{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T01:19:05Z","timestamp":1649207945240},"reference-count":24,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>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 \u201ccrash cart\u201d 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>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 <jats:italic>t<\/jats:italic>-test, <jats:italic>P<\/jats:italic> = 0.023). Median time-to-EVD was 92 min in the precart group compared to 64 min in the postcart group (rank sum test, <jats:italic>P<\/jats:italic> = 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 <jats:italic>t<\/jats:italic>-test, <jats:italic>P<\/jats:italic> = 0.177).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>An EVD \u201ccrash cart\u201d is a simple intervention that can significantly reduce time-to-EVD placement and may improve outcomes in patients requiring an EVD.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_371_2020","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T19:45:45Z","timestamp":1615923945000},"page":"362","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ventriculostomy supply cart decreases time-to-external ventricular drain placement in the emergency department"],"prefix":"10.25259","volume":"12","author":[{"given":"Henry","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Giner","sequence":"additional","affiliation":[{"name":"Department of Emergency, Jackson Memorial Hospital, Miami, Florida, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"Diaz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jackson Memorial Hospital, Miami, Florida, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Ann","family":"Sosa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jackson Memorial Hospital, Miami, Florida, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil K.","family":"Mahavadi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama Birmingham School of Medicine, Birmingham, Alabama, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"June","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jackson Memorial Hospital, Miami, Florida, United 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