To assess the current transition process for pediatric to adult epilepsy care, identify gaps, and establish a standardized pathway using a transition of care document (TOCD) to improve provider understanding and patient outcomes.

The transition from pediatric to adult epilepsy care lacks a universally accepted model. Despite efforts through systematic reviews to define best practices, variability in transition processes remains substantial. While the American Epilepsy Society provides 2 clinical practice tools for adolescents with and without developmental disabilities, these are limited in specificity and fail to account for all requirements of our heterogeneous epilepsy population. 

A retrospective chart review was conducted for patients transitioning from pediatric epilepsy and seen as a new visit in the adult epilepsy clinic. Data was collected to determine whether TOCD was available, whether records were transferred from the referring provider, and whether incomplete or missing records which then resulted in additional time spent during the visit.

Of the first 12 patients reviewed, 1 had TOCD from a pediatric epileptologist and 1 had document from the referring hospital. These documents did not have all information required for transition. Verbal or email transfer of information occurred for 3 patients,  partial records were sent for 2 patients and records were obtained after the visit for 2 patients. There was expedited transfer of care for 2 pregnant patients aged 18 and 21 years. There was only 1 patient who arrived with all prior records. 

Our findings highlight a lack of standardized structure or adherence to guidelines in the transition from pediatric to adult epilepsy care. The absence of consistent documentation underscores the need for a formalized transition of care workflow to ensure continuity, improve efficiency, and optimize patient outcomes. Our center goal is to establish a TOCD for the initial visit in adult epilepsy clinic thereby improving patient care.