The Feasibility of a Brain Care Self-assessment Tool in the Neurosciences Intensive Care Unit
Akashleena Mallick1, Courtney Nunley1, Zeina Chemali1, Christopher Anderson2, Jonathan Rosand1, Nirupama Yechoor1
1Neurology, Massachusetts General Hospital- Harvard Medical School, 2Neurology, Brigham and Women's Hospital
Objective:
We aim to evaluate the feasibility of the Brain Care Score (BCS) as an educational tool for primary and secondary prevention of brain disease in the Neurosciences Intensive Care Unit (NICU) at Mass General Hospital (MGH). A higher BCS signifies improved brain health and reduced risks of stroke, depression, and dementia.
Background:
The NICU faces educational challenges with critical patient conditions, resource limitations, and the demand for timely medical decisions. The 21-point BCS assesses physical, lifestyle, and social-emotional health. The score educates and motivates users to recognize brain health influences and areas for improvement.
Design/Methods:
From November 2022 to April 2023, we assessed feasibility of the BCS toolkit at MGH NICU. It included English and Spanish wall decals, flyers, and physical information cards with unique QR codes linked to a secure Redcap database in patient rooms, waiting areas, and public spaces. Participants completed surveys by scanning QR codes with smartphones, granting access to brain health resources and personalized goals. Engagement interventions included toolkit distribution, emails, and physician-champions and were analyzed using interrupted time series.
Results:
Among 43 QR code users, 36 completed the BCS survey. NICU had the highest participation (21), followed by the waiting area and information cards (7 each), with no Spanish-speaking engagement across any interventions. Physical health questions showed frequent disengagement, highest in HbA1c. NICU rooms showed a trend change from 1 to 13 records. Physician-champions prompted the most engaging intervention.
Conclusions:
This study revealed that the BCS is not feasible for the NICU despite identifying important barriers to engagement. Patients' critical conditions and the complexity of the tool hindered its educational value. However, the presence of a physician-champion increased engagement by 48%. The study underscored the importance of Spanish-speaking champions for Hispanic inclusion. Future research should prioritize face-to-face interactions and more straightforward tools to integrate into the ICU workflow effectively.