Background: The goal was to understand factors leading to prolonged wait times for neurological assessment of children with new onset seizures. A second objective was to develop an innovative approach to patient flow through and achieve a reduction in waiting times utilizing limited resources.

Methods:

Audit of the referrals, flow through, wait times

Identification of bottlenecks

Development of triaging strategy:

Suspected Febrile seizures and non-epileptic events;

Suspected benign and absence epilepsies;

Suspected other Focal epilepsies, generalized epilepsies, epilepsy under 2 years

Initiation of early telephone contact and support

Development of a ketogenic diet

Results: Using a triaging strategy and focusing on timely access to investigations, wait times for clinic evaluations were shortened despite larger numbers of referrals (mean wait time reductions from 179 to 91 days). Limiting factors such increase in referral numbers, attrition in support staff, interfered with sustainability of reduced wait times achieved in the initial phase of the program. Conclusions: This pilot study highlights the effectiveness of an innovative triaging strategy and improvements in patient flow through in achieving the goals of reduction in wait times for clinical evaluation and timely investigations to improve care for children with new onset seizures. Insights into limitations of such strategies and factors determining sustainability are discussed.