Time to third line therapy for RCSe

Measure Purpose: Rapid treatment and cessation of seizures

The numerator: Patients who were started on a third-line therapy* within 60 minutes of seizure onset (inpatient setting) or after arrival to the emergency department (outpatient setting)

*See full specifications for additional details

is divided by

The denominator: Patients > 1 month old with refractory convulsive status epilepticus

Exceptions are removed from the denominator for:

• Patient/caregiver refuse
• Care team document goals of treatment are not seizure control
• Patient in palliative care setting
• Patient is participating in clinical trial for the treatment of status epilepticus
• Intervention is delayed by clinical status such as hypotension precluding intravenous access

Key Phrases

Key phrases you should use to meet this measure include:

• Third-line therapy prescribed within 60 minutes of seizure onset
• Third-line therapy prescribed after arrival to the ED

Measure Calculation Example

Dr. Jimenez had 30 patients older than one month present to the ED or on her hospital service with refractory convulsive status epilepticus from January 1 to December 31 of the measurement year. This is the denominator. One patient was in palliative care and one patient was participating in a clinical trial. These patients are removed from the denominator.

Of the remaining 28 patients, 20 received a third-line therapy within 60 minutes of seizure onset or after arrival to the emergency department. This is the numerator.

Quality of care = 20/(30-2). Dr. Jimenez has a score of 71% for this measure.