Establishing a Transition Program for Young Adults With Epilepsy

Transition of young adults with epilepsy to an adult health care model continues to be challenging because of many barriers. A Quality Improvement project was developed to create a roadmap to assist young adults with epilepsy in successfully transitioning from our pediatric neurology clinic to adult neurology providers for lifetime epilepsy management.

Young adults with epilepsy aged 18-23 years with normal cognitive development were recruited to participate in our program. We conducted 4 interventions, each with 3 Plan-Do-Study-Act cycles from February 2023 to January 2025. The interventions included roadmap development, setting expectations for transition, expansion of patient communication modalities, and transition documentation. The outcome measure was defined as a successful transition from Dayton Children's Hospital (DCH) neurology clinic to an adult neurology clinic and was calculated by the number of patients who completed their first appointment with their adult neurology provider.

Of 102 patients enrolled in the program, we tracked 72 (70%) successful transitions with 26 pending further action (i.e., scheduled appointments, referrals pending approval, and unable to reach patients) and 4 dismissed from the department. Barriers in the process included missed appointments, inability to establish communication with patients, and delayed self-management behaviors. The program was adopted as standard practice in our department and continues to be effective 2 years later.

The DCH neurology team created and maintained a successful transition program for developmentally normal young adults with epilepsy to transition to an adult neurology clinic and assume responsibility for managing their health care needs.