Abstract
Background
To describe current state of quality improvement (QI) processes implemented in neurocritical care units (NCCU).
Methods
A 27-question-survey was sent to 2000 members (physicians, nurses, and pharmacists) of the Neurocritical Care Society. We describe the prevalence of QI, satisfaction with existing QI processes, barriers to NCCU QI, awareness of stroke (STK, CSTK), stroke get with the guidelines (GWTG), trauma quality improvement program (TQIP) and American Academy of Neurology (AAN) performance measures.
Results
The response rate was 22.5%; 73.7% of respondents were from US teaching hospitals, 87.9% practiced in dedicated neurocritical care units, and 43.4% in a program with a NCC fellowship. 44.6 % reported a dedicated NCCU QI program. Overall, 42% of the respondents reported satisfaction with existing NCCU QI processes. External ventricular drain infection was the most commonly tracked NCC QI metric (69.6%). Respondents indicated the highest level of awareness for CSTK (87.5%), STK (81.8%), and GWTG (81.8%), but indicated a relative lack of awareness for TQIP (42.7%), and AAN (46.2%) performance measures. Insufficient hospital (57.7%) and departmental support (36.5%) were reported common barriers to the successful implementation of an NCCU QI program.
Conclusion
A dedicated staffed NCCU QI program occurs in a minority of NCC units, and the lack of such programs may lead to clinician dissatisfaction. Institutional and departmental support may be critical elements of a successful and satisfactory implementation of NCCU QI.
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References
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Members, Quality Committee of the Neurocritical Care Society
Navaz Karanjia, MD, Associate Professor of Neurosciences and Anesthesiology, UC San Diego Medical Center, San Diego, CA, USA; Michelle Hill, MS, RN, AGCNS-BC, CNRN, CCRN, SCRN, OhioHealth-Riverside Methodist Hospital, Columbus, OH, USA; Debra Roberts, MD, Ph.D., Assistant Professor, Departments of Neurology, Anesthesiology and Perioperative Medicine and Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA; Casey Olm-Shipman, MD, MS, Assistant Professor, Departments of Neurology and Neurosurgery, University of North Carolina, Chapel Hill, NC, USA; Keith Dombrowski, MD, Assistant Professor, Department of Neurology, Duke University School of Medicine, Durham, NC, USA; Julius Gene S Latorre, MD, MPH, FAAN, FAHA, Associate Professor of Neurology and Neurosurgery, Upstate Medical University, Syracuse, NY, USA; Michael J. Souter, MB, ChB, FRCA, FNCS, Professor, Department of Anesthesiology & Pain Medicine, Adjunct Professor, Department of Neurological Surgery, University of Washington, Harborview Medical Center, Seattle, WA, USA
Funding
No internal or external funding was used for this study.
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Author AVL reports reserarch suport from Aqueduct Critical Care and salary support from Life Center Northwest. The other authors have no financial disclosures to report.
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The study was approved by the Institutional Review Board of the University of Washington. Participation in the survey implies informed consent from the participants.
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Lele, A.V., The Quality Committee of the Neurocritical Care Society. & Moheet, A.M. Neurocritical Care Quality Improvement Practices: A Survey of Members of the Neurocritical Care Society. Neurocrit Care 32, 295–301 (2020). https://doi.org/10.1007/s12028-019-00865-7
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DOI: https://doi.org/10.1007/s12028-019-00865-7