A quality improvement project successfully improved the percentage of visits in which folic acid counseling was provided over multiple iterative plan–do–study–act (PDSA) cycles, according to results published in Epilepsia. Sara Molisani, MD, and colleagues aimed to enhance documented folic acid supplementation counseling for patients with epilepsy from 23% to 50% by July 2020. The project enrolled women and girls with epilepsy aged 12 and older who were prescribed daily antiseizure medication. The main factors contributing to low counseling rates included limited time during clinic visits, lack of provider knowledge, and forgetfulness. To address these issues, interventions were implemented, including provider education and EHR features. Statistical analysis revealed an improvement in documented counseling rates from 23% to 73% between September 2019 and August 2022, with sustained performance over time. A best practice advisory that incorporated both education and EHR features was the most successful and sustainable intervention, with good acceptance among clinicians
