Testing and Turnaround Time for Stat EEGs: How do we get faster? (P3.262)

Objective: Quality improvement (QI) project to analyze a Stat-EEG patient population to find ways to improve testing and turnaround time (TAT). Background: Stat-EEGs are often requested for convenience rather than medical necessity leading to prolonged TATs for the true emergent Stat EEG. Staffing difficulties and lack of clinical acumen are hypothesized as additional contributors to increased TAT. We present an analysis of our institution’s Stat-EEG population. Design/Methods: In one year (9/2015–8/2016), 485 of 2158 Stat-EEGs were randomly reviewed from UPMC Presbyterian Hospital which performed 4967 total inpatient EEGs. Stat-EEGs were analyzed for TAT, ordering service, daytime vs. nights/weekends, and rate of worrisome patterns (WP). WP were defined as status epilepticus, seizures, periodic or lateralized rhythmic patterns. Results: Stat EEG represent 43% of inpatient EEGs. Median TAT for all Stat-EEGs was 186 minutes. There was a 58-minute difference in median TAT when comparing daytime (160 minutes) to night/weekend (218 minutes). Overall rate of WP was 21% with differences in daytime (24.6%) and nights/weekends (18.6 %) rates. The services most likely to order Stat-EEGs were Neurosurgery (28%), General Neurology (21%), and Stroke (15%). Stat-EEGs most likely to be worrisome were ordered by Medicine (30.6%) or NICU (29.2%). The opposite was true for General Neurology (15.7%). Conclusions: Faster TATs are correlated with higher rate of WP supporting the need for optimizing EEG monitoring resources and underscores the need to develop methods to pre-screen patients for EEG given the high study burden. While rate of WP variability by service can be partially explained by the varied patient populations it is likely Medicine teams are under-utilizing Stat-EEGs. General Neurology has the lowest rate of WP. Further analysis is needed to evaluate why, and the role of our own services to Stat-EEG abuse. Nighttime/Weekend studies have higher TAT. We are currently undertaking a QI project to improve our prescreening methods. Disclosure: Dr. Hanrahan has nothing to disclose. Dr. Jackowiak has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Paolini has nothing to disclose. Dr. Bagic has nothing to disclose. Dr. Popescu has nothing to disclose.