Amelioration of Claustrophobia and Disruptive Patient Motion in MR Imaging

DESCRIPTION provided by applicant Claustrophobia and disruptive patient motion longtime common impediments to MRI examination can be prevented or ameliorated with a non pharmacologic behavioral intervention administered by trained staff The potential benefits of such an intervention are highly significant as current practice alternatives are to cancel the study or administer sedation Inability to complete their MRI scans adversely affects an estimated patients every year in the US who are either deprived of a diagnosis subject to diagnostic delays and interpretation errors due to motion or are exposed to risks of pharmacologic sedation including death The imaging facilities in turn typically cannot fill the suddenly vacated scan slots and risk considerable lost revenue and efficiency The resulting negative patient experiences further lower patient satisfaction ratings The long term goal is to provide a validated clinically feasible means for non pharmacologic amelioration of claustrophobia and disruptive patient motion in MR imaging by training facility staff to assist patients through advanced rapport skills and comforting language Phase I accomplishments include designs of a prototype of Comfort Talk R Training and a facility site specific customizable online Training Support Platform to support MRI staffs in personalizing their skill development The results significantly reduced cancellations improved efficiency and increased patient satisfaction based on national benchmarks The goal of Phase II is to enable scaling and definitive testing of the hypothesized benefits for broad based commercialization Specific Aim pursues development of a scalable prototype for trainer training and certification using the andquot flipped classroomandquot principle beginning with preparatory web based course work to maximize time for mutual feedback and pedagogical skill practice during live training Practice and certification will include traditional tests and role play which will be progressively moved online into virtual environments within which a Candidate Trainerandapos s avatar interacting with virtual Patient avatars is expected to choose appropriate Comfort Talk R strategies In Aim intra institutional program adoption will be pursued through developing internal Trainer Champions supportive online courses for core staff who cannot participate in live training and for personnel who do not work in high anxiety and pain prone areas and a customizable Comfort Talk R patient app co branded with the site to enable vertical integration to the patient level The need for site specific individualization with regard to use of vocabulary and behavior patterns of staff will be integrated by capture and analysis of site entries to enable scaling of customized culture conscious content for specific patient populations and situations and further integration in subsequent training materials Aim targets unequivocal assessment of the effect of Comfort Talk R training including the newly trained trainers and local champions In a prospective randomized design at MRI satellites of the Ohio State and Duke University Medical Center effects on patient satisfaction economic outcomes and return on investment will be assessed PUBLIC HEALTH RELEVANCE Annually an estimated patients do not complete their scheduled MRI scans because of claustrophobia or inability to hold still Training staffs working in MRI facilities to provide Comfort Talk R will enable patients to complete high quality imaging without medication which will increase satisfaction and comfort while reducing sedation risks for patients and increase efficiency and reduce loss of revenue for facilities