This QI project aimed to ensure timely neuromodulation programming and adjustments in accordance with best practice to optimize therapeutic effects and minimize missed opportunities.

Neuromodulation therapy such as Responsive Neurostimulation (RNS) and Deep Brain stimulation (DBS) are FDA approved devices used for patients with drug-resistance epilepsy. The goal of these therapies are to reduce frequency and severity of seizures. Success is heavily dependent on timely, meticulous ongoing programming tailored to the patient's specific needs. To achieve this a dedicated device clinic is crucial for optimizing therapy. 

This project utilized Plan-Do-Study-Act (PDSA) methodology over one year. Protocol and process reviewed to identify areas that required improvement. To gain support from stakeholders, we engaged them early and often to discuss the project's value, goals, and to gather their input. Existing workflow, scheduling process, inconsistent appointment scheduling and documentation was reviewed.We developed a decision tree to triage patients which reduced missed opportunities and that helped create a device clinic for APPs to optimize the workflow and increase patient access. A retrospective chart review completed to assess protocol adherence to identify missed opportunities in optimizing device settings.The team refined the decision tree and workflow based on the preliminary data showing improvement.

This quality improvement project successfully reduced missed opportunities by standardizing the workflow process. The current streamlined process serves as a sustainable model for other clinics to improve efficiency by optimizing therapy to enhance patient care outcomes.