Value-based Care and Quality Improvement in Perioperative Neuroscience.

Value-based care and quality improvement are related concepts used to measure and improve clinical care. Value-based care represents the relationship between the incremental gain in outcome for patients and cost efficiency. It is achieved by identifying outcomes that are important to patients, codesigning solutions using multidisciplinary teams, measuring both outcomes and costs to drive further improvements, and developing partnerships across the health system.

The Need for Head Protection Protocols for Craniectomy Patients during Rest, Transfers and Turning.

After craniectomy, patients are generally advised to wear a helmet when mobilising to protect the unshielded brain from damage. However, there exists limited guidance regarding head protection for patients at rest and when being transferred or turned. Here, we emphasise the need for such protocols and utilise evidence from several sources to affirm our viewpoint.

Using the Postoperative Morbidity Survey to Measure Morbidity After Cranial Neurosurgery.

Background: The incidence of morbidity after cranial neurosurgery is significant, reported in up to a quarter of patients depending on methodology used. The Postoperative Morbidity Survey (POMS) is a reliable method for identifying clinically relevant postsurgical morbidity using 9 organ system domains. The primary aim of this study was to quantify early morbidity after cranial neurosurgery using POMS.

Wellbeing of Frontline Health Care Workers After the First SARS-CoV-2 Pandemic Surge at a Neuroscience Centre: A Cross-sectional Survey.

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected people of all ages, races, and socioeconomic groups, and placed extraordinary stress on health care workers (HCWs). We measured the prevalence of burnout and assessed wellbeing and quality of life (QoL) in HCWs at a single UK neuroscience center after the first pandemic surge.

Methods: A 38-item electronic questionnaire was disseminated through local team email lists between May 22 and June 7, 2020, to HCWs in a university neurosciences center.

Repurposing a Neurocritical Care Unit for the Management of Severely Ill Patients With COVID-19: A Retrospective Evaluation.

Background: The World Health Organisation declared a coronavirus disease 2019 (COVID-19) pandemic on March 11, 2020. Following activation of the UK pandemic response, our institution began planning for admission of COVID-19 patients to the neurointensive care unit (neuro-ICU) to support the local critical care network which risked being rapidly overwhelmed by the high number of cases. This report will detail our experience of repurposing a neuro-ICU for the management of severely ill patients with COVID-19 while retaining capacity for urgent neurosurgical and neurology admissions.

Early Postoperative Outcomes of Normal Pressure Hydrocephalus: Results of a Service Evaluation.

Background: Patients with normal pressure hydrocephalus (NPH) are often elderly, frail and affected by multimorbidity. Treatment is surgical with cerebrospinal diversion shunts. The selection of patients that are of an acceptable level of risk to be treated surgically has been a matter of debate for years and has deprived some patients of life-changing surgery.

Chronic subdural haematomas: a single-centre experience developing an integrated care pathway.

Objective: To improve quality of care for patients presenting with chronic subdural haematoma (CSDH) by introducing a multi-disciplinary integrated care pathway.

Summary Background: CSDH is a common neurological condition. Incidence rises with age and currently affects around 58/100 000 people over 70 years.

Current UK practice of pre-operative risk assessment prior to neurosurgery.

Background: Intra-cranial and spinal surgery is associated with significant morbidity (23.6% and 11.2%) (5) .

Titanium cranioplasty and the prediction of complications.

Objectives: Titanium cranioplasty (TC), the operative repair of a skull defect with an ergonomically manufactured plate to restore cosmesis, cranial function and reduce complications is a common neurosurgical procedure. It is technically simple but has high complication rates. This study aimed to determine the incidence and predictors of complications following TC.