Transition from Pediatric to Adult Specialty Care for Adolescents and Young Adults with Refractory Epilepsy: A Quality Improvement Approach

Jennifer A Disabato; Paul F Cook; Laura Hutton; Tristen Dinkel; Paul M Levisohn

doi:10.1016/j.pedn.2015.06.014

Transition from Pediatric to Adult Specialty Care for Adolescents and Young Adults with Refractory Epilepsy: A Quality Improvement Approach

J Pediatr Nurs. 2015 Sep-Oct;30(5):e37-45. doi: 10.1016/j.pedn.2015.06.014. Epub 2015 Aug 8.

Authors

Jennifer A Disabato¹, Paul F Cook², Laura Hutton³, Tristen Dinkel⁴, Paul M Levisohn⁵

Affiliations

¹ University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO. Electronic address: Jennifer.disabato@ucdenver.edu.
² University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO.
³ Department of Family Services, Children's Hospital Colorado, Aurora, CO.
⁴ Neurology Clinic, Children's Hospital Colorado, Aurora, CO.
⁵ Division of Child Neurology, University of Colorado School of Medicine, Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO.

PMID: 26260696
DOI: 10.1016/j.pedn.2015.06.014

Abstract

Adolescents and young adults with refractory epilepsy are particularly vulnerable to serious medical and psychosocial challenges during transition from pediatric to adult care. Quality improvement methods were used to address the transition process on an academic medical campus. Outcomes achieved were decreased time from referral to first appointment in the adult clinic, H=8.2, p=0.004, r=0.43; and increased social work referrals using decision support, z=10.0, p=0.0006, OR=6.13. As measured by the 13-item Patient Activation Measure, pre-post change in patient activation as an outcome of self-management education was not statistically significant.

Keywords: Adolescents; Clinical decision support; Epilepsy; Self-management; Transition.

MeSH terms

Academic Medical Centers / organization & administration
Adolescent
Adult
Child
Cohort Studies
Drug Resistant Epilepsy / diagnosis*
Drug Resistant Epilepsy / therapy*
Female
Humans
Male
Patient Care Team / organization & administration
Patient Education as Topic / organization & administration*
Patient Safety
Pediatrics / methods
Quality Improvement
Risk Assessment
Self Care
Transition to Adult Care / organization & administration*
Treatment Outcome
United States
Young Adult