Authors :
Presenting Author: Cheryl Minick, FNP-BC, CNRN – Joe DiMaggio Children's Hospital
Syndi Seinfeld, DO – Director of Epilepsy, Pediatric Neurology, Joe DiMaggio Children's Hospital; Candice Zizilas, DNP, FNP, MHA – NP, Critical Care, Naples Community Hospital
Rationale:
It has been identified that there is a gap in transitioning pediatric epilepsy patients to adult care. The purpose of this quantitative quasi-experimental quality improvement project was to assess for the sustained implementation of the AAP/AAFP/ACP Got Transition Six Core Elements of Health Care Transition ™ 3.0 clinical practice guideline and its impact on the transition referrals among adult epileptic patients in the pediatric neurology clinic at Joe DiMaggio Children’s Hospital, a year after implementation.
Methods:
The population samples were obtained from the electronic medical record. The search targeted current patients, of both office locations, with a diagnosis of epilepsy and between the ages of 18 and 30 years. Patients were excluded if they did not have a diagnosis of epilepsy and were under 18 or over 30 years of age. Patient with additional diagnoses that were not epilepsy were also excluded. The comparative group, before the implementation of
the AAP/AAFP/ACP Got Transition Six Core Elements of Health Care Transition ™ 3.0 clinical practice guideline, was 25. The implementation sample, collected during the first four weeks of the implementation of the practice guideline, was 48. The sample collected a year later, from January 2023 through March 2023, was 61. Comparison was made of the rates of transition referrals before implementation of the guideline, during the first four weeks of the implementation of the guideline, and a year later during a three month period, using chi-square test.
Results:
The results indicated statistically significant improvement in transition referral rates, X2 = 31.91, p < 0.001 when comparing all groups together and X2 = 32.55, p < 0.001 when comparing the comparative sample and sample from a year later. Also, there was statistically significant improvement in transition referral rates comparing the first four weeks of implementation to the three month period a year later, X2 = 7.57, 0.005 < p < 0.01. The average age of the comparative group was 20.68 years, 20.31 years in the implementation group, and a year later the average age is 19.08 years.
Conclusions:
There has been sustained implementation of the AAP/AAFP/ACP Got Transition Six Core Elements of Health Care Transition ™ 3.0 clinical practice guideline at the pediatric neurology clinic at Joe DiMaggio Children’s Hospital a year after implementation. This has resulted in continued improvement in transition referral rates and a decrease in older adult epilepsy patients remaining in the pediatric neurology practice. The initial education of providers, followed by weekly reminders the first four weeks, and then integration of the practice guideline within the clinic’s assessments has promoted and encouraged continued use of this guideline and may be effective in implementing and sustaining other practice guidelines.
Funding: No funding was received in support of this abstract.