Affiliations

Advocate Children's Hospital Park Ridge, Advocate Children's Hospital Oak Lawn, Advocate Lutheran General Hospital

Abstract

Background/Significance:

A Seizure Action Plan (SAP) provides individualized seizure management instructions, including medication administration and emergency protocols. SAPs are inconsistently completed at Advocate Children’s Hospital – Oak Lawn (ACH-OL) leading to missed opportunities for patient/caregiver education and potential safety risks during care transitions.

Purpose:

Using quality improvement (QI) methodology, we aimed to improve the SAP completion rate for patients admitted to ACH-OL with seizure from 13% to 75% between 9/1/2025-12/31/2025.

Methods:

English and Spanish speaking patients 0–18 years admitted to ACH-OL with seizure-related diagnoses (identified by ICD-10 codes) and discharged from a general pediatric service between 9/1/25- 12/31/25 were included. Convenience sampling was done by retrospective chart review. The primary outcome measure was the percentage of seizure encounters with an SAP completed before discharge. Secondarily, we trended days between electronic encounters related to seizure management within 14 days of discharge. The process measure was the percentage of SAPs documented in the correct electronic medical record (EMR) location. Staff perceptions of workflow impact were the balancing measure. Two Plan-Do-Study-Act (PDSA) cycles were implemented. The first was education for pediatric residents and hospitalists. Using feedback from the first cycle, the second cycle optimized the EMR workflow by modifying the SAP dot phrase.

Results:140 seizure-related encounters were reviewed. A statistical process control chart was used to trend the mean percentage of encounters with completed SAPs, which increased from 13% to 67%, indicated by achieving special cause variation after cycle 1. Post discharge electronic encounters remain a rare event, with days between events ranging from 5-69. The percentage of SAPs in the correct EMR location increased from 20% to 80%, identified by a nonrandom shift of data on a run chart after cycle 1. Provider surveys revealed 70% agreed or strongly agreed SAPs improve quality of discharge planning, and 90% agree or feel neutral that SAPs add a manageable amount of time to the discharge process.

Conclusion:Using QI methodology, we increased the SAP completion rate from 13% to 67%. While not yet at our goal of 75% completion, we saw significant improvement through cost effective, easily implementable interventions without negatively impacting staff workflow. Future plans include further EMR optimization.

Presentation Notes

Presented at Scientific Day; May 20, 2026; Milwaukee, WI.

Full Text of Presentation

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Document Type

Oral/Podium Presentation


 

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May 20th, 12:00 AM

SPARK (Seizure Plan for Action and Readiness in Kids): Improving Seizure Action Plan Completion for Hospitalized Children Using Quality Improvement Methodology

Background/Significance:

A Seizure Action Plan (SAP) provides individualized seizure management instructions, including medication administration and emergency protocols. SAPs are inconsistently completed at Advocate Children’s Hospital – Oak Lawn (ACH-OL) leading to missed opportunities for patient/caregiver education and potential safety risks during care transitions.

Purpose:

Using quality improvement (QI) methodology, we aimed to improve the SAP completion rate for patients admitted to ACH-OL with seizure from 13% to 75% between 9/1/2025-12/31/2025.

Methods:

English and Spanish speaking patients 0–18 years admitted to ACH-OL with seizure-related diagnoses (identified by ICD-10 codes) and discharged from a general pediatric service between 9/1/25- 12/31/25 were included. Convenience sampling was done by retrospective chart review. The primary outcome measure was the percentage of seizure encounters with an SAP completed before discharge. Secondarily, we trended days between electronic encounters related to seizure management within 14 days of discharge. The process measure was the percentage of SAPs documented in the correct electronic medical record (EMR) location. Staff perceptions of workflow impact were the balancing measure. Two Plan-Do-Study-Act (PDSA) cycles were implemented. The first was education for pediatric residents and hospitalists. Using feedback from the first cycle, the second cycle optimized the EMR workflow by modifying the SAP dot phrase.

Results:140 seizure-related encounters were reviewed. A statistical process control chart was used to trend the mean percentage of encounters with completed SAPs, which increased from 13% to 67%, indicated by achieving special cause variation after cycle 1. Post discharge electronic encounters remain a rare event, with days between events ranging from 5-69. The percentage of SAPs in the correct EMR location increased from 20% to 80%, identified by a nonrandom shift of data on a run chart after cycle 1. Provider surveys revealed 70% agreed or strongly agreed SAPs improve quality of discharge planning, and 90% agree or feel neutral that SAPs add a manageable amount of time to the discharge process.

Conclusion:Using QI methodology, we increased the SAP completion rate from 13% to 67%. While not yet at our goal of 75% completion, we saw significant improvement through cost effective, easily implementable interventions without negatively impacting staff workflow. Future plans include further EMR optimization.

 

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