaging—from devices that provide audiovisual stimulation during examination and testing to comfort-enhancing, antimicrobial pressure-management pads for medical imaging tables. These products are designed to reduce stress and movement, and make the scanning experience more tolerable to patients and more productive for the medical staff.

Studies reveal that about 10% of MRI exams are cancelled because of patient anxiety surrounding long, confining imaging procedures.

Clinical studies of postoperative recovery rates and stress reduction go back to the 1970s (see Science, 1984, by Roger Ulrich, University of Delaware), even to the simple extent of giving patients windows with a rural view (in contrast to a brick wall) in hospital rooms. As medical technology advances, and procedures—particularly MRI and other scanning methods—become more demanding on patients and medical staffers, so have accessories advanced to aid in the process.

Joey Fischer is a pioneer in the field of patient comfort. A nature photographer, Fischer was inspired to change the hospital visual environment when his father told him he was counting holes in the ceiling to ward off boredom during a hospital stay. Fischer and his wife, Janet, formed the Art Research Institute of Atlanta, and using Fischer’s appealing nature photographs and Janet’s interior design skills, they have installed visual therapy photomurals in more than 4,500 hospital and radiological facilities, including all 172 Veterans Affairs medical centers. “Soothing nature imagery, whether on the ceilings or on walls, becomes a focal point for the patient,” Fischer said. “As a result, patients are less likely to be agitated or squirm around, reducing the incidence of costly and time-consuming repeat imaging or treatment.”

Keeping Patients Still and Relaxed

Comfort products—from photomurals to table pads—can put patients at ease and keep imaging facilities on track.

Providers and manufacturers say there are a number of objectives of patient-comfort systems in radiological practice. These include helping to produce more accurate scans, eliminating the need for rescans, decreasing exam setup time, increasing patient throughput, reducing patient waiting, and enhancing job satisfaction among hospital staff. All these factors also combine to give a scanning facility a competitive advantage in a highly competitive field.

Studies reveal that about 10% of MRI examinations are cancelled because of patient anxiety surrounding long, confining imaging procedures. Loss in critical imaging revenue and delayed schedules are the inevitable result. This is especially true with pediatric radiology, where lying stationary for 30 to 60 minutes—and sometimes more—proves an impossible task for most children. The key to the process is keeping patients still, relaxed, and even entertained.

Resonance Technology Co Inc, Northridge, Calif, has introduced a number of audiovisual products to make the MRI scanning process safer, more pleasant, and less costly for both patients and operators. Among their new MRI-compatible technology is CinemaVision, a lightweight headset that integrates video display and audio systems into a single unit. With CinemaVision goggles patients see an image equivalent to a 62-inch video display viewed from a distance of 5 1/2 feet, with no artifacts or detrimental effects on MRI operation. The company’s versatile system allows patients to bring their own VHS tape or DVD, or choose from a library of items appropriate to their age group.

Sarah Melko, childlife specialist at the Children’s Hospital of Pittsburgh, uses two CinemaVision systems. “We’ve experienced a tremendous decrease in the need for sedation of children, up to an 80% difference,” Melko said. “When kids can view child-friendly movies instead of the tunnel for hours—some procedures can take up to 2 hours—this greatly enhances patient safety and satisfaction. It also reduces the probability of paradoxical reactions such as cardiac arrest after the procedure.”

Holly Kaselauskas, MRI supervisor at Wentworth-Douglass Hospital (WDH) in Dover, NH, agrees with Melko’s assessment. “Since the installation (of CinemaVision), Wentworth-Douglass Hospital MRI has noticed a significant decrease in patients who are unable to endure the MRI study due to claustrophobia. This has reduced cancellations, reschedules, and patient anxiety,” Kaselauskas said. “Ultimately, the image quality that the MRI department generates is excellent, due to the fact that patients are more relaxed and are holding still throughout the exam. Our patients love it and give us nothing but positive feedback since we began using the system.”

The manufacturer is also introducing to CinemaVision a range of features providing enhanced flexibility to users. Innovations allow anxious patients to see the reassuring face of technologists and communicate with them during the scanning process. Stereo sound level may be adjusted by patients directly from within the magnet. To deliver this capability inside a magnet room, Resonance Technology devices are engineered with no metal components to ensure integrity is not affected. “Patients who had to be sedated for procedures, particularly children, no longer have to endure this risk,” said Moktar Zirati, CEO and founder of Resonance Technology. “MRI sites also enjoy significantly faster workflow. In short, the results are more satisfied patients and higher-quality scans.”

Physical Comfort Plus Safety

A picture is worth a thousand words, according to Joey Fischer, whose soothing nature photography graces over 4,500 hospitals and radiological facilities.

MRI table pads are another relatively recent patient-comfort and safety accessory that has impressed radiologists. A single MRI machine scans 3,000 to 5,000 patients each year, while a CT scans even more. Over the years, patient flow on and off the table takes a toll on pads and positioners, causing fraying and tearing and often exposing the underlying foam material. This makes thorough cleaning impossible, presenting a sanitary risk to both patients and technologists. Patient Comfort Systems Inc, Hayward, Calif, has introduced MRI pads using TEMPUR? material (developed by Tempur-Pedic? Inc) that decrease patient motion, resulting in a significant reduction in both repeat sequences and patient callbacks.

Chris Roadcap, manager of technical services at High Field & Open MRI, an outpatient clinic in Louisville, Ky, said that Patient Comfort’s new MRI pads have a number of advantages over conventional pads. “They are more durable and easier to keep clean,” Roadcap said. “I often scan my wife, and she tells me the new pads are far superior and more comfortable to the older pads.”

According to Patient Comfort Systems’ founder, Peter Rothschild, MD, “For most MRI facilities, the significant rate of interrupted or aborted scans is a problem for workflow.” According to a study presented at an RSNA Annual meeting, “repeat sequences decreased by 56 percent and patient callbacks dropped by 50 percent when patients were scanned using new Patient Comfort Systems’ pressure-management pads compared to MRI manufacturer’s traditional pads.”

The antimicrobial features are a significant added benefit. The occurrence of “community acquired” MRSA (methicillin-resistant Staphylococcus aureus) is increasing rapidly and has been shown by the Centers for Disease Control and prevention to be capable of spreading to otherwise healthy people simply through contact with contaminated pads. Patient Comfort Systems’ introduction of infection-resistant design with permanent antimicrobial agents addresses the growing threat of infections spread by contact. Indeed, as pure comfort benefits advance, so do health benefits as well.

James Markland is a contributing writer for Medical Imaging. For more information, contact .