Quality Improvement: Project Improves Utilization in Epilepsy

According to a recent report published in Pediatrics, a quality improvement project can reduce the frequency of emergency department and/or hospital visits by children with epilepsy.

Reducing Visits Through Quality Improvement

The goal of the project by Anup D. Patel, MD, from the Nationwide Children’s Hospital in Columbus, Ohio, and colleagues was to decrease seizure-related emergency department and/or hospital visits by 20%, from a baseline of 17 to 13.6 visits per month per 1000 patients. Dr. Patel used the Institute for Healthcare Improvement model to develop a quality improvement project, with a defined outcome to decrease emergency department and/or hospital utilization for children with epilepsy. The study group led by Dr. Patel determined the rate of emergency department visits and unplanned hospitalizations for epilepsy patients and associated healthcare costs.

Dr. Patel and his group observed a 28% reduction in emergency department visits 19 months after implementation of the interventions (from 17 to 12.2 visits per month per 1000 patients; P <.0001). There was a 43% reduction in the average number of inpatient hospitalizations (from 7 to 4 admissions per month per 1000 patients; P <.0001). There were decreases in healthcare claims paid, with reductions of $115,200 for emergency department visits and $1,951,137 for hospitalizations.

Healthcare and Lean Six Sigma

Lean Six Sigma is a vital tool in the hospital environment. So many processes and procedures are deeply embedded in the culture. These behaviors are a challenge to change because of the “we have always done it that way” answer to a “why” and a lack of willingness to change course. No matter how obvious the flaws are in the current process, healthcare professionals like to stick to process and feel very uncomfortable with change. Lean Six Sigma is the perfect tool to make changes in deeply embedded institutional processes and breathe life into new, more efficient processes that save time, improve care and satisfaction.

Reference
Reduced Emergency Department Utilization by Patients With Epilepsy Using QI Methodology http://pediatrics.aappublications.org/content/early/2017/01/18/peds.2015-2358?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token