Authors :
Presenting Author: Allison Dye, DNP, APRN, CPNP-PC – Ann & Robert H. Lurie Children's Hospital of Chicago
Kelly Neven, MSN, FNP-BC – Ann & Robert H. Lurie Children's Hospital
Ashley McPartlin, DNP, APRN, CPNP-PC – Ann & Robert H. Lurie Children's Hospital
Amy Tennant, MSN, APRN, CPNP-PC – Ann & Robert H. Lurie Children's Hospital
Breanne Fisher, DNP, APRN, CPNP-PC – Ann and Robert H. Lurie Childrens Hospital of Chicago
Abigail Van Nuland, MS – Ann & Robert H. Lurie Children's Hospital
Linda Laux, MD – Ann and Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
David Bieber, MD – Ann & Robert H. Lurie Children's Hospital
Rationale: Seizures are a common neurological disorder in children. For patients with concern of new-onset seizures, an electroencephalogram (EEG) provides critical diagnostic information with implications for treatment (Hasan & Tatum, 2021). Many epilepsy centers recommend completion of a routine EEG (rEEG) prior to initial Neurology consultation, to improve utility of the visit.
At a pediatric institution in the Midwest, it was identified that availability of appointments for rEEGs were greater than that of Neurology providers, resulting in delay between rEEG completion and initial Neurology visit. We postulate this delay leads to increased no-show rates, as long wait times have been shown to be contributory (Glowacka et al., 2009). A same day rEEG and neurology provider clinic was implemented to improve patient throughput and efficiency, and to monitor effects of no-show rates.
Methods: A retrospective chart review was performed to identify patients referred to Neurology for concern for seizure. Baseline data over a two-week period in May 2023 was obtained. In November 2023, a same day rEEG and clinic visit was implemented. A retrospective review of the patients seen from 11/2023 to 5/2024 was completed. Patient age and gender, and dates of neurology referral, rEEG, and neurology visit were collected. Baseline no-show rates for the rEEG lab were assessed. New patients with referrals to neurology were included. Patients with referral for EEG only were excluded.
Results: B
aseline data over a two-week period in May 2023 was gathered, identifying 56 patients. The mean age was 5.2 years of age. The average time from neurology referral to time of rEEG was 21.3 days (range 1-88). The average time from rEEG to appointment was 54 days (range 0-177). Baseline FY23 data for the rEEG lab indicated an average no-show rate of 8.5% (range 3.6-12). Post-implementation, 85 patients were scheduled in the same day rEEG and Neurology visit clinic, of which 4 were no-shows. Of the remaining 81 patients, the average time from referral to rEEG and visit was 22 days. The average age of patient was 5.8 years. At initial visit, 27/81 (33%) patients were diagnosed with epilepsy, and 54/81 (66%) without epilepsy. Daily medication was started for 20/81 (25%) of the patients. Rescue medication was prescribed for 42/81 (52%) of patients. The no-show rate for the rEEG lab was an average rate 5.7%.
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