Improving Timeliness of Diagnosis and Treatment of Cauda Equina Syndrome at GSTT
Background
Why this project was needed
Cauda equina syndrome (CES) is a surgical emergency requiring urgent MRI and, in confirmed cases, prompt surgical decompression to prevent permanent neurological deficit. An internal review at GSTT identified variability in the time from patient presentation to MRI completion, with some cases experiencing delays due to out-of-hours scan availability and referral pathway inefficiencies. This QIP was designed to measure baseline performance and drive sustainable improvements in CES management times.
Aims
What the project set out to achieve
To audit current practice and timeframes for CES management at GSTT and to achieve measurable reductions in time-to-MRI through targeted quality improvement interventions.
Objectives
Specific measurable steps
- Audit time from ED arrival to MRI completion for all suspected CES presentations between October 2023 and January 2024.
- Achieve a 20% reduction in mean time to MRI scan measured at six months post-intervention.
- Achieve a 20% reduction in emergency MRI scans in favour of urgent outpatient scan pathways where appropriate.
- Achieve MRI confirming or refuting CES within 6 hours of presentation for 80% of patients within a 12-month period.
Discussion
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