Addressing barriers to surgical evaluation for patients with epilepsy

Publication date: September 2018Source: Epilepsy & Behavior, Volume 86Author(s): Chloe E. Hill, Jackie Raab, Delight Roberts, Timothy Lucas, John Pollard, Ammar Kheder, Brian Litt, Kathryn A. DavisAbstractObjectivePatients with poorly controlled seizures are at elevated risk of epilepsy-related morbidity and mortality. For patients with drug-resistant epilepsy that is focal at onset, epilepsy surgery is the most effective treatment available and offers a 50–80% cure rate. Yet, it is estimated that only 1% of patients with drug-resistant epilepsy undergo surgery in a timely fashion, and delays to surgery completion are considerable. The aim of this study was to increase availability and decrease delay of surgical evaluation at our epilepsy center for patients with drug-resistant epilepsy by removing process barriers.MethodsFor this quality improvement (QI) initiative, we convened a multidisciplinary team to construct a presurgical pathway process map and complete root cause analysis. This inquiry revealed that the current condition allowed patients to proceed through the pathway without centralized oversight. Therefore, we appointed an epilepsy surgery nurse manager, and under her direction, multiple additional process improvement interventions were applied. We then retrospectively compared preintervention (2014–2015) and postintervention (2016–2017) cohorts of patient undergoing the presurgical pathway. The improvement measures were patient throughput and pathway sojour...

Source: Epilepsy and Behavior - July 20, 2018 Category: Neurology Source Type: research