Innovation culture

Radiology: How a holistic approach can alleviate children's fears

An innovative, child-centered concept featuring Gerda the Giraffe can help to reduce children's fears of radiology examinations while also improving imaging results.
Katja Gäbelein
Published on May 13, 2024
Using creative methods applied by a multidisciplinary team, we developed a holistic approach that makes medical imaging examinations such as magnetic resonance imaging (MRI), computed tomography (CT), and fluoroscopy less stressful for children, parents, and medical staff. Throughout the whole development process, we interacted closely with our target group of 3- to 9-year-olds. The result? We’re proud to introduce Gerda, the brave giraffe!
<p>No, children aren’t just small adults. They differ from adults physically, cognitively, and also emotionally. However, just like adults, children sometimes need to undergo medical examinations: About ten percent[1] of all MRI, CT, and <a href="fluoroscopy">fluoroscopy</a> examinations are required for children – and the trend is rising.</p>
A medical imaging technique that uses X-rays to create images of internal organs and structures of the body in real time. In contrast to static X-rays, a moving image is recorded.
<p>Cold, sterile rooms. Not one familiar face among the hospital staff. An injection with a contrast agent that feels oddly hot or cold. Strange machines with narrow tubes where you have to lie very still, alone, and even control your breathing. Noises you've never heard before. Patients sometimes encounter such situations when undergoing CT, MRI, or fluoroscopy examinations.&nbsp;<br><br>What can be unnerving even for many grown-ups, is often just plain scary for youngsters. And many children are simply too young to stay as still as they would actually need to for such scans. This is why the relative risk of non-diagnostic images due to <a href="motion%20artifacts">motion artifacts</a> or scan interruptions is high.</p>
Image disturbances caused by movement of the patient during a medical imaging examination. They can lead to blurry images, double contours, or other image defects that make diagnosis difficult.
In some cases, children even need to be sedated, i.e., they're given medication to put them into a sleep-like state for the examination. However, that approach poses health risks and can increase the stress levels of the children and their parents. Moreover, the examinations then take longer due to the additional work step involved. This, in turn, puts an even higher burden on medical staff. Examination costs increase because additional staff have to be brought in for sedation. Studies have shown that the error rate for scans under sedation is seven percent.[2] All in all, failing to prepare young patients in a child-friendly way for what is to come can severely disrupt the clinical process.
Die Abbildung zeigt eine Illustration im Dschungelthema. Ein fröhlicher Affe hängt an einem Ast über einem großen MRI-Scanner, während ein anderer links vom Scanner verkleidet als Arzt bereitsteht. Zwei neugierige Giraffen schauen zu.
<p>This preparation process has yet to become standardized in many hospitals, explains Alexandra Zahn. “That's why we wanted to create an approach to help children to help themselves: The story of the brave giraffe Gerda and its accompanying materials are intended to empower children to help themselves so that they can feel strengthened as they face this unfamiliar situation.”&nbsp;<br><br>Alexandra Zahn is a Senior Key Expert on the topic of patient-centric healthcare transformation at Siemens Healthineers. About two years ago, she helped establish the Pediatric Radiology Experience. This project takes a holistic approach that includes parents and clinical staff in preventing the cross-transmission of stress and anxiety among all involved.</p>
<p>Hand-in-hand with pediatric patients — this concept applies to the entire patient pathway. It was developed by a team of multidisciplinary experts from fields such as <a href="user%20experience%20design">user experience design</a>, product design, and mechatronics. In numerous co-creation sessions with children between the ages of three and ten, problems were defined and solutions tested in practical settings with the children, then further explored and developed from a child's perspective.</p>
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Portrait von Alexandra Zahn, Senior Key Expert Patient Centric Healthcare Transformation, selbst mehrfache Mutter und Leiterin des Projektes Pediatric Experience. Alexandra trägt eine weiße Bluse mit einer zeitlos designten goldfarbenen Kette und ist vor einem hellgrauen Hintergrund fotografiert.

<p>Regular workshops were held with radiologists, radiology technologists, psychologists, child life specialists, educators, play therapists, and parents. To formulate the problem in detail and conduct practical tests, our team worked closely with leading clinical partners such as the University Hospital Carl Gustav Carus in Dresden, Universitätsklinikum Erlangen, and Charité – Universitätsmedizin Berlin in Germany, and the University Hospital Basel in Switzerland.&nbsp;<br><br><strong>Human-centered design - what does that mean? Watch the video to find out more:</strong></p>
<p>For this large-scale project, the team took a very methodical approach, integrating <a href="design%20thinking%20methods">design thinking methods</a> and various innovative approaches. They inched their way forward step by step – even sometimes taking a step backwards, figuratively speaking. This is intentional and part of the process, Zahn explains, as it's an iterative approach in which all process steps can be repeated at any time to optimize the product design and further develop the approach.</p>
A human-centered method of innovating that seeks to solve problems and generate new ideas. Interdisciplinary teams come together and work through a multistage creative process. The goal is to find the best solution for users.
<p>After the team had focused extensively on <strong>understanding</strong> the problem space in close exchange with all target groups, and had <strong>defined</strong> a solution framework, it kicked off the <strong>ideation phase</strong>. This phase involves searching for concrete solutions in brainstorming sessions. This led to the idea of producing a book to help children prepare for their medical examinations. The first <strong>prototype</strong> was created:</p>
<p>The team gave the prototypes to our clinical partners for <strong>implementation</strong> in their medical practice, meaning that children and parents tested them under the guidance of medical staff:</p>
<p>In 2022, the Pediatric Radiology Experience concept was awarded the UX Design Award by the International Design Center Berlin. But the team didn't rest on its laurels after this success: With the experience gained from the first clinical deployments and practical feedback, it was time to go "back to square one” – to the <strong>understanding</strong> phase.</p>
Click here for the UX Design Award page about the Pediatric Radiology Experience:
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<p>The feedback from the clinical partners highlighted challenges which the previous approach had not addressed, says Zahn: "With our human-centered approach, it's incredibly important that our ideas fit the needs of the users. That's why we're continuously making adjustments. Our motto is: Learn fast. Fail fast. Adapt fast." After <strong>defining</strong> the new challenges, we quickly moved on to the next <strong>ideation</strong> session:</p>
<p>The team continued pursuing the idea of a learning simulator. This led to the creation of the first <strong>prototype</strong>, which would later become a real product:</p>
The ideas for the learning simulator were still missing interactive, digital components. So the team decided to use a new innovation method to further refine the concept: In May 2023, the team took part in a hackathon with the project.
The project has been well received in clinical practice: "For example, we hear from our clinical partners at Dresden University Hospital that they receive very positive feedback on our concept from children, their parents, and clinical staff," says Zahn.
<p>Ultimately, this holistic approach can help everyone involved in the examinations to be happier and more relaxed: It can help clinical staff to follow a standardized process for preparing pediatric patients in the hectic daily routines of their hospital. They can also achieve better imaging results, reduce sedation rates, and thereby reduce the risks, time, and costs involved in the examinations.&nbsp;<br><br>It can help parents navigate the "medical jungle" in a relaxed manner, enabling them to accompany and support their children better, both before and during the examination. It takes children's needs seriously and helps them to cope with the unfamiliar situation — using both information and distraction. It also has the potential to encourage children to participate in actual therapy, which often follows an imaging test.</p>
Eine farbenfrohe Kinderzeichnung zeigt eine gelbe Giraffe mit braunen Flecken und den Text “siemens helfinirs” in mehrfarbigen Buchstaben.

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<p>The concept could be extended to a therapy itself, such as radiotherapy for cancer, says Zahn. Gerda and her friends could accompany children throughout their illness. The approach could also be adapted to other patient groups that need particularly empathetic treatment, such as people with autism or patients with dementia.&nbsp;<br><br>Gerda the giraffe will certainly not be the right protagonist for these last groups. But Zahn and our creative team will undoubtedly come up with a suitable replacement. Because it all comes down to <strong>understanding</strong>. First, however, let's sing the Magic Song together!</p>

​The Magic Song

The Magic Song
The Magic Song

By Katja Gäbelein
Katja Gäbelein is a digital editor and content creator for multimedia content at Siemens Healthineers. She specializes in technology and innovation.