{"id":"6211e7ba-7d33-4d45-aeb2-5f42692d9ea6","slug":"ventriculostomy-supply-cart-decreases-time-to-external-ventricular-drain-placement-in-the-emergency-department","title":"Ventriculostomy supply cart decreases time-to-external ventricular drain placement in the emergency department","authors":["Henry Chang","Michael Silva","Alexander Giner","Yvonne Diaz","Marie Ann Sosa","Grace Knudsen","Anil K. Mahavadi","June Ellis","Arlene Cameron","Carlos Andrei Quirós Núñez","Millicent A. Wynter","Kristine O’Phelan","Ricardo J. Komotar","Iahn Cajigas"],"abstract":"Background: Minimizing time-to-external ventricular drain (EVD) placement in the emergency department (ED) is critical. We sought to understand factors affecting time-to-EVD placement through a quality improvement initiative. Methods: The use of process mapping, root cause analyses, and interviews with staff revealed decentralized supply storage as a major contributor to delays in EVD placement. We developed an EVD “crash cart” as a potential solution to this problem. Time-to-EVD placement was tracked prospectively using time stamps in the electronic medical record (EMR); precart control patients were reviewed retrospectively. Results: The final cohorts consisted of 33 precart and 18 postcart cases. The mean time-to-EVD in the precart group was 99.09 min compared to 71.88 min in the postcart group (two-tailed t-test, P = 0.023). Median time-to-EVD was 92 min in the precart group compared to 64 min in the postcart group (rank sum test, P = 0.0165). Postcart patients trended toward improved outcomes with lower modified Rankin score scores at 1 year, but this did not reach statistical significance (two-tailed t-test, P = 0.177). Conclusion: An EVD “crash cart” is a simple intervention that can significantly reduce time-to-EVD placement and may improve outcomes in patients requiring an EVD.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/6211e7ba-7d33-4d45-aeb2-5f42692d9ea6/featured/hero-1781562218174.png","publishDate":"2021-07-19T00:00:00.000Z","doi":"10.25259/SNI_371_2021","categories":["Trauma","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/6211e7ba-7d33-4d45-aeb2-5f42692d9ea6/pdf"}