An MRI system at the University of California San Francisco Benioff Children's Hospital features a cable car theme. Credit: GE Healthcare

SHARE GE Healthcare industrial designers Erik Kemper (left) and Doug Dietz helped develop the idea of transforming the often-frightening process of MRI and CT scans into an adventure for children. Mark Hoffman

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Waukesha — The sight of a terrified little girl about to have an MRI scan gave Doug Dietz a different perspective on his work as an industrial designer at GE Healthcare — and led to a project that has turned imaging departments at 27 children's hospitals into small theme parks.

The idea that eventually emerged from a mix of brainstorming and research — with some persistence thrown in — was to transform a frightening medical test into a voyage on a spaceship, a visit to a pirate island and other adventures.

Imaging departments became elaborate sets. Technicians became amateur actors with scripts. And children were given starring roles.

"Children would cling to their mom's leg and start crying, and you would have to pry them off," said Kathleen Kapsin, radiology director of Children's Hospital of Pittsburgh, part of the University of Pittsburgh Medical Center. "Now they walk in and they are excited."

Imagine being a 6-year-old child about to be fed into the bore of a large, noisy machine and then being told not to move for 10 minutes, 30 minutes or longer.

That's what computerized tomography, magnetic resonance imaging and positron emission tomography — commonly known as CT, MRI and PET scans — entail.

Even some adults panic in MRIs with small bores, or openings.

Children often told the designers at GE Healthcare that the bore of the machine was the scariest part of the room.

"One of our designers said it looks like everything your mother told you stay away from," said Erik Kemper, also a designer.

Children's Hospital of Pittsburgh had to sedate almost every child younger than 9 who needed an MRI scan, Kapsin said, and more than 80% of the children who needed a CT scan.

An MRI scan typically lasts more than 30 minutes, a CT scan about 10 minutes.

Sedating a child meant calling an anesthesiologist and administering medication through an intravenous line.

Children would be terrified. Parents would be worried. And the hospital's expensive imaging equipment could do far fewer scans each day.

That was before the hospital worked with GE Healthcare to come up with what is now known as the Adventure Series.

Fewer than 27% of the children who needed MRIs and fewer than 3% of the children who needed CT scans had to be sedated in the fiscal year ended June, Kapsin said.

The genesis of the idea for the Adventure Series came from Dietz's visiting a children's hospital to see an MRI machine that he had helped design. During the visit, he saw a terrified girl clinging to her parents before a scan.

"It just broke my heart," Dietz said. "It was just an awful experience."

He remembers her parents catching each other's eyes.

"You could tell they didn't know what to do to help their daughter get through this experience," he said.

Dietz realized that he and the other industrial designers in Waukesha needed to use their skills to improve the patient's experience during imaging tests.

Children's Hospital of Pittsburgh — which had learned that finding ways to distract children lessened the need for sedation — was intrigued.

"There is nothing like one of your main customers telling you this is a great idea," Dietz said. "Their timing was just perfect."

Children's Hospital of Pittsburgh would become a key partner, with its interest making the project a priority.

The designers in Waukesha — one of GE Healthcare's five design studios worldwide — work in a large, open, somewhat disheveled room. It is a place where people still use pencils and occasionally even crayons.

The first brainstorming session took place at a day care center. Dietz made bag lunches for the designers. They then talked to doctors, staff at the Betty Brinn Children's Museum in Milwaukee and more children.

There was no one moment when someone came up with the idea for the Adventure Series. Instead, the idea gradually took shape.

Variety of themes

The series consists of a variety of themes for the different tests. For an MRI, it is a space voyage, with technicians telling children that the spaceship is about to go into hyper-drive when the machine becomes loud. For a PET scan, it is Camp Cozy, because children need to be calm and the test takes about 45 minutes.

GE Healthcare also has developed themes for specific hospitals. For a children's hospital in San Francisco, for example, it designed a theme around cable cars.

JWD-Creative, a Milwaukee ad agency, helped write the scripts and develop the artwork for the Adventure Series.

Part of the process is preparing kids for the scan, such as giving them coloring books tied to the theme the day before the test.

"We used the children's imagination to our advantage," said Kapsin of Children's Hospital of Pittsburgh. "Instead going to the CT scanner, you are going to Pirate Island. And when you go in, we have a monkey on a swing, so they can play with the monkey."

GE Healthcare estimates that the Adventure Series costs $50,000 to $100,000 for each "room" with imaging equipment.

The biggest expense can be goggles without any metal parts that can work inside an MRI machine. The goggles, which cost about $40,000, enable a child to watch a DVD tied to the theme or one of his or her choice.

The cost can be more than offset, however, if a hospital can do more scans a day and doesn't have to buy another MRI or CT-PET scanner.

"The best way to keep a child motionless is to keep them engaged and entertained," Kapsin said.

The technicians at Children's Hospital of Pittsburgh initially were skeptical of the idea. That quickly passed.

"We saw children excited and children happy instead of crying and upset," Kapsin said.

The technicians soon started getting into the role-playing, wearing scrubs that matched the theme and suggesting toys tied to the theme to give the children at the end of the scan.

The project now is cited as a model of innovation. Dietz has given TED talks on creativity and been featured in a book by Tom and David Kelley of IDEO, an international design firm in Palo Alto, Calif.

He also can tell a story about hearing a child asking her parents after a scan if they could do it again tomorrow.

"That probably was the biggest reward I could ever have," he said.