好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Schrodinger's CSF: Is the Study in Process?
好色先生, Research, and Methodology
P5 - Poster Session 5 (11:45 AM-12:45 PM)
15-014
To identify barriers to the existing process of CSF testing and implement refinements to improve the practice of cost-effective medicine.
At an urban academic hospital, we identified that many CSF tests sent out for processing were discontinued after specimens were collected. CSF testing is critical to neurologic workup, but inefficiencies in send-out testing lead to repeating invasive procedures and delaying diagnosis and treatment. Our quality improvement project aimed to reduce rates of study cancellation to prevent inadequacies in patient care. 
This prospective pre-post intervention QI study had two components. First, a survey was implemented to assess neurology residents’ comfort with CSF studies before and after a comprehensive guide (“tip-sheet”) was provided.  Second, we compared CSF study completion between all hospitalized patients on the neurology service from 2022-2024 before and after tip-sheet implementation. The SMART Aim was to decrease CSF study cancellations from 10% to 6.7% within one year. 
Across 785 patients, a total of 174 LPs were performed and 546 CSF samples were collected. 32 samples (9.5%) were discontinued before tip-sheet implementation, and 13 (6.2%) were discontinued afterward.  There were statistically significant decreases in discontinued labs for each send-out study (ENC2, p=0.003; VZV, p=0.001) except for the NY Encephalitis Panel, which happened to be not included in the tip-sheet. Forty-four percent of discontinued studies were due to missing requisition forms. Fifty-four percent of LPs were performed by neuro-interventional radiology (NIR). Resident surveys showed an increase in confidence ordering CSF studies but was not statistically significant. 
The QI Smart Aim resulted in a 35% decrease in CSF study cancellations. The only send-out study without statistically significant change was not on the tip-sheet, lending support to the efficacy of this intervention. Focusing on appropriate requisition form usage and coordinating collection of CSF studies with NIR team are clear next steps. 
Authors/Disclosures
Sarah Wang, MD
PRESENTER 		Dr. Wang has nothing to disclose.
Maksim Bakrenev, MD (Montefiore Medical Center) Dr. Bakrenev has nothing to disclose.
Sara Lee, MD Dr. Lee has nothing to disclose.
Mauricio Borda, MD Dr. Borda has nothing to disclose.
Rohan N. Patel Mr. Patel has nothing to disclose.
Thomas Draper, MD (Montefiore Medical Center) Dr. Draper has nothing to disclose.
Lauren Gluck, MD (Montefiore Medical Center) Dr. Gluck has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeautics. Dr. Gluck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Gluck has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen Rare Disease. Dr. Gluck has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Gluck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb.