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. 2024 Feb;14(1):e200231.
doi: 10.1212/CPJ.0000000000200231. Epub 2023 Dec 22.

Implementing American Academy of Neurology Quality Measures in Antigua Using Quality Improvement Methodology

Gaden Osborne  1 , Olivia Valenti  1 , Juniella Jarvis  1 , Evelynne Wentzel  1 , Jorge Vidaurre  1 , Dave F Clarke  1 , Anup D Patel  1
Affiliations

Implementing American Academy of Neurology Quality Measures in Antigua Using Quality Improvement Methodology

Gaden Osborne et al. Neurol Clin Pract. 2024 Feb.

Abstract

Background and objectives: The American Academy of Neurology has developed quality measures related to various neurologic disorders. A gap exists in the implementation of these measures in the different health care systems. To date, there has been no electronic health care record nor implementation of quality measures in Antigua. Therefore, we aimed to increase the percent of patients who have epilepsy quality measures documented using standardized common data elements in the outpatient neurology clinic at Sir Lester Bird Medical Center from 0% to 80% per week by June 1, 2022 and sustain for 6 months.

Methods: We used the Institute for Health care Improvement Model for Improvement methodology. A data use agreement was implemented. Data were displayed using statistical process control charts and the American Society for Quality criteria to determine statistical significance and centerline shifts.

Results: Current and future state process maps were developed to determine areas of opportunity for interventions. Interventions were developed following a "Plan-Do-Study-Act cycle." One intervention was the creation of a RedCap survey and database to be used by health care providers during clinical patient encounters. Because of multiple interventions, we achieved a 100% utilization of the survey for clinical care.

Discussion: Quality improvement (QI) methodology can be used for implementation of quality measures in various settings to improve patient care outcomes without use of significant resources. Implementation of quality measures can increase efficiency in clinical delivery. Similar QI methodology could be implemented in other resource-limited countries of the Caribbean and globally.

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Conflict of interest statement

The authors report no relevant disclosures. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp. TAKE-HOME POINTS → Epilepsy and Child Neurology quality measures were created by workgroups led by the American Academy of Neurology.→ A framework can be created to use quality improvement in neurology practices caring for people with epilepsy.→ Creation and implementation of standardized data entry around important quality measures in epilepsy be implemented in countries outside the United States.

Figures

Figure 1
Figure 1. Key Driver Diagram for Quality Improvement Project
Figure 2
Figure 2. Control Chart Showing the Percentage of Patients Seen in Outpatient Epilepsy Clinic With AAN Measures Documented During the Visit
See this image and copyright information in PMC

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