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UPJ INSIGHT: Pediatric Sedation Unit: A Safe Alternative to Outpatient Urological Procedures Under Anesthesia

By: Marissa K. Falkiewicz, MD, University of Wisconsin, Madison; Ruthie Su, MD, University of Wisconsin, Madison; Susan L. Jones, MBA, University of Wisconsin, Madison; Muhammad Shayan, MPA, Cordell Institute for Policy in Medicine and Law, Washington University of St Louis, Missouri; Walid A. Farhat, MD, University of Wisconsin, Madison; Megan E. Peters, MD, University of Wisconsin, Madison | Posted on: 17 Mar 2023

Falkiewicz MK, Su R, Jones SL, Shayan M, Farhat WA, Peters ME. Pediatric sedation unit: a safe, effective, and satisfactory alternative to outpatient pediatric urological procedures under anesthesia. Urol Pract. 2023;10(2)170-177.

Study Need and Importance

The operating room (OR) is an expensive and limited resource. There is a need to evaluate the efficacy, safety, cost, and parental satisfaction of performing minor urological procedures traditionally performed in an operating room in a pediatric sedation unit (PSU).

What We Found

All procedures were successfully and safely completed in the sedation unit. As detailed in the Figure, cost reduction was seen in procedures performed in the PSU vs the OR. Approximately $57,000 of cost savings per year was noted. Of the parents who responded to the survey, 83% were satisfied with the care their family received.

Figure. Bar graph depicting cost differential between 2 most common procedures occurring in the operating room and the pediatric sedation unit.

Limitations

Our PSU is a 6-bed outpatient center staffed by clinicians who specialize in pediatric procedural sedation, which may limit reproducibility at other centers. The relatively low survey response rate of 50% is another limitation, though responses were overwhelmingly positive, which reduces the likelihood and impact of significant response bias.

Interpretation for Patient Care

Minor urological procedures can safely be transitioned to the PSU and provide a cost-efficient alternative to the OR with high rates of parental satisfaction.

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