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Abstract Objective For people with drug‐resistant epilepsy, the use of epilepsy surgery is low despite favorable odds of seizure freedom. To better understand surgery utilization, we explored factors associated with inpatient long‐term EEG monitoring (LTM), the first step of the presurgical pathway. Methods Using 2001–2018 Medicare files, we identified patients with incident drug‐resistant epilepsy using validated criteria of ≥2 distinct antiseizure medication (ASM) prescriptions and ≥1 drug‐resistant epilepsy encounter among patients with ≥2 years pre‐ and ≥1 year post‐diagnosis Medicare enrollment. We used multilevel logistic regression to evaluate associations between LTM and patient, provider, and geographic factors. We then analyzed neurologist‐diagnosed patients to further evaluate provider/environmental characteristics. Results Of 12 044 patients with incident drug‐resistant epilepsy diagnosis identified, 2% underwent surgery. Most (68%) were diagnosed by a neurologist. In total, 19% underwent LTM near/after drug‐resistant epilepsy diagnosis; another 4% only underwent LTM much prior to diagnosis. Patient factors most strongly predicting LTM were age

Objective: Effective stroke care does not end with acute treatment during hospitalization, but extends through Objective: Effective stroke care does not end with acute treatment during hospitalization, but extends through rehabilitation and secondary stroke prevention. In transitions across care environments, stroke patients are vulnerable to errors in communication of diagnosis and treatment. This study aimed to demonstrate that formalized communication between the neurology team and the rehabilitation medicine team would promote secondary stroke prevention and minimize interruptions during rehabilitation.Methods: The intervention was a standardized verbal handoff by phone between the discharging neurology resident and the admitting rehabilitation resident regarding each patient at transfer. This retrospective cohort study compared a pre-intervention control group (September 2012- February 2013) and a post-intervention group transferred with the handoff (September 2013- January 2014). The outcomes measured included errors in communication of stroke severity, stroke mechanism, medications, and recommended follow-up (appointments and tests) as well as emergent brain imaging, return to the acute care facility, and readmission.Results: The pre- and post-intervention groups were similar with respect to number of patients (50 vs. 52) and demographics including gender (52% vs. 54% female), age (65.8 vs. 64.0 years), severity of illness as measured by the NIHSS (10 vs. 6.5), and stroke type (84% vs. 77% ischemic). Implementation of the handoff decreased errors in communication of diagnosis (NIHSS 92% vs. 74%, p=0.02; stroke mechanism 54% vs. 30%, p=0.02). Furthermore, the handoff decreased the proportion with errors in reconciliation of critical medications (42% vs. 23%, p=0.04). However, the intervention did not significantly reduce interruptions of the rehabilitation program, such as emergent brain imaging (8% vs. 12%, p=0.55) or transfers back to the acute care hospital (26% vs. 21%, p=0.56). Conclusions: Standardized handoffs decreased errors in communication of diagnosis and critical medications for secondary stroke prevention.