Purpose or Case Report: Anesthesiologists face challenges in practicing in locations outside of the operating room. In particular when working in the MRI environment there may be unfamiliarity of the physiologic monitors and other equipment, MRI safety policies and procedures, limited access to expected equipment or additional anesthesia providers, unsure imaging protocols and positions as well as inability to rescue patients in the MRI scanner room.
Methods & Materials: Radiology must also understand how lengthy or unpredictable imaging times, positioning, and monitoring and equipment issues challenges anesthesia providers as they care for patients in the MR environment.
Therefore anesthesiology and radiology must recognize possible risk factors while caring for patients in MRI and they must familiarize themselves with policies and procedures of both departments to ensure safe practice for the anesthetized children.
Results: To understand the risk of both anesthetizing patients and the risk MR safety, radiology and anesthesiology must partner to form a structure where anesthesiology, radiology and nursing collaborate to ensure that the needs for patient safety and the needs of MRI are met but ensuing that the priorities are first to the patient, next to the enterprise and third to the individual departments and division in order to provide the safest environment for our patients.
The structure has two committees:
Radiology, Anesthesia and Sedation (RAS) Committee and is an active working group to improve patient care and flow with ongoing initiatives that utilize appropriate metrics to measure improvement. Issues that cannot be solved in committee are escalated to the Operational Governance Oversight Committee.

Operational Governance Oversight Committee (meets quarterly): Provides oversight to ensure that the needs of all constituents are considered and met to the best degree possible. Overriding priorities are first to the patient, next to the enterprise, and third to the individual departments and divisions
Chairs from Anesthesiology, Pediatrics, Radiology, Chief Operating Officer, Chief Nursing Officer
Conclusions: Conclusion: The MRI environment can be challenging to anesthesiologists as they care for patients outside of their usual environment. Collaboration between both radiology and anesthesiology can improve the experience and safety of anesthetized patient during MRI exams.