Abstract Details

Title Cardiac Arrest Neuroprognostication Quality Improvement (CAN-QI) Project to Measure and Implement Reliable and Systematic Utilization of Evidenced-based Guidelines

Topic Neuro Trauma and Critical Care

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 7-009

Objective We designed and implemented a quality improvement (QI) project using a plan-do-study-act (PDSA) framework to assess and improve utilization of a new systematic approach and up-to-date use of current guidelines for neuroprognostication in adults with cardiac arrest with or without hypothermia treatment.

Background Effective neuroprognostication in comatose adult survivors of cardiac arrest is crucial for guiding clinical decisions and aligning care with patient and family expectations. Neurocritical Care Society 2023 Neuroprognostication Guidelines provide a structured approach to deliver evidenced-based care. A QI PDSA framework can be applied to measure baseline consistency of neuroprognostication recommendations and iterative testing of workflow in practice to utilize such recommendations.

Design/Methods Baseline assessment of neuroprognositication data (presence and clarity of summary assessment) was assessed retrospectively in adult patients (³ 18 years) referred to General Neurology Consult service for neuroprognostication after cardiac arrest ± hypothermia (7/1-9/30/2024). A smartphrase note for cardiac neuroprognostication was developed by authors with key stakeholder input obtained about baseline knowledge, current workflow, feasibility and ease-of-use of using open discussion (grand rounds) and survey assessment. Implementation of new workflow occurred 10/1/2024 with department email reminders.

Results Baseline data (N=18; 8 female; age range 35-82 years) demonstrated varied terminology and structure of notes. Baseline survey data from neurology physicians (N=21) demonstrated 76% (N=16) reported lack of uniformity of current neuroprognostication practice; <50% (N=10) were familiar with new 2023 guidelines; 100% rated important need for standardization. Initiated implementation of new smartphrase on 10/1/2024 with planned continued data assessments (use of smartphrase) and assessment of ease-of use including balancing measure of time to complete note.

Conclusions Baseline neuroprognostication assessment and summaries vary in workflow, language and clarity. Implementation of standardized workflow using a smartphrase that incorporates up-to-date evidenced based neuroprognostication guidelines can provide a mechanism of reliable and systematic care delivery to enhance communication with patients, families, and multidisciplinary teams.

Authors/Disclosures
Diana Marzouk, DO (VCUHS) PRESENTER	Dr. Marzouk has nothing to disclose.
Karissa Arthur, MD	Dr. Arthur has nothing to disclose.
Kelly Jernigan, NP	Ms. Jernigan has nothing to disclose.
Rashid S. Hussain, MD	Dr. Hussain has nothing to disclose.
Jessica Johns, MD (Virginia Commonwealth University)	Dr. Johns has nothing to disclose.
Shraddha Mainali, MD (Virginia Commonwealth University)	Dr. Mainali has received personal compensation for serving as an employee of Virginia commonwealth University.
Christine B. Baca, MD, FAAN (Virginia Commonwealth University)	Dr. Baca has nothing to disclose.

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