As the state's only pediatric hospital, the 275-bed Children's Hospital of Alabama averaged over 13,000 admissions and 620,000 outpatient visits last year. Nearly 50,000 children were seen in the emergency department. Add in another quarter-million visits to the ambulatory care center and the strain on the hospital's radiology facilities is clearly evident. The recent opening of the new Pediatric Imaging Center (PIC) is the Children's Health System's response to the need for expanded radiology capabilities. The hospital's radiology department serves the entire patient population. Prior to the opening of the new PIC, juggling the needs of each segment was difficult. "There was a constant dilemma of which patient comes first," explained Lynne Hamer, MEd, RT, director of pediatric imaging. High volume also slowed down the efficiency of the department. Lightening the load of the main hospital's radiology service became a priority. By January 2005, plans were underway to establish a satellite office for outpatient diagnostics. The PIC opened this past June. The obvious choice of location was Children's 7-year-old outpatient and after-hours care center in Hoover. "It just made sense to put it in a facility that already existed," Hamer said, referring to the Children's South building just off Interstate Highway 459. "It's geographically convenient and has a built-in referral base from the on-site clinics already in operation there." Existing space was renovated and now houses state-of-the-art imaging equipment that includes a 1.5 tesla MRI machine, a 16-slice CT scanner, ultrasound and digital X-ray systems. All of the equipment is designed for pediatric use and was carefully selected under the hands-on direction of Dr. Stuart Royal, MS, FACR, radiologist-in-chief for Children's Health System and past chairman of the Society of Pediatric Radiology. "There is often too much radiation in diagnostic imaging for children because the machines are designed for adults," Royal said. "We're extremely conscious of the radiation levels of CT scans and regular X-rays because there is significant concern that diagnostic exposure will cause cancer. We do them at the lowest dose possible. We use ALARA — as low as reasonably achievable — in everything we do." The PIC is staffed full-time by one of eight board-certified pediatric radiologists who rotate daily. "That's all these doctors do everyday is read pediatric images," Hamer said. "There's such a big difference in a child's anatomy and disease process." The physicians make themselves available to parents eager to hear the results and implications of their child's tests. "The doctors here have a special rapport with patients and families," Hamer said. The PIC's ten registered radiology technologists are all specially trained in pediatrics as well, and were hand-picked among applicants after a thorough interview process. "We developed a philosophy for the type of person we wanted to present the type of environment we wanted," Royal said. That environment notably and intentionally caters to the needs of its young patients and their worried parents. "You don't get a CT scan for nothing, so there's anxiety," Royal said. "We were able to design the PIC to be much more kid friendly. It has a calm feeling." The center's waiting area sets the comforting tone with floor-to-ceiling windows that flood the space with natural light and provide a bird's-eye view of the surrounding wooded landscape. Colorful sofas offer cushy seating and several gliders provide soothing rocking time for younger children. Toys, playhouses and a small jungle gym create an indoor playground. Beyond the waiting room doors, the PIC looks nothing like the advanced technical complex that it is. Rather, a playful underwater theme pervades the area. "A lot of time and effort was put into making it a child-friendly environment," Hamer said. "We chose an aquatic theme because we felt it was suitable for all ages, from young children to teens." Walls are painted to resemble waves, lighting fixtures look like giant bubbles and exam room doors feature porthole-type windows where passersby might spot a friendly porpoise or a school of fish painted on the glass. Elsewhere, sea turtles, stingrays and whales frolic through the murals that cover all four walls of the CT and MRI rooms. All the painting was done by local artist Laurie Kramer who donated much of her time. A custom-made miniature replica of a CT scanner familiarizes young patients with its workings, giving them the opportunity to "scan" a stuffed animal. A video and accompanying book help explain the procedure. To further lessen the tension, television sets in the testing rooms allow patients to watch movies or play video games. Music is piped through the center and lighting can be dimmed. Staff members wear regular clothing, rather than scrubs, to enhance the casual atmosphere. "The biggest thing is to reduce anxiety and apprehension in the children and their parents. When the kids are less anxious, their parents are, too," Hamer said. The center's goal is to perform approximately 680 imaging procedures per month. Marketing efforts are aimed at educating referring pediatricians throughout the state about the advantages offered by an imaging center dedicated to children, as well as its convenience for families outside the city of Birmingham. "It's a nicer environment and quicker in-and-out," Royal said. "We've brought all the expertise of Children's Hospital Radiology out to the community so you can get just as good a diagnosis here as downtown." ie. October 2006