Abstracts

Rationale: Epilepsy or seizure care is the most common neurological condition that presents to an emergency department (ED). Lack of an abortive seizure medication or a sub therapeutic dose has been shown as a risk factor for high ED utilization for seizure related care.Methods: A quality improvement (QI) project utilizing the Institute for Healthcare Improvement (IHI) model in hopes of improving patients receiving optimal dosing of abortive seizure medications was performed. Baseline of the percentage of patients receiving an abortive seizure medication at optimal dosing prior to presenting to the ED for seizure related care was measured and followed after implementation of specific interventions. Interventions aimed at reducing ED visits and unplanned hospitalizations using QI methodology were developed. Plan do study act (PDSA) cycles were utilized with adjustments made when needed.Results: 9 months following implementation of the interventions, optimal dosing improved from a baseline of 25% to 83%. Additionally, the average number of ED visits per month was reduced by 27%. For both outcome measures, a 2-sample Poisson rate exact test yielded a p-value < 0.0001.Conclusions: Applying QI methodology was highly effective in improving the percent of patients who received abortive medication for seizures at an optimal dose based on age and weight for children with epilepsy at a free standing children’s hospital, thus resulting in significant savings plus quality of life improvements for patients and families to attend school, work and activities.