Use of Templates in Implementing AAN Epilepsy Quality Measurement Set in Neurology Resident Clinic (P6.282)

Objective: A quality improvement study was undertaken at an urban medical center to evaluate the effectiveness of using templates in improving neurology resident adherence to AAN epilepsy quality measures. Background: In 2009, AAN convened a multidisciplinary work group to identify key measures in improving patient outcomes for epilepsy. The work group drafted AAN Epilepsy Quality Measurement Set after evaluation of expert consensus and evidence based research. In 2014, these measures were updated, and they now included seven total measures. Design/Methods: Epilepsy faculty created templates for physician notes to incorporated epilepsy quality measures into patient visit process. Neurology residents were encouraged to use these templates when documenting encounters with epilepsy patients in their continuity clinic. Subsequently, we reviewed 30 patients’ medical records. For each quality measure, a chi-square test of independence was calculated comparing rate of resident compliance before and after template use. P values Results: We found that after initiating template use, there was increased compliance with documentation of quality measures. Improvements in documentation for seizure frequency (χ 2 (1)=3.16, p=0.075), seizure intervention (χ 2 (1)=2.96, p=0.085), and etiology of seizure (χ 2 (1)=5.19, p=0.023) were not statistically significant. Residents had high rate of compliance with these measures prior to the intervention. There was statistically significant improvement in rate of documentation for medication side effect intervention (χ 2 (1)=17.8, p 2 (1)=18.5, p 2 (1)=27.7, p 2 (1)=9.92, p=0.0016). Our data set did not include enough patients with intractable seizures to evaluate for compliance with referral to epilepsy center. Conclusions: These results indicated that neurology resident adherence to AAN quality measures could improve with the use of templates. This study also identified areas for improvement in our resident training, such as epilepsy co-morbidity and patient counseling. Future studies would evaluate changes to health outcomes. Disclosure: Dr Mao has nothing to disclose. Dr. Chari has nothing to disclose. Dr. Sheikin has nothing to disclose. Dr. Mortati has nothing to disclose. Dr. Valsamis has nothing to disclose.