Cullman Regional Hospital Reduces Head CT Scans by 40% and Improves Patient Satisfaction

Cullman Regional Medical Center is a 145-bed hospital in Cullman, Alabama, that serves more than 175,000 residents in a six-county area, and is recognized as one of the region’s finest medical facilities. As the only hospital in the area for almost an hour in all directions, Cullman fills a great need and maintains a robust connection with the community.

Cullman dedicates itself to the health and well-being of the community it serves and is committed to improving performance using evidence-based interventions that increase the chances of healthy outcomes for patients. Cullman also recognizes the importance of patient satisfaction as a quality measure in health care.

40%

BrainScope Assessments Leading to CT Avoidance

54%

BrainScope Brain Function Assessments Indicating Concussion

41%

Decrease in Avg. LOS with BrainScope NEG SIC Results

The Challenge

Cullman’s emergency medicine team, led by Dr. Mark Christensen, Director of Emergency Medicine, was exploring ways to improve the care pathway for low- to mid-acuity (Glasgow Coma Scale 13-15) head-injured patients.

A clinical need
Assessing these injuries had been problematic. Clinical diagnosis of mild traumatic brain injury (mTBI) relied largely on CT scan findings—effective in screening for bleeding and intracranial brain injury, but not for functional injury such as concussion—and/or subjective report and response tests. Dr. Christensen not only wanted to provide objective information to patients but also to do so at the point of care, saving patient travel to a specialist miles away.
 
A patient need
Data indicated head-injured patients and their caregivers were leaving the emergency department (ED) frustrated, looking for more information about their brain injury.
 
Decision support
Wanting to quickly rule out intracranial bleeding while reducing head CT orders, and also providing patients with the confidence that they are received the best care possible at Cullman, Dr. Christensen looked to the latest advancements in mTBI decision support tools.

"We are looking to provide head-injured patients with the confidence they are receiving the best care possible at Cullman, and the necessary concussion-related information to seek follow-up care beyond the emergency medicine setting."

Mark Christensen, MD, Director of Emergency Medicine

The Solution

Dr. Christensen explored utilizing cutting-edge technology with specific parameters in mind:

  • Decrease CT utilization
  • Decrease LOS
  • Improve patient satisfaction

 

BrainScope implementation
Dr. Christensen found that BrainScope, heavily validated in clinical studies, demonstrated strong clinical performance (99% sensitivity, 98% NPV) as a decision support tool for suspected mTBI.
Further, BrainScope addressed each of the parameters outlined by the team. Championed by Dr. Christensen, and with training from BrainScope, the Cullman emergency medicine team successfully implemented BrainScope in the ED in the summer of 2020.
 

Case Study

Shortly after implementation, a 25-year-old pregnant patient presented to the ED with a head injury from a car accident. The patient had no LOC but complained of a headache. Typically, in this type of situation, a clinician would order a head CT. Of primary concern to the patient was exposing her unborn baby to radiation. The team considered performing a CT scan with a shield
over the patient’s belly, but elected to complete the BrainScope EEG assessment to obtain objective information to aid in determining the patient’s need for a CT scan, without radiation:

  • The patient was ruled unlikely for an intracranial bleed.
  • Together with the clinical assessment, the patient was in and out
    of the ED within one hour.
  • The team provided follow-up information tailored to the patient.
Mission accomplished
Since implementation, the emergency medicine team has been successful at identifying those at greatest risk, reducing unnecessary head CTs by 40%, decreasing LOS, and providing objective, actionable concussion information to patients. This patient and others for whom BrainScope has been prescribed have reported favorable impressions of Cullman and overall improved satisfaction.
 
 
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