Seize the day: A quality improvement approach to support transition of care and decrease 30-day readmissions for pediatric patients with epilepsy

Purpose

Elevated rates of 30-day readmission for children with epilepsy were noted at a stand-alone pediatric acute care facility. To address this issue, a standardized pathway was created and implemented in 2017. The main objective was to ensure that patients with epilepsy and their families were adequately prepared for discharge and the transition to home.

Design and methods

Using a quality improvement (QI) approach, a standardized education pathway was developed and implemented to decrease unplanned 30-day readmissions of patients with a diagnosis of epilepsy from a specialized neurology unit. An interprofessional care team received training to ensure standardized communication around the pathway approach and components. All patients with a diagnosis of epilepsy and their families were educated using the pathway and guided through additional simulation and teach-back exercises.

Results

Analysis demonstrated a 27.6 % decrease in unplanned 30-day readmissions in the 6 years following implementation. An estimated $950,000 in cost savings was achieved secondary to program implementation.

Conclusions

Utilizing the pathway standardizes epilepsy management education and decreases unplanned 30-day readmissions for pediatric patients diagnosed with epilepsy. A standardized educational plan is an essential component of patient discharge teaching and proper home management of epilepsy.

Practice implications

For sustainability, education needs to be continuously refreshed and included in onboarding new nurses. To ensure health equity, translation of the pathway into multiple languages is needed.