Implementation of Immersive Technologies in Pediatric Perioperative Care: A Multi-Institutional Survey Study

Background: Immersive technologies (ImTs), including virtual, augmented, or mixed reality, are increasingly used to support periprocedural pediatric patients, but clinical adoption varies widely across children’s hospitals and specialties. Multiple determinants for the adoption of ImT in health care have been identified; however, these have not been well characterized in pediatric perioperative settings. Aims: Among Society for Pediatric Anesthesia Improvement Network (SPAIN) member institutions, we describe the current state of pediatric perioperative ImT use, identify barriers and facilitators to ImT adoption, and report perceived implementation-related factors. Methods: We conducted a multi-institutional cross-sectional survey of pediatric perioperative practices via key contacts from SPAIN. Survey responses underwent mixed-methods analyses informed by the Consolidated Framework for Implementation Research. Results: Among 27 eligible institutions, 24 (89%) provided responses, 13 of which reported ImT use. Of these, 8 (62%) reported existing institutional infrastructure or governance to support ImT. Use patterns were highly heterogeneous, but use was commonly paired with the presence of champions, technology expertise, and available resource support. Use cases included anxiety reduction, distraction, and procedural support. Barriers, facilitators, and potential strategies for successful implementation were highlighted. Conclusions: ImT is used variably across pediatric anesthesia practices affiliated with SPAIN. These findings provide a descriptive snapshot of current practice and highlight factors commonly associated with adoption. Further work is needed to more rigorously characterize the implementation processes and evaluate strategies that may support integration of ImT into routine care in diverse clinical settings.