Anesthesia & Clinical Research
Open Access

Abstract

An Innovative Paradigm: Coordinating Anesthetic Care for Complex Pediatric Patients requiring Multiple Procedures

Jill E. Kilkelly and Jill Kinch

Background: The goal of the anesthesia coordination of care team is to optimize safety for children requiring multiple procedures under general anesthesia, by providing a single continuous anesthetic for imaging and surgical requests. Methods: We developed an inter-professional team to create a pathway for providers to request multiple procedures with one anesthetic. Data collected includes patient and family satisfaction and a growing expertise of best practices for planning such coordinated care. Results: The program began in December 2011, with over 300 cases completed to date. Through the development of this program, we have evolved our clinical expertise to provide optimal combinations and sequencing of procedures under one continuous anesthetic. Conclusions: After a review of the literature, our team has not identified another care organization that consistently and prospectively plans for one continuous anesthetic for multiple procedures for children. Evidence supports this necessary planning, as there is a growing body of scientific research suggesting a possible risk of long term neurocognitive deficits related to anesthetic exposure at an early age. Certainly this approach is the right thing to do for patient safety, and it also is very appreciated by families.