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

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 we...

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Bibliographic Details
Published in:Journal of pediatric nursing 2015-09, Vol.30 (5), p.e37-e45
Main Authors: Disabato, Jennifer A., Cook, Paul F., Hutton, Laura, Dinkel, Tristen, Levisohn, Paul M.
Format: Article
Language:English
Subjects:
Academic Medical Centers - organization & administration
Adolescent
Adolescents
Adult
Child
Clinical decision support
Clinical outcomes
Cohort Studies
Disease management
Drug Resistant Epilepsy - diagnosis
Drug Resistant Epilepsy - therapy
Epilepsy
Female
Humans
Male
Nursing
Patient Care Team - organization & administration
Patient Education as Topic - organization & administration
Patient Safety
Pediatrics
Pediatrics - methods
Quality Improvement
Quality of care
Risk Assessment
Self Care
Self-management
Social work
Transition
Transition to Adult Care - organization & administration
Transitions
Treatment Outcome
United States
Young Adult
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Summary: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.
ISSN:0882-5963
1532-8449
DOI:10.1016/j.pedn.2015.06.014