Epilepsy quality performance in a national sample of neurologists and primary care providers: Characterizing trends in acute and chronic care management.

Introduction: Epilepsy-specific quality indicators and performance measures have been published and revised multiple times. The application of epilepsy-specific quality measures has been demonstrated in a few healthcare systems. However, there is no information to date on changes in epilepsy performance measures over time, and across settings, in a national sample.

Systematic Review of the Military Career Impact of Mental Health Evaluation and Treatment.

Introduction: Military leaders are concerned that active duty members' fear of career impact deters mental health (MH) treatment-seeking. To coalesce research on the actual and perceived consequences of MH treatment on service members' careers, this systematic review of literature on the U.S.

Measuring coordination of epilepsy care: A mixed methods evaluation of social network analysis versus relational coordination.

Objectives: Coordination of multidisciplinary care is critical to address the complex needs of people with neurological disorders; however, quality improvement and research tools to measure coordination of neurological care are not well-developed. This study explored and compared the value of social network analysis (SNA) and relational coordination (RC) in measuring coordination of care in a neurology setting. The Department of Veterans Affairs Healthcare System (VA) established an Epilepsy Centers of Excellence (ECOE) hub and spoke model of care, which provides a setting to measure coordination of care across networks of providers.

Guidelines and Quality Standards for Adults with Epilepsy.

Guidelines and quality measures for epilepsy care have the potential to improve the quality of epilepsy care. Quality measures are increasingly used for pay-for-performance. This article describes different guidelines and quality measures that have been used to identify best practices, types of best practices for use in clinical care developed using each of these approaches, and information on how to interpret the recommendations in specific guidelines and quality measures described elsewhere in this issue.

Providers' perspectives on treating psychogenic nonepileptic seizures: frustration and hope.

Recent diagnostic and treatment advances in psychogenic nonepileptic seizures (PNES) have the potential to improve care for patients, but little is known about the current state of PNES care delivery in the Veterans Health Administration (VA). We conducted semistructured interviews with 74 health-care clinicians and workers in the VA, eliciting provider perceptions of PNES care. Data were analyzed according to principles of Grounded Theory.

Implementation of the Epilepsy Center of Excellence to improve access to and quality of care--protocol for a mixed methods study.

Background: To address the growing problem of epilepsy among aging Veterans and younger Veterans who have experienced a traumatic brain injury (TBI), the Veterans Health Administration (VA) has implemented 16 Epilepsy Centers of Excellence (ECOE) to assure increased access to high quality of care for Veterans with epilepsy. Each ECOE consists of a network of regional hubs to which spoke facilities refer Veterans for subspecialty treatment. The ECOEs are expected to improve access to and quality of epilepsy care through patient care, consultation and education.

The prevalence of epilepsy and association with traumatic brain injury in veterans of the Afghanistan and Iraq wars.

Objective: To examine the association of epilepsy with traumatic brain injury (TBI) in Afghanistan and Iraq (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) Veterans.

Design: Cross-sectional observational study.

Participants: A total 256 284 OEF/OIF Veterans who received inpatient and outpatient care in the Veterans Health Administration in fiscal years 2009-2010.