Abstracts

Rationale: Despite different activation techniques, a significnat percentage of patients do not have their typical seizures/events in the epilepsy monitoring unit (EMU), which often leads to nondiagnostic studies. Many of our patients reported that being in a hospital environment with restrictions on ambulation and physical activity were the main reason why their typical events did not occur in the EMU. Based on this feedback, we decided to evaluate the need for a new EMU room design. We surveyed patients on factors that influence the likelihood of seizures/events in the EMU. We also surveyed epileptologists on whether a new EMU room design is needed and what it should accomplish. Methods: A survey was mailed to patients previously admitted to our adult EMU over a period of 2 years. For 3 months, EMU patients were also asked to complete the survey upon discharge. The questions included: What helped/would have helped trigger events? What makes it less likely for events to occur? What changes would make it more likely for events to occur? The epileptologist survey was posted on member-only online forums of the American Academy of Neurology Epilepsy Section and the American Epilepsy Society. Questions included: Is there a need to change the design of typical EMU rooms? What problems exist in the current design? What goals can a new design accomplish? Do you agree it is possible to design an EMU room where patients ambulate independently without compromising their safety? Results: 102 patients completed the survey. The following factors were reported to decrease the likelihood of events in the EMU: being away from stress (63%), being confined to bed (48%), and being in an artificial environment (38%). Changes that patients thought could increase the likelihood of seizures/events included: decreasing medications faster (44%), being able to ambulate independently (36%) and being able to exercise (31%). Among patients who did not have seizures/events, 53% attributed that to being confined to bed, and the most commonly suggested change was allowing ambulation without supervision. Seventy-seven epileptologists completed the provider survey. Most respondents (74%) thought there was a need for a new EMU room design due to multiple limitations in current design. Most respondents (80%) agreed that the artificial environment and restrictions on ambulation and physical activity may reduce the likelihood of events. 79% thought it is possible to design a room where patients can ambulate independently without compromising their safety. Most thought that a new design could improve patient satisfaction (83%), patient safety (69%) and diagnostic yield (58%). Conclusions: A majority of patients and epileptologists feel that the artificial environment and restrictions on ambulation may decrease the likelihood of recording seizures/events in the EMU. Most surveyed epileptologists feel there is need for a EMU room design, and think it could improve patient safety and the diagnostic yield of EMU studies. Most feel it is possible to design a room where patients can ambulate independently without compromising their safety. The results led to an ongoing collaborative effort to “reimagine” EMU room design to improve patient safety and the diagnostic yield of EMU studies. Our team includes interior designers, physicians, nurses, EEG technologists and patients. Funding: None.