Abstract Details

Title Reducing Hospitalization Related to Seizures in Children: A Quality Improvement Initiative

Topic Child Neurology and Developmental Neurology

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-007

Objective

To reduce Epilepsy/seizures related admissions by 30% over one year of project application compared to baseline through use of quality improvement approach

To reduce Emergency department visits related to seizures/seizure like episodes

Cost-benefit analysis of epilepsy care clinic in the emergency department to determine long term feasibility

Background Seizures are important cause of neurology related ED visits, many of which can be managed on outpatient basis, and help reducing healthcare costs. In the given quality improvement study, we aim to reduce admissions and emergency visits to the hospital using QI methodology.

Design/Methods In the first PDSA cycle, patients were triaged into high risk for readmissions while visiting outpatient clinic. The second cycle involved creation of epilepsy hotline and identifying target patients; by providing resources to transport to the clinic, direct access to tell about medication related issues etc. In third PDSA, Access to outpatient EEG and clinic visits was improved by systems approach and improving waitlist. The last cycle targeting ED visits involves creation of urgent epilepsy clinic, with after office hours access to a neurologist in the emergency department.

Results In terms of ED visits, no changes in total ED visits were seen when compared to data from previous year. Seizure related admissions have been reduced to 43% compared to 54% (p=0.007) from the matched data prior to implementation of the QI. Routine EEG testing in emergency rooms improved from 6.5 per month before the PDSA to 3.3 per month (p=0.12). Currently, urgent epilepsy care at ED is being set up.

Conclusions Systems related approach, targeting patients at risk of visits and improved access can reduce seizure related admissions. Creation of urgent epilepsy care at ED is expected to help further bypass expensive admission visits.

Authors/Disclosures
Ayush Gupta, MD PRESENTER	The institution of Dr. Gupta has received research support from Child neurology foundation . The institution of Dr. Gupta has received research support from EMD Serono.
Benn Cusick, Med-Student	Mr. Cusick has nothing to disclose.
Rebecca Hart, MD	Dr. Hart has nothing to disclose.
Samir R. Karia, MD (University of Louisville)	Dr. Karia has nothing to disclose.

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