Abstracts

Rationale: The goal of performing a video electroencephalogram (VEEG) is to study a person s behaviors and brain activity during a seizure. Patients are typically admitted to an Epilepsy Monitoring Unit (EMU) to conduct a VEEG study. In 2012 from January to July, there were 198 patients admitted to the EMU. On average, it took 122 minutes from the time the patient was admitted to the room to the time the patient was hooked up to the VEEG electrodes. The long wait delayed the start of the VEEG monitoring, and over two hours of time to potentially capture seizure activity was lost. This delay also set back patient discharge time, which had a negative impact on patient satisfaction and patient flow. Methods: The admission process was evaluated for areas needing improvement. Issues were identified in the areas of communication, consistency, role responsibilities, and the timing of the arrival of the patient care team members. A new process map for EMU admissions was developed to make the admission to hook up process more streamlined. After implementation of the new process, six weeks of real-time data was collected on the flow of all patients admitted to the EMU. The goal was to decrease the cycle time of admission to start of hook up from 122 minutes to 30 minutes.Results: The new admission process map helped to communicate expectations and to define each team member s responsibilities. Duplicated steps were eliminated, and time wasted was reduced. By following the new process map, cycle time of patient admission to EMU beds to the start of VEEG electrode hook up decreased dramatically to an average of 18 minutes, exceeding the original goal of 30 minutes.Conclusions: With the implementation of the new EMU admission process, there has been improvement in communication and teamwork among all patient care team members. Through team collaboration, we have been able to make the admission to hook up process more consistent and efficient. Expediting the start of VEEG monitoring potentially allows for earlier capture of seizure activity and earlier discharge of patients, enabling other patients to come in for a study sooner. This helps to increase revenue for the hospital as well as improve patient satisfaction.