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Introduction. The use of cEEG in the care of critically ill patients is increasing. A 2014 survey of neurophysiologists described cEEG practices (Gavvala et al, 2014), but further characterization has been lacking. This study explores the structure of cEEG programs in the adult critical care setting.

Methods. We conducted 21 in-depth interviews from 13 institutions that use cEEG in the adult critical care setting and additionally surveyed 36 physicians to provide information about their institutions. The interview and survey questions addressed cEEG program structure and processes. Interviews were recorded, transcribed, and analyzed using a directed content analysis approach.

Results. The interviewees and survey respondents reported the characteristics of their institutions, fellowship programs, and their own practices in reading cEEG. There was variability between institutions in terms of resources available and structure of the programs. Most interviewees and respondents reported use of the ACNS nomenclature for cEEG reporting but consistency of use was variable. The majority reported using quantitative EEG with variable application. The process of communication regarding cEEG varied, with some institutions utilizing a more defined structure of communication.

Conclusion. Despite the growing demand for cEEG, program structure and practices varied between institutions. There remains a need for defining parameters for cEEG program structures between institutions with different characteristics. The lack of uniformity between programs must be considered given the widespread use of cEEG in clinical decision-making for critically ill patients. In order to ensure health equity and effective systems, there must be standardization across hospitals.