Value-Based Care for Acute Pediatric Seizure Management: Operational Models, Quality Metrics, Barriers, and Financial...

Area of Science:

• Pediatric Neurology
• Healthcare Operations
• Value-Based Care

Background:

• Acute pediatric seizure care is a high-volume, resource-intensive process impacting multiple healthcare domains.
• Limited literature exists on value-based frameworks in pediatric neurology, necessitating anchored, measurable clinical problems.
• Acute seizure care serves as a model for developing and assessing value in pediatric neurology.

Purpose of the Study:

• To describe a framework for creating value in acute pediatric seizure care.
• To identify key process levers and outcome domains for assessing value.
• To address barriers to implementation and propose a roadmap for improvement.

Main Methods:

• Topical review of existing literature on acute pediatric seizure care.
• Development of a framework based on five process levers: specialist evaluation, protocolized management, diagnostic stewardship, discharge planning, and outcome measurement.
• Assessment across four outcome domains: clinical, patient/family, operational, and financial.

Main Results:

• Value is created through timely specialist evaluation, protocolized acute management, diagnostic stewardship, reliable discharge planning, and structured outcome measurement.
• Outcomes are assessed across clinical, patient/family, operational, and financial domains.
• Common barriers include insurance, limited diagnostic capacity, sedation bottlenecks, delayed follow-up, and inequitable access.

Conclusions:

• The proposed framework provides a structured approach to enhance value in acute pediatric seizure care.
• Addressing implementation barriers is crucial for successful adoption and improvement.
• The framework's analytic approach can be adapted to other pediatric neurology inpatient presentations.