Monitoring Guideline Adherence in Severe Traumatic Brain Injury

Abstract

Traumatic brain injuries (TBI) significantly impact global health, often resulting in death or long-term disability. We developed a quality dashboard to monitor adherence to severe TBI guidelines, leveraging data from Rennes University Hospital's clinical data warehouse collected between January 2020 and December 2023. We included 193 patients from the surgical ICU who were over 18 years old and excluded those without adequate intracranial pressure (ICP) monitoring data. The study utilized the French Anesthesiology and Intensive Care Society guidelines and the Brain Trauma Foundation's 4th Guidelines Edition to assess guideline adherence over the first seven days of hospitalization. Our dashboard, built using the flexdashboard and Plotly R libraries, presents patient demographics, clinical assessments, and treatment adherence. Despite limitations, such as reduced interoperability and the absence of clinician usability testing, our tool represents a pioneering effort in TBI guideline compliance, with plans for future enhancements including expanded guideline evaluation and improved dashboard sharing capabilities.