Outcomes of a care bundle strategy at a dedicated private surgical center for idiopathic normal pressure hydrocephalus

Abstract Background Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent and surgically treatable condition in the elderly. Ventriculoperitoneal (VP) shunting is the standard treatment, yet outcomes may vary depending on surgical expertise and care delivery models. This study evaluates outcomes of a care bundle strategy for iNPH at a private healthcare provider under public contract. Methods We performed a retrospective analysis of a prospectively collected cohort of consecutive patients undergoing VP shunt placement for iNPH at a private hospital between November 2024 and November 2025. All procedures were performed by two senior consultant neurosurgeons adhering to a care bundle strategy. Clinical outcomes and patient-reported experience measures (PREM) were assessed at one month postoperatively. Results Eighty patients were included, with 100% follow-up for clinical outcomes and 83% response ( n = 60) to PREMs. Mean time from referral to surgery was 28.5 ± 15 days. Overall clinical status improved in 93% of patients, with a gait improvement in 88%, and improvement rates of 24% and 29% for continence and cognition, respectively. No reoperations were required within the timeframe of the study. Patient satisfaction was high across all domains, with a mean likelihood-to-recommend score of 9.8 ± 0.69. Conclusion VP shunt placement within a consultant-led care bundle pathway at a private surgical center was associated with high patient-reported efficacy, low complication and reoperation rates, and excellent patient satisfaction. These findings support the feasibility and safety of dedicated iNPH care bundle models outside traditional academic centers to improve timely access to treatment.